Institute of Medicine Home Healthcare Workers Use Of PPE Ruth Ann Ellison BSN MBA Vice President Clinical Regulatory Compliance 1
Apria Healthcare is the leading provider of durable medical equipment &services in the U.S. providing care/services to over 2 million patients annually 475 + locations 11,600 employees 20,000+ deliveries per day 2 Note: Map includes both Apria and Coram locations. 2
Service Line Overview Infusion Enteral Nutrition Sleep Apnea Respiratory HME Business Description Infusion medication In the home Nutritional products delivered through tube feeding Sleep Apnea products and services Home respiratory products and services Home medical equipment Products/Services IV antibiotics, TPN, IVIG, factor and other specialty drugs Formula, pumps, kits & supplies CPAP, BiPAP, masks & supplies Oxygen, nebulizers, unit dose medications & ventilators Beds, wheelchairs, aids to daily living & negative pressure wound therapy (NPWT) (1) Based on management estimates 3
Our Comprehensive Service Offerings Are Provided In The Home Setting Hospitals Core Infusion Services Physician Offices Sleep Care Patient Focused Healthcare Services Complex Ventilator Care Program Case Managers Nutrition Services Respiratory Services Direct Patient Request Home Medical Equipment 4
Diverse Group of Healthcare Workers Approximately 6300 of our employees provide direct patient care/ services 2,400+ Clinicians 1,000+ respiratory therapists ~650 nurses ~650 pharmacy staff Over 2500 Patient Service Technicians Responsible for delivery, setup and patient education to home care patients that require home medical equipment to support their clinical needs in the home setting Transition Hospital Discharges To Home Delivery Clinical Capabilities 5 5
Corporate Culture Education -Employee -Patient Access To PPE and Hand Hygiene Products Reporting Setting Expectations Infection Control PPE System Driven Model Enterprisewide Deployment Increase Compliance Increase Worker Safety Increase Preparedness To Manage Pandemic Event Compliance - CMS Quality Standards -Accreditation Emergency Preparedness 6
Logistics Logistics Access To Personal Protective Equipment (PPE) Must Be Readily Available At The Facility and On The Road PPE Kits and Infection Control Supplies Are Standard Vehicle Stock For All Service Technician Vehicles PPE Kits -gowns, foot covers and gloves Boxes of gloves are standard stock Waterless hand cleaner Disinfectant and Decontamination Products
Continuity of Care Pandemic Preparedness Lessons Learned Mitigation Preparedness Response Presented By: Ruth Ann Ellison RN BSN MBA 8 Recovery
Patient Preparedness Begins At Patient s Admission Apria Patient Emergency Plans include, but are not limited to the following: All patients receive an admission packet that includes the following information in case of emergency: How to contact the Branch 24/7/365 Direction to contact 911 for Police of Fire Department Follow Community Public Health Advisories For All Community Emergency Events Including Potential Pandemic Events 9
When Natural Disasters Strike: Preparedness Planning Is Critical Hurricane Katrina Case Study 16 impacted branches in LA, MS & AL Six employees lost homes 5000 impacted patients 9000 lines of equipment 45 other branches absorbed displaced patients Daily conference calls with corporate command center Region distribution center in Houston, TX converted to staging facility Apria Healthcare tanks are loaded by employees and volunteers onto a military helicopter. 10
When Natural Disasters Strike: Infection Control Needs Can Quickly Escalate 11
When Natural Disasters Strike: Southern California Firestorm 12
When Natural Disasters Strike: Southern California Firestorm SCA Firestorm Case Study Multiple County evacuations 20,000 Apria patients impacted Supported all local shelters and evacuation centers Asked to support hospital and longterm care facility evacuation to quickly established shelters 13
Apria Activates Pandemic Response Plan Influenza A (H1N1) Virus Corporate activated our National Pandemic Emergency Response Team comprised of our Clinical, Logistics, Procurement, and Information Systems experts. Early deployment accurate information to our branch staff and patients was an initial priority. Enterprise wide communication via email to branches, conference calls Patient education information included in each delivery Community Communications Supply chain and procurement resources assessed Staffing and Human Resources monitored local staffing needs in the event of Pandemic expansion and need for redeployment of staff 14
Pandemic Preparedness - Lessons Learned Pandemic response requires modification to the typical natural disaster response plan, including but not limited to: Allow for contingencies to sustain vital patient care services for anticipated extended time frames delivery frequency, supply volume Pandemic event could last months based on the type of organism, vehicle of transmission, and ability to contain expansion. Where natural disasters occur we are prepared to manage the relocation of operations for a short period of time, but an expanding pandemic event will more likely focus on supporting essential services for a protracted period of time Staffing becomes a daily concern Impact of national and community regulatory directives CDC, state and county health department directives can change daily Provide early and factual information with frequent updates is essential Alternative Communication Technologies: Having alternative communications technologies designed, tested and ready to deploy can be a huge benefit to the enterprise during times of local, regional and state emergency. Local Broadband DSL/Cable Modem Internet Services w/ VPN Access Wireless/Cellular Air cards in Laptops running ICS & VPN Access Laptops configured with Dial-Up Networking Emergency Cellular handsets with Push to Talk radio features for coordination efforts and branch to branch communications. Apria now has these alternative technologies bundled within small 24 x 24 boxes for immediate deployment to any Apria location during times of emergency. 15