NHSPI NHSPI Domain and Sub-domain Definitions

Transcription

1 NHSPI NHSPI 2014 Domain and Sub-domain Definitions 1

2 Domain: Health Security Surveillance 2014 NHSPI Domain & Sub-domain Definitions The ongoing systematic collection, analysis, and interpretation of data, closely integrated with the timely dissemination of these data to those responsible for preventing and controlling disease, exposure, and injury. Sub-domain: Health Surveillance & Epidemiological Investigation The creation, maintenance, support, and strengthening of passive and active surveillance to: Identify, discover, locate, and monitor threats, disease agents, incidents, and outbreaks Provide relevant information to stakeholders Monitor/investigate adverse events related to medical countermeasures The sub-domain includes the ability to successfully expand these systems and processes in response to incidents of health significance. Sub-domain: Biological Monitoring & Laboratory Testing The ability of agencies to conduct rapid and accurate laboratory tests to identify biological, chemical, and radiological agents to address actual or potential exposure to all hazards, focusing on testing human and animal clinical specimens. Support functions include discovery through: Active and passive surveillance (both pre- and post-event) Characterization Confirmatory testing Data reporting Investigative support Ongoing situational awareness Laboratory quality systems are maintained through external quality assurance and proficiency testing. 2

3 2014 NHSPI Domain & Sub-domain Definitions Domain: Community Planning & Engagement Coordination across the whole community organizations, partners, and stakeholders to plan and prepare for health incidents, and to respond to and recover from such incidents with the goal of ensuring community resiliency, well-being, and health. Sub-domain: Cross-Sector / Community Collaboration The coordination necessary to engage community-based organizations and social networks through collaboration among agencies primarily responsible for providing direct health-related services. Partners include public health, healthcare, business, education, and emergency management in addition to federal and nonfederal entities necessary to facilitate an effective and efficient return to routine delivery of services. Sub-domain: Children & Other At-Risk Populations Actions to protect individuals specifically recognized as at-risk in the Pandemic and All-Hazards Preparedness Act (i.e., children, senior citizens, and pregnant women), and those who may need additional response assistance including those who have disabilities, live in institutionalized settings, are from diverse cultures, have limited English proficiency (or are non-english-speaking), are transportation disadvantaged, have chronic medical disorders, and have pharmacological dependency; all of whom have additional needs before, during, and after an incident in the functional areas of communication, medical care, maintaining independence, supervision, and transportation. Sub-domain: Management of Volunteers during Emergencies The ability to coordinate the identification, recruitment, registration, credential verification, training, and engagement of healthcare, medical, and support staff volunteers to support the jurisdiction s response to incidents of health significance. Sub-domain: Social Capital & Cohesion The community social capital that helps society function effectively, including social networks between individuals, neighbors, organizations, and governments, and the degree of connection and sense of belongingness among residents. 3

4 2014 NHSPI Domain & Sub-domain Definitions Domain: Incident & Information Management The ability to: Mobilize all critical resources from any source Establish and maintain command, control, and coordination structures within the affected community Provide necessary legal, administrative, and logistical support Exchange multijurisdictional, multidisciplinary public health and medical-related information, intelligence, plans, and situational awareness Sub-domain: Incident Management & Multi-Agency Coordination The ability to establish and maintain a unified and coordinated operational structure with processes that appropriately integrate all critical stakeholders and support the execution of core capabilities and incident objectives. This sub-domain includes the capability to direct and support an event or incident with public health or medical implications by establishing a standardized, scalable management system consistent with the National Incident Management System and coordinating activities above the field level by sharing information, developing strategy and tactics, and managing resources to assist with coordination of operations in the field. Sub-domain: Emergency Public Information & Warning The ability to develop systems and procedures that facilitate the communication of timely, accurate, and accessible information, alerts, warnings, and notifications to the public using a whole-community approach. This sub-domain includes using risk communication methods to support the use of clear, consistent, accessible, and culturally and linguistically appropriate methods to effectively relay information regarding any threat or hazard, the actions taken, and the assistance available. Sub-domain: Legal & Administrative The capabilities and capacities responsible for assisting in the execution of preparedness and response activities, incident management systems, and decision-making authority. This sub-domain includes: Improving efficiencies in daily operations Reducing administrative barriers during response operations Ensuring efficient acquisition of resources, use of emergency funds, and implementation of legal and liability protective measures needed to take action during an incident affecting health security 4

5 2014 NHSPI Domain & Sub-domain Definitions Domain: Healthcare Delivery The delivery of healthcare services under crisis conditions in a disaster will likely be related to the ability to deliver such services under conventional conditions. Rather than simply focus on the surge response to healthcare delivery (2013 NHSPI Structure), the Healthcare Task Force felt it is important to link national health security preparedness to the ability to provide care on a day-to-day basis. Any given portion of the emergency response system is not going to be able to deliver services under surge conditions if the underlying foundation of service delivery is itself in question or unsupported. Given this important assumption, the Healthcare Delivery domain in the 2014 NHSPI Structure purposefully incorporates many baseline capabilities that comprise the delivery of healthcare across a continuum of locations (sub-domains). To a certain degree, not all healthcare services will fit fully into one or another of the sub-domains featured in the 2014 Index Structure. Emergency department care, for example, may be considered as part of both the inpatient and outpatient sub-domains. Most emergency departments are located in hospital settings, and a certain percentage of patients stabilized and treated there become admitted patients. However, there are also many patients who do not require admission and are stable for discharge, and thus may be thought of as being managed in the outpatient setting. There are other examples of supportive services that facilitate the delivery of healthcare; for example, pharmacy services can be thought of as a function of each of the sub-domains listed. The overarching intent of the 2014 NHSPI Structure changes is to be as inclusive as possible of all of the elements that comprise healthcare delivery. Healthcare is defined as the prevention, diagnosis, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by the medical, nursing, and allied health professions. Healthcare includes (but is not limited to) primary, secondary, tertiary, and quaternary care, and is delivered in a variety of settings, such as outpatient/ambulatory, inpatient/hospital, long-term, home care, prehospital care, and mental and behavioral healthcare. Sub-domain: Prehospital Care Prehospital care is generally provided by emergency medical services (EMS) and, includes 911 and dispatch, emergency medical response, field assessment and care, and transport (usually by ambulance or helicopter) to a hospital and between healthcare facilities. Sub-domain: Inpatient Care Inpatient care refers to care for a patient who is formally admitted (or hospitalized ) to an institution for treatment and/or care and stays for a minimum of one night in the hospital or other institution. 5

6 Sub-domain: Long-Term Care 2014 NHSPI Domain & Sub-domain Definitions Long-term care refers to a continuum of medical and social services designed to support the needs of people living permanently or for an extended period in a residential setting with chronic health problems that affect their ability to perform everyday activities. This includes skilled nursing facilities, rehabilitation services, etc. Sub-domain: Mental & Behavioral Healthcare Mental and behavioral healthcare is the provision and facilitation of access to medical and mental/behavioral health services including: medical treatment, substance abuse treatment, stress management, and medication with the intent to restore and improve the resilience and sustainability of health, mental and behavioral health, and social services networks. It includes access to information regarding available mass care services for at-risk individuals and the entire affected population. Sub-domain: Home Care Home care is clinical and nonclinical care that allows a person with special needs to stay in their home. It may also be assumed to include the management of patient care needs for those patients not sick enough to require hospitalization or long-term care, or for whom hospitalization is not deemed to be of benefit. Other examples of home care include, but are not limited to: skilled nursing visits, respiratory care services, provision of durable medical equipment, hospice, and pharmacist services. 6

7 Domain: Countermeasure Management 2014 NHSPI Domain & Sub-domain Definitions Health management services that account for programs, products, and systems necessary to be prepared for, protected from, and resilient against chemical, biological, radiological, nuclear, and explosives (CBRNE) agents and emerging infectious disease threats. Sub-domain: Medical Materiel Management, Distribution, & Dispensing The ability to acquire, maintain (e.g., cold chain storage or other storage protocol), transport, distribute, and track medical materiel (e.g., pharmaceuticals, gloves, masks, and ventilators) before and during an incident and recover and account for unused medical materiel after an incident. This capability includes managing the research, development, and procurement of medical countermeasures in addition to the management and distribution of medical countermeasures. Sub-domain: Countermeasure Utilization & Effectiveness The level to which the community has achieved preparedness for vaccination and immunization and the level to which the community completes a course of countermeasure usage or follows through in the use of an intervention. This also covers the resultant outcome from the appropriate use of the intervention. 7

8 2014 NHSPI Domain & Sub-domain Definitions Domain: Environmental & Occupational Health Evaluation and prevention of impacts from natural and man-made effects that could adversely affect the health of the public and workers through exposures to hazardous physical, chemical, radiological, and biological agents in air, water, food, soil, and the built environment. In addition, the provision of science-based guidelines and interventions to minimize potential short- and long-term impacts to the affected populations is included. Sub-domain: Food & Water Security The sufficient availability, access, use, and protection of safe and clean food and water resources to support human well-being and health. Sub-domain: Environmental Monitoring The systematic collection and continuous or frequent standardized measurement and observation of: The environment (air, water, land/soil, and plants) Environmental specimens analyzing the presence of an indicator, exposure, or response (warning and control), including monitoring the environment for vectors of disease to give information about the environment to assess past and current status and predict future trends 8