Pandemic Planning

Communication leadership and tactics in

this unique critical situation

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Communication tactics during a pandemic

What we’ll discuss:

Recognizing the rationale

Why pandemic communication is “different”from other disaster planning

Provide innovative tactics and creative ideas for communication during this crisis time.

Where to get planning documents/best practice materials for your own planning

Open a CHI–based dialogue for future communication on this topic

It’s not just the “Fear of the Week” game

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But it’s not Y2K either

• We’ve had pandemics in the past---there is substantial scientific evidence that we will have another in our lifetime.

• It’s not a hallucination, in fact indicators are in place suggesting it may well be a process already begun

A different “animal” - a bird Avian or “Bird Flu” faces us nowCDC :Highly pathogenic

avian influenza A (H5N1):

• In birds: more than 50 countries • In humans: 12 countries

2003: ~ 300 cases / ~172 deaths 2006-07: 143 cases/93 deaths• Not currently present in birds or humans

in North America

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Recognize the rationalePandemic flu v familiar Seasonal Flu Seasonal: 3 influenza viruses currently

circulate worldwideAdults may have partial immunity

(protection) to seasonal flu BUT: there’s no pre-

existing immunity to a NEW VIRUS that is dramatically different from past viruses

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HHS: Unlike seasonal influenza, where infection ranges from mild to serious symptoms in most people, the disease caused by H5N1 is far more severe and happens quickly, with pneumonia and multi-organ failure commonly seen.

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Isn’t there a vaccine now?

A new vaccine was just approved by the FDA for use in humans…sounds like good news, BUTwhile we are faith-based facilities, …it’s not the miracle we’d like it to be

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About the vaccine

The vaccine will not be sold commercially; instead the supply vaccine will keep it in a national stockpile.

To date, HHS has purchased 13 million doses of this vaccine, enough to cover 6.5 million people. [US population:>298 million]

More on the vaccine

• Ideally: vaccinate in advance, but these viruses mutate as they spread so new vaccines are constantly needed.

• Time & technology: it takes months to produce new vaccines - we still use 1950s technology; and to produce it in mass quantities and to distribute it will take even longer

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We will be the first generation to PREPARE for a pandemic

“Different” planning needed

Traditional disaster planning is designed to sustain our services, supplies and staffing for a few days or maybe a week: working extra hours, borrowing supplies & resources from others, etc can get us through it.

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Pandemic planning is preparing for a much longer timeframe-sustaining the critical strain on supplies, resources, employees & their families.

Can we sustain our services for 12 weeks?

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“Ah-hah” moments for us• Avian flu will probably spread in waves

of 6-12 weeks at a time

• Shortages will affect at least the region– In Lancaster County there is only a 3-day

supply of food– Local groceries even WAL*MART---keep only

2-3 day supply of food on hand– There is no long-term storage closer

than KC or Denver

Pandemics HAVE happened before

CDC and WHO - using these as guidelines for planningWhen What How bad?

1918 Spanish Flu•Origin:

Kansas

•Extremely virulent•6 mos: 25,000,000 in US died [x2 worldwide]

1957 Asian flu•Originated in China

•Low mortality•Spread to US in 8 months•70,000 died in US

1966 Hong Kong •Moderate morbidity•Spread to US in 3 months•34,000 died in the US

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The healthcare system will be heavily impacted

• 50% of ill persons will seek outpatient medical care & large numbers will require hospitalization.

• Length of stay predictions 4-8 days

• Average of 2 secondary infections will occur per infected person.

• Anticipate largest need for hospitalization being in those with multiple underlying illnesses and high acuity

“During a pandemic,

healthcare could be in its finest hour.” Dr. Dan Noble – State of Nebraska Pandemic Planning

Conversely: if we are NOT planning and preparing in

advance, it could be our most disastrous hour

0Employee impact

The attack will limit the number of healthcare personnel available to care for patients as well asaffect the availability of supplies and other services.

• About 20% of working adults will be infected at any given time.

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• Many workers may be asymptomatic while infectious and the incubation period may be as little as two days, (same as seasonal influenza).

• Some staff will refuse to come to work at all, others will be willing to work long and consecutive shifts.

“Different” Healthcare planning

Glimpses into the scope of healthcare issues to be addressed

Supplies/surge capacity:• Where will we get supplies when we run

out?• What supplies will need first/most:

O2/vents/ventilator tubing/etc• What additional supplies will we need:

portable O2 / IV fluids & Central line/PICC insertion kits/Gloves/masks (N-95 and regular) /alcohol hand rubs/ body bags

Additional considerations

• Cancel elective procedures• How can we expand our

services/care?– Have identified alternative care

locations – Have assessed O2 and vacuum access

in all rooms– Looking for “portable” ventilators– Alternative staffing patterns

NIsolation

•Isolating a few rooms/a wing/a floor/closing entire hospital

•How triage patients for extended periods of time-use clinics, nearby school gymnasiums?

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“Social Distancing”

This is a newer concept we will learn fast.

• Avoiding face-to-face interactions whenever feasible.

• Can employees in some areas work from home?

• Can we do telephone triaging of some patients?

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Policies need to be amended ---in

advanceSick leave policiesTravel policiesVaccination policesPrivacy policesInsurance coverage policiesBereavement policiesStaffing ratiosNew hire policies/hire retirees?How screen those returning to work?

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Screenings & ethics

How to screen own employees inside the workplace as:– fit for work– fit for restricted work– not fit for work

Ethical issues change: ventilator use/etc.

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Remember-when this is over

• You may be subject to law suits---have your polices defined in advance and as much as possible---reviewed by lawyers

• You will have to all work together again one day, so the fewer ‘rash” decisions you need to make the better---plan ahead and include your rationale

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Demonstration time!

Red / Yellow / Green Everyone got a colored

card when they walked in.

Take your card, hold it in your hand and stand up, please.

Red / Yellow / Green

We are a mini hospital and all of us are the staff.

Those with a RED card, please hold it up high.

Red cards

• You are sick or infected and soon to be sick.

• It’s assumed---based on the projections from past pandemics and the extremely virulent nature of our current threat, Avian flu, that from 23-50% of employees will be sick and unable to work.

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NYellow CardsYou are home caring

for someone else:• Your children are sick• School/Daycares are closed so

your children are all at home• You have no transportation to

get to work, buses and other mass transit is not running/car needs repairs/spouse has the only car/etc

• You are afraid to come into work and refuse to do so

• This could represent another 20-35% of the work

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Green CardsYOU are the workforce!• Can you work you own full shift?• How many shifts can you work to

help-out and for how long?

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How can advance planning help?

“Red cards” – sick associatesNot a lot we can really do for you:• Locate vaccine in

advance/administer in advance, if possible

• Emphasize employee wellness • Deliver accurate information

re: protecting selves and family

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How can planning help?

“Yellow cards”-stay home folks• Transportation shuttles

from workplace• Form babysitting pools• Allow partial shifts/flexibility as much as

possible• Provide ways for associates to communicate• Provide factual info & safe guidelines to

lessen the number of those afraid to go to work

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How can planning help?

“Green Cards”-holding down the fort

• Identify on-site break rooms/sleep areas/allow more or longer breaks

• Devise flexible shifts to accommodate family needs or exhaustion from hitting all

• Offer free or lower cost food (if possible)• Stress lowering tactics/use your EAP• Allow links to home & family/computer

cams/free phones/

The role of communication

3 basic audiences

As communication leaders we will need to

• Help reduce fear • Provide accurate information • Provide innovative communication

tools/processes for a wide variety of needs and audiences.

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General public will need:

• Factual information on the pandemic • Factual information on the disease:

guidelines for providing care at home/when to contact a doctor/etc

• Info on our clinics/services---who is open/who has vaccine/who is offering special services (if any)

• Who in the city or area has vaccine• How to talk to children• FAQs

NThe media

• Details as to when & where next news conference or briefing is scheduled.

• List of phone numbers of appropriate people to contact at your hospitals/clinics/services.

• The means to request info or interviews and get timely answers.

• Updated & accurate data from your hospital.• Possible photos or video they can use on-air

or in print.

NYour own associates

They will need to communicate with hospital/dept/others

• Need 2-way communication tools other than phones

• Employees at home need to get factual info about the medical center

• Also want general disease info: symptoms, treatments, etc for them & their family. Who has vaccine?

• Is there organized transportation available to get to work? If so—maps, routes, timelines

• How enter building if areas are isolated? Do I need to get cleared? How?

Communication tactics

Your internet website can become a principal communication tool for all audiences

Communication tactics

Create “dark” or inactive pages in advance---to be activated when the pandemic is near or identified

Make the pages easy to access for both your associates and the general public

What info to provide

General Info on Avian Flu –all audiences will need this What is Avian Flu?        Caring for family; symptoms, definitions of flu terms Frequently Asked Questions (FAQs) Vaccine information 

Think outside the computer “box”

Your first thought will be to provide helpful links to the CDC and WHO websites and many others.

BUT….

Everyone in your area, the country, maybe the world, will be trying to access these same pages.

Develop/create pages• The basic information on what is Avian Flu,

symptoms, how treat, etc, you can copy-and-paste onto your own web pages

• Develop your own tips or prevention tactics-have your experts/professionals develop them

• Set up links to information you already have on your website---so it is easy to find when someone needs it related to a pandemic. Our “Child Care topics”

Get creative

• Find or develop – Check Lists and

Survival Tips: 

home supplies; groceries, pharmaceuticals, etc and where to find items

• How to talk to your children• How to set up babysitting pools• How set up car pools-or neighbor

rotations for grocery store trips

Just-in-time info

You will have to develop a process to keep this current:

• What vaccines are available now? 

• Updated info on city or area resources & your own clinics---who is open/who has vaccine/where to go for other-than-pandemic reasons /who is offering special services (if any)

• Who in the city or area has vaccine now?

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Establish networks

Set up your contacts for just-in-time info in advance and re-contact them just prior to pandemic so you can get the info you need---ask them preferred time and preferred way to communicate: email, phone, cell

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Some info can be activated before a pandemic, even now

While a pandemic offers us the unique opportunity to see it coming—remember that everyone else in your area will need the same supplies at same time.

Start with your associates---then for the general publicRight now shape your message: offer planning tips “for any disaster” to your community and your associates.

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Start the planning

Hold on-site “Be Prepared” seminars over lunch hours or at other key times.

These will help you set the stage for the more difficult issues your hospital will need to address.

Who can’t use a check list of tools, food and other supplies to have on-hand in the event of a three-day power outage?

Keep the issue alive

Use your in-house communication vehicles---the intranet, newsletters, flyers to update associates as to news on pandemic planning steps completed, Avian flu, preparedness tips

Team celebration todayLet’s celebrate---100% of departments have now

completed the surge capacity planning as part of our ongoing pandemic/disaster planning. Join the planning team for “disaster cookies” outside the café 10-3 today!

Media info online

You want to provide details as to when & where next

news conference is scheduled.

•Periodic, well-timed briefings or news conferences can help set YOUR HOSPITAL up as the healthcare leaders who are on top of the situation.

•You can reassure the public via the media that you are meeting needs.

NBe media-friendly

On your website media pages, provide:

• List of phone numbers of appropriate people to contact

• Email links so media can request info or interviews---of the “right” person

• Updated data from Saint Elizabeth • Possible photos or video they can use on air

or in print.

Associates have HUGE communication needs

Be “Bloggers”

Set up blogs online for each department• To be updated with accurate specific info:

staffing needs, isolation levels, supply shortages, etc.

• Blogs offer a chronological info• Staff at home can send emails or add

“comments” that they can work 6 hours, but not 12 b/c child is sick…they can check the blog a bit later to see if that’s OK with the care team.

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Providing transportation?

• Shuttle schedules• Shuttle maps• Shuttle sign up sheets

More info for Associates

In-house communication

The Intranet – can become your primary means for updating in-house associates, medical teams, affiliated physicians, etc. on an ongoing basis (keep current, squelch rumors).

“Level 3, East is now an isolation area…..”

• Intranet “ticker” (scrolling message) will direct associates and others to appropriate information areas on the intranet or list status updates of the hospital.

• Web pages for updated info e.g. supplies needed, staffing needs, etc.

• Pages for accessing tools: special

screening forms, triage tools, algorithms, policy changes, etc

Any planning will not be “wasted”

Disaster planning already in place offers short term guidelines—

how will you extend those “solutions” for extended periods such a 6-12 weeks?

How do we get started?

There is help!

Gather all the info and planning material you can find

I will prove you with links via email to numerous documents, also to our own in-progress planning documents

Form a committee

Should be led by Infection control/ PI/CQI, or similar entity-

But include representatives from a cross-section of departments

Introduce the planning idea to all

• Keep Associates informed: Use newsletters, flyers, etc to let them know there is a committee and what it’s currently doing.

• Hold “Be Prepared” mini-seminars---keeping scare tactics to a minimum

• Make presentations to management teams/nursing leadership/other stakeholders

Avoid Pandemic fatigue

• Don’t set timelines too tight.

• Use “test” departments first to complete planning forms so you have something to show the others

• Interject fun activities – celebrate along the wayPresent awards for the first 5 departments that turned in their planning form

Web links

Questions or comments

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Thank you for Your attention

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