The Agency for Healthcare Research and Quality's (AHRQ) portfolio of bioterrorism research is a natural outgrowth of AHRQ's ongoing efforts to develop evidence-based information aimed at improving the quality of the U.S. health care system. This work is a critical component of the larger initiative of the U.S. Department of Health and Human Services to develop public health programs to combat bioterrorism.
Projects and activities comprising AHRQ's comprehensive bioterrorism preparedness portfolio are designed to assess and enhance the interface between the clinical care delivery system and public health infrastructure.
Medication/Vaccine Distribution
State and Regional Models
Surge Capacity
Pediatric Focus
Information Technology
Clinician Training
Clinical/Public Health Linkages
Translating/Disseminating Bioterrorism Research into Practice
PPE, Decontamination, Isolation/Quarantine, Laboratories
Optimizing
Clinical Preparedness for Bioterrorist Attacks Using Simulation Modeling and
Data from Recent Anthrax Attacks
Institution: Weill Medical College of Cornell University
Award: IDSRN Contract No. 290-00-0013-2
Period: 4/1/2002-3/31/2003
Funding: $164,989
Description: This project’s activities included: the refinement
of a Weill–developed computer simulation model for distribution
of antibiotics with real time data; the dissemination of the Points of
Distribution (PODs) simulation model to local, State, and Federal governments;
and the incorporation of new capacity data from anthrax cases into the
simulation inpatient treatment model.
National Guidelines for Mass Distribution
Centers
Institution: Weill Medical College of Cornell University
Award: IDSRN
Contract No. 290-00-0013-3
Period: 9/1/2002-4/30/2003
Funding: $240,000
Description: Work included the development of national guidelines for mass distribution centers needed in response to a bioterrorist event and the development of the resource materials needed to implement the guidelines.
Regional Models for Bioterrorism Preparedness
Institution: Stanford/UCSF Evidence-based Practice Center (EPC)
Award: EPC Contract No. 290-02-0017
Period: 11/30/2002-12/31/2003
Funding: $499,217
Description: An evidence report is being developed for use in identifying potential relevant regional models for the delivery of medical and non-medical services in the event of a bioterrorist attack. This includes a framework for identifying the key decisions made by clinicians, public health officials, and others during a bioterrorism response. The contractor is also identifying the information systems that enable regionalization of services.
Regionalization: Health Systems Preparedness for Bioterrorism
Institution: Booz Allen Hamilton
Award: Contract No. 290-00-0019-2
Period: 2/10/2003-5/10/2004
Funding: $599,992
Description: This contract will expand
the current hospital readiness questionnaire developed in a prior task order
to address issues of regionalization and the connections and integration of
individual hospitals to other regional health systems, facilities, and public
health. The impact on long-term care and home care needs in the recovery
phase of a bioterrorist attack will also be addressed.
Regional Health Care System Preparedness for Bioterrorist
Events
Institution: Denver Health
Award: IDSRN Contract No. 290-00-0014-5
Period: 10/15/2002-10/14/2003
Funding: $452,386
Description: This project examines the effects of regional care models
and their impact on resource allocation and capacity in the event of
a bioterrorist
event, as well as the effect of such an event on hospital and health
care systems' costs, outcomes, and staffing. Facility characteristics
needed to establish individual facilities as isolation or quarantine
units for the regions
are being identified. Characteristics of exportable models to regional,
state, and local policymakers are being identified.
Systematic Regional Inventory of Critical
Resources to Respond to Bioterrorism
Institution: Abt Associates
Award: IDSRN Contract No. 290-00-0003-5
Period: 10/1/2002-12/31/2003
Funding: $483,146
Description: Using the laboratory of Geisinger Health Systems’ service
area (six-county region of east–central Pennsylvania), a regional
inventory tool is being developed. The rural-based inventory tool will
be a relational database accompanied by a “process” manual
for immediate use. The tool will be Web-accessible to other regions and
municipalities for development of a regional inventory of critical health
care and other emergency resources needed to respond to a bioterrorist
attack.
AHRQ-Sponsored Workbook for Sharing Regional
Bioterrorism Preparedness Tools
Institution: RTI
Award: IDSRN Contract No. 290-00-0018-5
Period: 10/1/2002-9/30/2003
Funding: $485,877
Description: The assessment of the health
system requirement and inter-organizational relationships necessary for regional
bioterrorism preparedness is being conducted by this contractor. This assessment
includes the examination of the effects of regional care models and their
impact on resource allocation and capacity as well as the full spectrum of
expected health care needs following a potential bioterrorist event.
Developing Tools for State-wide Planning
and Response to Bioterrorist Attacks
Institution: Weill Medical College of Cornell University
Award: IDSRN Contract No. 290-00-0013-4
Period: 10/1/2002-9/30/2003
Funding: $338,177
Description: Weill Medical College will expand and implement New York
Presbyterian Healthcare System’s (NYPHS) existing surge capacity
information system (HERIS, Hospital Emergency Response Information System)
as a regional model for New York State. It will estimate staffing requirements,
cost, and outcomes of a potential bioterrorist event for NYPHS, establish
appropriate data systems and readiness measures, and develop risk communication
messages and dissemination plans for NYPHS staff, New York metro area
health care providers, and the public.
Predicting Health Care Use Resulting from
Terrorism: Tools to Aid State Planning
Institution: Emory University
Award: IDSRN Contract No. 290-00-0011-2
Period: 10/1/2002-9/30/2003
Funding: $269,707
Description: This project examines private sector health care utilization patterns following the terrorism and anthrax events of the Fall of 2001. This work will inform estimates of the potential impact of bioterrorism on public health hospitals and clinics.
Specific objectives addressed include surge capacity; system-wide data and
infrastructure needs; effective risk communication with all parties; and data
systems and tools for forecasting health care capacity demands.
Rocky Mountain Regional Health
Emergency Assistance Line & Triage Hub Model
Institution: Denver Health
Award: IDSRN Contract No. 290-00-0014-6
Period: 10/15/2002-10/14/2003
Funding: $267,056
Description: The requirements, specifications,
and resources needed to develop a public health emergency contact center
that is highly integrated with public health agencies are being determined. The
goal is efficient management of surges in patient demand to the health
care delivery system during a bioterrorist event or other public health
emergencies.
Modeling U.S. Health Systems' Epidemic Response Capacity
Institution: Weill Medical College of Cornell University
Award: Grant No. U01 HS14341
Period: 9/30/2003-9/29/2005
Funding: $840,262
Description: The U.S. hospital capacity for bioterrorism and public health emergency response will be assessed using advanced computer modeling techniques. Plans call for the development of discrete event simulation models of hospital treatment for the six Category A bioterrorist agents (smallpox, anthrax, botulism, plague, tularemia, and viral hemorrhagic fevers) and for Severe Acute Respiratory Syndrome (SARS). Patterns of emergency health service utilization in the setting of public health emergencies will be evaluated in a second component of this study. These two complementary study components will provide tools to improve forecasting health system capacity and for planning an efficient epidemic response.
Discharge Criteria for Creation of Hospital Surge Capacity
Institution: Johns Hopkins University
Award: Grant No. U01 HS14353
Period: 9/30/2003–9/29/2005
Funding: $911,199
Description: The focus of this project is the development of an easy-to-apply
method for pre-designating hospitalized patients suitable for early discharge
in the event of a disaster. The tool will be tested and evaluated in comparison
with the current ad hoc method of identification of such patients. Such
capability is necessary for addressing hospital surge capacity needs that
may arise under those circumstances.
Bioterrorism Preparedness in Rural and Urban Communities
Institution: University of Florida
Award: Grant No. U01 HS14355
Period: 9/30/2003–9/29/2005
Funding: $889,072
Description: Using qualitative and quantitative methods, the grantee will
assess existing resources and response mechanisms in rural and neighboring
urban communities to meet anticipated immediate and long-term health needs
arising from bioterrorist events. Based on the assessment results, an
intervention will be developed to educate health care providers concerning
mental health needs, a subject that has received less attention in rural
communities. The overall goal of this project is bioterrorism and other
public health emergency preparedness regarding intermediate and long-term
health needs such as long-term care, rehabilitation, chronic physical
ailments, and mental health.
Preparing Volunteer Nurses for Public Health Emergencies
Institution: : Vanderbilt University Medical Center
Award: Grant No. U01 HS14358
Period: 9/30/2003–9/29/2005
Funding: : $1,090,145
Description: This is a study to determine the effectiveness and efficiency
of learning programs designed to educate nurses volunteering for service
in their local community Medical Reserve Corps (MRC). Two types of learning
programs will be compared: a face-to-face version and an online version,
both of which will be designed using the principles of the national How
People Learn framework. The project will also focus on defining user characteristics
that predict selection of and effective/efficient completion of learning
programs. The adequacy of technology integration in learning emergency
response content will also be determined.
Pediatric Disaster Preparedness and Response
Conference
Institution: Columbia University
Award: Grant No. R13 HS13855
Period: 9/30/2002-9/29/2003
Funding: $49,246
Description: Conference activities included the review
and summarization of existing data on the needs of children in disasters;
the development of a consensus on the needs of children in disasters;
and the
creation of a research agenda to address the existing knowledge gaps involving
studies focused on the needs of children in disasters and other potential
terrorist events. Consensus recommendations are forthcoming through peer
reviewed journals as well as through the electronic media.
Bioterrorism: Automated Decision Support
and Clinical Data Collection
Institution: Children's Hospital Boston
Award: Contract No. 290-00-0020-1
Period: 9/29/2000-6/30/2003
Funding: $749,917
Description: This project developed a prototype database
and Web site to give clinicians the opportunity to report suspicious trends
of possible bioterrorist events. It also developed prototypes for
decision support systems for clinicians to give them "just-in-time" information
and advice on appropriate response.
Models and Protocols for Pediatric Bioterrorism Preparedness:
Pediatric Research Collaborative and Just-in-time Information and Reporting
Systems
Institution: Children's Hospital Boston
Award: Contract No. 290-00-0020-2
Period: 5/1/2003-10/1/2004
Funding: $699,630
Description: Decision support tools for clinicians, aimed at providing
just-in-time information in response to a bioterrorism event, will be
developed. A reporting system that responds to sentinel events, or trends
that alert the system to such an event, will also be developed, as will
a collaborative for pediatric bioterrorism preparedness.
Enhancement of the Technology Interface
for the Cincinnati Pediatrics Research Group for Bioterrorism Surveillance
Institution: Children's Hospital
Center, Cincinnati
Award: PBRN Grant No. R21 HS13506
Period: 9/30/2002-9/29/2004
Funding: $100,000
Description: This regional network of pediatric providers
will develop a system to allow electronic solicitation of data using handheld
devices and wireless communications. Since the system will allow real time
transmission of clinical impressions and symptoms, one of its intended uses
is bioterrorism surveillance.
Pediatric Terrorism Preparedness Resource
Guide
Institution: American Academy of Pediatrics
Award: Contract No. 03R 000097
Period: 12/1/2002-9/1/2003
Funding: $100,000
Description: Planning meetings were convened to formulate the substantive
information needed to develop a Pediatric Terrorism Preparedness Resource
guide. The guide would serve as the nation's
first comprehensive clinical and policy reference on the needs of children
following a terrorism attack or other disaster.
Using Information Technology to Improve Clinical Preparedness
for Bioterrorism
Institution: Mellon Pitt Corporation (MPC)
Award: Contract No. 290-00-0009-2
Period: 2/1/2003-7/31/2004
Funding: $483,697
Description: This work focuses on the
use of information systems to track and plan for bioterrorist events,
including the development of a prototype electronic bed tracking tool. An
assessment tool will be developed that will aid public health decisionmakers
in planning
for and acquiring tools related to early warning public health surveillance
systems and other relevant information technology systems that address
bioterrorism.
Training for Bioterrorism and Rare Public Health Events: Update
Institution: John Hopkins University EPC
Award: EPC Contract No. 290-02-0018-2
Period: 9/30/2002-10/31/2003
Funding: $417,767
Description: This work includes an
update of the literature review on training practices for bioterrorism
with a new emphasis on disaster drills, including best practices for successful
disaster drills. A tool is also being developed for evaluating disaster
drills and table top exercises. The tool will be provided to the states
through HRSA's
National Hospital Bioterrorism Preparedness Program.
Expansion of Innovative Approaches to Training
Clinicians to Recognize and Respond to Bioterrorist Attacks
Institution: University of
Alabama at Birmingham
Award: Contract No. 290-00-0022-2
Period: 9/16/2002-10/15/2003
Funding: $506,998
Description: The existing Web-based training
tool, developed under a project previously funded at the University
of Alabama, provides information about anthrax and smallpox and
provides continuing education credits. It was primarily targeted to emergency
physicians and nurses, infection control practitioners, pathologists
and radiologists.
The Web site has been expanded to offer continuing education for
family medicine, internal medicine, pediatrics, and dermatology.
Training for Improved Provider Response
to Bioterrorism
Institution: State
of Connecticut Department of Public Health
Award: Partnerships for Quality (PFQ) Grant No. U18 HS13693
Period: 9/30/2002-9/29/2004
Funding: $100,000*
Description: This project will identify
specific training programs for "front line" clinicians and evaluate their
effectiveness for bioterrorism preparedness.
Developing an Innovative Technology-based
Training Intervention for Hospital Bioterrorism Preparedness Training
Institution: RTI International
Award: Contract No. 290-00-0021-2
Period: 10/1/2002-9/30/2003
Funding: $299,740
Description: This contract explores
the application of a technology-based, noncontiguous training approach
to hospital training drills for bioterrorism preparedness. An innovative
bioterrorism preparedness drill tool that offers a cost-efficient and
effective mechanism
for training hospital personnel is being developed.
Evaluation of Bioterrorism Training for Clinicians
Institution: Johns Hopkins University
Award: Grant No. U01 HS14337
Period: 9/30/2003-9/29/2005
Funding: $991,843
Description: This project will develop and apply evidence-based expert consensus process techniques to create standard "best practice" educational content for training community clinicians in bioterrorism and disaster response. Two distinct modular training courses, one using traditional teaching techniques and the other using Web-based technology, will be developed and evaluated. The educational effectiveness and costs of the two course formats will be directly measured and compared in a variety of healthcare settings in a prospective, randomized controlled cohort study. The expected product from this study is an exportable model process for course development, training, tracking, and evaluation.
WReN's Response to Emerging Public Health
Threats: Enhancement of the Technology Interface
Institution: University of
Wisconsin
Award: PBRN Grant No. R21 HS13494
Period: 9/30/2002-9/29/2004
Funding: $48,118
Description: This network will expand its existing interface with
the public health surveillance network to allow ongoing monitoring for bioterrorism.
The surveillance system will allow the network to evaluate its role in detecting
and responding to emerging public health threats, such as acts of bioterrorism.
North Carolina Family Practice PBRN: Enhancement of the
Technology Interface for Bioterrorism Surveillance
Institution: University of North Carolina (UNC)
Award: PBRN Grant No. R21 HS013521
Period: 9/30/2002-9/29/2004
Funding: $149,980
Description: This network of family physician
practices will test data transfer systems (linked to state epidemiological
systems) and methods of practice-based surveillance for signs and symptoms
of disease clusters that suggest bioterrorism.
Measurement and Bioterrorism Preparedness: An Impact Study
Institution: Joint Commission
on Accreditation of Healthcare Organizations (JCAHO)
Award: PFQ Grant No. U18 HS13728
Period: 9/30/2002-9/29/2004
Funding: $100,000*
Description: This project will assess
improvements in linkages between health care organizations, the public health
infrastructure, and emergency response entities in the wake of multiple influences,
such as implementation of revised Joint Commission emergency management standards,
occurrence of national events, and provision of federal funding for bioterrorism
preparedness.
A Case Study of Community Resource Integration
for Bioterrorism Readiness
Institution: Texas A&M University Foundation
Award: PFQ Grant
No. U18 HS13715
Period: 9/30/2002-9/29/2004
Funding: $100,000*
Description: The Texas Center for Medical Strategy, Training, and Readiness (TC-MEDSTAR)
will design, develop, implement, and evaluate a case study to help communities
integrate resources for readiness to respond to homeland security needs.
Partnership for Advancing Quality Together:
Transportability of Bioterrorism Preparedness Interventions
Institution: RTI International
Award: PFQ Grant No. U18 HS13706
Period: 9/30/2002-9/29/2004
Funding: $100,000*
Description: This research will contribute
to the knowledge base about successfully implementing initiatives to enhance
safety and security. A report will be developed from case study data to explicate
critical issues related to the transportability of bioterrorism preparedness
interventions.
Improving Healthcare Responses to Bioterrorist
Events
Institution: The Altarum
Institute, Michigan
Award: PFQ Grant No. U18 HS13683
Period: 9/30/2002-9/29/2004
Funding: $100,000*
Description: A simulation model called
the Healthcare Complex Model (HCM) is being tested for its utility and validity
to support bioterrorism readiness planning. Plans call for testing and validating
the HCM's ability to support planning for a rural healthcare network and identifying
further enhancements needed in the model for application to urban settings
under different bioterrorism attack scenarios.
User Liaison Program (ULP) Dissemination
Support: Bioterrorism Preparedness
Institution: Health Systems Research, Inc.
Award: ULP program
Period: 10/1/2002-9/30/2003
Funding: $349,940
Description: Five 90-minute, Web-assisted
audio conferences will be conducted throughout 2003 focusing on bioterrorism
and health systems preparedness. Each conference will focus on AHRQ-supported
bioterrorism research findings and promising practices implemented by
states,
localities, and health systems.)
User Liaison
Program (ULP) Dissemination Support: Bioterrorism Preparedness
Institution: National Academy for State Health Policy (NASHP)
Award: ULP program
Period: 10/1/2002-9/30/2003
Funding: $349,718
Description: A 1.5-day regional bioterrorism
and health system preparedness workshop will be conducted in the Fall
2003 focusing on AHRQ supported bioterrorism research findings and promising
practices
implemented by states, localities, and health systems. Contractor will
also conduct two site visits in the Fall 2003 for State officials to
learn about
two well developed systems for responding to potential bioterrorism events.
User Liaison Program (ULP)
Dissemination Support: Bioterrorism Preparedness
Institution: AcademyHealth
Award: ULP program
Period: 10/1/2002-9/30/2003
Funding: $299,926
Description: Two 1.5 day regional bioterrorism
and health system preparedness workshops in the fall of 2003 will be conducted
focusing on AHRQ supported bioterrorism research findings and promising practices
implemented by states, localities and health systems. Five written briefs
focusing on bioterrorism issues raised in the regional workshops and during
the national Web-assisted audio conferences conducted by AHRQ will be prepared.
Development of Models for Emergency Preparedness: Personal Protective Equipment, Decontamination, Isolation/Quarantine, and Laboratory Services Capacity
Institution: Science Applications International Corporation (SAIC)
Award: Contract No. 290-00-0023-2
Period: 7/1/2003–9/30/2004
Funding: $298,325
Description: Project will develop guidelines for bioterrorism preparedness, specifically addressing personal protective equipment, decontamination, isolation/quarantine, and laboratory capacity. Guidelines will include but not be limited to cost assessments and impact, regulatory and legal compliance considerations, and training. Exercise scenarios that incorporate best practices and guidelines for training of medical, public health, law enforcement, and emergency management for the above mentioned subjects will be developed.
*Partnership for Quality Grants are funded at up to $100,000 for the Phase I Planning Year. Funding for Phase II is dependent on availability of funds and satisfactory progress of the project.
Current as of November 2003
Internet Citation:
AHRQ Bioterrorism Preparedness Research Portfolio: Fiscal Years 2002-03. November 2003. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/bioterport.htm
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