The Johns Hopkins
Office of Critical
Event Preparedness and Response has received federal
grants totaling $3.5 million to develop plans for health
system response to bioterrorism and other disasters,
including infectious disease outbreaks.
Among the grants was one awarded to Gabor D. Kelen,
director of CEPAR and chair of the Johns Hopkins
Department of Emergency Medicine, who received $1
million from the Agency for Healthcare Research and Quality
to develop a system that pre-identifies those hospital
patients who would be at minimal risk if immediately
discharged in order to provide space for incoming patients
who are the victims of bioterrorism or other disasters.
Previous "surge capacity" efforts have focused on
screening and initiating treatment for incoming patients,
as well as on the ability of hospital emergency departments
to handle a sudden influx of victims, Kelen said. "But the
reality is that, at least initially, hospitals will bear
the brunt of caring for the sick and injured, and inpatient
capacity may become severely constrained during a bioterror
event that requires isolation of patients and thus forces
the closure of beds or wards normally open to general
patients."
Rather than "the current ad hoc method of identifying
patients" for early dismissal after a disaster occurs,
Kelen said, "there is a need to develop a generalized,
easy-to-apply method to predesignate hospitalized patients
suitable for early discharge, should a disaster require the
creation of hospital surge capacity."
Gary Green, also of the Department of Emergency
Medicine, received another $1 million grant from the Agency
for Healthcare Research and Quality to develop and test a
Web-based technology to train a large number of community
health care providers in bioterrorism and disaster
response.
Kelen said that although the need to swiftly train all
health care workers in critical event preparedness is
widely recognized, the "tools for rapid, inexpensive and
task-appropriate training do not currently exist." Green's
project will create standard, "best practice" educational
content for training community clinicians in bioterrorism
and disaster response, using traditional teaching
techniques and also employing Web-based technology, with
each method ready for nationwide use. These programs would
be similar to those used by Johns Hopkins to train
employees to comply with the new federal Health Insurance
Portability and Accountability Act, which provides
regulations to protect the privacy of patient health
information.
Kelen said that another Hopkins Emergency Department
expert, Richard Rothman, has received a $1.05 million grant
from the National Institute of Allergy and Infectious
Diseases to conduct a five-year study on the rapid
detection of blood-borne and pulmonary infectious diseases
by using the latest universal bacterial and viral
microbiologic diagnostics. Funding for this award comes
under a $40 million multi-institutional programmatic award
— a Research Center of Excellence — led by
Myron Levine of the University of Maryland and Donald Burke
of Johns Hopkins and includes leading investigators in
various fields, such as infectious diseases and
microbiology, both within and outside the institution.
In addition, the U.S. Department of Health and Human
Services' Office of Emergency Preparedness has given a
$500,000 grant to CEPAR to develop a model for regional
surge capacity plans and a generic template for
implementing regional surge capacity systems in different
areas of the country. James Scheulen, administrator for
CEPAR and for the Department of Emergency Medicine, will
oversee this project, Kelen said.
"A key component of CEPAR's mission is to serve as a
model medical/public health disaster response office and to
develop systems and procedures for critical event response
that can be adapted for use in other major metropolitan
areas, nationally and worldwide," Kelen said. "We are
pleased that the AHRQ and the Department of Health and
Human Services recognize the advances we already have
achieved."
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