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Surge Capacity and Health System Preparedness

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Education and Training for a Qualified Workforce

Slide Presentation by Michael Allswede, D.O.

On March 2, 2004, Michael Allswede, D.O., made a presentation in a Web Conference entitled National Public Health Strategy for Terrorism Preparedness and Response.

This is the text version of Mr. Allswede's slide presentation. Select to access the PowerPoint® slides (1.2 MB).

Surge Capacity and Preparing the Workforce

Michael Allswede, D.O.
Associate Professor of Emergency Medicine
Section Chief, Special Emergency Medicine Response
Department of Emergency Medicine
University of Pittsburgh Medical Center Health System
Pittsburgh, PA

Slide 1

Non-Contiguous Training Overview

  • The Non-Contiguous Training Concept is a method of planning and training the acquisition of WMD related skills.
  • The ability to train during down-time or other hours will prove to:
    • Improve skill level of the staff.
    • Cost less than standard drills.
  • Tracking skill deficits in key personnel will improve the safety of the system.

Slide 2

Non-Contiguous Objectives

  • Disseminate individual knowledge and skills prior to the drill.
  • Train on objectives, not "time-based" CME/CEU.
  • Drill for integration and for "macro" organization.
  • Leadership training:
    • Must be dynamic "war game."
    • Model on "Sim-City."

Slide 3

Disaster Interactions

  • WMD events cause "triage inversion."
    • Least injured present first.
    • Most injured remain for extrication.
    • Contaminated victims precede scene information.
  • WMD events contaminate hospitals unless hospitals are protected.
    • Hospital personnel were among victims in Tokyo Sarin.
  • Hospitals and providers are "non-renewable" in the short term.

Slide 4


  • Afloat Training Exercise and Management System (ATEAMS).
  • Allows skill acquisition and maintenance to be ongoing.
  • Drills are for system evaluation, not skill acquisition.
  • Assigns skills by duty station.

Slide 5

The Problem with Disaster Drills

  • Hospitals cannot stop their normal function to play in a drill.
    • Disaster drills are pre-announced.
    • Community drills scheduled at the convenience of community the morning.
    • Morning is busy time for hospitals.
      • Disasters happen at night when staffing levels are thinnest.

Slide 6

The Problem with Disaster Drills

  • Shifting extra personnel is expensive.
    • $3,000 per hour at UPMC for ED personnel.
    • Extra non-clinical personnel?
    • Extra administrative personnel?
    • Victim Volunteers?
    • EMS-Medical Command-Civic Services?
      • $16 Million for TOPOFF II.

Slide 7

The Problem with Disaster Drills

  • Training a shift at a time is inefficient.
    • 1 shift equals:
      • 8% of total nurses.
      • 5% of total attendings.
      • 0% of residents and house staff.
    • Experienced people AVOID disaster drills.
    • Moulage is never the real thing.

Slide 8


  • Classic classroom teaching.
  • Distance learning.
  • Video interface.
  • Memory enhancement tools.

Slide 9

Acquire Skills

  • Virtual interface.
  • Training room.
  • Video demonstration.
  • Self-learning.

Slide 10

Practice Skills

  • Announced drills.
  • Group drills.
  • Segmented testing.
  • Simulation.

Slide 11


  • Large drills.
  • Actual events.

Slide 12

For More Information:

Contact: Lucy Savitz, Ph.D., M.B.A. at

Current as of May 2004

Internet Citation:

Surge Capacity and Preparing the Workforce. Text version of a slide presentation at a Web conference—Education and Training for a Qualified Workforce. Agency for Healthcare Research and Quality, Rockville, MD.

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