These recommendations are offered to assist in development of a system that could be used during a mass casualty or evacuation event to locate, track, and regulate patients and evacuees. The recommendations can provide decision support to persons and organizations responsible for patient and evacuee movement, health care and transportation resource allocation, and incident management.
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Prepared by:
Abt Associates
Investigators:
Tom Rich,
Project Director
Paul Biddinger,
Co-Principal Investigator
Richard Zane,
Co-Principal Investigator
Andrea Hassol
Lucy Savitz
Margarita Warren
Contents
Executive Summary
1. Project Origin and Background
2. The National System: Goals and Objectives
2.1. Locating and Tracking
2.2. Regulating
3. Recommendations for a Phase I National System
3.1. Patient/Evacuee Data Elements
Minimum Data Elements
Secondary Data Elements
3.2. Obtain Patient/Evacuee Data From Existing Systems
Feeder Systems
Illustrative Data Flow Between Feeder Systems and the National System
Implications of Relying on Feeder Systems
3.3. Link a Limited Number of Feeder Systems to the National System
Federal Tracking Systems
Information Systems At Hospital Systems
Disaster Shelter Registration Systems
3.4. Focus on a Limited Number of Health Care and Transportation Resources
3.5. System Operation
3.6. Implementation Plan and Estimated Costs
Task 1: Project Start Up
Task 2: System Specification
Task 3: System Development and Testing
Task 4: Pilot Test
Task 5: Documentation
Estimated Phase I Costs
4. Priorities for Subsequent Phases
4.1. Linking Additional Feeder Systems to the National System
4.2. Improving Health Care and Transportation Resource Availability Data
Appendixes
Appendix A: Project Team and Steeering Committee Members
Key Project Staff
Steering Committee Members
Appendix B: Legal Issues
Relevant Federal Legal and Regulatory Issues
Patient Information and Privacy Standards
Relevant State Legal and Regulatory Issues
Patient Information and Privacy Standards
Complaints and Incident Reports
Patient Rights
Discharge Planning; Advocacy Office
Reportable Diseases, Isolation and Quarantine
Appendix C: Existing Systems: Tracking Systems
Overview
Systems Used at the Local or Regional Level
Systems Used or in Development at the Federal Level
Appendix D: Institutional Records Systems
Summary
Hospitals
Nursing Homes
Home Health
Shelters
Prisons and Jails
Other People Needing Evacuation Assistance
Hospitals
Typology and Definitions
Hospital Intake and Discharge Processes
Existing Hospital Information Technology Systems with Population-Level or Client-Level Data
Hospital Perceptions: Benefits of Evacuation Tracking
Hospital Privacy and Confidentiality Issues
Nursing Homes
Nursing Home Typology and Definitions
Nursing Home Intake and Discharge Processes
Existing Nursing-Home Information Technology Systems with Population-Level or Client-Level Data
Nursing Home Evacuation Plans
Nursing Home Perceptions: Benefits of Evacuation Tracking
Nursing Home Privacy and Confidentiality Issues
Home Health
Home Health Typology, Population and Definitions
Home Health Intake and Discharge Processes
Existing Home Health Information Technology Systems with Population-Level or Client-Level Data
Home Health Evacuation Plans
Home Health Perceptions: Benefits of Evacuation Tracking
Home Health Privacy and Confidentiality Issues
Shelters
Shelter Typologies and Definitions
Homeless Shelter Intake and Discharge Processes
Shelter Information Technology Systems
Shelter Privacy and Confidentiality Issues
Shelter Perceptions: Benefits of Evacuation Tracking
Prisons and Jails
Corrections Typology and Definitions
Existing Corrections Information Systems
Special Evacuation Issues in Jails and Prisons
Privacy and Confidentiality in Corrections
Correctional Staff Perceptions: Benefits of Evacuation Tracking
Data for Other People Needing Evacuation Assistance
Appendix E: Resource Availability Systems
Hospital Assets
Hospital Baseline Resource Inventories
Hospital Real-time Availability Systems
National Hospital Availability Systems (HAvBED)
Nursing Home Assets
Baseline Resource Inventories
Real-time Availability Systems
Home Health
Baseline Resource Inventories
Real-time Availability Systems
Shelter Assets
Baseline Shelter Resource Inventories
Real-time Shelter Availability Systems
Transportation Assets
Baseline Transportation Resource Inventories
Real-time Transportation Availability Systems
Corrections: Prisons & Jails
Baseline Corrections Resource Inventories
Real-time Corrections Availability Systems
Other "Mixed" Asset Systems
Local Crisis Management Resource Availability Systems
Appendix F: Resource Requirements Models
AHRQ Hospital Surge Model
Mass Evacuation Transportation Model
Copyright Information, Acknowledgements, and Disclaimer
Development of Recommendations for a National Mass Patient and Evacuee Movement, Regulating, and Tracking System was funded by the U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Preparedness and Response, the U.S. Department of Homeland Security's (DHS) Federal Emergency Management Agency and the U.S. Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response. The authors would like to acknowledge the efforts of the Department of Defense (DoD) and the contributions of DoD project lead Captain F. Christy Music, We also want to acknowledge the contributions of the members of the Project Steering Committee, who are identified in the appendix of this report.
This project was awarded to Abt Associates Inc. under
Agency for Healthcare Research and Quality Contract No. 290-00-0003, Task
Order #12. Opinions or points of view expressed in this document are those
of the authors and do not necessarily reflect the official position of the
Agency for Healthcare Research and Quality.
This document is in the public domain and may be used
and reprinted without permission except those copyrighted materials noted for
which further reproduction is prohibited without the specific permission of
copyright holders.
AHRQ Publication No. AHRQ-09-0039-EF
Current as of February 2009
Internet Citation:
Recommendations for a National Mass Patient and Evacuee Movement, Regulating, and Tracking System. AHRQ Publication No. AHRQ-09-0039-EF, February 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/prep/natlsystem/
540 Gaither Road Rockville, MD 20850 
