According to Indiana projections, an outbreak of pandemic flu attacking 15 percent of the population could cause more than 16,000 total excess hospital admissions over eight weeks. With a 35 percent attack rate, excess admissions soar to 39,000 (Indiana State Department of Health, 2006). In a state with just over 17,600 total hospital beds, such surges could cripple hospitals and clinics that are already operating at close to capacity.
At Purdue, industrial engineering professor Mark Lawley and a team of researchers are helping Indiana prepare for a bird flu outbreak through their work with local health departments in the state.
Lawley spent last year on sabbatical working for St. Vincent’s Hospital in Birmingham, Alabama, evaluating pandemic plans through the use of simulation modeling. That experience equipped him to lead a similar project through Purdue’s Regenstrief Center for Healthcare Engineering, focusing on accessing Indiana’s degree of plan preparedness for a pandemic flu outbreak.
Lawley assembled a large interdisciplinary team that included Deb Koester, a Doctor of Nursing Practice (DNP) student, along with individuals from a variety of backgrounds and experiences such as nursing, computer graphics technology, civil engineering, industrial engineering, and statistics.
The team visited or called every local health department in Indiana to assess every aspect of its ongoing public health effort in pandemic planning. Important items discussed included the health department’s interaction with key stakeholders in the community, such as politicians, emergency medical services, law enforcement, healthcare providers, local businesses, and community support agencies. Also, the group surveyed how local health departments are currently receiving information from healthcare providers and how they plan to obtain evolving, changing communication in the event of a pandemic. The team also surveyed the means of communicating with the public, contingency plans for how health services and businesses will continue to operate during an outbreak, and mass planning for vaccines, medicine, and mortuary services.
“Most departments had already thought about these issues,” says Lawley. “We were trying to assess how far along they were in the process.” After developing reports for each county, the group summarized the results for the state.
“Proper planning by local health departments will allow for the most effective emergency response during a pandemic by each of the 94 counties in a coordinated manner,” says Koester. “Counties throughout the state are currently in the process of developing plans in cooperation with the Indiana State Department of Public Health and Indiana Department of Homeland Security.” At this point, the state is focused on tabletop exercises, where community plans are exercised for a hypothetical scenario, volunteer management, design of alternate care facilities, and public education so that people will know what actions to take during an emergency.
Lawley would like to apply his team’s findings to system assessment and modeling tools, so that research team can see how the different plans across the counties could be coordinated state–wide. Synchronizing the plans is important so that resources can be used efficiently in order to save lives during a public health emergency.