The document proposes a demonstration project called ASCEND that would accelerate scalable community emergency networks. It would link regional healthcare facilities, private and public assets under a unified vision to create an integrated medical evacuation solution for regional emergencies. The project would implement software and operations to coordinate facilities, ambulances, hospitals and other resources across multiple jurisdictions to improve emergency response capabilities and allow the region to access additional national assistance if needed to handle large-scale incidents.
The Blessings and Curses of Offering a Free Public APIEric Caron
This deck was presented on Wednesday, September 14th 2016, to API World (https://apiworld2016.sched.org/). It was presented by Eric Caron, of Best Buy, and dives into some common lessons about offering a public API and describes easy solutions to better serve the business & community.
Renew OnDemand™ is the industry's only cloud application built specifically to maximize recurring revenue. This application arms sales teams, executives, and channel partners with a complete system to renew customer contracts and subscriptions. Learn how Renew OnDemand can help you retain more customers and increase your recurring revenue by
-- turning disparate data into renewal-ready opportunity
-- making your sales teams more effective
-- gaining deeper business insights through dashboards and analytics
Renew OnDemand™ is the industry's only cloud application built specifically to maximize recurring revenue. This application arms sales teams, executives, and channel partners with a complete system to renew customer contracts and subscriptions. Watch the demo to learn how Renew OnDemand can help you retain more customers and increase your recurring revenue.
Companies are leaving money on the table. There is huge opportunity to increase renewal rates and capture more recurring revenue. Learn best practices to improve your renewals program.
This document is a profile for Gerrit Otten who works as a system and network administrator with experience in new media. He offers services such as designing, building, and managing virtual, Windows, and Linux environments. He also develops web applications and integrates social networks with business applications. His contact information is provided.
Webinar: 5 steps to maximize recurring revenue ServiceSource
Are you maximizing your recurring revenue performance?
Did you know $30 billion in recurring revenue goes unrenewed each year?
ServiceSource & Rockwell Automation share 5 proven best practices to help industrial system companies boost and retain more revenue.
The Blessings and Curses of Offering a Free Public APIEric Caron
This deck was presented on Wednesday, September 14th 2016, to API World (https://apiworld2016.sched.org/). It was presented by Eric Caron, of Best Buy, and dives into some common lessons about offering a public API and describes easy solutions to better serve the business & community.
Renew OnDemand™ is the industry's only cloud application built specifically to maximize recurring revenue. This application arms sales teams, executives, and channel partners with a complete system to renew customer contracts and subscriptions. Learn how Renew OnDemand can help you retain more customers and increase your recurring revenue by
-- turning disparate data into renewal-ready opportunity
-- making your sales teams more effective
-- gaining deeper business insights through dashboards and analytics
Renew OnDemand™ is the industry's only cloud application built specifically to maximize recurring revenue. This application arms sales teams, executives, and channel partners with a complete system to renew customer contracts and subscriptions. Watch the demo to learn how Renew OnDemand can help you retain more customers and increase your recurring revenue.
Companies are leaving money on the table. There is huge opportunity to increase renewal rates and capture more recurring revenue. Learn best practices to improve your renewals program.
This document is a profile for Gerrit Otten who works as a system and network administrator with experience in new media. He offers services such as designing, building, and managing virtual, Windows, and Linux environments. He also develops web applications and integrates social networks with business applications. His contact information is provided.
Webinar: 5 steps to maximize recurring revenue ServiceSource
Are you maximizing your recurring revenue performance?
Did you know $30 billion in recurring revenue goes unrenewed each year?
ServiceSource & Rockwell Automation share 5 proven best practices to help industrial system companies boost and retain more revenue.
The document discusses a proposed regional approach called ASCEND that would link healthcare facilities and emergency assets into an integrated medical evacuation system. It outlines the need for such a system given increasing risks from natural disasters, terrorism, and public health crises. The proposal describes how ASCEND would coordinate six functions - emergency management, EMS, healthcare facilities, transport, special needs transport, and support - to accelerate emergency response across larger geographic areas and patient volumes.
Eric Caron presenting at Ignite Minneapolis #2 at Bedlam Theatre in Minneapolis, Minnesota. March 4, 2010 as part of Global Ignite Week. Video of the presentation accompanying these slides can be seen at: http://www.youtube.com/watch?v=InDkmFN3ov8
The document discusses the seven wonders of the ancient world as identified by Antipater of Sidon around the 2nd century BC. These wonders were the Pyramids and Sphinx of Giza in Egypt, the Temple of Artemis (Diana) in Ephesus, the Hanging Gardens of Babylon in Iraq, the Mausoleum at Halicarnassus in Turkey, the Statue of Zeus at Olympia in Greece, the Lighthouse of Alexandria in Egypt, and the Colossus of Rhodes on the Greek island of Rhodes. Today, only the Pyramids of Giza remain standing as one of the original seven wonders.
Artroplastia Total do Joelho - Dr. Cláudio Gholmia.Ricardo Montija
Nessa aula, o dr. Claudio Ghomia da Clínica Uniort faz o estudo de caso de dois pacientes que se submeteram ao procedimento de Artroplastia Total do Joelho (ATJ).
The document describes how to create a customer journey map in 6 steps:
1. Define objectives and prioritize customer journeys to map.
2. Create a draft journey map showing customer actions, touchpoints, and milestones.
3. Host workshops with internal and external stakeholders to review the map and identify gaps.
4. Validate the map using customer data and feedback.
5. Design a new customer experience to address gaps.
6. Create delivery maps showing how teams and processes support the customer journey.
This document is an interactive presentation about classifying animals into vertebrates and invertebrates. It begins with an introduction and objectives. It then discusses vertebrates, defining them as animals with backbones, and categorizing them into classes such as fish, amphibians, reptiles, birds, and mammals. Each class is then further described. The document also covers invertebrates, which do not have backbones, categorizing them into phyla such as sponges, worms, arthropods, mollusks, and echinoderms. Specific examples are provided for each category along with distinguishing features.
Ellen Burstyn: From Detroit Dreamer to Hollywood Legend | CIO Women MagazineCIOWomenMagazine
In this article, we will dive into the extraordinary life of Ellen Burstyn, where the curtains rise on a story that's far more attractive than any script.
How are Lilac French Bulldogs Beauty Charming the World and Capturing Hearts....Lacey Max
“After being the most listed dog breed in the United States for 31
years in a row, the Labrador Retriever has dropped to second place
in the American Kennel Club's annual survey of the country's most
popular canines. The French Bulldog is the new top dog in the
United States as of 2022. The stylish puppy has ascended the
rankings in rapid time despite having health concerns and limited
color choices.”
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Discover the Beauty and Functionality of The Expert Remodeling Serviceobriengroupinc04
Unlock your kitchen's true potential with expert remodeling services from O'Brien Group Inc. Transform your space into a functional, modern, and luxurious haven with their experienced professionals. From layout reconfiguration to high-end upgrades, they deliver stunning results tailored to your style and needs. Visit obriengroupinc.com to elevate your kitchen's beauty and functionality today.
Best Competitive Marble Pricing in Dubai - ☎ 9928909666Stone Art Hub
Stone Art Hub offers the best competitive Marble Pricing in Dubai, ensuring affordability without compromising quality. With a wide range of exquisite marble options to choose from, you can enhance your spaces with elegance and sophistication. For inquiries or orders, contact us at ☎ 9928909666. Experience luxury at unbeatable prices.
[To download this presentation, visit:
https://www.oeconsulting.com.sg/training-presentations]
This presentation is a curated compilation of PowerPoint diagrams and templates designed to illustrate 20 different digital transformation frameworks and models. These frameworks are based on recent industry trends and best practices, ensuring that the content remains relevant and up-to-date.
Key highlights include Microsoft's Digital Transformation Framework, which focuses on driving innovation and efficiency, and McKinsey's Ten Guiding Principles, which provide strategic insights for successful digital transformation. Additionally, Forrester's framework emphasizes enhancing customer experiences and modernizing IT infrastructure, while IDC's MaturityScape helps assess and develop organizational digital maturity. MIT's framework explores cutting-edge strategies for achieving digital success.
These materials are perfect for enhancing your business or classroom presentations, offering visual aids to supplement your insights. Please note that while comprehensive, these slides are intended as supplementary resources and may not be complete for standalone instructional purposes.
Frameworks/Models included:
Microsoft’s Digital Transformation Framework
McKinsey’s Ten Guiding Principles of Digital Transformation
Forrester’s Digital Transformation Framework
IDC’s Digital Transformation MaturityScape
MIT’s Digital Transformation Framework
Gartner’s Digital Transformation Framework
Accenture’s Digital Strategy & Enterprise Frameworks
Deloitte’s Digital Industrial Transformation Framework
Capgemini’s Digital Transformation Framework
PwC’s Digital Transformation Framework
Cisco’s Digital Transformation Framework
Cognizant’s Digital Transformation Framework
DXC Technology’s Digital Transformation Framework
The BCG Strategy Palette
McKinsey’s Digital Transformation Framework
Digital Transformation Compass
Four Levels of Digital Maturity
Design Thinking Framework
Business Model Canvas
Customer Journey Map
Part 2 Deep Dive: Navigating the 2024 Slowdownjeffkluth1
Introduction
The global retail industry has weathered numerous storms, with the financial crisis of 2008 serving as a poignant reminder of the sector's resilience and adaptability. However, as we navigate the complex landscape of 2024, retailers face a unique set of challenges that demand innovative strategies and a fundamental shift in mindset. This white paper contrasts the impact of the 2008 recession on the retail sector with the current headwinds retailers are grappling with, while offering a comprehensive roadmap for success in this new paradigm.
The Most Inspiring Entrepreneurs to Follow in 2024.pdfthesiliconleaders
In a world where the potential of youth innovation remains vastly untouched, there emerges a guiding light in the form of Norm Goldstein, the Founder and CEO of EduNetwork Partners. His dedication to this cause has earned him recognition as a Congressional Leadership Award recipient.
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Zodiac Signs and Food Preferences_ What Your Sign Says About Your Tastemy Pandit
Know what your zodiac sign says about your taste in food! Explore how the 12 zodiac signs influence your culinary preferences with insights from MyPandit. Dive into astrology and flavors!
The Genesis of BriansClub.cm Famous Dark WEb PlatformSabaaSudozai
BriansClub.cm, a famous platform on the dark web, has become one of the most infamous carding marketplaces, specializing in the sale of stolen credit card data.
The document discusses a proposed regional approach called ASCEND that would link healthcare facilities and emergency assets into an integrated medical evacuation system. It outlines the need for such a system given increasing risks from natural disasters, terrorism, and public health crises. The proposal describes how ASCEND would coordinate six functions - emergency management, EMS, healthcare facilities, transport, special needs transport, and support - to accelerate emergency response across larger geographic areas and patient volumes.
Eric Caron presenting at Ignite Minneapolis #2 at Bedlam Theatre in Minneapolis, Minnesota. March 4, 2010 as part of Global Ignite Week. Video of the presentation accompanying these slides can be seen at: http://www.youtube.com/watch?v=InDkmFN3ov8
The document discusses the seven wonders of the ancient world as identified by Antipater of Sidon around the 2nd century BC. These wonders were the Pyramids and Sphinx of Giza in Egypt, the Temple of Artemis (Diana) in Ephesus, the Hanging Gardens of Babylon in Iraq, the Mausoleum at Halicarnassus in Turkey, the Statue of Zeus at Olympia in Greece, the Lighthouse of Alexandria in Egypt, and the Colossus of Rhodes on the Greek island of Rhodes. Today, only the Pyramids of Giza remain standing as one of the original seven wonders.
Artroplastia Total do Joelho - Dr. Cláudio Gholmia.Ricardo Montija
Nessa aula, o dr. Claudio Ghomia da Clínica Uniort faz o estudo de caso de dois pacientes que se submeteram ao procedimento de Artroplastia Total do Joelho (ATJ).
The document describes how to create a customer journey map in 6 steps:
1. Define objectives and prioritize customer journeys to map.
2. Create a draft journey map showing customer actions, touchpoints, and milestones.
3. Host workshops with internal and external stakeholders to review the map and identify gaps.
4. Validate the map using customer data and feedback.
5. Design a new customer experience to address gaps.
6. Create delivery maps showing how teams and processes support the customer journey.
This document is an interactive presentation about classifying animals into vertebrates and invertebrates. It begins with an introduction and objectives. It then discusses vertebrates, defining them as animals with backbones, and categorizing them into classes such as fish, amphibians, reptiles, birds, and mammals. Each class is then further described. The document also covers invertebrates, which do not have backbones, categorizing them into phyla such as sponges, worms, arthropods, mollusks, and echinoderms. Specific examples are provided for each category along with distinguishing features.
Ellen Burstyn: From Detroit Dreamer to Hollywood Legend | CIO Women MagazineCIOWomenMagazine
In this article, we will dive into the extraordinary life of Ellen Burstyn, where the curtains rise on a story that's far more attractive than any script.
How are Lilac French Bulldogs Beauty Charming the World and Capturing Hearts....Lacey Max
“After being the most listed dog breed in the United States for 31
years in a row, the Labrador Retriever has dropped to second place
in the American Kennel Club's annual survey of the country's most
popular canines. The French Bulldog is the new top dog in the
United States as of 2022. The stylish puppy has ascended the
rankings in rapid time despite having health concerns and limited
color choices.”
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Discover the Beauty and Functionality of The Expert Remodeling Serviceobriengroupinc04
Unlock your kitchen's true potential with expert remodeling services from O'Brien Group Inc. Transform your space into a functional, modern, and luxurious haven with their experienced professionals. From layout reconfiguration to high-end upgrades, they deliver stunning results tailored to your style and needs. Visit obriengroupinc.com to elevate your kitchen's beauty and functionality today.
Best Competitive Marble Pricing in Dubai - ☎ 9928909666Stone Art Hub
Stone Art Hub offers the best competitive Marble Pricing in Dubai, ensuring affordability without compromising quality. With a wide range of exquisite marble options to choose from, you can enhance your spaces with elegance and sophistication. For inquiries or orders, contact us at ☎ 9928909666. Experience luxury at unbeatable prices.
[To download this presentation, visit:
https://www.oeconsulting.com.sg/training-presentations]
This presentation is a curated compilation of PowerPoint diagrams and templates designed to illustrate 20 different digital transformation frameworks and models. These frameworks are based on recent industry trends and best practices, ensuring that the content remains relevant and up-to-date.
Key highlights include Microsoft's Digital Transformation Framework, which focuses on driving innovation and efficiency, and McKinsey's Ten Guiding Principles, which provide strategic insights for successful digital transformation. Additionally, Forrester's framework emphasizes enhancing customer experiences and modernizing IT infrastructure, while IDC's MaturityScape helps assess and develop organizational digital maturity. MIT's framework explores cutting-edge strategies for achieving digital success.
These materials are perfect for enhancing your business or classroom presentations, offering visual aids to supplement your insights. Please note that while comprehensive, these slides are intended as supplementary resources and may not be complete for standalone instructional purposes.
Frameworks/Models included:
Microsoft’s Digital Transformation Framework
McKinsey’s Ten Guiding Principles of Digital Transformation
Forrester’s Digital Transformation Framework
IDC’s Digital Transformation MaturityScape
MIT’s Digital Transformation Framework
Gartner’s Digital Transformation Framework
Accenture’s Digital Strategy & Enterprise Frameworks
Deloitte’s Digital Industrial Transformation Framework
Capgemini’s Digital Transformation Framework
PwC’s Digital Transformation Framework
Cisco’s Digital Transformation Framework
Cognizant’s Digital Transformation Framework
DXC Technology’s Digital Transformation Framework
The BCG Strategy Palette
McKinsey’s Digital Transformation Framework
Digital Transformation Compass
Four Levels of Digital Maturity
Design Thinking Framework
Business Model Canvas
Customer Journey Map
Part 2 Deep Dive: Navigating the 2024 Slowdownjeffkluth1
Introduction
The global retail industry has weathered numerous storms, with the financial crisis of 2008 serving as a poignant reminder of the sector's resilience and adaptability. However, as we navigate the complex landscape of 2024, retailers face a unique set of challenges that demand innovative strategies and a fundamental shift in mindset. This white paper contrasts the impact of the 2008 recession on the retail sector with the current headwinds retailers are grappling with, while offering a comprehensive roadmap for success in this new paradigm.
The Most Inspiring Entrepreneurs to Follow in 2024.pdfthesiliconleaders
In a world where the potential of youth innovation remains vastly untouched, there emerges a guiding light in the form of Norm Goldstein, the Founder and CEO of EduNetwork Partners. His dedication to this cause has earned him recognition as a Congressional Leadership Award recipient.
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Zodiac Signs and Food Preferences_ What Your Sign Says About Your Tastemy Pandit
Know what your zodiac sign says about your taste in food! Explore how the 12 zodiac signs influence your culinary preferences with insights from MyPandit. Dive into astrology and flavors!
The Genesis of BriansClub.cm Famous Dark WEb PlatformSabaaSudozai
BriansClub.cm, a famous platform on the dark web, has become one of the most infamous carding marketplaces, specializing in the sale of stolen credit card data.
NIMA2024 | De toegevoegde waarde van DEI en ESG in campagnes | Nathalie Lam |...BBPMedia1
Nathalie zal delen hoe DEI en ESG een fundamentele rol kunnen spelen in je merkstrategie en je de juiste aansluiting kan creëren met je doelgroep. Door middel van voorbeelden en simpele handvatten toont ze hoe dit in jouw organisatie toegepast kan worden.
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1. Accelerating Scalable Community Emergency Network Demonstration
Ascend links regional healthcare facilities with
private and public assets under a unified vision
that results in an integrated, scalable medical
evacuation solution during a regional emergency.
2. Agenda
Introduce U.S. Air Ambulance
Provide historical context for discussion
Discuss our concept for a regional approach to emergency management
Outline steps we will take to implement ASCEND for Indiana
3. U.S. Air Ambulance Corporate Overview
Headquartered in Sarasota, FL
23 years experience
Licensed ground and air ambulance provider
180 employees
97,000 patients, 100% safety record
4. Relevant Corporate Experience
Preferred provider for U.S. Department of State
Contractor EMS program for Iraq, DoD
Consultant to cruise line industry
Last five years for DHS – evacuations of foreign
nationals
Hurricane Katrina – FEMA
Hurricane Wilma – U.S. Marshals Service
Hurricanes Gustav and Ike – four private hospital
evacuations
Proprietary software development
Developer of unique service HELP
5. External Emergencies Have an Epicenter
Epicenter
Epicenter – The area of an emergency
which is unsafe or uninhabitable
6. Measures of Emergencies - Scale
Epicenter
EMAC Federal
Local Regional Statewide Border States Interstate
State Interstate
Scale
7. Measures of Emergencies – Scope
General
Population
Transportation
Disadvantaged
Population
Nonmedical
Assisted
Living
Long Term
Care
Scope Epicenter
Medical Long
Term Care
Medical
General
Medical
Medical
ALS / ICU
Medical Special
Needs
EMAC Federal
Local Regional Statewide Border States Interstate
State Interstate
Scale
8. Our Products - HELP
General
Population
Transportation
Disadvantaged
Population
Nonmedical
Assisted
Living
Long Term
Care
Scope
Medical Long
Term Care
Medical
General
Medical
Medical
HELP
ALS / ICU
Medical Special
Needs
EMAC Federal
Local Regional Statewide Border States Interstate
State Interstate
Scale
9. HELP Provides Additional Resources for Large Scale Disaster
HELP provides access to transportation assets and receiving
hospitals outside the Region
Second Tier Providers Hospital Network Outside
Mobilized for Hospital of Emergency Zone
10. Our Products - SPEAR
Special Patients Emergency Ambulance Response
General
Population
Transportation
Disadvantaged
Population
Nonmedical
Assisted
Living
Long Term
Care
Scope
Medical Long
Term Care
Medical
General
HELP
Medical
Medical
ALS / ICU
Medical Special
Needs SPEAR
EMAC Federal
Local Regional Statewide Border States Interstate
State Interstate
Scale
11. SPEAR Program
Special Patient Emergency Ambulance Response Program
Patients Dispersed From a Major
Burn Incident to Verified Burn Centers
Many special needs patients cases
cannot be transferred at the regional
level. For instance, a large burn
incident may require coordinating
the transfer of multiple patients
throughout the United States to
verified burn centers.
Verified Burn Center
12. Our Products - ASCEND
Accelerating Scalable Community Emergency Network Demonstration
General
Population
Transportation
Disadvantaged
Population
Nonmedical
Assisted
Living
Long Term
Care
Scope
Medical Long
Term Care
Medical
General
ASCEND HELP
Medical
Medical
ALS / ICU
Medical Special
Needs SPEAR
EMAC Federal
Local Regional Statewide Border States Interstate
State Interstate
Scale
13. Are Local Communities Ready For Accelerating Emergency?
January 6, 2005 2:40 AM
• Two trains collided in Graniteville, South Carolina,
- Small population 7,000
• 1 train carried 92 tanks of chlorine gas,1 tank ruptured
– Upgraded tank
• 90 tons of chlorine gas forms a deadly cloud that
flowed toward a sleeping public
- Low wind speed 2 mph
• 3:00 AM - Sheriff notified
• 3:45 AM - State Emergency Management Notified
• 5:09 AM - Local emergency system notified residents to
evacuate
• 9:00 AM - Local EOC set up and available to assist
• 5,400 people evacuated
• 330 people self presented to the hospital ER for treatment
- ER was unable to identify the chemical for several hours
• 525 people were treated in ER, 300 in first three hours
• 71 hospitalized, 25 ICU, 8 vented, 9 people died
14. Accident or Terrorism – Major Local Implications
National Planning Scenarios
• Chlorine Tank Explosion – National Planning Scenario 1 Improvised Nuclear Device
2 Major Earthquake
• In 2007, terrorists used chlorine gas 7 times on U.S. troops 3 Aerosol Anthrax
4 Major Hurricane
• In urban area – 100,000 hospitalized 5 Pandemic Influenza
6 Radiological Dispersal Device
• 10,000 vents required
7 Plague
8 Improvised Explosive Device
• 10,000 people die
9 Blister Agent
10 Food Contamination
11 Toxic Industrial Chemicals
12 Foreign Animal Disease
13 Nerve Agent
14 Cyber Attack
15 Chlorine Tank Explosion
15. Natural Disasters Have Accelerated During Last Four Decades
1993 Midwest Floods
1994 Northridge Earthquake
2005 Hurricane Katrina
16. Terrorism Against Americans Has Escalated
Probability of Dirty Bomb Attack in Next Decade – 40 percent
Terrorism Against Americans
Iran
1961 – First U.S. Aircraft Hijacking 1979
1974 – Patty Hearst Kidnapping
1979 – Iran, U.S. Embassy Hostages Oklahoma City
1983 – Lebanon and Kuwait 1979
U.S. Embassy Bombings
1988 – Pan Am Flight 103
1993 – World Trade Center Bombing
1995 - Oklahoma City Bombing
1996 – Saudi Khobar Towers Bombing
1996 – Centennial Olympic Park Bombing
1998 - Unabomber U.S.S. Cole
1998 - Kenya and Tanzania 2000
U.S. Embassy Bombing
2000 - U.S.S. Cole Bombing
2001 – 9/11 Coordinated Attacks
World Trade Center and Pentagon
2001 – Anthrax Attacks New York
2002 – Beltway Sniper Attacks 2001
2009 – Fort Hood Shootings
17. Possibility of Unprecedented Disaster is Very Real
2002 Analysis - Dirty Cobalt Bomb in Manhattan:
• 400 square Miles Contaminated
• Manhattan uninhabitable
• 1 in 100 Die from Cancer
Hurricane Katrina Not Unprecedented:
• Hurricane Katrina: 200 B Kobe, Japan 1995 7.2 Richter Scale
• Kobe, Japan Earthquake: 500 B
2009 New Madrid Earthquake Study (6.9 R):
• Trillion dollars in losses
• 130 hospitals destroyed
• 80,000 lives lost
New Madrid Earthquake 1811 8.3 Richter Scale
1895 6.8 Richter Scale
18. Nation is Not Ready to Combat New Madrid Earthquake
• Reliance on NDMS assets for evacuations
• will not arrive for 72 hours
• limited capacity
• not fully effective for special needs
patients
• National ambulance contract inadequate
• musters 600 ambulances
• relies on unplanned coordination
of the Joint Field Office
• EMACs were not effective in coordinating 66,000
personnel during Hurricane Katrina and have not
yet built that capability
• Multiple jurisdictional, technical, and regulatory
roadblocks that inhibit an effective response
must be overcome
• As late as 2008 Hurricane Gustav:
Our four customers in New Orleans were all told
by FEMA and the State that they could not get
ambulances for four days
19. Through Grants, DHS and HHS are Influencing National Direction
1997-Metropolitan Medical Response System (MMRS)
• Emergency preparedness systems
• Respond to public health crisis
2001-Emergency Management Performance Grants (EMPG)
• Expanded to all-hazards planning
• Fill gaps not covered by other federal programs
2002-Hospital Preparedness Program (HPP)
• Bio-terror attacks and pandemics
• Primary focus expanded to all-hazards
2002-Bioterrorism Training and Curriculum Development Program
(BTCDP)
• Train healthcare workforce
• Bioterrorism to all-hazards
2003-Urban Area Security Initiative (UASI)
• High-risk, high-threat urban areas
• Prepare, response and prevent all emergencies
2005-Regional Catastrophic Preparedness Grant Program (RCPGP)
• Catastrophic incident preparedness
• Regional all-hazard planning
20. America Has Vast Emergency Response Resources
America has the resources to
combat a national catastrophe:
• 45,000 Ground Ambulances
• 50,000 Paratransit Vehicles
• 70,000 Medically Equipped Buses
•150,000 Fire Trucks
• 800 Rotor Wing Ambulances
• 300 Fixed Wing Ambulances
• 525 Military and Reserve C-130 Aircraft
• 5,000 Hospitals
• 17,000 Nursing Facilities
• 3,000 County Emergency Managers
Air Ambulance locations 2009
• 800,000 Police Officers
• 400,000 National Guard troops
• Over 1 million Active Military Personnel
Stationed in the U.S.
21. Two Dimensions of an Emergency – Speed and Scale
SPEED vs. SCALE
Response Static
Time
Velocity
Response
Time
Response Acceleration
Time
22. Effective Medical Response Must Integrate Six Functions
To maximize emergency medical response capability,
regions must integrate six functions into a
Community Emergency Network (CEN)
that acts as one seamless unit
Emergency Management
Health Care Facilities Emergency Medical Service
CEN
Emergency Support Special Needs Transport
Inter-facility Transport
23. Interdependent Medical Response Chain
Interstate
Regional Receiving
Frontline Inter-facility Hospitals Hospitals
Hospital ER Transport Inventory
Pre-hospital Regional Interstate
Inpatient Interstate
Ambulances Hospitals Transport
Hospital Special
Admissions Needs
Transport
Patient Flow
Evacuation Expansion
Emergency Acceleration
24. Link 1 – Pre-hospital Ambulance Network
Pre-hospital
Ambulances
Epicenter
Epicenter – The area of an emergency
which is unsafe or uninhabitable
25. Link 2 – Front Line Hospital Emergency Rooms
Frontline
Hospital ER
Pre-hospital
Ambulances
Front Line Hospitals – Functioning Hospitals nearest the Epicenter
During a community emergency, front line hospitals’ primary emergency
function is to provide stabilization and first definitive medical care to persons
coming from the epicenter that require medical treatment.
26. Net Patient In-Flow Accelerates
In a large scale emergency, the pace of patient arrival to
front line hospitals will accelerate, potentially overwhelming
ERs and creating the need to initiate ER surge capability
Self Present Hospital
Emergency Room Admission
Discharge
Ambulance
27. CEN Responds Early To Shared Info
Frontline
Hospital ER
As the front line hospital’s ER becomes inundated with
self presenters, first respond ambulances react by
diverting. In addition, before a hospital in-patient
levels reach divert status, inter-facility ambulances
Pre-hospital respond to relieve front line hospital of stable patients.
Ambulances Inpatient
Hospital
Admissions
ABC Hospital
ER Hospital
Wait Time hrs: 2.4 Hospital Capacity: 92%
Capacity %: 122 Net Admit RPH: 17
Net Arrival RPH: 21 ER At Capacity: 3.4 Hrs
Acceleration %: 82 Bed Divert: Burn
Critical ER Capacity 85%
Inter-facility Requirement: 20 ALS
11 BLS
28. Links 4-6 Interfacility Transport and Regional Hospitals
Regional
Frontline Inter-facility Hospitals
Hospital ER Transport Inventory
Pre-hospital Inpatient Regional
Ambulances Hospital Hospitals
Admissions
29. All Members of the CEN Share Info Early
As the emergency progresses:
• First response ambulances relay knowledge about
patients coming in the epicenter.
•Front line hospitals relay information about the
conditions they are treating.
•The community network assesses the potential for a
coordinated response and prepare to participate in the
emergency.
Support
Services
Shared Information Special Needs
Patient Transporter
Epicenter
Regional
Front Line Inter-facility Hospital
Hospital Transporter
31. Regional Hospitals Accept Patients, Share Emergency Resources
As the velocity of intake increases at front line hospitals, Inter-facility
transfers must occur. With the aid of a Seamless Emergency Operations
Center (SEOC), the region coordinates patient movement:
• Front line hospitals identify patient transfer needs
• Regional hospitals identify available beds
• Logistics identifies and coordinates inter-facility transfers and
obtains resources from outside the region as needed.
Seamless Emergency
Operations Center
Shared Information,
Analysis, and
Coordination
of Resources
Epicenter Stabilized Patients
Surge Resources
Front Line Regional
Hospital Hospital
33. SEOC Assists Local EOC
The SEOC provides the Local EOC invaluable real-time
information to make critical decisions and assists the
EOC with real-time analysis.
Some hospitals may find themselves inside the epicenter
and require full evacuation of their hospitals.
Seamless Emergency
Operations Center
Shared Information, Local Emergency
Analysis, and Operations Center
Shared Information
Coordination
And Coordination
of Resources
of assets
Front Line
Hospital
Epicenter
Stabilized Patients
Surge Resources
Front Line Regional
Hospital
Hospital
34. Regional Response Integrates with Federal Response
Regional Interstate
Frontline Inter-facility
Hospitals Receiving
Hospital ER Transport
Inventory Hospitals
Pre-hospital Inpatient Regional Interstate
Ambulances Hospital Hospitals Transport
Admissions
35. Region Accesses HELP as Need Surpasses Regional Capability
If the velocity of patients entering the regional medical system continues
to exceed the region’s capacity to treat them, SEOC can coordinate
patient movement through HELP:
• Network of interstate ambulances and receiving hospitals
• 24 hour response as opposed to NDMS 72 hour response
Seamless Emergency
Operations Center
Shared Information, Local
Analysis, and EOC
Coordination
of Resources
HELP
Areomedical HELP HELP Receiving
Staging Center Patient Transporters Facility Network
(over 600 companies) (600 Facilities)
Epicenter Stabilized Patients Stabilized Patients
Surge Resources Surge Resources
Front Line Regional Regional Regional
Hospital Hospital Hospital Ambulances
36. SEOC Manages National Special Needs Transfers
Regional Interstate
Frontline Inter-facility
Hospitals Receiving
Hospital ER Transport
Inventory Hospitals
Pre-hospital Inpatient Interstate Interstate
Regional
Ambulances Hospital Transport Special
Hospitals
Admissions Needs
Transport
Patients Dispersed From a Major
Burn Incident to Verified Burn Centers
Many special needs patients cases
cannot be transferred at the regional
level. For instance, a large burn
incident may require coordinating
the transfer of multiple patients
throughout the United States to
verified burn centers.
Verified Burn Center
37. Proposed Steps
1. Unify and Implement Regional goals
2. Codify and Implement Software Solution
3. Prepare and Implement Operations
38. Outline Of ASCEND Service:
Facilitation / consultation
1. Facilitate Unified vision
2. Document current status vs. goal
3. Outline steps to reach unified goals
4. Create Integrated critical path
5. Establish incremental milestones
6. Overcome operational, technical and legislative roadblocks.
7. Develop detailed protocols and procedures
Unified
Region-Wide
Vision Integrated
Critical Path
Local and Integrated Detailed
Hospitals State Incremental Protocols and
EOC’s
Milestones Procedures
Pre-hospital Inter-facility
Ambulances Transporters
39. Outline Of ASCEND Service:
Software Solution
• Outline current enterprise solutions
•Create bridge software solution
•Codify Protocols into an Enterprise Software System
• Provide Training and Exercises on ASCEND software
ASCEND
EWA
Salamander
Phoenix
40. Outline Of ASCEND Service:
Operations
•Provide Logistical Operations Center
• Provide HELP Solution
• Provide Special Needs Patients solutions