Prioritization of Human services Specialist Immunization.

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Prioritization of Medicinal services Specialist Immunization NVAC/ACIP Flu Pandemic Arranging Working Gathering June 15-16, 2005 James Bentley Carolyn Spans Matt Cartter Victoria Davey Steve Gordon Debra Demand Kristin Nichol Peggy Rennels Patrician Simone LJ Tan Rick Zimmerman
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Prioritization of Healthcare Worker Vaccination NVAC/ACIP Influenza Pandemic Planning Working Group June 15-16, 2005

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James Bentley Carolyn Bridges Matt Cartter Victoria Davey Steve Gordon Debra Levy Kristin Nichol Peggy Rennels Patrician Simone LJ Tan Rick Zimmerman HCW Prioritization Subgroup Members

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Data Sources for Population Estimates Bureau of Labor Statistics American Hospital Association Professional social orders Kindness of colleagugesges outsiders

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Estimated Size of Healthcare Workforce Overall 14.8 million Hospitals 5.1 million Outpatient centers 2.9 million Nursing homes 1.6 million* Home wellbeing 734,000 EMS suppliers 820,000 *Excludes private consideration

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Overarching Assumption To lessen all-reason grimness and mortality by safeguarding the human services workforce and conveyance of key medicinal services administrations

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Definition of HCW Any individual who gives direct patient consideration and those in medicinal services settings who obligations are expected to keep up crucial human services administrations Acute-care doctor\'s facilities, nursing homes*, gifted nursing offices, earnest consideration focuses, physician’s workplaces, facilities, home care and blood accumulation focuses *excludes exclude helped living offices

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Estimated Impact of Pandemic on Healthcare Delivery System Illnesses: 20-47 million Hospitalizations: 314,000-734,000 Outpatient visits: 18-42 million Deaths: 89,000-207,000 Meltzer, MI EID 1999;5:659-71

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Relationship Between Nurse Staffing and Health Outcomes Lower attendant staffing proportions connected with: Longer clinic stays Higher rates of medicinal services related diseases Increased inpatient mortality

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Potential Impact of Pandemic in General Hospitals AHA Hospital Statistics, 2004 Edition

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Potential Impact of Pandemic in General Hospitals Staff incorporate FTE doctors, RNs, LPNs, dental practitioners, restorative and dental students

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Potential Impact of Pandemic in General Hospitals Assume 25% diminishing in staff

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Vaccination Strategies: Option 1 Vaccinate direct patient consideration staff (doctors and attendants) Limitation : Will not have the capacity to keep up other fundamental administrations, for example, housekeeping, dietary.

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Option 1: Estimated Vaccine Doses Hospitals 1.9 million Nursing homes 769,240 Home Health 487,620 Outpatient 141,646 EMS 820,000 TOTAL 3,299,326

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Vaccination Strategies: Option 2 Vaccinate “frontline” social insurance laborers and the individuals who give consideration to (ED, ICUs, geriatric units, transplant units) and crucial human services administration specialists Limitation : High-chance patient not geologically isolated inside of the office

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Vaccination Strategies: Option 3 Vaccinate “comprehensive” medicinal services team* that would be involved laborers crosswise over claims to fame to give a scope of administrations to sick patients (e.g, surgery, obstetrics, pediatrics, gen therapeutic, and so forth) who could be cohorted or physically isolated on “flu wards” Limitation : Would just be a potential system amid ahead of schedule stage on pandemic when case burden is low *Include key health awareness administrations staff

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Vaccination Strategies: Option 4 Vaccinate direct patient consideration specialists and an extent of those expected to keep up key social insurance administrations. Abandon some self-sufficiency to nearby chiefs in regards to designation of antibody inside of these gatherings. Confinement : May make bedlam/disarray because of variability in prioritization

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Option 4: Estimated Vaccine Doses Hospitals 3.7 million Nursing homes 1.1 million Home Health 531,000 Outpatient 585,470 EMS 820,000 TOTAL 6,771,470 Includes Healthcare professionals, Healthcare bolster, administration/administrator bolster/upkeep

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SUMMARY Depending system for prioritization HCW definition number of obliged dosages 3-7 million Need to consider both subjective and quantitative staffing assets Limitations to numbers (classifications not fundamentally unrelated; sources shift)

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Supplemental Measures for Healthcare Facilities Deferral of guests Cancelation of elective methods and confirmations Furlough of trivial specialists??

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Outstanding Issues How would we incorporate antibody technique with antiviral solution procedure? Should nursing homes be viewed as/took care of uniquely in contrast to other social insurance offices? What is rate of non-appearance among social insurance workforce? How would we convey antibody non-healing center based HCWs? .:tsli

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