How Normal Business Operations Can Enhance Disaster Response and Community Resiliency
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1 How Normal Business Operations Can Enhance Disaster Response and Community Resiliency Xxxxx-xx/Footer The American Society for Automation in Pharmacy January 16,
2 Disclosures Erin Mullen is an employee of RxResponse. The conflict of interest was resolved by peer review of the slide content. She declares no other conflicts of interest or financial interest in any product or service mentioned in this program, including grants, employment, gifts, stock holdings, and honoraria. ASAP s and NCPA s education staff declares no conflicts of interest or financial interest in any product or service mentioned in this program, including grants, employment, gifts, stock holdings, and honoraria. 2
3 Objectives Following this educational session, the pharmacist will be able to: Identify roles and responsibilities for community pharmacy following natural disasters. Describe actions that state governments may take that may impact pharmacy practice and patient care in emergency situations. Identify best practices for pharmacy business continuity planning. 3
4 Gis.fema.gov/maps/FEMA_Presidential_Disaster_Declarations_2000_2012%20.pdf 4
5 Pharmacy: Community Healthcare 94% Americans living within 5 miles of a retail pharmacy 2 >60,000 Number of Community Pharmacies in the US 2 75% Percent of people rating the honesty & ethics of pharmacists as high or very high 3 12 Average number prescriptions filled per person per year in the US 4 5
6 Pharmacy Services after a Disaster Rapid needs assessment after hurricanes As many as 29% of households have identified access to pharmacy services as an unmet need 5 Emergency rooms often turned to as alternate 6,7 Don t have the inventory or personnel to meet the needs Situational awareness of open pharmacies helps Patients meet needs for chronic and acute healthcare issues Identify areas of greatest need for intervention by emergency management Maintain employment, tax base, and business continuity 6
7 Response Roles Pharmacy 6,7 Community Health Resource / Triage Vaccination & Prophylaxis Volunteers for medical surge needs Maintenance medications for survivors and disaster workers Pharmaceutical logistics and cold chain management Behavioral Health Support Return to Service / Business Continuity 7
8 Business Continuity: Disaster Planning Identify what hazards apply to your business. Determine the risk that these hazards pose to your business. Develop plans and procedures to help your business prepare for, respond to and recover from interruptions. Continue to refine your plans through exercises and evaluation of how they performed in real events. 8
9 Business Continuity Best Practices NCPA Disaster Preparedness Checklist 9 Compile essential contact information Discuss plans with vendors Copies of current documents & licenses Photo/Video documentation (BEFORE & keep current) Back up computer/it information store off-site, know how to recover information Identify potential partners storage, alternate locations Cross-train personnel 9
10 Business Continuity Best Practices A Pharmacist s Guide to Pandemic Preparedness 10 Employees Evaluate employee access to healthcare, mental health, social, and other services during an emergency, and improve services as needed. Establish a system to account for employee status. Disseminate information to your employees about your emergency preparedness and response plan. Encourage your employees to make personal preparations 10
11 Business Continuity Best Practices A Pharmacist s Guide to Pandemic Preparedness 10 Pandemic- Specific Understand national, state, and local health policies regarding possible quarantines, school closures, and transportation closures. Encourage and track annual influenza vaccination for employees. Evaluate need for antiviral medications to protect your employees and plan for access, storage, dispensing, and distribution consistent with laws and regulations. Disseminate information to your employees about your pandemic preparedness and response plan. Develop options for conducting safer customer contacts in the event of pandemic. 11
12 What can change during an Emergency Response? Curfews Access for employees, vendors Fuel Power Practice Act Immunizations Protocols Emergency supply Distribution Insurance Emergency Use Authorization PREP Act: Liability DEA CMS Local State Federal 12
13 Synergies for Disaster Response Supply Chain & Community Pharmacy Inventory Variety Depth Public Health & Emergency Management Dispensing Expertise Flexibility Recordkeeping & reporting Automated Resupply Rapid* Rapid?* Payment Patient Health Insurance Event-driven, often changing Emergency Prescription Assistance Program Locations Established Temporary Personnel Experienced, Licensed Volunteer Surge Capacity OTJ training 13
14 Pandemic Influenza Planning 2009: Pharmacies as H1N1 Vaccination sites Ongoing projects, with CDC, ASTHO and NACCHO: 11,12 Antiviral distribution Nurse triage lines Pharmacy collaborative practice agreements Emergency Prescription Assistance Program 14
15 Situational Awareness: Reporting of Open Pharmacies Patients Access needed acute & chronic care Pharmacies Maintain business continuity Public Health Concentrate response where needed 15
16
17 Rx Open Reporting Process Baseline data Pharmacies not on either report (Not participating/ Unknown status) Pharmacies with billing activity (Open status) Once a day report Participating pharmacies with no billing activity (Participating/ Unknown status) Pharmacies that have been confirmed to be closed/ destroyed 17
18 Rx Open Methodology: Planning Considerations Pros No reporting burden on the pharmacy No information collection burden on jurisdiction Information is collated in one location for multiple jurisdictions Updated daily Low False Positive reporting Cons Lag in reporting False Negatives Non-participating pharmacies = incomplete assessment 18
19 Response Activities: Hurricane Sandy in Numbers 21 Days mapping tool open >10,000 Pharmacy statuses mapped 11 + DC States mapped 4 Regulatory changes for Pharmacy 60+ Requests for information 71 Unique after action items 19
20
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22 Restoration of Pharmacy Services 22
23 Response Activities: Moore Tornadoes Restoration of Pharmacy Services: Moore Tornadoes 5/20/2013 Percent Participating Pharmacies Open 100% 95% 90% 85% 80% 75% 70% Cleveland l Lincoln County McClain County Oklahoma County County Pottawatomie County 5/21/2013 5/22/2013 5/23/
24 Take Aways Community Resilience Pharmacies and pharmacy care is part of the critical healthcare infrastructure Members of the pharmaceutical supply chain are resilient partners in community response after disaster Normal Business Processes Can Aid Response Lessen reporting burden of affected businesses Reduce analysis burden for each interested audience Situational Awareness & Information Sharing Pharmacies & software vendors can assist in response efforts by ensuring your clients are participating in information sharing 24
25 Rx Response Erin Mullen (office) (cell) 25
26 Bibliography 1: FEMA. FEMA Disaster Declarations : NACDS. NACDS Chain Member Fact Book : Gallup. Honesty and Ethics in Professions, : IMS Health. Declining Medicine Use and Costs: For Better or Worse? May, : M McNeil, et al. MMWR. Rapid Community Needs Assessment After Hurricane Katrina --- Hancock County, Mississippi, September , March 10, : M Hogue, et al. Public Health Reports. The Nontraditional Role of Pharmacists After Hurricane Katrina: Process Description and Lessons Learned. March/April : LL Pincock, et al. Am J Health-Sys Pharm. Pharmacist Readiness Roles for Emergency Preparedness. April, : Association of Contingency Planners. Business Continuity 101 9: NCPA Foundation. Disaster Preparedness Checklist : APhA, ASHP, NACDS Foundation. A Pharmacist s Guide to Pandemic Preparedness : ASTHO. Antiviral Distribution Resources 12: HHS ASPR. Emergency Prescription Assistance Program 26
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