Jenny Atas MD Associate Professor Wayne State University Medical Director Region 2 South Medical

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Emergency Management Emergency Management Strategies:Strategies:

Lessons Learned in Lessons Learned in Developing Specifications, Developing Specifications, Procuring, Housing and Procuring, Housing and Maintaining a 100-Bed Maintaining a 100-Bed

Mobile HospitalMobile HospitalJenny Atas MDJenny Atas MD

Associate ProfessorAssociate ProfessorWayne State UniversityWayne State University

Medical DirectorMedical DirectorRegion 2 South MedicalRegion 2 South Medical

Bio-Defense NetworkBio-Defense Network

Mark SparksMark SparksLogistics/Planning OfficerLogistics/Planning OfficerRegion 2 South MedicalRegion 2 South Medical

Bio-Defense NetworkBio-Defense Network

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Presentation OverviewPresentation Overview Project BackgroundProject Background Acquisition Process and Acquisition Process and

Specifications Specifications Durable and Non-Durable Durable and Non-Durable

Equipment Acquisition ProcessEquipment Acquisition Process Storage & Deployment Storage & Deployment

ConsiderationsConsiderations

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PROJECTPROJECTBACKGROUNDBACKGROUND

~ Organization ~~ Organization ~

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Project Background ~ OrganizationProject Background ~ Organization Pre 9-11: District OrganizationPre 9-11: District Organization

88 Emergency Emergency Management Districts Management Districts covering 83 Countiescovering 83 Counties

4545 Public Health Public Health DepartmentsDepartments

65 65 Medical Control Medical Control Authorities (oversight Authorities (oversight of pre-hospital of pre-hospital system) system) with no seat with no seat at the tableat the table

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Project Background ~ OrganizationProject Background ~ OrganizationPost 9-11: New Paradigm of Post 9-11: New Paradigm of

PlanningPlanning

HealtHealth h

CareCare

PubliPublic c

HealtHealthh

Emergency Emergency ManagemeManageme

ntnt

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Medical Control Medical Control AuthoritiesAuthorities

Hospital/Pre-hospitalHospital/Pre-hospital

HRSAHRSA((now now HHS HHS

ASPRASPR))

CDCCDC

Local Health Local Health DepartmentsDepartments

Other Local/Regional Other Local/Regional PartnersPartners

Coordinated State/Local/Regional Coordinated State/Local/Regional PlanningPlanning

Project Background ~ OrganizationProject Background ~ OrganizationPost 9-11: HHS Grant Post 9-11: HHS Grant

ProgramsPrograms

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Project Background - OrganizationProject Background - Organization

Post 9-11: Regional Post 9-11: Regional OrganizationOrganization

8 Medical Bio-Defense 8 Medical Bio-Defense RegionsRegions Mirror of 8 E.M. DistrictsMirror of 8 E.M. Districts Incorporates 65 Incorporates 65 MCAs MCAs Bioterrorism CoordinatorBioterrorism Coordinator Medical DirectorMedical Director Emergency Preparedness Emergency Preparedness

Coordinator Coordinator (Local Health Department)(Local Health Department) EpidemiologistEpidemiologist SNS Technical AdvisorSNS Technical Advisor

Seat at the tableSeat at the table

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Project Background ~ OrganizationProject Background ~ OrganizationRegion 2 South (R2S) OverviewRegion 2 South (R2S) Overview 33 Counties; Counties; 97 97 local political jurisdictions; local political jurisdictions;

2.6 2.6 million peoplemillion people 1414 P.A. 390 Emergency P.A. 390 Emergency

Management/Homeland Security Programs Management/Homeland Security Programs ((44 with Public Health authority) with Public Health authority)

66 Public safety mutual Public safety mutual aid organizations aid organizations

44 Public Health Authorities Public Health Authorities 44 Medical Control Authorities Medical Control Authorities 3737 Hospitals Hospitals 6969 Fire/EMS agencies Fire/EMS agencies 1111 Private/EMS agencies Private/EMS agencies

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Regional Partnership with Regional Partnership with Emergency Management is CriticalEmergency Management is Critical

Development of surge plans, Development of surge plans, procedures and resources must involve procedures and resources must involve all disciplinesall disciplines

Take full advantage in the ability Take full advantage in the ability to to leverage other federal funding leverage other federal funding streams (restrictions / allowances)streams (restrictions / allowances)

Allows you to mitigate duplication of Allows you to mitigate duplication of effort on all frontseffort on all fronts

Project Background ~ OrganizationProject Background ~ OrganizationLessons LearnedLessons Learned

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PROJECTPROJECTBACKGROUNDBACKGROUND~ Foundation ~~ Foundation ~

DHHS NBHPP Program Guidance for Fiscal DHHS NBHPP Program Guidance for Fiscal 2006 dictates that states have the ability to 2006 dictates that states have the ability to

surge outside hospitals and healthcare surge outside hospitals and healthcare systemssystems

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Project Background ~ FoundationProject Background ~ FoundationSituationSituation

Hospitals in Michigan Hospitals in Michigan have incorporated the have incorporated the ability toability to surge 20%surge 20% above the average daily above the average daily census. census.

Even with these additional 7,000 beds Even with these additional 7,000 beds there there stillstill exists insufficient surge response exists insufficient surge response capabilitycapability to address the needs that a medium to address the needs that a medium level pandemic level pandemic

MEMSMEMS remains the primary method of remains the primary method of addressing addressing

Medical Surge Capacity and Capability (MSCC)Medical Surge Capacity and Capability (MSCC) Hurricane KatrinaHurricane Katrina demonstrated the utility of demonstrated the utility of

surge facilitiessurge facilities

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Project Background ~ FoundationProject Background ~ Foundation

Situation Situation Pandemic FluPandemic Flu

Outbreak of a moderately severe pandemic flu Outbreak of a moderately severe pandemic flu would exhaust surge capacity within the first two would exhaust surge capacity within the first two weeksweeks

Natural and Man-Made DisastersNatural and Man-Made Disasters Trauma victims immediately exhaust surge capacityTrauma victims immediately exhaust surge capacity Non-urgent health problems are exacerbated and Non-urgent health problems are exacerbated and

further increase healthcare demandsfurther increase healthcare demands Local Healthcare EmergenciesLocal Healthcare Emergencies

International air-traveler quarantine International air-traveler quarantine 2003 SARS: 3,017,496 international passengers thru DTW2003 SARS: 3,017,496 international passengers thru DTW

““All hazards” response capabilityAll hazards” response capability

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Project Background ~ FoundationProject Background ~ Foundation

SituationSituation In light of these factors a decision was In light of these factors a decision was

made to utilize HRSA/ASPR funding to made to utilize HRSA/ASPR funding to develop two self-contained all-weather develop two self-contained all-weather mobile field hospitals or “surge facilities”mobile field hospitals or “surge facilities” Initially Initially develop and equip a 100-bed unitdevelop and equip a 100-bed unit

Lay the groundworkLay the groundwork Based on available funding, develop a Based on available funding, develop a

50-bed unit50-bed unit Extension of 100-bed unitExtension of 100-bed unit Rapid acquisition; rely on established Rapid acquisition; rely on established

specificationsspecifications

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Project Background ~ Foundation Project Background ~ Foundation Patient and Staff Planning Patient and Staff Planning

AssumptionsAssumptions The Mobile Field Hospital would be The Mobile Field Hospital would be

designed…designed… For patients suffering from For patients suffering from COPD, asthma, congestive COPD, asthma, congestive

heart failure (no C-PAP or vent), chronic pain heart failure (no C-PAP or vent), chronic pain syndrome, and behavioral conditions, and needing syndrome, and behavioral conditions, and needing IV hydration and IV antibiotic therapy IV hydration and IV antibiotic therapy

With With a 4:1 ratio of adult to pediatric patientsa 4:1 ratio of adult to pediatric patients With With a planned admission/discharge rate of 23 a planned admission/discharge rate of 23

hourshours To be To be operated by a core team of medical operated by a core team of medical

professionalsprofessionals augmented by volunteers (Michigan augmented by volunteers (Michigan Volunteer Registry)Volunteer Registry)

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Project Background ~ FoundationProject Background ~ FoundationLessons LearnedLessons Learned

Don’t recreate the wheelDon’t recreate the wheel Patient profile from the Katrina Patient profile from the Katrina

disaster experiencedisaster experience Patient demographics from Patient demographics from

Michigan CensusMichigan Census Staff profile from existing Michigan Staff profile from existing Michigan

plans for Alternate Care plans for Alternate Care Facilities/MEMS ModelFacilities/MEMS Model

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Transportable Transportable Emergency Surge Emergency Surge

Assistance Medical Assistance Medical UnitUnit

( TESA)( TESA)

~ Facility Acquisition ~ Facility Acquisition Process ~Process ~

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TESA Project ~ Facility Acquisition ProcessTESA Project ~ Facility Acquisition ProcessGrant ApplicationGrant Application

Region 2 South was selected to develop the Region 2 South was selected to develop the 100-Bed TESA Unit100-Bed TESA Unit

The project was outlined in Region 2 South’s FY The project was outlined in Region 2 South’s FY 06-07 HRSA Grant Application06-07 HRSA Grant Application Statewide resourceStatewide resource; housed in S.E. Michigan ; housed in S.E. Michigan

and operated by “strike teams” from across the stateand operated by “strike teams” from across the state Complete project within the grant yearComplete project within the grant year Establish a Task Force to:Establish a Task Force to:

Research the different platforms Research the different platforms and associated and associated planning, operational, administrative and planning, operational, administrative and logistical considerationslogistical considerations

Recommend Recommend how to best configure and develop how to best configure and develop the facility within budgetary constraintsthe facility within budgetary constraints

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Project was approved; Project was approved; $1,000,000 budget$1,000,000 budget Task ForceTask Force formed in October 2006. formed in October 2006. Agencies represented:Agencies represented:

Region 2 South Medical Bio-Defense NetworkRegion 2 South Medical Bio-Defense Network Michigan Department of Community Health, Office Michigan Department of Community Health, Office

of Public Health Preparednessof Public Health Preparedness Michigan Department of State Police, Emergency Michigan Department of State Police, Emergency

Management/Homeland Security DivisionManagement/Homeland Security Division Michigan-1 Disaster Medical Assistance TeamMichigan-1 Disaster Medical Assistance Team

TESA Project ~ Facility Acquisition ProcessTESA Project ~ Facility Acquisition Process Grant Approval / Initial StepsGrant Approval / Initial Steps

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TESA Project - Facility Acquisition ProcessTESA Project - Facility Acquisition Process Task Force DeterminationsTask Force Determinations

The recommended The recommended basic platformbasic platform for the facility would be a for the facility would be a “soft-“soft-walled”walled” shelter structure. shelter structure.

To account for cost uncertainties, the To account for cost uncertainties, the platform (and invitation to submit platform (and invitation to submit proposals) would be designed around:proposals) would be designed around: A core 50-bed facility (to include A core 50-bed facility (to include

areas for triage, supply, admin, and areas for triage, supply, admin, and staff support)staff support)

25-bed add-on patient wards25-bed add-on patient wards..

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TESA Project - Facility Acquisition Process TESA Project - Facility Acquisition Process

Task Force RequirementsTask Force Requirements Basic Requirements for the 50-Bed CoreBasic Requirements for the 50-Bed Core

Separate staff and patient entrancesSeparate staff and patient entrances Separate areas for facility administration, Separate areas for facility administration,

facility supplies, staff lounge and staff hygiene, facility supplies, staff lounge and staff hygiene, and patient care wardsand patient care wardsa. Staff hygiene must have a changing area, sink, a. Staff hygiene must have a changing area, sink,

shower and toilet, cold and hot water, an on-board shower and toilet, cold and hot water, an on-board potable water supply with a water distribution potable water supply with a water distribution system and a gray water containment systemsystem and a gray water containment system

Each patient ward must be equipped with a Each patient ward must be equipped with a private field toiletprivate field toilet (the Brief Relief (the Brief ReliefTMTM system, or system, or equivalent)equivalent)

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TESA Project – Facility Acquisition ProcessTESA Project – Facility Acquisition Process

Task Force RequirementsTask Force Requirements Basic Requirements for the Entire Shelter Basic Requirements for the Entire Shelter

SystemSystem Completely self-containedCompletely self-contained Trailer-mounted generatorsTrailer-mounted generators Maximum component size (98”w, 50”d, 50”h)Maximum component size (98”w, 50”d, 50”h) Man-portableMan-portable components (maximum 75lb per components (maximum 75lb per

workerworker)) Rapidly erected without the use of tools or Rapidly erected without the use of tools or

equipmentequipment Must provide all-weather climate controlled Must provide all-weather climate controlled

environmentenvironment Materials must meet NFPA StandardsMaterials must meet NFPA Standards Must be interoperable with existing FEMA-Must be interoperable with existing FEMA-

NDMS assetsNDMS assets

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TESA Project - Facility Acquisition ProcessTESA Project - Facility Acquisition Process Task ForceTask Force DeterminationsDeterminations

Proposal/Bid Quotation RequirementsProposal/Bid Quotation Requirements Must provide a comprehensive description of:Must provide a comprehensive description of:

Proposed system componentsProposed system components Warranties, manuals, parts availability guaranteesWarranties, manuals, parts availability guarantees Where requirements are met or exceededWhere requirements are met or exceeded Where requirements are not met and why a variance Where requirements are not met and why a variance

should be consideredshould be considered How it will be packaged w/container dimensionsHow it will be packaged w/container dimensions

Must include diagrams (50-bed core, 75-bed Must include diagrams (50-bed core, 75-bed and 100-bed configurations)and 100-bed configurations)

Must identify single POC for notices and Must identify single POC for notices and inquiresinquires

Must be submitted by e-mail (formatted in MS Must be submitted by e-mail (formatted in MS Word and Adobe PDF.Word and Adobe PDF.

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TESA Project - Facility Acquisition Process TESA Project - Facility Acquisition Process Task ForceTask Force DeterminationsDeterminations

Parameters establishedParameters established to select potential to select potential shelter sources:shelter sources: Identify potential sources known by the Task Identify potential sources known by the Task

Force to manufacture shelters thatForce to manufacture shelters that Generally met platform requirementsGenerally met platform requirements Were in common use as mobile medical facilitiesWere in common use as mobile medical facilities

To maximize practical competition, limit the To maximize practical competition, limit the minimum number of potential sources to minimum number of potential sources to 33

To minimize the procurement process, limit To minimize the procurement process, limit the the maximum number of potential maximum number of potential sources to 6sources to 6

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TESA Project - Facility Acquisition ProcessTESA Project - Facility Acquisition Process Task Force DeterminationsTask Force Determinations

Six potential platform sourcesSix potential platform sources were were identifiedidentified 4 4 that generally met shelter requirements and that generally met shelter requirements and

had been used by members of the Task Forcehad been used by members of the Task Force 1 1 that generally met shelter requirements but that generally met shelter requirements but

was unknown to members of the Task Forcewas unknown to members of the Task Force 11 that manufactured “hard-walled” shelters, that manufactured “hard-walled” shelters,

was unknown to members of the Task Force but was unknown to members of the Task Force but was a Michigan-based companywas a Michigan-based company

These These 6 potential vendors6 potential vendors were e-mailed were e-mailed the Invitation to Submit a Combined the Invitation to Submit a Combined Proposal/Bid Quotation Proposal/Bid Quotation

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……that would be that would be e-mailed to e-mailed to pre-selected pre-selected vendors.vendors.

Task Force Task Force determinations determinations were reduced were reduced to a 3-page to a 3-page invitation to invitation to submit a submit a combined combined Proposal/Bid Proposal/Bid Quotation…Quotation…

TESA Project - Facility Acquisition ProcessTESA Project - Facility Acquisition Process The RFP/RFQ PackageThe RFP/RFQ Package

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……that would be that would be e-mailed to e-mailed to pre-selected pre-selected vendors.vendors.

Task Force Task Force determinations determinations were reduced were reduced to a 3-page to a 3-page invitation to invitation to submit a submit a combined combined Proposal/Bid Proposal/Bid Quotation…Quotation…

TESA Project - Facility Acquisition ProcessTESA Project - Facility Acquisition Process The RFP/RFQ PackageThe RFP/RFQ Package

27Vendor 6

Vendor 5

Vendor 4

Vendor 3

Vendor 2

Vendor 1

TESA Project - Facility Acquisition ProcessTESA Project - Facility Acquisition Process Evaluating Proposals/QuotesEvaluating Proposals/Quotes

All invitees respondedAll invitees responded Hundreds of pagesHundreds of pages

Each with unique formatEach with unique format Some highly detailed and Some highly detailed and

well organizedwell organized Some lacked detail and Some lacked detail and

organizationorganization All were printed, All were printed,

bound and distributed bound and distributed to each member of to each member of the Task Forcethe Task Force

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COMPARABLESCOMPARABLES Quote DurationQuote Duration CostCost Max Size ContainerMax Size Container AssemblyAssembly # Basic Units# Basic Units Access DoorsAccess Doors Area (sq. ft.)Area (sq. ft.) FurnitureFurniture PowerPower LightingLighting OutletsOutlets HVACHVAC NDMS Interop?NDMS Interop? Trailer BootTrailer Boot WarrantyWarranty FramingFraming FabricFabric InsulationInsulation Hygiene CenterHygiene Center FlooringFlooring TrainingTraining

Vendor 1

Vendor 2

Vendor 3

Vendor 4

Vendor 5

Vendor 6

TESA Project - Facility Acquisition ProcessTESA Project - Facility Acquisition Process Evaluating Proposals/QuotesEvaluating Proposals/Quotes

THE EVALUATION MATRIXTHE EVALUATION MATRIX

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TESA Project - Facility Acquisition ProcessTESA Project - Facility Acquisition Process Awarding the ContractAwarding the Contract

2 vendor’s RFP/RFQ met specs, the other 4 2 vendor’s RFP/RFQ met specs, the other 4 were eliminated from competition were eliminated from competition

Task Force members to NDMS conference to Task Force members to NDMS conference to inspect both shelter systemsinspect both shelter systems Gained experience - revised specificationsGained experience - revised specifications Requested final quote on revised specificationsRequested final quote on revised specifications

Reviewed final quotesReviewed final quotes Unanimous agreement to award contractUnanimous agreement to award contract

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TESA Project - Facility Acquisition ProcessTESA Project - Facility Acquisition Process Lessons LearnedLessons Learned

Need Need experienced and knowledgeable experienced and knowledgeable teamteam to avoid pitfalls when expediting a to avoid pitfalls when expediting a complex projectcomplex project

Need Need comparison matrixcomparison matrix to efficiently to efficiently deal with variable specificationsdeal with variable specifications

No substitute for getting your hands No substitute for getting your hands dirtydirty (in-person inspection and assembly) (in-person inspection and assembly)

No substitute for face-to-face No substitute for face-to-face discussiondiscussion with vendor representatives with vendor representatives

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TESATESAPROJECTPROJECT

~ ~ Facility Specifications ~Facility Specifications ~

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10,000 Sq. Ft. 10,000 Sq. Ft. Enclosed AreaEnclosed Area

20,000 Sq. Ft. 20,000 Sq. Ft. Footprint Footprint (125’ x 158’)(125’ x 158’)

5 Generators 5 Generators (4 @ (4 @ 36kW and 1 @ 56 kW)36kW and 1 @ 56 kW)

16 HVAC16 HVAC 15 @ 42K BTU heat/3.5 15 @ 42K BTU heat/3.5

ton cool/29K heat stripton cool/29K heat strip 1 @ 60K BTU 1 @ 60K BTU

heat/cool/HEPA positive heat/cool/HEPA positive or negative pressure)or negative pressure)

4 Hygiene Centers4 Hygiene Centers Each with sink, shower, Each with sink, shower,

toilet, hot Htoilet, hot H22O, 500-O, 500-gallon fresh and gray gallon fresh and gray water holding tankswater holding tanks

16 Interconnected 16 Interconnected SheltersShelters 1 each for 1 each for

Administration, Staff, Administration, Staff, Supply (w/boot) and Supply (w/boot) and Intake/Triage/TreatIntake/Triage/Treat

1 ten-bed Patient Ward 1 ten-bed Patient Ward (isolation)(isolation)

7 ten-bed Patient Wards7 ten-bed Patient Wards 4 five-bed Patient Wards4 five-bed Patient Wards

DesignDesign 4:1 ratio of adult to 4:1 ratio of adult to

pediatric patientspediatric patients Admit/Discharge Rate: Admit/Discharge Rate:

23 hours (= 100 patients 23 hours (= 100 patients per day)per day)

Over Over 1,0001,000 Separate PiecesSeparate Pieces

TESA Project – Facility SpecificationsTESA Project – Facility SpecificationsQuick SpecsQuick Specs

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TESA Project – Facility SpecificationsTESA Project – Facility SpecificationsThe DesignThe Design

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TESA Project – Facility SpecificationsTESA Project – Facility SpecificationsTactical LabelingTactical Labeling

The components of The components of each individual shelter each individual shelter are:are: Color-coded & Color-coded &

labeledlabeled Packaged togetherPackaged together

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TESA Project - Facility SpecificationsTESA Project - Facility SpecificationsTactical StorageTactical Storage

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TESA Project – Facility SpecificationsTESA Project – Facility SpecificationsAs Built (40-Bed Unit)As Built (40-Bed Unit)

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TESA Project – Facility SpecificationsTESA Project – Facility Specifications Lessons LearnedLessons Learned

Color-code and label individualColor-code and label individual shelter shelter componentscomponents Facilitates handlingFacilitates handling Has limitationsHas limitations

Only so many distinct colorsOnly so many distinct colors Correlates only to complete 100-bed layoutCorrelates only to complete 100-bed layout

Because it is a Because it is a white vinyl tent labor white vinyl tent labor intensiveintensive for cleaning before repackaging for cleaning before repackaging

Setup and tear down takes expertiseSetup and tear down takes expertise Requires the development of specialized teamsRequires the development of specialized teams

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~ ~ Equipment & Supply Equipment & Supply Acquisition~Acquisition~

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TESA Project ~ Equipment/Supply Acquisition TESA Project ~ Equipment/Supply Acquisition ProcessProcess

Patient & Staff ProfilePatient & Staff Profile The Mobile Field Hospital would be designed…The Mobile Field Hospital would be designed…

ForFor patients suffering from COPD, asthma, patients suffering from COPD, asthma, congestive heart failure (no C-PAP or vent), congestive heart failure (no C-PAP or vent), chronic pain syndrome, and behavioral chronic pain syndrome, and behavioral conditions, and needing IV hydration and IV conditions, and needing IV hydration and IV antibiotic therapy antibiotic therapy

With aWith a 4:1 ratio of adult to pediatric patients4:1 ratio of adult to pediatric patients With aWith a planned admission/discharge rate of 23 planned admission/discharge rate of 23

hourshours To be operated by a core team of medical To be operated by a core team of medical

professionalsprofessionals augmented by volunteers (Michigan augmented by volunteers (Michigan Volunteer Registry)Volunteer Registry)

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Task Force DeterminationsTask Force Determinations The stakeholder Task Force determined to The stakeholder Task Force determined to

utilize sole-source provider of medical utilize sole-source provider of medical supplies and equipment to outfit the supplies and equipment to outfit the facilityfacility Previously qualified sourcePreviously qualified source Current source of ACC and NEHC facilities for Current source of ACC and NEHC facilities for

MEMS components. MEMS components. Demonstrated abilityDemonstrated ability

Medical expertise to identify and meet needs (based on Medical expertise to identify and meet needs (based on expected patients and healthcare staff)expected patients and healthcare staff)

Professional packagingProfessional packaging Competitive pricingCompetitive pricing

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Comprehensive Comprehensive questionnaire was questionnaire was used to refine the used to refine the patient profile and patient profile and then determine then determine whatwhat level of level of service would be service would be provided over a provided over a given period of given period of time time

TESA TESA Project ~ Project ~ Equipment/SupplyEquipment/Supply Acquisition Acquisition ProcessProcess

Patient Profile QuestionnairePatient Profile Questionnaire

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Capability WorksheetCapability WorksheetFunction Function (sample)(sample)

Adult Adult PEDSPEDS InfantInfant

AirwayAirway XX XX XXWound Wound TreatmentTreatment

XX XX XX

IV TherapyIV Therapy XX XX XXOrtho CareOrtho Care XX XX XXEENTEENT XX XX XXGenitourinaryGenitourinary XX XX XXGastrointestinalGastrointestinal XX XX XXMedication Medication AdminAdmin

XX XX XX

Emergency CareEmergency Care XX XX XX

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TESA Project ~ Equipment/Supply Acquisition TESA Project ~ Equipment/Supply Acquisition Process Process

Master TemplateMaster Template Master Template Master Template

was used to was used to generate the type generate the type of treatment of treatment which could be which could be offered and the offered and the type and quantity type and quantity of equipment and of equipment and supplies needed. supplies needed.

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TESA Project – Equipment/Supply Acquisition TESA Project – Equipment/Supply Acquisition Process Process

The DesignThe Design

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50



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TESA Project ~ Equipment/Supply Acquisition TESA Project ~ Equipment/Supply Acquisition Process Process

Lessons LearnedLessons Learned Patient ProfilesPatient Profiles will define the treatment will define the treatment

modalities necessarymodalities necessary Establish a cacheEstablish a cache which is broadly used so that which is broadly used so that

replenishment is easier and can be integrated replenishment is easier and can be integrated into a local healthcare system into a local healthcare system

Establish Establish Augmentation SetsAugmentation Sets to supplement to supplement specialty areasspecialty areas

OB-GYNOB-GYN PEDSPEDS IsolationIsolation O2 TherapyO2 Therapy NurseryNursery

Establish and procure Establish and procure basic equipment listsbasic equipment lists which do not require long training sessionswhich do not require long training sessions

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~ ~ Storage & Deployment Storage & Deployment Considerations ~Considerations ~

MAXIMIZEMAXIMIZEDEPLOYMENT AND RECOVERY DEPLOYMENT AND RECOVERY

SPEEDSPEED

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TESA Project ~ Storage/Deployment TESA Project ~ Storage/Deployment Considerations Considerations

Tactical Containerization & Tactical Containerization & LabelingLabeling

Color-coded labelsColor-coded labels Color-coded Color-coded

packagespackages Color-coded Color-coded

containers and containers and augmentation setsaugmentation sets

Modules which are Modules which are color-coded and color-coded and containerizedcontainerized

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TESA Project ~ Storage/Deployment TESA Project ~ Storage/Deployment Considerations Considerations ContainersContainers

StorageStorage Pallet sizePallet size WeightWeight

DeploymentDeployment On or off pallets?On or off pallets? Storage of Storage of

shipping materialsshipping materials Re-packingRe-packing SustainmentSustainment

HVAC UNITHVAC UNIT

COT RACKSCOT RACKS

HEPA HVACHEPA HVAC

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Transporting & HandlingTransporting & Handling Transport VehicleTransport Vehicle

Semi-trailersSemi-trailers Flat bedFlat bed Dry boxDry box

Box truckBox truck Material Material

HandlingHandling EquipmentEquipment Fork LiftsFork Lifts Pallet JacksPallet Jacks

FLAT BED SEMI-TRAILERFLAT BED SEMI-TRAILER

BOX TRUCKBOX TRUCK

CONSTRUCTIOCONSTRUCTIONN

HI-LOHI-LO

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Trailer-Mounted GeneratorsTrailer-Mounted Generators ShippingShipping

Flat BedFlat Bed - loading - loading & unloading& unloading Need loading dockNeed loading dock Need material Need material

handling equipmenthandling equipment IndividualIndividual

Multi tow-vehicles Multi tow-vehicles and drivers and drivers

GEN-SETS IN STORAGEGEN-SETS IN STORAGE

SHIPPING GEN-SETSSHIPPING GEN-SETS

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Storage SpaceStorage Space

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Storage SchemeStorage Scheme

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Lessons LearnedLessons Learned Color-coding Color-coding simplifies storage, simplifies storage,

“picking”, shipping and sustainment “picking”, shipping and sustainment planning and executionplanning and execution

Consider the storageConsider the storage of shipping of shipping materials (pallets, containers, etc.) in materials (pallets, containers, etc.) in deployment plansdeployment plans

Know your material handling Know your material handling equipment needsequipment needs Field (e.g. parking lot) vs. fixed facility Field (e.g. parking lot) vs. fixed facility

(e.g. conference/exhibition center) (e.g. conference/exhibition center)

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Emergency Management Strategies: Emergency Management Strategies: Lessons Learned in Developing Specifications, Lessons Learned in Developing Specifications,

Procuring, Housing and Maintaining a 100-Bed Procuring, Housing and Maintaining a 100-Bed Mobile HospitalMobile Hospital

Jenny Atas MDJenny Atas MDR2S Medical DirectorR2S Medical Directore-mail: e-mail: [email protected]@2south.org

Mark SparksMark SparksR2S Planning & Logistics R2S Planning & Logistics OfficerOfficere-mail: e-mail: [email protected]@2south.org

Documents

Jenny Atas MD Associate Professor Wayne State University Medical Director Region 2 South Medical