C
Workshop Agendas1

Irvine Workshop

March 12, 2009

The Beckman Center

Irvine, CA


Orlando Workshop

April 14, 2009

Disney’s Coronado Springs Resort

Lake Buena Vista, FL


New York Workshop

April 27, 2009

Albert Einstein College of Medicine

Bronx, NY


Chicago Workshop

May 8, 2009

American Medical Association

Chicago, IL

1

To save space, the individual agendas from each regional meeting have been compiled into a single document. Under each session speakers have been identified based on each meeting location at which they participated: Irvine, Orlando, New York, and/or Chicago.



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C Workshop Agendas1 Irvine Workshop March 12, 2009 The Beckman Center Irvine, CA Orlando Workshop April 14, 2009 Disney’s Coronado Springs Resort Lake Buena Vista, FL New York Workshop April 27, 2009 Albert Einstein College of Medicine Bronx, NY Chicago Workshop May 8, 2009 American Medical Association Chicago, IL 1 To save space, the individual agendas from each regional meeting have been compiled into a single document. Under each session speakers have been identified based on each meeting location at which they participated: Irvine, Orlando, New York, and/or Chicago. 95

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96 CRISIS STANDARDS OF CARE Workshop Objectives: • Illuminate the progress and successes of efforts underway to establish local, state, and regional standards of care protocols. o What have been some of the barriers in establishing protocols? o What solutions have been developed to operationalize standards of care protocols? • Improve regional efforts by facilitating a dialogue and coordination among neighboring jurisdictions. • Discuss the roles and responsibilities of each stakeholder community in the development and implementation of standards of care protocols, including officials from state and local health departments and providers. • Examine what resources, guidelines, and expertise have been used to establish standards of care protocols, including legal and ethical expertise that has been used to establish standards of care protocols. • Identify and discuss resource requirements that will be necessary from federal, state, and regional authorities to advance and accelerate the establishment of standards of care protocols. Welcoming Remarks New York DEAN ALLEN SPIEGEL, Albert Einstein College of Medicine of Yeshiva University Chicago JAMES J. JAMES, American Medical Association Welcome, Introductions, and Workshop Objectives Irvine, Orlando, New York, Chicago SALLY PHILLIPS, Agency for Healthcare Research and Quality, Workshop Chair

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97 APPENDIX C SESSION I: OVERVIEW AND CURRENT NATIONAL EFFORTS Session Objective: Provide an overview of current efforts under way nationally to assist state and local leaders in establishing standards of care protocols. Standards of Care During a Mass Casualty Event—Federal Guidance Irvine, Orlando, New York, Chicago SALLY PHILLIPS, Agency for Healthcare Research and Quality, Workshop Chair Surge Capacity Continuum: Conventional, Contingency, and Crisis Irvine, Chicago JOHN HICK, Hennepin County Medical Center, MN Orlando, New York DAN HANFLING, Inova Health System Altered Standards of Care Continuum: Conventional, Contingency, and Crisis Irvine, Orlando, New York, Chicago DAN HANFLING, Inova Health System Framing Legal and Ethical Considerations Irvine CHERYL STARLING, California Department of Public Health Orlando, New York, Chicago TIA POWELL, Montefiore-Einstein Center for Bioethics Discussion with Attendees

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98 CRISIS STANDARDS OF CARE SESSION II: LOCAL AND STATE STANDARDS OF CARE PROTOCOLS Session Objective: An interactive discussion with local, state, and regional officials about efforts to establish standards of care. Discuss implementation strategies and how these protocols were advanced to become operational entities in their respective communities. What are the current opportunities and barriers to facilitating improved implementation of protocols? Session Objectives and Background Irvine, Chicago JOHN HICK, Hennepin County Medical Center, MN, Session Chair Orlando, New York DAN HANFLING, Inova Health System, Session Chair Panel Discussion with State and Local Leaders Irvine KAY FRUHWIRTH, Los Angeles County Emergency Medical Services Agency KRISTI KOENIG, University of California–Irvine PAUL PATRICK, State of Utah Department of Health SUSAN ALLAN, University of Washington School of Public Health CHRISTINE DENT, Saint Alphonsus Regional Medical Center, ID Orlando JOHN ROBINSON, Baptist Memorial Hospital–North Mississippi ROY ALSON, North Carolina Office of Emergency Medical Services ROBERT HOOD, Florida Department of Health KENN BEEMAN, Mississippi State Department of Health New York TIA POWELL, Montefiore-Einstein Center for Bioethics DONNA LEVIN, Massachusetts Department of Public Health LISA KAPLOWITZ, Alexandria Health Department, Virginia RICK HONG, Delaware Division of Public Health

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99 APPENDIX C Chicago JANET ARCHER, Indiana State Department of Health DAVID FLEMING, University of Missouri School of Medicine KERRY KERNEN, Summit County Health District, OH KEN BERKOWITZ, Veterans Health Administration National Center for Ethics in Health Care Response Panel Irvine STEPHEN CANTRILL, Denver Health Medical Center JEFFREY DUCHIN, Public Health, Seattle and King County CHERYL STARLING, California Department of Public Health Orlando STEPHEN CANTRILL, Denver Health Medical Center RADM ANN KNEBEL, Office of the Assistant Secretary for Preparedness and Response, U.S. Department of Health and Human Services JACK HERRMANN, National Association of County and City Health Officials New York STEPHEN CANTRILL, Denver Health Medical Center CHERYL PETERSON, American Nurses Association Chicago STEPHEN CANTRILL, Denver Health Medical Center CHERYL PETERSON, American Nurses Association TIA POWELL, Montefiore-Einstein Center for Bioethics Discussion with Attendees • What resources, guidelines, and expertise have been used to establish standards of care protocols? • What are the current opportunities and barriers to creating stronger partnerships and how can these issues be addressed? • What strategies have been used to help integrate these protocols into practice? • What are the current opportunities and barriers to facilitating improved implementation of protocols?

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100 CRISIS STANDARDS OF CARE SESSION III: PROVIDER COMMUNITIES Session Objective: Discuss the roles and responsibilities of the key provider communities in the development and implementation of standards of care protocols. Identify and discuss solutions related to implementing protocols into practice. Session Objectives and Background Irvine, Orlando, New York, Chicago STEPHEN CANTRILL, Denver Health Medical Center, Session Chair Panel Discussion with Stakeholder Leaders Irvine SUE HOYT, St. Mary Medical Center, Long Beach, CA DEBRA WYNKOOP, Utah Hospitals and Health Systems Association ASHA DEVEREAUX, Sharp Coronado Hospital, CA KEVIN MCCULLEY, Association for Utah Community Health Orlando J. PATRICK O’NEAL, Georgia Department of Human Resources KNOX ANDRESS, Louisiana Poison Center SHAWN ROGERS, Oklahoma State Department of Health LORI UPTON, Texas Children’s Hospital MARY FALLAT, University of Louisville, KY New York VALERIE SELLERS, New Jersey Hospital Association BRIAN CURRIE, Montefiore Medical Center CATHERINE RUHL, Association of Women’s Health, Obstetric and Neonatal Nurses GEORGE FOLTIN, New York University School of Medicine/Bellevue Hospital Chicago MICHAEL ROBBINS, Chicago Department of Public Health LESLEE STEIN-SPENCER, National Association of State EMS Officials

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101 APPENDIX C MARIANNE LORINI, Akron Regional Hospital Association CONNIE J. BOATRIGHT, Managed Emergency Surge for Healthcare (MESH), IN Response Panel Irvine EDWARD GABRIEL, The Walt Disney Company KATHRYN BRINSFIELD, Office of Health Affairs, Department of Homeland Security MARGARET MCMAHON, Emergency Nurses Association Orlando EDWARD GABRIEL, The Walt Disney Company KATHRYN BRINSFIELD, Office of Health Affairs, Department of Homeland Security MARGARET MCMAHON, Emergency Nurses Association CHERYL PETERSON, American Nurses Association New York JACK HERRMANN, National Association of County and City Health Officials MARGARET MCMAHON, Emergency Nurses Association CHERYL PETERSON, American Nurses Association Chicago JAMES J. JAMES, American Medical Association MARGARET MCMAHON, Emergency Nurses Association CHERYL PETERSON, American Nurses Association Discussion with Attendees • What concerns do provider communities have in implementing policies into practice? • How do protocols get implemented operationally? o Who is responsible for implementing plans during events? o What are the triggers? • What action steps are required to improve involvement of the provider community in the development of standards of care protocols?

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102 CRISIS STANDARDS OF CARE SESSION IV: INTERSTATE AND NEIGHBORING COMMUNITY COOPERATION AND COORDINATION Session Objective: Discuss what cooperation and coordination will be required between neighboring states and communities in preparation and when implementing standards of care protocols. Discuss the roles of specific stakeholders. Identify what resources will be required and how those may be shared. Explore the current opportunities and barriers to facilitating improved cooperation and coordination and how these may be overcome. Session Objectives and Background Irvine CHERYL STARLING, California Department of Public Health, Session Chair Orlando EDWARD GABRIEL, The Walt Disney Company, Session Chair New York JACK HERRMANN, National Association of County and City Health Officials, Session Chair Chicago SALLY PHILLIPS, Agency for Healthcare Research and Quality, Session Chair Panel Discussion with State and Local Leaders Irvine NANCY AUER, Swedish Medical Center, WA MARK GOLDSTEIN, Memorial Health System, CO JEFFREY RUBIN, California Emergency Medical Services Authority Orlando TERRY SCHENK, Florida Department of Health ROBERT BALL, South Carolina Department of Health and Environmental Control RAYMOND PEPE, Uniform Law Commission

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103 APPENDIX C New York STEVEN GRAVELY, Troutman Sanders LLP JAMES HODGE, Johns Hopkins University FLOYD RUSSELL, West Virginia University JAMES GEILING, White River Junction Veterans Administration Medical Center Chicago TIM WIEDRICH, North Dakota Department of Health WILLIAM FALES, Michigan State University–Kalamazoo Center for Medical Studies PAULA NICKELSON, Department of Health and Senior Services, MO TIMOTHY CONLEY, Western Springs Fire Department and Emergency Medical Services, IL Response Panel Irvine DAN HANFLING, Inova Health System SHAWN FULTZ, Department of Veterans Affairs LTC(P) WAYNE HACHEY, Department of Defense CAPT DEBORAH LEVY, Centers for Disease Control and Prevention Orlando DAN HANFLING, Inova Health System SHAWN FULTZ, Department of Veterans Affairs LTC(P) WAYNE HACHEY, Department of Defense CAPT DEBORAH LEVY, Centers for Disease Control and Prevention JAMES BLUMENSTOCK, Association of State and Territorial Health Officials New York DAN HANFLING, Inova Health System RICHARD CALLIS, Department of Veterans Affairs Chicago DAN HANFLING, Inova Health System DARLENE WEISMAN, Department of Veterans Affairs

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104 CRISIS STANDARDS OF CARE Discussion with Attendees • What cooperation will be needed between states and neighboring communities? • What are the roles of providers and other stakeholders in ensuring cooperation and coordination? • How can resources best be shared during an event and what plans and agreements need to be in place? • What strategies can be used to improve coordination and cooperation among neighboring jurisdictions? SESSION V: GENERAL DISCUSSION WITH WORKSHOP PARTICIPANTS AND ATTENDEES Session Objective: Discuss what opportunities and constraints exist to implementing standards of care at local, state, and regional jurisdictions. Review opportunities and challenges identified during the workshop. Identify and discuss the most promising near-term opportunities for improving standards of care protocols at local, state, and regional jurisdictions. Discuss common threads that emerged among each of the regional workshops. Synopsis of Today’s Discussions: Common Threads SALLY PHILLIPS, Agency for Healthcare Research and Quality, Workshop Chair Discussion with Attendees • What new ideas have surfaced in this meeting today that should be explored further? • What specific challenges arise in the development of standards of care protocols? • What action steps are required to integrate these strategies into the current public health system? • What resources and further infrastructure investments will be necessary in the short- and long-term?