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RDHRS Pilot Projects Demonstrate Value during the COVID-19 Response

The Regional Disaster Health Response System​ (RDHRS) pilots address health care preparedness, establish best practices, and explore th​e effectiveness and viability of an RDHRS across the United States. The projects also support building ASPR’s first regional Centers of Excellence.

​In the second year of the pilot projects, beginning in late September 2019, the two recipients— University of Nebraska Medical Center in Omaha, Nebraska and Massachusetts General Hospital in Boston, Massachusetts— were initially focused on creating several initiatives to improve health care preparedness. However, in light of COVID-19, they rapidly pivoted to a response posture.

The effectiveness of their response reflects a dedication to the goals of the second year of the pilots, which include providing clinical expertise to support health care surge planning, increasing situational awareness of health care systems, and updating resource management processes.

The RDHRS pilots support COVID-19 preparedness and response efforts by:

 

Region 7 Regional Disaster Health Response Ecosystem (RDHRE) Successes

The Region 7 DHRE leveraged first-year pilot successes to respond to COVID-19 in four critical areas:

Bring Together Critical Stakeholders

        • ​Cultivated relationships established during Year One including those with the following entities: the Nebraska Emergency Management Agency, National Guard, and other public health officials.

Share Relevant Information

        • ​​​Created a state-wide medical operations coordination center (MOCC), which conducted daily briefings and discussions on key opportunities and vulnerabilities throughout the state.
        • Con​ducted six regional webinars to share promising practices for addressing health system challenges. These webinars were attended by more than 1,000 people, and there were 2,500 visits to the DHRE webpage between February and June.
        • Created a regional map and dashboard to display COVID-19 case counts and an overlay of health care facilities, vulnerable populations and other critical information for managing response.
        • Developed a standardized, state-wide information-sharing platform, Knowledge Center. As of May 13, 2020, 92 interrelated COVID-19 events with more than 4,700 unique log entries have been made in the Knowledge Center including, an uploaded document, a resource request, meeting minutes, or a statement of information.

Provide Needed Expertise

        • Created, organized, and delivered resources to improve understanding of the challenges and impact of COVID-19 on the region.
        • Contributed to the development of a standard operating procedure (sharing protocols, developing plans for specific workflows and spaces) for the distribution of ultraviolet light germicidal irradiation towers to each of the six Nebraska health care coalitions (HCC) for decontamination and re-use of N-95 masks.

Prepare for Additional COVID-19 Cases

        • Facilitated a NE/RegionVII after-action, virtual conference to better understand successes, lessons learned, and remaining gaps from Phase 1 of the COVID-19 response.
        • Collaborated with Nebraska leaders to create a forecasting and recovery data tool that can be used across other states in the region.
        • Building upon strengths and areas for improvement from the past several months of response efforts.
        • Working with FEMA and regional ASPR leaders to assess shortages of supplies and barriers to obtaining and conserving PPE.
        • Collaborating with Region VII federal partners to better understand, help facilitate, and provide any needed subject matter expertise for future vaccine distribution strategies.

Region 1 Regional Disaster Health Response System (R1 RDHRS)

The R1 RDHRS leveraged first year pilot successes to respond to COVID-19 in four critical areas:

Bring Together Critical Stakeholders

        • Partnered with state public health departments and specialty medical providers to maximize equitable access to life-saving health care and public health system resources, including ventilators and extracorporeal membrane oxygenation (ECMO) centers.

Share Relevant Information

        • ​​​​​Created and disseminated relevant COVID-19 resources, including clinical knowledge toolkits, emerging promising practices, and protocols to health care organizations across the state, region, and country.

Provide Needed Expertise

        • Established a group of clinical representatives from all area hospitals to optimize intensive care unit (ICU) surge capacity and load-balance the distribution of critically ill, COVID-19 positive patients to ensure ICU beds were always available to critically ill patients in a timely fashion.
        • Established a committee of subject matter experts to:
        • Provide clinical expertise to local and state partners related to alternate care site (ACS) planning;
        • Provide recommendations to state partners on the best approach for collaborating with skilled nursing facilities (SNF) and long-term acute care hospitals to better ensure COVID-19 positive patients can be discharged as needed to post-acute facilities;
        • Adapt the Boston Convention Center into a large ACS in conjunction with the Governor of Massachusetts; and
        • Develop a live disaster telemedicine pilot system capable of supporting real-time access to critical care specialists for hospitals in need. The system features a rapidly deployable, easy-to-use, HIPAA-compliant telemedicine platform that can provide hospitals with access to obtain critical care expertise regarding the care of COVID-19 positive patients.

Prepare for Additional COVID-19 Cases

        • ​​​Participated in an ASPR Technical Resources, Assistance Center, and Information Exchange (TRACIE) "Use of Telemedicine in Alternate Care Sites" webinar addressing the use of telemedicine to deliver usual medical care and provide access to necessary medical specialists (such as intensivists) in a disaster.
        • Working with the MA Department of Public Health to acquire new ventilators for surge events.
        • Examining how best to evaluate, acquire, and distribute PPE from the state and other sources to assure the safety of the health care workforce and support continuity of services.
        • Collaborating with the MA Department of Public Health to develop a formal, permanent policy and mechanism to distribute ventilators and other specialty medical devices across the health care system through a partnership with state authorities and appropriate medical experts.

To learn ​more, please visit the NE/Region 7 DHRE COVID-19 Resources webpage and the R1 RDHRS COVID-19 Resource webpage.​​