ClosedPODPartners.org: A Train-the-Trainer Toolkit, Website and Online Class

State: CA Type: Model Practice Year: 2010

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The issue addressed by this practice is dispensing of medical countermeasures. Local Health Departments across the country must develop the capacity to dispense antibiotics quickly and safely to entire populations in the event of a bioterrorism disaster. ClosedPODPartners.org illustrates step by step information about what organizations can do to help local health departments meet that goal.

The goal of this project was to develop an easily accessible and adaptable toolkit for Closed POD Partners to use as a way to implement and sustain a Closed POD plan within their organization. Our objectives to meet this goal were as follows:
• Outline step by step instructions on how organizations can dispense medications in a public health emergency
• Ensure all materials are accessible and of high quality
• Ensure all content is broadly applicable
• Develop a sustainable training plan
• Develop adaptable and usable tools and resources

Overall, by developing this toolkit we intended to bridge the gap in resources available to those organizations that were interested in becoming a Closed POD Partner with their Local Health Department. At the end of the project we achieved our main goal of developing an easily accessible and adaptable toolkit for Closed POD Partners to use as a way to implement and sustain a Closed POD plan within their organization. The resulting online training is broken down into five different training modules:
• Module one is introductory and discusses the concept of mass antibiotic dispensing and Closed PODs, how to get medications and basic information for Closed POD planning within the organization.
• Module two covers policies, decisions and working with Local Health Departments.

This section describes the specifics of policies and requirements that potential Closed POD Partners should evaluate, such as taking medications, employee tracking, privacy, confidentiality, liability protection and facility considerations, before incorporating the program into their emergency plans.
• Module three discusses staff roles in a Closed POD, including basic Incident Command concepts, organizational charts and also the various job roles in a Closed POD, for example, the Closed POD Coordinator, Information Officer, Operations Chief, Screener, Dispenser, Inventory, etc.
• Module four is a self paced training that discusses the checklists and steps that need to be taken to activate and operate a Closed POD. This includes How a Closed POD works, communications, logistics and layout, set up instructions, supplies, screening and dispensing and Just-In-Time Training.
• The fifth and final module houses all of the documents and forms that are referenced and appear throughout the previous four modules. This section also includes a glossary of terms used in the trainings.

Through these five modules we achieved our main objectives of outlining step by step instructions on how organizations can dispense medications in a public health emergency, developing a sustainable training plan and adaptable and usable tools and resources, and ensuring all materials are accessible and of high quality and all content is broadly applicable.

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San Francisco Department of Public Health
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ClosedPODPartners.org: A Train-the-Trainer Toolkit, Website and Online Class
The issue addressed by this practice is dispensing of medical countermeasures. Local Health Departments across the country must develop the capacity to dispense antibiotics quickly and safely to entire populations in the event of a bioterrorism disaster. ClosedPODPartners.org illustrates step by step information about what organizations can do to help local health departments meet that goal. The goal of this project was to develop an easily accessible and adaptable toolkit for Closed POD Partners to use as a way to implement and sustain a Closed POD plan within their organization. Our objectives to meet this goal were as follows: • Outline step by step instructions on how organizations can dispense medications in a public health emergency• Ensure all materials are accessible and of high quality • Ensure all content is broadly applicable • Develop a sustainable training plan • Develop adaptable and usable tools and resources Overall, by developing this toolkit we intended to bridge the gap in resources available to those organizations that were interested in becoming a Closed POD Partner with their Local Health Department. At the end of the project we achieved our main goal of developing an easily accessible and adaptable toolkit for Closed POD Partners to use as a way to implement and sustain a Closed POD plan within their organization. The resulting online training is broken down into five different training modules: • Module one is introductory and discusses the concept of mass antibiotic dispensing and Closed PODs, how to get medications and basic information for Closed POD planning within the organization. • Module two covers policies, decisions and working with Local Health Departments. This section describes the specifics of policies and requirements that potential Closed POD Partners should evaluate, such as taking medications, employee tracking, privacy, confidentiality, liability protection and facility considerations, before incorporating the program into their emergency plans. • Module three discusses staff roles in a Closed POD, including basic Incident Command concepts, organizational charts and also the various job roles in a Closed POD, for example, the Closed POD Coordinator, Information Officer, Operations Chief, Screener, Dispenser, Inventory, etc. • Module four is a self paced training that discusses the checklists and steps that need to be taken to activate and operate a Closed POD. This includes How a Closed POD works, communications, logistics and layout, set up instructions, supplies, screening and dispensing and Just-In-Time Training. • The fifth and final module houses all of the documents and forms that are referenced and appear throughout the previous four modules. This section also includes a glossary of terms used in the trainings. Through these five modules we achieved our main objectives of outlining step by step instructions on how organizations can dispense medications in a public health emergency, developing a sustainable training plan and adaptable and usable tools and resources, and ensuring all materials are accessible and of high quality and all content is broadly applicable.
The issue addressed by this practice is dispensing of medical countermeasures. Local Health Departments across the country must develop the capacity to dispense antibiotics quickly and safely to entire populations in the event of a bioterrorism disaster, which is a key element in the CDC Public Health Emergency Preparedness (PHEP) grant and the foundation of the Cities Readiness Initiative (CRI) program. ClosedPODPartners.org illustrates step by step information about what organizations can do to help local health departments meet that goal. Specifically, this toolkit addresses the topic of alternative methods of dispensing and is focused on the element of pushing antibiotics out into the community via cross-sector partnerships with a goal of being able to dispensing medications to an entire jurisdiction within 48 hours of a large-scale infectious disease emergency. To determine the relevancy of emergency mass antibiotic dispensing and the need for a Closed POD Partner toolkit in the community we asked our stakeholders what would be helpful to them as Closed POD Partners and set up a clear communication pathway along the way. We held a focus group meeting as part of our product development process, soliciting ideas for the toolkit that could fill current gaps in resources and also encourage other organizations to sign on as Closed POD Partners. Our focus group consisted of 23 members that represented retail and financial establishments in the private sector, community-based organizations, higher education institutions, faith based organizations and federal agencies. Attendance in the focus group was completely voluntary and the wide range of representation alone sent the message that cross-sector partnerships for public health preparedness and alternative methods of mass dispensing is still relevant in our community and a toolkit is needed to help continue to support those partnerships. In addition to contacting local stakeholders within our community, we researched currently available tools addressing mass antibiotic dispensing and reached out to our public health emergency planner counterparts in other jurisdictions. We contacted Tarrant County to solicit their interest in a “Train-the-Trainer Guide for Closed POD Partners” as a possible complimentary element to their “Preparing Your Business for Emergencies, Natural and Man Made Disasters” toolkit. Their response was extremely enthusiastic, replying that they would readily welcome and accept this “needed” addition, again reflecting the relevancy of our product in the community. Our project addresses the issue of dispensing emergency medical counter measures quickly and safely to entire populations using alternative methods of dispensing by illustrating the importance of Closed POD partnerships and then providing step by step instructions on how organizations can dispense medications in a public health emergency. Our toolkit fills the need of what stakeholders asked for as a way to initiate and sustain a Closed POD Partner program in their organization. The toolkit addresses specifics of meeting stakeholder needs for mass antibiotic by: • Acknowledging that local health departments cannot meet the objective of mass antibiotic dispensing in 48 hours alone and the need to foster relationships with community partners, • Emphasizing the Local Health Department’s understanding of the stakeholders need for continuity of operations in a catastrophic public health emergency • Illustrating the desire for Local Health Department to provide Closed POD Partners with all of the tools and resources that they will need to successfully aid Local Health Departments in mass dispensing and also successfully care for employees, employee’s family members, clients and/or patients. • Illustrating the importance of considering the policies and requirements that potential Closed POD Partners should evaluate, such as taking medications, employee tracking, privacy, confidentiality, liability
Agency Community RolesThe San Francisco Department of Public Health was responsible for creating and implementing the ClosedPODPartners.org project. SFDPH facilitated a focus group to kick off our project by inviting our current and potential Closed POD Partners. SFDPH was responsible for all of the data analysis that occurred in the project, including the interpretation of data to determine the priorities of the toolkit from our current and potential Closed POD partners across all sectors. Once we completed the data analysis, SFDPH was responsible for developing the content and narrative for our online training as well as all of the content and the types of documents that needed to be part of the toolkit. After establishing a draft version of the toolkit, SFDPH was responsible for ensuring its relevance and usability before committing the final version to a vendor. SFDPH developed a review tool that stakeholders would use to provide feedback on each section of the kit and also the documents and resources that would be paired or referenced throughout the training. Once we got feedback from our stakeholders, SFDPH was responsible for incorporating all of the comments into the draft toolkit. SFDPH staff was responsible for choosing and hiring a vendor. We worked with our chosen vendor to develop a script that would be used for the voiceover portion of the toolkit as well as helping choose appropriate graphics and animations that would be part of the training. In addition to the toolkit content development process, SFDPH was also in charge of developing marketing materials for our toolkit. SFDPH worked with the City graphics department on a color scheme, tag lines and images that would be used for marketing our product. The final design for our post-cards and advertising materials was then applied by SFDPH staffs to the documents and resources that were part of the toolkit to ensure consistent branding. Upon completion of developing ClosedPODPartners.org, SFDPH hosted two different meetings unveiling the toolkit. We now maintain the website and solicit feedback about how to enhance or improve it. Our role is to be accountable to prospective Closed POD partners and answer all of their questions thoroughly. Our specific stakeholders throughout this project included: Levi-Strauss, Charles Schwab, The Gap, First Republic Bank, SFReady, McKesson, ORC Worldwide, Bay Area Response Coalition (BARCFirst), Building Owners and Managers Association (BOMA), University of San Francisco, Barclay’s Global, Dolores St. Community Services, Judicial Council of California,19th Ave. Health Center, and Federal General Services Administration: Region 9. Each stakeholder had a significant role in the development of ClosedPODPartners.org. Their attendance at the kick off meeting was vital to the project, as their input via the surveys, checklists, and group discussion that were part of that meeting provided us with input about motivation to participate in the Closed POD Program, usefulness of tools that would be in the kit, the minimum pieces of information that had to be in toolkit, and factors for sustainability within their organizations. The information from our stakeholders ultimately provided the foundation for our entire development process and final product. Ensuring that we involved stakeholders from all five Closed POD sectors (Faith and Community Based Organizations, Private Sector and Federal Agency large employers, and Higher Education Institutions), ensured that Closed POD stakeholders around the country would have proper representation in the development of this toolkit. We kept in constant contact with our stakeholders during the development process, keeping them informed about the results of the data analysis of their priorities as well as the progress of the toolkit. Our stakeholders continually had the opportunity to offer any thoughts or input they had between the time of the kick off meeting and receiving the draft toolkit.  Costs and ExpendituresThe San Francisco Department of Public Health was one of 51 local jurisdictions that applied for NACCHO’s “Mini Advanced Practice Center (APC)” grant to develop and implement a public health preparedness project within our community. Our project, ClosedPODPartners.org, was based on an identified gap within the Advanced Practice Center portfolio. SFDPH was awarded $100,000 to develop our product. All funds were folded into our operating costs of sfcdcp.org, which included supporting the salaries of six staff members from SFDPH based on the percentage of time spent on the project. This totaled $54,266 of our allotted funding. The remaining portion of the grant that wasn’t spent on personnel went towards hiring an outside contractor to design the toolkit using content developed by staff from SFDPH ($43,000), refreshments for initial input meeting for toolkit development and for final showcase presentation ($800), mailings and reproduction expenses for surveys and marketing ($400), and miscellaneous office supply or internet-related costs ($1,532). Work on the project commenced once the funding was received by NACCHO. We started the process by soliciting current Closed POD Partners, both private and public, to get implementation ideas for the final toolkit. This took shape via a focus group meeting that used surveys, checklists and group discussion inquiring about motivation to participate, usefulness of tools and factors for sustainability for out toolkit. After analyzing data collected from our focus group, we used the data to create step by step instructions for how an organization could become a Closed POD Partner and how to incorporate their Closed POD dispensing model into their continuity of operations (COOP) program. To further meet the need of our partners, the toolkit was put into a format that was Web-based and easily accessible anytime anywhere and free of cost, as well as being self-paced and suitable for all learning styles. Overall, this project took over 500 man hours to complete. Once the toolkit was finished it was presented at three different forums for our current Closed POD Partners and also emergency planning counterparts. The funding source for this project came in full from NACCHO’s APC Innovative Solutions in Public Health Preparedness grant. ImplementationTo achieve our overall goal and objectives, we knew that we had to involve our stakeholders from the inception of the project. The first step would be to invite our stakeholders to a kick-off meeting to discuss the project and garner input. We created a survey and checklist and used existing networks and relationships between SFDPH and business associations to call together a smaller group (approximately 20-30 participants) representing a variety of organizations (community based, corporate, academic etc.), to solicit in-person feedback/comments about what should be in the toolkit. After receiving the data from our survey and checklist we then analyzed the data, identifying key points that would be essential to train the trainer program and key points where explicit instructions/explanation will be needed for program’s intended audience. Evaluation indicators for this step were the quality of entered data and the survey results. Next we needed to develop our training curriculum base on the results from the survey Once the draft version of the toolkit and curriculum was developed we then put together a tool to aid our stakeholders in offering feedback. Upon receiving comments and edits we incorporated them in the toolkit and then finalize the specific tools that are part of the training curriculum. We sent the final version of the curriculum to a graphic Web designer who recorded the voiceover component of the training and also created the website and animated training itself. As we received drafts of the chapters from our designer we offered feedback specifically on graphics, animations and the onscreen content that would be seen by the end user. We also ensured there was a section just for the documents and resources that were mentioned or shown throughout the curriculum. Part of the completion of the specific tools was to have a professional graphic designer work closely with SFDPH staff to ensure all materials had a consistent look and can be completed both electronically as well as in hard copy. During document development and completion we also ensured that all tools had space for our to include their logos and contact information and they were all created in multiple formats (pdf, Word, txt files) such that organizations with different software systems can use them equally. SFDPH had six months to develop the final version of our ClosedPODPartners.org toolkit. Our initial project scope of work was supposed to commence in April and end in September following this timeline: Step one: By April 30, 2009, develop and distribute at least 300 surveys directed to a variety of private businesses and organizations - soliciting their input to ensure that training materials ultimately meet their needs. Step two: By May 31, 2009, analyze survey data, identifying key points that will be essential to train the trainer program and key points where explicit instructions/explanation will be needed for program’s intended audience. Step three: By July 31, 2009, develop the training curriculum. Step four: By Aug. 31, 2009, finalize the specific tools that are part of the training curriculum. Step five: By Sept. 29, 2009, produce, post and distribute hard and electronic copies of all materials. Step six: By Sept. 29, 2009, market existence of training program. However, due to the H1N1 outbreak and delayed receipt of funds, we had to request an extension of the final deliverables in addition to augmenting the initial set of tasks that would complete each major chorological objective. Ultimately the project spanned eight months and we still achieved our initial goal and objectives.
The goal of this project was to develop an easily accessible and adaptable toolkit for Closed POD Partners to use as a way to implement and sustain a Closed POD plan within their organization. Outline step by step instructions on how organizations can dispense medications in a public health emergency. By using survey and a checklist to collect stakeholder information on behalf of their organization we intended to obtain data regarding the topics and resources that would be a priority and ensure the toolkit was relevant for stakeholders across five different sectors. A topic or resource was deemed a priority if at least 50% of stakeholders in attendance at the kick off meeting placed it as priority and a method of delivery was deemed a priority if at least 35% of stakeholders in attendance placed it as priority. Data was collected by SFDPH via a multiple-choice survey where participants could circle items that applied to their organization and a likert scale checklist where participants to rank each individual item on the list independent of the others on a scale from 0-3 with three being the topic of most concern and zero being a topic of least concern or not applicable to the organization. The multiple-choice survey asked participant to provide information about their organization’s emergency preparedness programs, including how often they conduct emergency preparedness training, how much time they spend on training, modalities of all types of training that occur within their organization, who they would dispensing antibiotics to in a public health emergency, types of staff, resources they could provide, limiting factors and specific documents they would want in the toolkit. The intention of the checklist was to determine what content in the training was absolutely necessary. The data for this project was collected once during the kick off meeting before any of the content of the toolkit was developed. Recipients of data derived from the initial kick off meeting included both stakeholders in attendance and those who were not, staff working on the project, management in the SFDPH Communicable Disease and Prevention Unit, and the fiscal sponsors of the project. We learned that over half of our participants felt they could incorporate Closed POD training into their existing operations. Most noted that staff would be self motivated to participate but further encouragement could come by offering incentives like community service hours. Of the limitations and needs identified, it appeared that many gaps could be resolved through the development of guidance and planning support including ensuring Closed POD partners will be able to have access to direct point-to-point communications and allowing organizations to make the choice to share information about their participation as they see best. Therefore it would be helpful if the toolkit provide information and resources on planning materials, training materials and response materials. The outcome for this objective was that we successfully developed step by step instructions on how organizations can dispense medications in a public health emergency. This was done both in the format of the interactive multi-media training as well as in the documents and resources that were developed. This outcome is long term in that there is now a tangible resource available to current and potential Closed POD Partners. Ensure all content is broadly applicable and materials are accessible and of high quality. We expected that our stakeholders would find the tools and resources at least reasonably adaptable and usable. Performance measures to determine adaptability and usability were anecdotal. A tool was deemed adaptable and usable if, upon asking our stakeholders during the final in person unveiling presentations what their impression of the tools were, the stakeholder felt that the tool appeared to be easy to access, enter their own information and add to their current emergency pla
ClosedPODPArtners.org has sufficient stakeholder commitment to perpetuate the practice. Now that the website is live, stakeholders can access the toolkit at anytime and begin to incorporate the program and plans into their current emergency preparedness and response plans. This includes registering with their local health department as a Closed POD, which further commits them to the program. Stakeholders that were part of the development and review process are also members of the committees and workgroups where SFDPH has representation, including. BOMA, BARCFrist, SFReady, etc. Through these forums stakeholders have consistent access to SFDPH staff to asking questions about aspects of the toolkit, offering feedback about the toolkit and its supporting documents and resources, and gaining assistance and onsite training and information. This access, again, increases the ability to ensure stakeholder commitment and also allows SFDPH to get a sense of the level of stakeholder commitment and how to augment its efforts based on need. Many stakeholders specifically in San Francisco and the greater Bay Area were already committed to the Closed POD Program. However, the development and launch of ClosedPODPartners.org and its supporting resources will allow these organizations to further sustain the Closed POD program and better incorporate it into their all hazards and continuity of operations plans. Many of the stakeholders who were part of the development and review process also serve as unofficial “advocates’ of the program, championing the cause of partnering with the local health department for mass dispensing efforts at industry events and meetings, which ultimately increases stakeholder commitment. SFDPH also works with stakeholders in other health departments across the country. Because of the national scope of this project, other public health emergency planners can access the website and toolkit and advocate for the use of it in their own jurisdictions and local organizations. This again increases stakeholder participation and by having a consistent and nationally accessible toolkit, also provides more incentive for commitment to the program. Our long term plan to sustain the use and improvement of ClosedPODPartners.org has already commenced. Our first project was to develop a quality assurance plan outlining the roles and responsibilities of SFDPH and our Closed POD partners. This would be part of the process for Closed POD Partners in the City and County of San Francisco to receive liability coverage from the City Risk Manager in the event of an emergency so catastrophic that the Closed POD Plan would be activated. We feel that by having this liability coverage in place ahead of time it will be more appealing for all types of Closed POD Partners to want to join the program. As part of our quality assurance plan, SFDPH will be responsible for creating and maintaining the Closed POD Registry, which is a confidential database that houses information regarding the name and type of organization, contact information for three people in organization, employee and client Information. Each Closed POD Partners that has completed the Registry form will receive annual reminders about updating their information, the status of their plans and also their training progress in the program. SFDPH will also send quarterly updates via a newsletter about emergency planning issues, training opportunities and other meetings, events and updates pertaining to mass antibiotic dispensing and cross-sector partnerships. Communications with Closed POD Partners will also include a list-serve managed by SFDPH, and all communications will reference the ClosedPODPartners.org website for documents, updates, etc. All registered Closed POD Partners will be required to meet specific training requirements. Completion of these requirements will be overseen by SFDPH staff. This includes SFDPH holding at least one in-person training every two years. This trai
 
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