An influenza pandemic exercise in a major urban setting, Part I: Hospital health systems lessons learned and implications for future planning.

A 2007 pandemic exercise in Maricopa County, Arizona, the 5th largest urban population in the United States, revealed major vulnerabilities in planning, response, resource utilization, and the decision-making process, which would be common to any large urban setting where multiple independent organizations exist and have not yet coordinated or shared their plans. Communication challenges are both prevalent and magnified in large urban settings. There must be tough, broad-based decision making by healthcare leadership with guidance and processes at every level to assure compliance to the primary goals of pandemic flu plans necessary to control the transmission rate of the disease. A unifying decision-making element such as a Health-related Emergency Operations Center is critical for the coordination, which serves all urban health systems. Education and training in pre-event protocols for triage management is crucial at every level where resources will be scant. This is especially true in admissions to intensive care units and priorities for ventilator use.

An influenza exercise in a major urban setting. II. Development of a health emergency operations center.

Strong relationships and partnerships must be developed for the mitigation of untoward secondary events and positive outcomes during large-scale disasters. Although a health-related emergency operations center-like structure within the Incident Command Structure is advantageous for every community, the process by which it is developed within a large urban setting will be a unique challenging task and requires unprecedented collaboration, cooperation, and coordination. This study explains the necessary components of a uniquely demanding development process leading to a health-related emergency operations center for Maricopa County, Arizona, the creation of which has significantly improved the effectiveness of multiagency involvement, communication, and decision making. Similar challenges will be faced by other urban settings.

An influenza pandemic exercise in a major urban setting, Part I: Hospital health systems lessons learned and implications for future planning.

A 2007 pandemic exercise in Maricopa County, Arizona, the 5th largest urban population in the United States, revealed major vulnerabilities in planning, response, resource utilization, and the decision-making process, which would be common to any large urban setting where multiple independent organizations exist and have not yet coordinated or shared their plans. Communication challenges are both prevalent and magnified in large urban settings. There must be tough, broad-based decision making by healthcare leadership with guidance and processes at every level to assure compliance to the primary goals of pandemic flu plans necessary to control the transmission rate of the disease. A unifying decision-making element such as a Health-related Emergency Operations Center is critical for the coordination, which serves all urban health systems. Education and training in pre-event protocols for triage management is crucial at every level where resources will be scant. This is especially true in admissions to intensive care units and priorities for ventilator use.

Community hospitals and military sustainment training.

Military medical personnel are involved in missions at home and abroad that require well-sustained skills, particularly relative to trauma response. Depending on the Department of Defense base of assignment, exposure to adequate volumes of patients with acute injury is diminishing. This article presents information on a civilian-military alliance in Maricopa County, Arizona, that is forging new territory to assist military medical personnel in getting the hands-on experiences required to maintain current skills and acquire new ones.