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INFECTIOUS DISEASE
EMERGENCY RESPONSE PLAN
Mental Health, Alcohol & Other
Drugs
MNC LHD
Mental Health Alcohol & Other Drugs Infectious Disease
Emergency Response Plan
Phases of a Pandemic
PHASE KEY ACTION FACILITY ACTIONS
ALERT
(MNCLHD/
NSW
Health
Inititated)
Alert to the risk of pandemic
and preparing for a pandemic
Prepare: increased pandemic
preparedness activities
Prevention and Preparedness activities
o Develop facility plans
o Exercise Plan
o Training staff in Pandemic awareness and
Infection Control practices
o Review Business Continuity planning
o Identify communication strategies with staff and
managers
o Promote seasonal Fluvax
DELAY Delay entry of the virus to
Australia with border measures
Increased vigilance for cases
(overseas and domestic and
increased monitoring of the
virus (to look for genetic
mutations in the virus)
Escalate preparedness activities
for possible pandemic (move
from ‘preparedness’ to
‘readiness’)
Stand down the response if the
pandemic is averted before it
arrives in Australia
o Ensure current contact details available for
Public Health Unit
o Audit PPE stock levels
o Audit staff Fluvax levels
o Monitor Antiviral stocks
o Review and update plans
o Implement staff communication strategies
o Ensure current case definition available
o Implement Enhanced ED Triage Appendix 1
o Erect appropriate hospital signage
o Escalate Infection Control training
o Review plans for screening stations/flu clinics
location
CONTAIN
PROTECT
Contain the establishment of the
pandemic strain in Australia
Ensure the health system is best
able to cope with an influenza
pandemic
o Continue above activities
o Implement screening stations Appendix 2
o Implement influenza Clinics when needed
Appendix 3
o Review plans for service wind down cessation
o Identify staff skills
o Review overflow facility locations and plans
Appendix 3
o Review plans for designated wards/hospital for
Influenza Appendix 4
o Review plans for Vaccination clinics and
identify suitable personnel
SUSTAIN
PROTECT
Sustain the response while we
wait for a customised pandemic
vaccine to become available.
Minimise transmission and
maintain health services
o Continue above activities
o Implement plans for service wind
down/cessation
o Implement overflow facilities if required
o Implement designated ward/hospital
CONTROL Control the pandemic with o Implement vaccination clinics
PHASE KEY ACTION FACILITY ACTIONS
PROTECT
vaccine
Careful downscaling of
response as pandemic brought
under control, to an eventual
standing down of control
measures in the recovery phase
o Review of service provision and recommence
services
o Decommission designated wards/hospitals as
required
o Decommission overflow facilities as required
RECOVER Restore the health system and
return to ALERT phase as
quickly as possible
Enhanced vigilance for a
subsequent wave: increased
vigilance for cases and
increased monitoring of the
virus (to look for genetic
mutations)
Recovery
o Return to usual level of service provision
o Enhance vigilance for subsequent wave
1. Introduction This plan has been developed to outline the Mental Health, Alcohol & Other Drugs
response that would be required to manage an infectious disease emergency e.g.
Pandemic Influenza.
This plan is linked to the MNCLHD Infectious Disease Emergency Response Plan.
2. Communication Communication through the facility will follow the communication process documented in
the Mental Health, Alcohol & Other Drugs Plan. The Service manager is central to feeding
up, to the Health Service Functional Area Coordinator (HSFAC), and disseminating down
relevant information, to all team members. As such notification of an outbreak will derive
from the Chief Executive (CE).
2.1 - Media
No staff shall speak with the media
2.2 –Staff
Strategies to communicate with the MNCLHD workforce during the response and
recovery phase will include:
Staff/service Newsletter
MNCLHD Intranet – alerts and links
Global email alerts
Standing agenda item on hospital executive meetings
Standing agenda item on ward/unit/department meeting
Staff notice boards
Ward/department/unit communications book
3.1 Service Manager Responsibilities Responsible for:
On an ongoing basis ensures service plans are current and could become
operational when required – you may be a victim ensure your staff are aware of
the planning in place
Actively support the implementation of the ‘Staff Seasonal Influenza Vaccination’
program
Provide rapid communication to the HSFAC if unusual developments arise
Ensure service wide communication regarding updates, changes and response
requests
Review resources and allocate resources based on effectiveness of response
operations across area of responsibility
Monitor sustainability of service response and provide reports to the HSFAC
Assist with planning operations by attendance at planning meetings when
requested
Ensure welfare and safety of all personnel
Maintains log of all activities.
4. Service Response
4.1 Workforce
To maximize staff availability a number of strategies will need to be in
place:
Identification of staff with specialty skills who can be rapidly up
skilled to again work in other specialty & generalist areas
Education plan utilising CNE’s and CNCs and other non frontline
staff from specialty areas to provide existing in service education
packages to these identified staff
Promote Influenza vaccination rates amongst all staff
Accommodation alternatives for staff willing to work but reluctant
to return home during the event
Stage Strategy Staffing
Requirements
Pre surge
No infectious
disease outbreak
identified
Community education on infection prevention and
training to come home care of infected relatives.
Ongoing training of clinical staff for influenza care and
other essential services during an outbreak.
Planning to be put into process for potential surge:
Data collection to identify.
Staff prepare to work in outbreak areas
Staff who will not or should not work in
outbreak areas (those identified as vulnerable)
Staff who are prepared to work in outbreak
areas other than their won can be provided with
alternative to going home and avoiding the
possibility of infecting house hold members
Staff who work at more than one facility,
information to include type of facility (private
hospital/ GP/dental surgery) or any other
employment
Staff who work in non-clinical areas and are
prepared to work in outbreak areas
Staff who may not come to work at all
Conscientious objectors to immunisation
Screening of both internal and external staff
(eg Security guards) and patients/clients who
have travelled from the risk zone identified in
the current case definition – including locum
Routine staffing
Stage Strategy Staffing
Requirements
and agency staff
Recent immunizations – two (2) weeks’
window before they are considered protected –
immunisation provider to inform staff member
of the at time of immunisation
Identify staff with specialist skills in infectious
diseases and the management of at risk patient
groups (critical care, paediatric, maternity and
immunocompromised) for possible deployment
during an infectious disease outbreak
Identify specialised equipment in your area list
last maintenance check ensure all equipment
operational
Alert
Possible
infectious disease
outbreak
identified
Implement screening questions for clients,
visitors and externally sourced staffing
resources (e.g. Security)
Staffing for each phase of operation identified
in each service
Expect surge in demand from people whose
caregivers are unwell
Start activities for surge e.g. planning of non-
essential services that can be suspended to
bolster workforce
Staff training as new staff are employed
Commence education of staff identified for
deployment to different clinical areas
Ensure Communications strategies developed to
encourage community and staff resilience
Advertise Mental Health Access Line
o Brochure/Information to other
emergency/disaster agencies
o Contact details of local mental health
teams
o Direct communications with clients –
Service Contract Information (SCI)
Mental Health Outcomes and
Assessment Tool (MHOAT)
o Use of central Mental Health Drug and
Alcohol Office (MHDAO) information
o Enhanced education for staff on
infectious disease control processes
o Identify demand, utilisation and
resources of the EAP
Stage Strategy Staffing
Requirements
Develop and circulate information booklet for
consumers and NGOs regarding access to
service, medication supply and routine clinic
management
Develop a vulnerable persons list for consumers
and staff (updated weekly initially) on Mondays
criteria includes (continuation of business as
usual):
o Isolation (transport, MH care, medical
care, medication {depot, opioid
treatment Clozapine})
o >65
o Physical health, Co-morbidities
Develop individual patient plan to address risks
identified
Develop a list of staff to work from home/other
sites and other specialty areas
Consider approval of leave
Identify supply chains, pathways into the LHD
and mitigation strategies
Confirm current levels of supply
Education/information on MH effects to be
given to relevant partners upon request, via
written format
Provision of specific training to ‘non MH’ staff
Infectious
disease outbreak
Minor surge 5-
10% in
presentations
Continue strategies identified above
Staff to be deployed to outbreak areas on a
needs basis
Provide education as per education plan for IDE
For staff willing to work extra hours, establish
12 – hour shifts up to the maximum as per
award conditions
Initially staff will be deployed within the same
facility then a facility within the same district
Identify staff and requirements for non-clinical
staff to work remotely
Staff can be released to work in the private
hospital that has a MOU in place to assist with
service provision
Implement all LHD-wide decisions including
staff travel between facilities. Consider internal
also as needed.
Ensure communications strategies deployed to
Stage Strategy Staffing
Requirements
encourage community and staff resilience
o Relevant MH information provided by
MH
o Distribute to hospital and community,
DMH & Media Unit staff
Ongoing monitoring of vulnerable groups by
direct line supervisors
Initiate MH first Aid advice
Radio and newspaper briefing and updates
MH professionals will assist by collaborating
with other services and working within a multi-
disciplined team structure
Implement daily 0800H meeting in each
clinical team to risk assess consumers ability to
attend clinics, review vulnerable patients list
and plan strategies to address issues
Clozapine Clinics moved to Ellimatta House
(Port Macquarie) & Wide Street (Kempsey)
AOD to suggest solution for Coffs (DN)
Issues from 8am handover will go to the 9.30
daily bed meeting
Moderate Surge
11 -15% increase
in presentations
Continue strategies identified above
Redeploy clinical staff from deferred services
Defer annual leave and leave of absence until
the IDE ends
Intensify education for staff deployed to care
for patients in specialised groups, critical care
paediatric, maternity and mental health
Education to be enhanced to support needs of
deployed staff and volunteers as per education
plan for an IDE
Set additional On Call Executive Manager
Roster i.e. one per network for CCN and
HMCN & implement cross CN meeting
Consider
Saturday and Sunday reviews & 0930 bed
meeting
Suspend across district (intra-district) transfers
where possible based on risk assessment
Suspend routine community clinics and ECT
Introduce 24hour coverage of Emergency
Department utilising community staff
(MH&DA)
Non –clinical staff
work remotely
Stage Strategy Staffing
Requirements
Divert consumers from ED via use of
o Telehealth
o Provision of clinics at GP services or
partnering NGO services
o Maximise medication dispensing for
OTP
o Admit dis-regulated consumers not able
to be cared for at home who are
identified as ‘potentially infective’ into
ward 2 bed area Ward 1A
Consultation Liaison support for consumers in
general wards or ICU
Combine mental health and drug and alcohol
workforce
All district staff based off hospital campus to
work from hospital facility
Offer workforce flexibility e.g. 12 hour shifts,
location, specialty, remote access for staff who
may need to work from home
Cease all non-urgent meetings and education
MH management for disorders that develop or
are exacerbated in this phase should be
identified. Management should include
infection control implementation and
monitoring clients of mental health care
systems by:
Triage of the person via 1300 number and
utilise Mental Health Emergency Care Rural
Access Program (MHEC-RAP)
Suspending ECT services
Infection control services to assist with
planning and advise on monitoring of all health
clients
Major Surge
16-20% increase
in presentation
Continue strategies identified above
Recall staff from leave
Training non clinical staff to provide support
services such as meals. Personal care, patient
movement for treatment and site cleaning
Support HCW’s and their families to enable
continued working during and IDE, e.g. child
care or elder care
Admit dis-regulated consumers not able to be
cared for at home who are identified as
Stage Strategy Staffing
Requirements
‘potentially infective’ into Ward 1A non-
commissioned area utilising community and
non-clinical staff
Supporting
Health Care
Workers
Provide Basic Personal support during and IDE with
provision of,
Meals
Regular rest periods
Secure areas for personal belonging
Access to communication devices in non-
operational areas
Liaise with corporate serviced re provision of
meals and ongoing maintenance
Establish a process for emotional and
psychological support for staff, utilizing
available resources, mental health, social work
EAP
Liaise with Mental health unit to deploy
counsellors to support staff with grief, trauma
stress, crisis and emotional support.
4.2 Education
Education for the prevention and management of Infectious disease outbreaks.
Adherence to infection control guidelines is one of the key interventions to prevent the spread of
infection during routine health care delivery in an IDE. Education of staff working within
MNCLHD incorporates the basic principles of infection control, such as hand washing,
indication for PPE, methods of donning and doffing PPE, isolation precautions, and cough
etiquette. This ongoing education is currently provided by a mix of staff within the LHD and is
essential to the prevention of hospital acquired infections and infectious disease outbreaks.
In the event of an IDE it it’s likely that additional education of staff patients, visitors and the
community will be required, the scale of the IDE will dictate the level of resources required to
provide this educational support. Depending on local infection control resources witting each of
the two network on the MNCLH it is likely that even small to moderation infection control
outbreaks may consume existing human resources, reducing the number of staff available to
provide the required educational support. In preparation for infectious disease outbreaks each
facility should have a documented plan to enhance as escalate educational activities as required.
The educational plans should incorporate strategies to:
1. Provide staff with education relating to predictable infectious disease outbreaks e.g.
Seasonal influenza;
2. Alert staff of new or potential infectious disease outbreaks in the work environment:
3. Escalate the frequency of education relating to infection control principles in response to
an infectious disease outbreak; and
4. Provide specialty based education to support staff caring for specific patient populations
in the event of major IDE
The facility plans should be based on a staged approach that escalated the educational response
to match the level of the IDE.
The following table identifies issues to be considered in the development of these local plans
.
Stage Strategy Staffing requirements
Pre-surge
No infectious
disease
outbreak
identified
Routine education on infection control principles
such as
Hand washing
Indications for PPE
Methods of donning and doffing PPE
Isolation precautions
Couch etiquette
Routine education on the prevention of infectious
disease outbreaks should also incorporate the
preparation for foreseeable IDE e.g. seasonal
influenza.
Education in preparation for the seasonal influenza
education should incorporate information to enable
health care workers to
Undertake collection of pathology
specimens from patients (if this is within
their scope of practice) and initiate the
procedures for transportation of specimens
to confirm/deny the presence and type of
infectious agent.
Understand the role of the immune system
and the importance of vaccines in
preventing infection
Identify the indications dosage efficacy
contraindication and side effects of
available specific medications e.g.
antimicrobials/antiviral
Provide information to visors of the
hospital environment with IDE symptoms
on the risk they pose to patients and staff as
well as the role of hand washing and PPE
Provide information to visitors of patients
on the risks to their health when visiting
patients with possible/confirmed IDE to
Additional staff ( e.g.
infection control liaison
nurses, clinical nurse
educators ,etc.) may be
required to assist with
education relating to IDE
Stage Strategy Staffing requirements
hospitalised patients
Identify symptoms of patients with the
identified IDE
List the treatment strategies for the
critically ill presenting with complications.
The relevant vaccination to the community,
high risk persons and health care workers.
Identify staff with specialist skills in infectious
disease and the management of at risk patent
groups for possible deployment during an
infectious disease outbreak. Review the need for
education to maintain competency in these staff
and implement appropriate education as required.
Identify possible resources top up skill staff in the
management of specific population if required
Notify staff of nature of the IDE and
recommended infection control measures
Escalation of education related to relevant
infection control procedures in response to
the IDE
Increase education and availability of
relevant vaccines where applicable
Provide education materials e.g. posters
information booklets) relating to the IDE
for patients and visitors where applicable
Consider the need to intensify education for
staff caring for specialised patient groups
and implements and required
Access hospital, LHD, State and or
National resources to assist in the education
of staff of visitors in the management of the
current IDE.
Minor Surge
5-10%
As per pre surge with further escalation in the
frequency of education activities
May require additional
staff and reduction of
planned education e.g.,
workshops in – service
mandatory education to
free up staff to assist
with patient
care/educational support
Stage Strategy Staffing requirements
Moderate
Surge
11-15%
As per minor surge with an increase focus on the
need for qualified bedside educators to assist in the
management of patients
Implement plan to support staff caring for patient
groups being most affected by the infectious
disease outbreak.
Implement plans to support staff working in areas
outside of their immediate expertise
Utilise clerical administration staff etc. to access
resources relating to infectious disease outbreak to
assist education staff in providing clinical support
Cancel any non –
essential educational
activities unrelated to
current infectious
disease threat
Increase numbers to the
bedside with educators
where possible
Major surge
16-20%
As per moderate surge with a major focus on
bedside education, supervision and clinical
support.
Maximum number of
education staff
supporting and
supervising patient care
at the bedside.
4.3 Business Continuity
Prioritise services that can be suspended to maximize staff
Unit
Continuation
Priority
Sustainability Options Comments
4.4 Work Health and Safety
A safe working environment is pivotal to a successful response
Ensure a safe environment for patients and staff and ensure the risk of in
hospital transmission is minimised
Ensure all staff are competent in infection control and maintain ongoing
competency
Ensure all staff have access to required PPE
Ensure all staff have access to and are encouraged to access any available
vaccines
Develop a process to monitor all health care workers for symptoms prior to
entering the workforce if required
Develop a process for daily monitoring of staff absences from work if
required
Ensure all staff are kept informed of the IDE status
