The document provides comprehensive training information for Point of Dispensing (POD) managers within Hamilton County Public Health, outlining their roles, responsibilities, and operational procedures during public health emergencies. It details the incident command structure, management of staffing and resources, and communication protocols to ensure efficient POD operation. The training aims to equip managers with the necessary skills for effective POD activation, operation, and demobilization, including patient tracking and inventory management.

1. Hamilton County Public Health Point of Dispensing (POD) POD Manager Training

2. Point of Dispensing (POD) POD Manager Training Carter Pittman, BS, EMT-P HCPH Emergency Response Coordinator Cincinnati-Hamilton Co. MRC Coordinator

3. Point of Dispensing A Point of Dispensing (POD) is a special location that is established to allow medication and/or vaccines to be distributed very rapidly to the public in the event of an emergency.

4. Purpose To provide POD Managers with the knowledge and information necessary to carry out tasks assigned at the point of dispensing (POD).

5. Objectives To define the qualifications and the role of the POD Manager To describe the POD Management Structure (Incident Command System – ICS) To describe POD activation and maintain POD operations To understand the function Components of POD Operations

6. Contents POD Manager POD Site Information POD Activation POD Components POD Operations General Considerations Demobilization

7. POD Manager Da’ BOSS!!!

8. POD Manager Public Education Transportation Client/Public Tracking Triage Decision Making Inventory Reporting Traffic Management Communications Safety Support and Guidance Security Quality Control Dispensing Staff Shift Schedules Training Storage Mental Health Parking

9. POD Manager Qualifications Proven leadership Able to multi-task Able to manage Able to make decisions rapidly Must have quality customer service skills Able to work under pressure Knowledgeable on POD functionality and responsibility “ Greatest Good For the Greatest Number”

10. POD Manager POD Manager Absolute on site authority Responsibility for meeting the safety and productivity expectations for a a single POD during a specific shift Will be the overseer of the basic POD functionality

11. POD Manager POD Manager Check on status of POD activities such as: Indivudual throughput Medication inventory status provide hourly status to DOC Supplies status Medications dispensed Personnel and volunteer resources

12. POD Manager Ideally, the individuals pre-assigned to given PODs should be involved in designing the POD so they will have buy-in to the plan POD design really cannot be done in a vacuum by planners at “Higher Levels” and dumped on the POD manager. No buy-in and no confidence in the plan. By pre-designating who the POD manager and supporting leaders will be at a given site, that POD manager can begin to develop their team.

13. INCIDENT COMMAND STRUCTURE (ICS)

14. Incident Command Structure (ICS) An organization structure used to manage incidents both large and small. This system provides: Standardized management concepts Flexibility for a variety of incidents Provides common framework for Incident response

15. Incident Command Structure (ICS) Basic features: Common terminology in “plain talk” Modular organization (easy to grow or shrink) Management by objectives Chain of Command Manageable span of control

16. Overall ICS Structure Incident Commander Finance / Administration Logistics Operations Planning PIO Safety Officer Liaison Officer POD 1 POD 2 POD 3 POD 4 POD Manager POD Manager POD Manager POD Manager Dispensing Site Coordinator

17. POD ICS Structure POD Manager Operations Section Lead Security Section Lead Logistics Section Lead Planning Section Lead/Safety Site Information Resource Lead Liaison Officer Griage Unit Leader Registration Unit Leader Screening Unit Leader Dispensing Unit Leader Communication Unit Leader Pharmacy Unit Leader Personnel/Volunteer Leader Supplies Unit Leader Finance Section Lead Exit Unit Leader Special Needs Unit Leader

18. Accountability in ICS ICS utilizes an orderly chain of command Each individual has one and only one supervisor All personnel are expected to follow established procedures for checking in and checking out of the POD ICS names and positions can vary, but should be identical within the same jurisdiction

19. POD Site Information

20. POD Site Information Proficient in the use of the POD notebook and indicate how it is laid out Comprehend the POD Plan including security, volunteer, communication and site lay out Identify Standing Orders in reference to medications

21. POD Site Information Command and Control Prophylaxis of First Responders & Families Credentialing POD Communications Treatment Centers POD Transportation Demobilization Plan POD Equipment and Supplies Develop a POD Site Plan that has all of the critical information located with easy access – POD Notebook

22. POD Site Information The POD Notebook should include: Maps

23. POD Site Information

24. POD Site Information The POD Notebook should include: Flow Diagrams

26. POD Site Information The POD Notebook should include: Inventory

27. POD Site Information The POD Notebook Should include how the POD site will flow (i.e. traditional)

28. POD Site Information Drive-Thru point of dispensing The POD Notebook Should include how the POD site will flow (i.e. Drive-thru)

29. POD Site Activation Here we go!!!

30. POD Site Activation Three Points to remember: Triaged Educated Medicated

31. POD Site Activation Notification: POD staff Political Officials Partners and Stakeholders Include POD facility

32. POD Site Activation Prepare to Operate POD Use pre-occupation checklist for facility Review standing orders, individual education, forms Make sure necessary copies are made Set-up ICS structure Designate one person to begin logging all supplies and personnel arriving Assign arriving POD staff general/command positions Assess need for any additional equipment

33. POD Site Activation Set-Up POD Site Delineate traffic patterns with barriers, cones, signs Obtain walkers and wheelchairs for use in POD Label all rooms at POD including rest rooms Mark entrance and exits with large clear signs

34. POD Site Activation SNS Arrival Delineate a location specifically for SNS arrival POD Manager and Logistics prepare to receive supplies POD Manager sign for supplies Logistics verifies orders/quantity POD Manager makes sure supplies are inventoried, secured and placed out to the proper stations.

35. POD Site Activation Prepare stations Griage, Registration, Screening, Dispensing, Individual Education and Exit (including supplies and equipment)­­ Arrange for EMT/EMS support Obtain facility support including janitorial support as necessary Prepare refrigerator and/or space for receipt of prophylaxis Check electrical power, water, HVAC systems Establish communications (HAM Radio Operators, etc) ICS 205 Prepare to Operate POD

36. POD Site Activation Staffing Prepare staff organizational chart Sign-in Staff/Volunteers (ICS 211) Planning (Personnel/volunteer lead) should take over responsibility of volunteers/staff Dispense ID Badges/Vests Review credentials of licensed staff Assign staff/volunteers Pass-out Job Action Sheets

37. POD Site Activation Staffing POD Manager will provide briefing (ICS 201) Objectives of the shift Latest event information and environmental conditions Hazards or threats to staff safety and health Communication protocol Informational flow and reporting requirements Conduct Just-in-Time Training Staff in place at stations

38. POD Site Activation Pre-Operational POD Security Assign Security Staff to POD exterior, interior and medications Review security procedures with staff Walk Through Take all staff through the POD steps for familiarity and to check for potential bottlenecks Notification Notify DOC that POD is ready to open when all items are checked off

39. POD Site Activation Operations Begin Operations Be vigilant towards bottlenecks and areas that is not moving rapidly Work with Pharmacy Tech/Logistics to verify hourly count Relay hourly count to DOC as requested Respond to any areas of concern – utilize the Liaison as a resource Make sure breaks are given as needed Tend to the needs of the staff if needed

40. POD Site Activation Operations MOST IMPORTANT Be vigilant towards bottlenecks and areas that is not moving rapidly KEEP THE LINES MOVING!!!!

41. POD COMPONENTS

42. POD Inventory Management Systems A patient/inventory tracking system will be used throughout POD operations (this can be paper/electronic or both) This system will: Register individuals Screen individuals Track dispensing to individuals Track staff access to the site Monitor inventory amounts Perform other dispensing related operations

43. Core POD Stations Entrance Area/Griage Station Registration/Public Education Medical Assessment (Screening) Dispensing Exit/Public Education

44. Core POD Stations POD Four Basic Areas Intake Screening Exit Dispensing 1 2 3 4

45. Entrance Area/Griage Station One entrance provided for the general public Security at entrance checking identity (driver’s license, social security card, etc.) Signs posted (multilingual) Initial screening occurs here to determine movement

46. Entrance Area/Griage Station Station serves to immediately screen symptomatic, sick or known exposed individuals. Transportation to treatment center or alternative care center. Medical staff needed Personnel Protective Equipment (PPE) needed

47. Registration/Patient Education Two main activities Registration of public Completion of forms

48. Medical Assessment Level I - Screening (Drug/Clinical Review Station) Medical staff to screen forms Contraindications for further assistance (move to Level II Screening) If no assistance needed (move to dispensing station)

49. Medical Assessment Level II - Screening (Pharmacy/Medical Consulting Station) Medical staff to determine appropriate medication Educational materials may be provided Directed to Dispensing Station

50. Dispensing Dispensing of medications/vaccinations May have various modes of dispensing stations to handle fast track, pediatric, alternative medications, etc. Forms checked for proper receipt of medications Directed to Forms Collection and Exit Education Station

51. Exit – Collection of Forms/Patient Education All forms and documentation collected Staff insures completeness of forms Final instructions provided and/or literature distributed by health educators Answer last-minute questions If vaccination conducted, observe the individuals condition prior to exit.

52. Supplementary Stations Special Services/Interpreter Station Mental/Physical Disabilities Station Mental Health Station First Aid Station Respite Area for POD Staff

53. Communications Radio, cell phone, whistles, bullhorn, walkie-talkie, fax POD Manager ensures internal communications are tested prior to opening POD Make sure you know how to use any communication equipment assigned to you prior to shift

54. POD Security Measures Provide a safe environment during all phases of POD operations Identification of staff, volunteers and public entering the POD Secure SNS Material at PODs Control entrance and exit Maintain crowd control Maintain perimeters around specific areas

55. Other Considerations Signs posted (multilingual) Public Education materials (biological agents, prophylaxis information [multilingual]) Assistance provided through Special Service’s Station or Physical Disabilities Station (i.e., wheelchair, interpreter, etc.)

56. POD Signs

57. Sample Use of POD Signs

58. Job Action Sheet - Components Job Title Supervisor’s Name Job Mission Immediate duties upon activation On-site operation duties Deactivation phase

59. Standards of Care During a public health emergency, normal standards of care and operating procedures may be altered only after approval from the State of Ohio or the Center for Disease Control and Prevention. Altered standards of care might include: Reduction of documentation requirements Allowing one family member to accept medication for a household (For Ohio – allow pickup for up to 20 people) Reduced or eliminated observation requirements

60. General Considerations No one communicates with media unless directed Staff will be given and overall message to share with the population Observe for signs of stress and inappropriate behavior (staff and public) Set code phrase for staff to use indicating potential problem Keep a log (ICS Form 214) End of Shift –remember to brief on coming crew

61. Communicating Beyond the POD All media inquiries should be sent to the PIO Respect privacy of people working and attending POD Dispel any rumors immediately Follow your protocol on communication with friends and family

62. Signs of Stress and Fatigue in Self and Others Lack of concentration Increasing number of non-critical errors Critical errors Irritability Worry Feeling ill

63. End of Shift Debriefing with your oncoming position coverage Turn in all reports (logs) and equipment Sign-out through staging area Have a cold one and relax!!!!

64. DEMOBILIZATION

65. Demobilization of POD Informing the public is vital Breakdown activities to pre-event status Use Checklists Post-occupation Inventory and supply Personnel resources Debrief staff – use Debriefing Form/Log Collect all other forms and documentation

66. Demobilization of POD Prepare After Action Report which includes: Background to what occurred Summary of Events Operational Period Number of Public treated List of all personnel involved Evaluation of process Description of Operations Challenges/Problems identified Results/Outcomes

67. Demobilization of POD POD command staff will dismiss as necessary POD command staff and property representative will conduct a joint inspection of facility to assess conditions documenting by post-occupation checklist and photos

68. Questions????

69. Contact Information Carter Pittman Emergency Response Coordinator Hamilton County Public Health 250 William H. Taft, 2 nd Floor Cincinnati, Ohio 45219 Phone: 513-946-7889 [email_address]