Organizational Information

Participating Institutions

Columbia University

Columbia University was founded in 1754 as King’s College by royal charter of King George II of England. It is the oldest institution of higher learning in the state of New York, located in the Morningside Heights and Washington Heights areas of Manhattan; and has 3,145 faculty, 7,054 undergraduate and 16,278 graduate and professional students. The University administration and the Schools of Law, Business, Engineering, General Studies, Journalism, Music, Architecture, International Affairs, Graduate School of Arts and Sciences and Columbia College are located on the main campus, as are Barnard College and Teachers College. Columbia University Medical Center (CUMC) is one of fewer than 20 academic health centers that includes the four major health sciences graduate schools (medicine, dentistry, nursing, and public health) and is a leader in biomedical research. This is especially true in the areas of infectious diseases, epidemiology and microbial pathogenesis. The Medical Center was established in 1928 through an alliance between the Presbyterian Hospital and Columbia University's Health Sciences Division.

The Center for Health Policy at Columbia University School of Nursing has extensive experience in projects related to the requirements of this project. Among projects of the Center are Bioterrorism Preparedness: Curricula for Health Workers, the development of a curricular framework for training national, state, and local public health workers in bioterrorism preparedness and response; leadership in the Center for Public Health Preparedness, part of a national system of academic centers for public health preparedness established by the Centers for Disease Control and Prevention; leadership in the New York/New Jersey Public Health Training Center, a center funded through HRSA whose mission is to improve the nation’s public health system by strengthening the technical, scientific, managerial and leadership competence of the current and future public health workforce and Preparedness in Hospitals, a project to identify core emergency/disaster preparedness competencies for the hospital workforce.

Adelphi University

Established in 1896, Adelphi University educates a diverse student body in the arts, sciences, humanities, business, education, nursing, social welfare, and clinical psychology. Today, the University has 634 full-time and part-time faculty members, and serves a student body of more than 7,700 undergraduate and graduate students on the main Garden City campus as well as facilities in New York City, Hauppauge, and Poughkeepsie, NY. Adelphi University's schools and programs include the College of Arts and Sciences, the Gordon F. Derner Institute of Advanced Psychological Studies, the Honors College, the School of Business, the School of Education, the School of Nursing, and the School of Social Work.

The University has a mission of service to Long Island, the New York metropolitan region, and the nation, and has a long tradition in the area of emergency preparedness education. In fact, the University opened its Nursing School in 1944 in response to the pressing need for nurses created by the United States' entry into World War II. The University has close ties with Nassau County governmental and business leaders, as well as local citizens and community groups. Faculty and students from the School of Nursing have engaged in many projects with the Nassau County Department of Health and the Office of Emergency Management. Such projects have included: a drill to test the receipt, breakdown and distribution of the Strategic National Stockpile (SNS); another drill to test the Medical Reserve Corps’ ability to operate a Point of Distribution (POD) Clinic for a simulated Tularemia outbreak, and an actual POD clinic operation for the mass distribution of influenza vaccinations to 7,600 individuals in a senior citizen influenza vaccine POD clinic. In addition, the University has recently initiated a post-masters certificate program in emergency management through its College of Arts and Sciences, and has an application pending with the New York State Department of Education for approval of a newly created masters degree in Emergency and Disaster Nursing, and a corresponding post masters certificate program for nursing in the same area.

University at Albany School of Public Health

The UA SPH was the first school of public health in the nation in a formal partnership with its state health department. Recognized nationally as a groundbreaking new model for public health education, the UA SPH offers professional programs that are integrated with academic training to provide "real-world" internships and field placements. The School is based on a formal Memorandum of Understanding between the University at Albany, State University of New York and the New York State Department of Health and is overseen by an Advisory Committee with equal participation from these two organizations. Dozens of public health research staff, laboratory based research staff, and senior management from NYS DOH serve as academic faculty at the UA SPH. In this mutually beneficial relationship, students receive tested and innovative instruction from a faculty working directly with emerging health issues, as well as through collaborative research and program grants conducted by the two collaborative entities.

The Northeast Regional Public Health Leadership Institute (NEPHLI) has been an integral part of public health workforce development at the University at Albany School of Public Health since 1997. NEPHLI offers a year-long experiential program to improve the leadership skills of public health practitioners from state and local public health departments and allied organizations, academia, and public health associations. NEPHLI’s faculty includes experts from the fields of leadership and organizational development, public health, emergency preparedness, management and risk communications.

University of Kansas School of Medicine - Wichita

In 2005, the University of Kansas School of Medicine-Wichita (KUSM-W) celebrates 30 years of providing education as a community based medical school in the central plains of the United States, offering a diverse community of rural and urban dwellers. KUSM-W provides state-of-the-art programs to benefit the citizens of Wichita, the state of Kansas and beyond. As a pioneer in community-oriented medical education, KUSM-W fully supports the concept of giving back to the greater community from which it draws its support, and does so by providing expert evaluation protocols and process to multiple community partners, including the Kansas Department of Health and Environment, the Kansas Association of Local Health Department and many others. These partnerships include a multi-state coalition (Kansas, Kentucky, Missouri) based on the School of Public Health at St. Louis University.

In January 2002, KUSM-W created the Kansas Public Health Workforce and Leadership Development (WALD) Center. The WALD Center is a Web-based virtual education center that enables the integration and coordination of a continuous preparedness, information and education endeavor for the public health workforce in Kansas and beyond. It is focused on the individual public health worker’s need and strives to identify continuing education goals. It gives all health workers the opportunity to improve their skills and knowledge while also grooming them to become workforce leaders. The WALD Center is a designated HRSA Academic Practice Partner of the Heartland Public Health Education and Training Center. Funding sources are the Association of Schools of Public Health and Association of Teachers of Preventive Medicine, both through the Centers for Disease Control and Prevention, Health Resources and Services Administration, and the Kansas Department of Health and Environment.

WALD Center’s main objectives are to provide preparedness training and education to health workers across the state and beyond, improve the state of public health in Kansas and beyond, and reduce health disparities. Examples of this expertise include the work of the WALD Center’s faculty and staff on the following projects:

Working relationships

The organizations coming together in this consortium have extensive experience in coordinated approaches to emergency preparedness. Specific examples include:

Finally, nurses, the largest single group of health professionals found in personal care and public health services in rural and underserved areas, are well represented in the expertise of this project, advisory board membership, and in target audience areas.

Organization

Structure

As illustrated in the organizational chart found in Appendix C, the NYCEPCE has a small central core to assure that objectives are met and coordination continues as planned, with each member of the consortium responsible for the direct management of project components within the work plan.

Responsibilities

In order to accomplish the goals and objectives of this cooperative agreement, each of the three Consortium members (CU, AU and UA SPH) has agreed to:

As the organizational hub for this consortium, the Center for Health Policy at the Columbia University School of Nursing will:

Ongoing Coordination

Routine coordination to assure that product development is not duplicated and that lessons learned are shared and challenges dealt with quickly will be done by a Coordinating Committee chaired by the project director and composed of the senior staff person at each participating institution and a representative of the project evaluation team. This Coordinating Committee will meet monthly, in person or by conference phone call, and will make extensive use of electronic communications between meetings.

Individual project management

Each participating institution will be responsible for its portion of the work plan, for selection and supervision of staff or contract agents to fulfill that work plan, and for providing needed information to the administrative center in a timely fashion. It is likely that for major sub-projects a small working group that includes representatives of the target population or institution, experienced trainers from the responsible institution, expert any anticipated technology, and if relevant, a representative from other components of the consortium doing related work, will be constituted to guide the activity. These groups will be time-limited and will have specific deliverables as identified in the workplan.

History

2003-05: Progress of HRSA BTCDP project # 6T01HPO1411-02-02
Columbia University has had a very successful experience with the continuing education proposal funded by the Bioterrorism Training and Curriculum Development Program (BTCDP) in 2003. The project proposed to develop an expanded program of continuing education in emergency preparedness for key health professionals in the greater New York City area by updating and expanding existing basic emergency preparedness and response competency-based training program for clinicians, developing and offering web-based training for all target audiences, evaluating all components of the project and developing a continuation plan. The targeted audience included hospital-based and community-based physicians, nurses, nurse practitioners, physician assistants and dentists, especially the 25,000 professionals associated with the New York-Presbyterian Healthcare System network of hospitals. The emphasis of this effort was to deliver the essential competencies in emergency preparedness and response training to clinicians who participate in the surge of support needed within a hospital’s emergency response plan but are not the clinicians who are first on the scene or first to receive patients. Funding for this project was made available to the Principal Investigator in late December, 2003, making the 2003-2004 project year only 9 months in length.

Six awareness-level training modules were identified as essential to the entire target audience with little need to tailor them to a specific discipline: An Introduction to Emergency Preparedness (2 hours), Biological Incidents (one hour), Chemical Incidents (one hour), Radiological and Nuclear Incidents (one hour), Explosive Incidents (one hour) and The Special Needs of the Pediatric Population (one hour). Each module reflects the four goals of the BTCDP, which are to: 1. recognize indications of a terrorist event; 2. meet the acute care needs of patients, including pediatric and other vulnerable populations, in a safe and appropriate manner; 3. participate in a coordinated, multi-agency response to terrorist events and other public health emergencies; and 4. rapidly and effectively alert the public health system of such an event at the community, state, and national level. The modules were based on a combination of core competencies for clinicians19 and competencies for all hospital workers20 and consistently addressed the above referenced goals by asking the learner to know how to recognize symptoms of chemical, biologic and radiological agents, know how to treat the injuries stemming from chemical, biologic, radiological agents, know his or her role and others’ roles in the response and know how to alert the public health system of his or her suspicions.

The project began with a comprehensive literature and web resource review to assure that updated specific content on key potential agents of terrorism with associated clinical management were included. The project staff worked collaboratively with the CPHP at Columbia, and with the HRSA BTCDP Curriculum Development Project at Columbia to assure that consistent approaches were being presented to all relevant audiences and to avoid duplicating existing materials. Six content experts joined the project, representing a variety of emergency preparedness venues, including Presbyterian Hospital, New York Methodist Hospital and Brooklyn Medical Center Emergency Departments, New York - Presbyterian Healthcare System Bio-terrorism Subcommittee, the federal Hazmat training program, the U.S. Navy Medicine Office of Homeland Security, the Hospital Emergency Local Planning Taskforce (jointly sponsored by the New York State Department of Health and the New York City Mayor’s Office of Emergency Management), and the Columbia University Mailman School of Public Health’s Center for Public Health Preparedness. The content experts had primary responsibility for designing the six training modules and worked from materials such as The Hospital Emergency Incident Command System,21 Advanced HAZMAT Life Support courses,22 Center for Disease Control and Prevention’s Emergency Preparedness and Response guidelines,23 Occupational Safety and Health Administration’s Emergency Preparedness and Response,24 and the American Academy of Pediatrics emergency care guidelines.25

In these awareness level trainings, emphasis was placed on the clinician whose main contribution to the response will be to report to the institution for assignment, rather than reporting to an emergency scene or to the emergency department during the event. This complements the specific subject matter on how to recognize and treat persons injured by a Chemical, Biological, Radiological, Nuclear and Explosive (CBRNE) incident or other naturally occurring emergency. This emphasis grew from the increasing awareness that while pre-hospital providers and emergency department clinicians had multiple opportunities to consider how incident command on scene and at the hospital might affect their work, most other clinicians did not have this observational opportunity. To encourage participation, continuing education credit was made available to all qualified participating clinicians.

All modules were first tested in a face-to-face classroom format using PowerPoint LCD projection of key material, a narrative and accompanying handouts for illustration, exercises and additional information. The forums were varied, including large group seminars with multiple modules and small group sessions presenting a single module. The audiences included hospital and community based clinicians (physicians, dentists, physician assistants and nurses) and a small number of hospital administrative staff.

Pre- and post-tests conducted at pilot presentations indicate a high level of learning, particularly on the emergency response system and expected roles. Each subsequent offering was adjusted in response to participant and presenter reactions during the presentation and from post-test and course evaluation materials. Adjustments included clarification of clinician roles per the specific incident featured, changes in distribution of time across the presentation, improvements in interactive exercises included in the training and changes in the content emphasized. Approximately 250 clinicians participated in at least one of these pilot sessions. The clinicians experienced at least one and as many as six of the modules. These individuals came from five hospitals within the New York Presbyterian system and included 100 physicians, 70 nurses, 60 dentists and 15 physician assistants, 10 administrators and 10 non-clinical personnel.

Introduction to the 2005-06 Project

Columbia University has expanded the current project through its partnership with Adelphi University (AU) and the University at Albany School of Public Health (UASPH) to form The New York Consortium for Emergency Preparedness Continuing Education (NYCEPCE). The mission of the NYCEPCE is to work under a cooperative agreement with the Health Resources and Services Administration to extend and strengthen the competency of health professionals in New York State and New York City to respond effectively to emergency events of all kinds. As a result of the competency-based continuing education to be offered through this Consortium, health professionals will have an increased ability to identify potential emergencies, respond rapidly within institutional and community incident management systems, communicate across clinical and public health organizational lines and provide effective care for those affected.

19 Association of Teachers of Preventive Medicine, Columbia University School of Nursing. (2005). Clinician Competencies During Initial Assessment and Management of Emergency Event. Available at: http://cpmcnet.columbia.edu/dept/nursing/institutes-centers/chphsr/clinician-comps.pdf

20 Center for Public Health Preparedness Columbia University Mailman School of Public Health, Center for Health Policy Columbia University School of Nursing. (2003). Emergency Preparedness and Response Competencies for Hospital Workers. July 2003. Available at: http://www.gnyha.org/eprc/general/guidelines/EmergencyPrepHospComps.pdf

21 HEICS San Mateo County Health Services Agency and the Emergency Medical Services. (1998). The Hospital Incident Command System, June 1998. Third Edition, Vol. 1. Available at: http://www.emsa.cahwnet.gov/Dms2/HEICS98a.pdf

22 Advanced HAZMAT Life Support. Available at: http://www.ahls.org/

23 Center for Disease Control and Prevention’s Emergency Preparedness and Response guidelines. Available at: http://www.bt.cdc.gov/

24 Occupational Safety and Health Administration’s Emergency Preparedness and Response. Available at: http://www.osha.gov/fso/osp/innovations.html.

25 American Academy of Pediatrics (2001). Care of Children in the Emergency Department: Guidelines for Preparedness. Pediatrics Vol. 107 No. 4, pp 777-781.

 

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©2006 The New York Consortium for Emergency Preparedness Training for Hospital Clinicians Continuing Education