Hospital Preparedness Program (HPP) Ebola / OSP Preparedness Measures

---

Overview

Ebola Implementation Guidance
Ebola Part A - Admin Info
Ebola Part A - ETC(s)
Ebola Part A - AH(s)
Ebola Part A - Awardee HCC PMs
Ebola Part A - ETC Ebola PM
Ebola Part A - ETC OSP PM
Ebola Part A - AH Ebola PM
Ebola Part A - AH OSP PM
Ebola Part A - Impact

---

Sheet 1: Ebola Implementation Guidance

Number	1
Part	A
Activity	Activity A: Develop a Concept of Operations.
Measure	Time, in minutes, it takes from an assessment hospital’s notification to the health department of the need for an inter-facility transfer of a patient confirmed with Ebola or other special pathogen to the arrival of a staffed and equipped EMS/inter-facility transport unit, as evidenced by a no-notice exercise or real-world event.
	*Note: This measure does not apply for awardees/facilities addressing other special pathogens
Reporting Element	Assessment Hospital
Data Source	Coalition or Assessment Hospital Exercise or Real-World Event
Metrics	Start Time: Time the health department was notified by the assessment hospital, or time from the health department’s decision, of the need for an inter-facility transfer.
	Stop Time: Time of arrival of a staffed and equipped EMS/inter-facility transport unit.
Goal	Within 240 minutes or 4 hours
Definitions	Assessment Hospital: Pre-designated facilities that are prepared to receive and isolate a patient under investigation (PUI) for Ebola and care for the patient until an Ebola diagnosis can be confirmed or ruled out and until discharge or transfer is completed.
	EMS/Inter-facility transport unit: Entities identified in the awardee’s CONOPS responsible for the transport and patient care during transport of an actively monitored or directly actively monitored (AM/DAM) patient to an Ebola assessment facility or to provide inter-facility transport (i.e., from a frontline facility to an Ebola assessment/treatment facility or from an Ebola assessment facility to an Ebola treatment facility).
	No-notice exercise: Unannounced exercise, including drills, functional, and full-scale exercises.
Number	2
Part	A
Activity	Activity B: Assure Readiness of Ebola Treatment Centers.
Measure	Proportion of rostered/covered staff that are trained in safely donning and doffing personal protective equipment (PPE).
Reporting Element	Ebola Treatment Center
Data Source	Ebola Treatment Center
Metrics	Numerator: Total number of rostered/covered staff that completed training.
	Denominator: Total number of rostered/covered staff.
Goal	100% of rostered/covered staff
Definitions	Rostered/covered Staff: Individuals that have been pre-identified to provide ongoing care and treatment to patients with confirmed Ebola or patient under investigation (PUI).
	Donning: The administration or act of putting on PPE.
	Doffing: The removal of used PPE; this is a high-risk process that requires a structured procedure, a trained observer, and a designated area for removal to ensure protection.
	Trained: Individuals who have completed Ebola/infection control and safety training to specifically include proper donning (putting on PPE) and doffing (taking off PPE) methods. (http://www.cdc.gov/vhf/ebola/hcp/ppe-training/)
	PPE: Devices or equipment designated to provide protection while providing care for a confirmed or suspected patient with Ebola.
Number	3
Part	A
Activity	Activity B: Assure Readiness of Ebola Treatment Centers.
Measure	Time it takes for all rostered/covered staff to receive just-in-time (JIT) training, upon notification of a patient with Ebola or other special pathogen at the regional Ebola and other special pathogen treatment center.
Reporting Element	Ebola Treatment Center
Data Source	Ebola Treatment Center Exercise or Real-World Event
Metrics	Start Time: Time of notification (in hours and minutes) of a patient confirmed with Ebola or other special pathogen at the regional Ebola and other special pathogen treatment center.
	Stop Time: Time all rostered/covered staff completed JIT training (in hours and minutes).
Goal	Within 72 hours
	*Note: Recommendation from facilities that have successfully treated Ebola is for JIT training to be completed within 24 hours.
Definitions	Notification: The ETC receives notification from the health department that the regional Ebola and other special pathogen treatment facility in their region received a confirmed patient.
	Rostered/covered Staff: Individuals that have been pre-identified to provide ongoing care and treatment to patients with confirmed Ebola or patient under investigation (PUI).
	Just-In-Time (JIT) training: Training that is conducted as a refresher to prepare for a patient with Ebola or other special pathogen, including donning and doffing, facility-specific protocols and procedures, and care/treatment protocols.
Number	4
Part	A
Activity	Activity B: Assure Readiness of Ebola Treatment Centers.
Measure	Time until an Ebola treatment center is ready to admit a patient with Ebola or other special pathogen as evidenced by an exercise or actual patient transfer.
Reporting Element	Ebola Treatment Center
Data Source	Ebola Treatment Center Exercise or Real-World Event
Metrics	Start Time: Time the ETC was notified (in hours and minutes) that a patient confirmed with Ebola or other special pathogen was admitted to the regional Ebola and other special pathogen treatment center in their region.
	Stop Time: Time ETC is ready to admit a patient with Ebola or other special pathogen (in hours and minutes).
Goal	Within 72 hours (upon notification of a patient confirmed with Ebola or other special pathogen at a regional Ebola and other special pathogen treatment centers)
	*Note: Recommendation from facilities that have successfully treated Ebola is for ETCs to be ready to admit a patient within 24 hours.
Definitions	Notification: The ETC receives notification from the health department that the regional Ebola and other special pathogen treatment center in their region received a confirmed patient.
Number	5
Part	A
Activity	Activity B: Assure Readiness of Ebola Treatment Centers.
Measure	Proportion of rostered/covered staff contacted by hospital within 4 hours of a patient confirmed with Ebola or other special pathogen admission to a regional Ebola and other special pathogen treatment center.
Reporting Element	Ebola Treatment Center
Data Source	Ebola Treatment Center Exercise or Real-World Event
Metrics	Numerator: Number of rostered/covered staff contacted within 4 hours of notification of a patient with confirmed Ebola at the regional Ebola and other special pathogens treatment center.
	Denominator: Total number of rostered/covered staff.
Goal	100% of rostered/covered staff
Definitions	Rostered/covered Staff: Individuals that have been pre-identified to provide ongoing care and treatment to patients with confirmed Ebola or patient under investigation (PUI).
	Confirmation: Laboratory-confirmed diagnostic evidence of Ebola virus or other special pathogen.
	Contact: The hospital successfully contacted the staff members (and received a response) by phone, email, or automated alert system.
Number	6
Part	A
Activity	Activity B: Assure Readiness of Ebola Treatment Centers.
Measure	Proportion of rostered/covered staff contacted that indicated they are able to report to fulfill Ebola or other special pathogen-related staffing needs within 72 hours.
Reporting Element	Ebola Treatment Center
Data Source	Ebola Treatment Center Exercise or Real-World Event
Metrics	Numerator: Number of rostered/covered staff able to report within 72 hours to fulfill Ebola or other special pathogen-related staffing needs.
	Denominator: Total number of rostered/covered staff contacted.
Goal	100% of contacted rostered/covered staff
Definitions	Rostered/covered staff: Individuals that have been pre-identified to provide ongoing care and treatment to patients with confirmed Ebola or patient under investigation (PUI).
	Contact: The hospital successfully contacted the staff members (and received a response) by phone, email, or automated alert system.
Number	7
Part	A
Activity	Activity B: Assure Readiness of Ebola Treatment Centers.
Measure	Proportion of Ebola Treatment Centers (ETCs) that can access their PPE supply (i.e., know location and have sufficient quantity of unexpired supply) within 10 minutes of transfer notification or upon the patient’s arrival (if no notification) of a patient suspected of Ebola or other special pathogen.
Reporting Element	Ebola Treatment Center
Data Source	Ebola Treatment Center Exercise or Real-World Event
Metrics	Numerator: Number of ETCs that can access their PPE supply within 10 minutes of transfer notification or upon the patient’s arrival (if no notification) of patient suspected with Ebola or other special pathogen.
	Denominator: All ETCs in an awardee’s jurisdiction.
Goal	100% of Ebola Treatment Centers
Definitions	Transfer Notification: The ETC receives notification from the health department, assessment hospital, or EMS of an incoming patient suspected of Ebola or other special pathogen.
	PPE Access: The ability to identify the location and have sufficient quantity of unexpired supply of PPE at the patient care location(s) (e.g., emergency department, intensive care unit, Ebola treatment unit).
	Sufficient: The extent to which the availability of PPE supplies meets the pre-identified needs (i.e., CDC guidelines, needs assessment, CONOPS).
Number	8
Part	A
Activity	Activity B: Assure Readiness of Assessment Hospitals.
Measure (Ebola)	Time, in seconds, from active monitoring/direct active monitoring (AM/DAM) patient’s arrival to placement in isolation at assessment hospital.
Measure (OSP)	This measure does not apply for assessment hospitals addressing other special pathogens
Reporting Element	Assessment Hospital
Data Source	Assessment Hospital Exercise or Coalition Exercise, or Real-World Event
Metrics	Start Time: Time in minutes and seconds of AM/DAM patient’s arrival at assessment hospital.
	Stop Time: Time in minutes and seconds of AM/DAM patient’s placement in isolation at assessment hospital.
Goal	Less than or equal to 60 seconds
Definitions	AM/DAM: Active monitoring means that the state or local public health authority assumes responsibility for establishing regular communication with potentially exposed individuals, including checking daily to assess for the presence of symptoms and fever, rather than relying solely on individuals to self-monitor and report symptoms if they develop. Direct active monitoring means the public health authority conducts active monitoring through direct observation.
	Isolation: Precautions that are taken in a health care facility to prevent the spread of an infectious agent from an infected or colonized patient to susceptible persons. Isolation practices can include placement in a private room or with a select roommate, the use of protective barriers such as masks, gowns and gloves, a special emphasis on handwashing (which is always very important), and special handling of contaminated articles.
Number	9
Part	A
Activity	Activity B: Assure Readiness of Assessment Hospitals.
Measure	Time, in minutes, it takes an assessment hospital to identify and isolate a patient suspected with Ebola or other special pathogen following emergency department triage, as evidenced by a real-world case or no-notice exercise.
Reporting Element	Assessment Hospital
Data Source	Assessment Hospital Exercise or Coalition Exercise, or Real-World Event
Metrics	Start Time: Time of the initiation of an emergency room triage in minutes and seconds.
	Stop Time: Time the patient is placed in isolation in minutes and seconds.
Goal	Less than or equal to 5 minutes
Definitions	No-notice exercise: Unannounced exercise, including drills, functional, and full-scale exercises.
Number	10
Part	A
Activity	Activity B: Assure Readiness of Assessment Hospitals.
Measure (Ebola)	Proportion of health care facility and emergency medical services (EMS) workers in PPE, of those make contact with an AM/DAM suspected Ebola patient under investigation (PUI) after health department notification to the assessment hospital and/or EMS Agency.
Measure (OSP)	Proportion of health care facility and emergency medical services (EMS) workers in PPE that a patient suspected of an other special pathogen makes contact with after health department notification to the assessment hospital or EMS agency.
Reporting Element	Assessment Hospital
Data Source	Assessment Hospital Exercise or Coalition Exercise, or Real-World Event
Metrics	Numerator: The number of health care facility and EMS workers in PPE while in contact with an AM/DAM Ebola patient (or patient suspected of an other special pathogen) after notification to an EMS agency or assessment hospital.
	Denominator: The total number of health care facility and EMS workers in contact with an AM/DAM Ebola patient, after notification to an EMS agency or assessment hospital.
Goal	100% of health care facility and EMS workers
	*Note that the goal is for no health care or EMS worker to be without PPE while in contact with an AM/DAM suspected Ebola patient after notification.
Definitions	AM/DAM: Active monitoring means that the state or local public health authority assumes responsibility for establishing regular communication with potentially exposed individuals, including checking daily to assess for the presence of symptoms and fever, rather than relying solely on individuals to self-monitor and report symptoms if they develop. Direct active monitoring means the public health authority conducts active monitoring through direct observation.
	Notification: Communication of a PUI or suspected patient to an assessment hospital.
	Start time: The assessment hospital or EMS agency receives notification from the health department of an incoming patient suspected of Ebola or other special pathogen, or patient’s arrival (if no notification).
	Stop time: When discharge or transfer is completed.
Number	11
Part	A
Activity	Activity B: Assure Readiness of Assessment Hospitals.
Measure (Ebola)	Number of health care facility and EMS workers in PPE that an AM/DAM suspected Ebola patient makes contact with after health department notification until isolation.
Measure (OSP)	This measure does not apply for assessment hospitals addressing other special pathogens
Reporting Element	Assessment Hospital
Data Source	Assessment Hospital Exercise or Coalition Exercise, or Real-World Event
Metrics	Number of health care facility and EMS workers in PPE that make contact with an AM/DAM suspected patient between the time of notification and isolation.
Goal	Less than or equal to 3
Definitions	AM/DAM patients: Active monitoring means that the state or local public health authority assumes responsibility for establishing regular communication with potentially exposed individuals, including checking daily to assess for the presence of symptoms and fever, rather than relying solely on individuals to self-monitor and report symptoms if they develop. Direct active monitoring means the public health authority conducts active monitoring through direct observation.
	Isolation: Precautions that are taken in a health care facility to prevent the spread of an infectious agent from an infected or colonized patient to susceptible persons. Isolation practices can include placement in a private room or with a select roommate, the use of protective barriers such as masks, gowns and gloves, a special emphasis on handwashing (which is always very important), and special handling of contaminated articles.
	Start time: The assessment hospital or EMS agency receives notification from the health department of an incoming patient suspected of Ebola or other special pathogen, or patient’s arrival (if no notification).
	* Note: Health care facility and EMS involve all hospital or EMS personnel in the facility or transport unit in either clinical or non-clinical roles
Number	12
Part	A
Activity	Activity B: Assure Readiness of Assessment Hospitals.
Measure	Proportion of emergency department staff trained at least annually in infection control and safety.
Reporting Element	Assessment Hospital
Data Source	Assessment Hospital
Measure	Numerator: Number of emergency department staff trained at least annually in infection control and safety.
	Denominator: Total number of emergency department staff.
Goal	100% of emergency department staff
Definitions	Infection control and safety: Policies and procedures used to minimize the risk of spreading infections, especially in health care facilities (e.g. identification/isolation principles, clinical protocols for laboratory and patient care while in PPE, and bodily fluid clean-up/containment).
Number	13
Part	A
Activity	Activity B: Assure Readiness of Assessment Hospitals.
Measure	Proportion of intensive care unit staff trained at least annually in infection control and safety.
Reporting Element	Assessment Hospital
Data Source	Assessment Hospital
Metrics	Numerator: Number of intensive care unit staff trained at least annually in infection control and safety.
	Denominator: Total number of intensive care unit staff.
Goal	100% of intensive care unit staff
Definitions	Infection control and safety: Policies and procedures used to minimize the risk of spreading infections, especially in health care facilities (e.g. identification/isolation principles, clinical protocols for laboratory and patient care while in PPE, and bodily fluid clean-up/containment).
Number	14
Part	A
Activity	Activity B: Assure Readiness of Assessment Hospitals.
Measure	Proportion of assessment hospitals that can access their PPE supply (i.e., know location and have sufficient quantity of unexpired supply) within 10 minutes of transfer notification or arrival, if no notification, of a patient suspected with Ebola or other special pathogen.
Reporting Element	Assessment Hospital
Data Source	Assessment Hospital Exercise
Metrics	Numerator: Number of assessment hospitals that can access their PPE supply within 10 minutes of transfer notification or arrival, if no notification, of a patient suspected with Ebola  or other special pathogen.
	Denominator: Number of assessment hospitals in the awardee’s jurisdiction.
Goal	100% of Assessment Hospitals
Definitions	Assessment Hospital: Pre-designated facilities that are prepared to receive and isolate a PUI for EVD and care for the patient until an Ebola diagnosis can be confirmed or ruled out and until discharge or transfer is completed.
	Transfer Notification: The ETC receives notification from the health department, assessment hospital, or EMS of an incoming patient suspected of Ebola or other special pathogen.
	PPE Access: The ability to identify the location and have sufficient quantity of unexpired supply of PPE at the patient care location (e.g. emergency department, intensive care unit, Ebola treatment unit).
	Sufficient: The extent to which the availability of PPE supplies can meet the pre-identified needs (i.e., CDC guidelines, needs assessment, CONOPS).
Number	15
Part	A
Activity	Activity C: Develop Capabilities of Health Care Coalitions to enable their members to care for Ebola patients.
Measure (Ebola)	Proportion of frontline facilities that receive information from their coalition on the quantity and location of personal protective equipment (PPE) supply within 8 hours of a patient under investigation’s (PUI) arrival at a coalition member facility.
Measure (OSP)	Proportion of frontline facilities that receive information from their coalition on the quantity and location of personal protective equipment (PPE) supply within 8 hours of a suspected patient arrival at a coalition member facility.
Reporting Element	Frontline Facility
Data Source	Coalition Exercise
Metrics	Numerator: Number of frontline facilities that receive information about PPE quantities and locations of PPE from their coalition within 8 hours of a patient under investigation’s (PUI) arrival at a coalition member’s facility.
	Denominator: Total number of frontline facilities in the coalition.
Goal	100% of frontline facilities
Definitions	Frontline Facility: Frontline facilities are hospitals and other health care providers that are not designated Ebola assessment hospitals or Ebola treatment centers that have the possibility of a suspected Ebola or other special pathogen patient encounter if a patient were to access the health care system.
Number	16
Part	A
Activity	Activity C: Develop Capabilities of Health Care Coalitions to enable their members to care for Ebola patients.
Measure	Proportion of frontline facilities that have received coalition-funded training.
Reporting Element	Coalition
Data Source	Coalition
Metrics	Numerator: Total number of frontline facilities that received coalition-funded training.
	Denominator: Total number of frontline facilities in the coalition.
Goal	75% of frontline facilities received coalition-funded training
Definitions	Frontline Facility: Frontline facilities are hospitals and other health care providers that are not designated Ebola assessment hospitals or Ebola treatment centers that have the possibility of a suspected Ebola patient encounter if a patient were to access the health care system outside of the active monitoring/direct active monitoring program.
Number	17
Part	A
Activity	Activity C: Develop Capabilities of Health Care Coalitions to enable their members to care for Ebola patients.
Measure	Proportion of EMS agencies engaged in all phases of the Ebola and other special pathogen preparedness process, of those that are required to execute the awardee’s CONOPs that are.
Reporting Element	Coalition
Data Source	Coalitions and awardee
Metrics	Numerator: Number of EMS agencies engaged in all phases of Ebola and other special pathogen preparedness process, of those required to execute the awardee’s CONOPs.
	Denominator: Number of EMS agencies that are required to execute the awardee’s CONOPs
Goal	100% of EMS agencies
Definitions	EMS agencies required to execute the awardee’s CONOPS: EMS agencies that will provide 9-1-1 emergency medical services to suspect Ebola patients’ homes or other locations; inter-facility EMS agencies that will transport suspect or confirmed patients with Ebola between frontline health care facilities, assessment hospitals, Ebola treatment centers, regional Ebola and other special pathogen treatment centers, and airports.
	All Phases of the Ebola and other special pathogen Preparedness Process: All Phases includes planning, training, exercising, and responding with other Ebola preparedness partners.
Number	18
Part	A
Activity	Activity C: Develop Capabilities of Health Care Coalitions to enable their members to care for Ebola and other special pathogen patients.
Measure	Proportion of coalitions within an awardee’s jurisdiction that participate in the Health care-Associated Infection (HAI)/Infection Control
	advisory group
Reporting Element	Coalition
Data Source	Awardee
Metrics	Numerator: Number of coalitions participating in the HAI Advisory group.
	Denominator: Number of coalitions within an Awardees jurisdiction.
Goal	80% of coalitions participate in HAI Advisory Group
Definitions	HAI Advisory Group: An advisory committee charged with making recommendations on the prevention of health care-associated infections.

---

Sheet 2: Ebola Part A - Admin Info

U.S. Department of Health and Human Services Hospital Preparedness Program (HPP) Ebola Part A End-of-Year Preparedness Measures Administrative Information

Awardee

Maryland

Point of Contact

Address

City/Town

Select

State/Province

Jurisdiction planned and exercised an Ebola scenario in Year 2

Zip/Postal Code

Jurisdiction planned and exercised an other special pathogen scenario in Year 2

Email Address

Phone Number

Note: Please enter the total amount that is added together all year in Year 3.

Total Amount Allocated

Total Amount Disbursed

Status of the Jurisdiction Facilities

Select

---

Sheet 3: Ebola Part A - ETC(s)

U.S. Department of Health and Human Services Hospital Preparedness Program (HPP) Ebola Part A End-of-Year Preparedness Measures Ebola Treatment Centers (ETCs)

Facility Name*

Address

City

State

Zip code

Amount Allocated

Amount Disbursed

Status (Choose from the Dropdown List)

Total Amount

$0.00

$0.00

University of Maryland, Medical Center

22 S Greene St

Baltimore

Maryland

21201

Active ETC, exercising Ebola

Johns Hopkins Hospital

1800 Orleans Street

Baltimore

Maryland

21287

Active ETC, exercising OSP

Select

Select

Select

Select

Select

Select

Select

Select

*Note:If any assessment hospitals (AHs) from the previous year have switched to an ETC in the Year 3, you do not need to enter the information again in this worksheet. Please go to the Ebola Part A – AH(s) worksheet and change the status of the pre-populated facility, which will automatically appear in the Ebola Part A - ETC(s) worksheet.

Select

Active ETC, exercising Ebola

Active ETC, exercising OSP

ETC switched to AH in Year 3, exercising Ebola

ETC switched to FH in Year 3

No longer a participating facility

---

Sheet 4: Ebola Part A - AH(s)

U.S. Department of Health and Human Services Hospital Preparedness Program (HPP) Ebola Part A End-of-Year Preparedness Measures Assessment Hospitals (AHs)

Select

Facility Name*

Address

City

State

Zip code

Amount Allocated

Amount Disbursed

Status (Choose from the Dropdown List)

Active AH, exercising Ebola

Total Amount

$0.00

$0.00

Active AH, exercising OSP

Anne Arundel Medical Center

5712 Warwick Pl

Chevy Chase

Maryland

20815

Active AH, exercising Ebola

AH switched to ETC in Year 3, exercising Ebola

Frederick Memorial Hospital

400 W 7th St

Frederick

Maryland

21701

Active AH, exercising OSP

AH switched to FH in Year 3

Holy Cross Hospital

1500 Forest Glen Road

Silver Spring

Maryland

20910

Select

No longer a participating facility

Peninsula Regional Medical Center

100 E Carroll St

Salisbury

Maryland

21801

Select

MedStar Southern Maryland Hospital Center

7503 Surratt's Road

Clinton

Maryland

20735

Select

Select

Select

Select

Select

Select

*Note:If any Ebola Treatment Center (ETC) from the previous year has switched to an AH in the year 3, you do not need to enter the information again. Please go to Ebola Part A - ETC(s) worksheet and change the status of the pre-populated facility, which will automatically appear in the Ebola Part A - AH(s) worksheet.

---

Sheet 5: Ebola Part A - Awardee HCC PMs

Performance Measure Number

U.S. Department of Health and Human Services Hospital Preparedness Program (HPP) Ebola Part A End-of-Year Preparedness Measures Awardee/Healthcare Coalition (HCC) Performance Measures

Response

Activity A: Develop a Concept of Operations

Does the concept of operations include a signed agreement between your jurisdiction and the jurisdiction where the regional Ebola and other special pathogen treatment center is located allowing for the transfer of a patient with Ebola

Health Care Coalitions

Yes

Does the concept of operations include a plan for coordinating with other states within the region to identify airports that can accept air transport of Ebola patients

Frontline Facilities

No

Does the concept of operations include a jurisdictional-level communications strategy for notifying health care partners

EMS

Does the concept of operations include a plan for the safe intra-state transport of potential or confirmed Ebola patients

Assessment Hospitals

Does the concept of operations include a plan for the safe inter-state transport of potential or confirmed Ebola patients to a regional Ebola and other special pathogen treatment center

Ebola Treatment Centers

If "NO", please specify the date you will meet these requirement (MM/DD/YYYY)

Other (please specify)

Does your concept of operations identify roles and responsibilities for the following: (choose all that apply)

If "Other", please specify

Activity B: Assure Readiness of Ebola Treatment Centers

Total Number of Ebola treatment centers (ETCs) (Denominator for PM7)

2

1

1

Activity B: Assure Readiness of Assessment Hospitals

1

Total Number of Assessment hospitals (AHs) (Denominator for PM14)

1

Activity C : Develop Capabilities of Health Care Coalitions to enable their members to care for Ebola patients

Total Number of frontline facilities in the coalition (Denominator for PM15,PM15(OSP),PM16)

15

Number of frontline facilities that receive information from their coalition on the quantity and location of personal protective equipment (PPE) supply within 8 hours of a patient under investigation’s (PUI) arrival at a coalition member facility (Goal:100% of frontline facilities)

15(OSP)

Number of frontline facilities that receive information from their coalition on the quantity and location of personal protective equipment (PPE) supply within 8 hours of a suspected patient arrival at a coalition member facility (Goal:100% of frontline facilities)

16

Number of frontline facilities that have received coalition-funded training (Goal:75% of frontline facilities received coalition-funded training)

Total Number of EMS agencies that are required to execute the awardee’s CONOPs (Denominator for PM17)

17

Number of EMS agencies engaged in all phases of Ebola and other special pathogen preparedness process, of those required to execute the awardee’s CONOPs (Goal:100% of EMS agencies)

Total Number of coalitions within the jurisdiction (Denominator for PM18)

5

18

Number of coalitions within an awardee’s jurisdiction that participate in the Health care-Associated Infection (HAI)/Infection Control (Goal:80% of coalitions participate in HAI Advisory Group)

Comments/Additional information

---

Sheet 6: Ebola Part A - ETC Ebola PM

Performance Measure Number

U.S. Department of Health and Human Services Hospital Preparedness Program (HPP) Ebola Part A End-of-Year Preparedness Measures Ebola Treatment Centers Ebola Performance Measures

Ebola Treatment Centers Ebola Performance Measures

University of Maryland, Medical Center

ETC3

ETC4

ETC5

ETC6

ETC7

ETC8

ETC9

ETC10

Activity A: Develop a Concept of Operations

1

Time, in minutes, it takes from an assessment hospital’s notification to the health department of the need for an inter-facility transfer of a patient confirmed with Ebola or other special pathogen to the arrival of a staffed and equipped EMS/inter-facility transport unit, as evidenced by a no-notice exercise (Goal: Within 240 minutes or 4 hours)

Activity B: Assure Readiness of Ebola Treatment Centers

Health Care Coalitions

Total Number of rostered/covered staff (Denominator for PM2,PM5,PM6)

Frontline Facilities

2

Total Number of rostered/covered staff that are trained in safely donning and doffing personal protective equipment (PPE) (Goal : 100% of rostered/covered staff)

EMS

3

Time, in hours, it takes for all rostered/covered staff to receive just-in-time (JIT) training, upon notification of a patient with Ebola or other special pathogen at the regional Ebola and other special pathogen treatment center (Goal : Within 72 hours)

Assessment Hospitals

4

Time, in hours, until an Ebola treatment center is ready to admit a patient with Ebola or other special pathogen as evidenced by an exercise or actual patient transfer (Goal: Within 72 hours)

Ebola Treatment Centers

5

Number of rostered/covered staff contacted by hospital within 4 hours of a patient confirmed with Ebola or other special pathogen admission to a regional Ebola and other special pathogen treatment center (Goal : 100% of rostered/covered staff)

Other (please specify)

6

Number of rostered/covered staff contacted that indicated they are able to report to fulfill Ebola or other special pathogen-related staffing needs within 72 hours (Goal :100% of contacted rostered/covered staff)

7

Are the Ebola treatment centers (ETCs) able to access their PPE supply (i.e., know location and have sufficient quantity of unexpired supply) within 10 minutes of transfer notification or upon the patient’s arrival (if no notification) of a patient suspected of Ebola or other special pathogen? (Goal:100% of Ebola Treatment Centers)

Comments/Additional information

Yes

No

---

Sheet 7: Ebola Part A - ETC OSP PM

Performance Measure Number	U.S. Department of Health and Human Services Hospital Preparedness Program (HPP) Ebola Part A End-of-Year Preparedness Measures Ebola Treatment Centers Other Special Pathogens Performance Measures
		Johns Hopkins Hospital	ETC3	ETC4	ETC5	ETC6	ETC7	ETC8	ETC9	ETC10
Activity B: Assure Readiness of Ebola Treatment Centers
	Total Number of rostered/covered staff (Denominator for PM2,PM5,PM6)
2	Total Number of rostered/covered staff that are trained in safely donning and doffing personal protective equipment (PPE) (Goal : 100% of rostered/covered staff)
3	Time, in hours, it takes for all rostered/covered staff to receive just-in-time (JIT) training, upon notification of a patient with Ebola or other special pathogen at the regional Ebola and other special pathogen treatment center (Goal : Within 72 hours)
4	Time, in hours, until an Ebola treatment center is ready to admit a patient with Ebola or other special pathogen as evidenced by an exercise or actual patient transfer (Goal: Within 72 hours)
5	Number of rostered/covered staff contacted by hospital within 4 hours of a patient confirmed with Ebola or other special pathogen admission to a regional Ebola and other special pathogen treatment center (Goal : 100% of rostered/covered staff)
6	Number of rostered/covered staff contacted that indicated they are able to report to fulfill Ebola or other special pathogen-related staffing needs within 72 hours (Goal :100% of contacted rostered/covered staff)
	Comments/Additional information

---

Sheet 8: Ebola Part A - AH Ebola PM

Performance Measure Number

U.S. Department of Health and Human Services Hospital Preparedness Program (HPP) Ebola Part A End-of-Year Preparedness Measures Assessment Hospitals Ebola Performance Measures

Assessment Hospitals Ebola Performance Measures

Anne Arundel Medical Center

AH3

AH4

AH5

AH6

AH7

AH8

AH9

AH10

Activity A: Develop a Concept of Operations

1

Time, in minutes, it takes from an assessment hospital’s notification to the health department of the need for an inter-facility transfer of a patient confirmed with Ebola or other special pathogen to the arrival of a staffed and equipped EMS/inter-facility transport unit, as evidenced by a no-notice exercise or real-world event (Goal: Within 240 minutes or 4 hours)

Activity B: Assure Readiness of Assessment Hospitals

8

Time, in seconds, from active monitoring/direct active monitoring (AM/DAM) patient’s arrival to placement in isolation at assessment hospital (Goal: Less than or equal to 60 seconds)

9

Time, in minutes, it takes an assessment hospital to identify and isolate a patient suspected with Ebola or other special pathogen following emergency department triage, as evidenced by a real-world case or no-notice exercise (Goal: Less than or equal to 5 minutes )

Total number of health care facility and EMS workers in contact with an AM/DAM Ebola patient, after notification to an EMS agency or assessment hospital (Denominator for PM10,PM10(OSP),PM11)

10

Number of health care facility and emergency medical services (EMS) workers in PPE, of those make contact with an AM/DAM suspected Ebola patient under investigation (PUI) after health department notification to the assessment hospital and/or EMS Agency (Goal:100% of health care facility and EMS workers)

11

Number of health care facility and EMS workers in PPE that an AM/DAM suspected Ebola patient makes contact with after health department notification until isolation (Goal: Less than or equal to 3)

Total Number of emergency department staff (Denominator for PM12)

12

Number of emergency department staff trained at least annually in infection control and safety (Goal:100% of emergency department staff)

Total Number of intensive care unit staff (Denominator for PM13)

13

Number of intensive care unit staff trained at least annually in infection control and safety (Goal :100% of intensive care unit staff)

14

Are the assessemnt hospitals able to access their PPE supply (i.e., know location and have sufficient quantity of unexpired supply) within 10 minutes of transfer notification or arrival, if no notification, of a patient suspected with Ebola or other special pathogen? (Goal:100% of Assessment Hospitals)

Comments/Additional information

Yes

No

---

Sheet 9: Ebola Part A - AH OSP PM

Performance Measure Number	U.S. Department of Health and Human Services Hospital Preparedness Program (HPP) Ebola Part A End-of-Year Preparedness Measures Assessment Hospitals Other Special Pathogens Performance Measures
		Frederick Memorial Hospital	AH3	AH4	AH5	AH7	AH8	AH9	AH10
Activity B: Assure Readiness of Assessment Hospitals
9	Time, in minutes, it takes an assessment hospital to identify and isolate a patient suspected with Ebola or other special pathogen following emergency department triage, as evidenced by a real-world case or no-notice exercise (Goal: Less than or equal to 5 minutes )
10(OSP)	Number of health care facility and emergency medical services (EMS) workers in PPE that a patient suspected of an other special pathogen makes contact with after health department notification to the assessment hospital or EMS agency (Goal:100% of health care facility and EMS workers)
	Total Number of emergency department staff (Denominator for PM12)
12	Number of emergency department staff trained at least annually in infection control and safety (Goal:100% of emergency department staff)
	Total Number of intensive care unit staff (Denominator for PM13)
13	Number of intensive care unit staff trained at least annually in infection control and safety (Goal :100% of intensive care unit staff)
	Comments/Additional information

---

Sheet 10: Ebola Part A - Impact

U.S. Department of Health and Human Services Hospital Preparedness Program (HPP) Ebola Part A Preparedness Measures Impact

Please rate your level of agreement with each of the following statements: 1 –Not prepared; 2 – Slightly prepared; 3 –Moderately prepared; 4 –Adequately prepared; 5 – Very prepared

Response

27a.My state/jurisdiction, including coalitions, frontline health facilities, and inter-facility transport providers, was prepared for an Ebola event in or before July 2014

1

27b.My state/jurisdiction, including coalitions, frontline health facilities, and inter-facility transport providers, is prepared for an Ebola event after July 2014

2

Please provide a written response in 250 words or less

3

28a.Describe the impact of the Hospital Preparedness Program Ebola Preparedness and Response Activities funding on the overall preparedness of your state/jurisdiction for an Ebola or other special pathogen event. This may include capabilities developed as a result of funding or guidance from this program or other synergies you experienced. In addition, describe any impacts that translate to all-hazards preparedness.

4

28b.Describe any remaining gaps in the overall preparedness of your state/jurisdiction for an Ebola or other special pathogen event. Note: Gaps are not limited to the existing capabilities.

5