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NY Website looks at Hospital Quality

You've got to see this website hosted by the NYS Department of Health. Interesting data on hospital quality and comparative data. Although there is no data pertaining to preparedness activity, the site explains the quality points that we as a community should be looking at.

Prevention Quality Indicators
is a great site to consider.


NIMS: By any other name

Just when you thought it was safe to respond to an emergency, DHS has announced NIMS refit and updates in a recent press release. So, now that you've competed all those on-line annoying classes and taken all those ICS classes, you're ready to respond and manage disaster events! Maybe not. We'll have to wait and see, but I'll bet we'll all be sitting and/or tabbing through a series of "new and improved" NIMS classes. As if we don't have anything else to do.

Anyway, according to the press release...

"...NIMS expands on the original version released in March 2004 by clarifying existing NIMS concepts, better incorporating preparedness and planning and improving the overall readability of the document. The revised document also differentiates between the purposes of NIMS and the National Response Framework (NRF) by identifying how NIMS provides the action template for the management of incidents, while the NRF provides the policy structure and mechanisms for national-level policy for incident management."


"...The basic tenets of NIMS remain the same. There have been several improvements to the revised NIMS document which will aid in readability and usefulness of preparing, preventing, and responding to incidents. For example, the revised document places greater emphasis on the role of preparedness and has reorganized its components to mirror the progression of an incident. Recognizing the importance of private sector partners and NGOs in incident response, FEMA has ensured that those entities have been more fully integrated throughout NIMS. The new document is consistent with the NRF, and together they provide a single, comprehensive approach to incident management."

Get the new NIMS document here and make sure you tune into Mitigation Journal: The All Hazards Podcast. We'll be reviewing this in detail on shows in the very near future.


Elders and Pharm - A Must Read

This article from CNN is a must read for every emergency responder. We've been talking about the dangerous combination of prescription medication and over-the-counter supplements in classes for quite some time. The growth of supplement use among all age ranges in the Untied States has been increasing steadily since the 1980's.

"...One in 25 people in the study, or about 2.2 million people, were taking a potentially risky combination of medications. That number jumped to one in 10 among men who were 75 to 85 years old."

With particular attention to the elder population, we have to be aware that; as the number of prescription medication rises, so will the chance of an adverse medication reaction. Adverse medication reactions account for thousands of hospital admissions and requests for emergency medical service. In many cases, traditional pre-hospital education is lacking in the area of medication awareness and getting a medication profile. Responders must take into account patient medication and potential interactions with OTC supplements as a contributing factor.

Tune in to my podcast, Mitigation Journal: The All-Hazards Podcast, we'll be talking more about this issue in the near future.


Need Triage Training...turn on the Wii

Check out this article in Government Technology - ( just in time for the holidays, too. You can hone your triage skills with a video game!

I'm not sure that this training will ever replace live, functional exercises, but it may help keep skills up between trainings and drills. Still, the best way to learn triage skills is with live, dynamic participants and role-play of victims in scenario based training. I know that is a lot to ask...but it is the best way to learn.


Anniversary and Goals

Goals are good things to review this time of year. And as this year of 2008 comes to an end I am reviewing the intent and goals of Mitigation Journal. Both the blog and the podcast have seen an explosion of readers/listeners. Mitigation Journal The All Hazards Podcast continues to be ranked in the top 3 on iTunes in the Local organizations and government category. I'm simply humbled by the response from the community and the number of people who I've come to rely on to get this stuff done.

I almost forgot to mention this topic, but as the calendar is down to just one page, I thought it would be nice. The blog has been going for three-years (since November 2005) with over 140 posts and several feature articles, and the podcast has just turned two-years old with 92 weekly editions, numerous in-service training sessions...and thousands of listeners.

So a simple "thank you" is in order to everyone who has helped make this effort worth it. We'll be moving in several new directions for 2009 and I'll be looking forward to your continued support!

Please contact me with your insight, thoughts and comments. If you have an idea about what you'd like to hear, read, or see us do in 2009, I'd love to hear from you! You can reach me at anytime by email, calling our voice mail line at 585-672-7844.
I'll be posting our Year in Review segment here and on the podcast shortly after 1/1/2009. Please join us!


As It Happens - Plane Crash

I'd like to direct everyone over to Eric Holdemans blog; Disaster Zone. Besides the fact that I follow his blog closely, there is a wealth of insight posted there. Eric was kind enough to speak with me on Mitigation Journal a few weeks back on the topic of technology in disasters (see #86). One of the items we discussed was the use of social networking sites, YouTube, and services like Twitter; the ability to get real-time data from forward observers (those actually at the incident site).

A recent posting on Disaster Zone highlights this potential...and Eric puts the topic in focus.
( A passenger on board the plane that skidded off the runway recently. Here is the direct link to the Twitter page from this passenger.

Holiday Gift Cards

They are better than a tie...a gift card for health care! Check out the story from a Rochester, NY news station

I think this is a great idea and may go hand-in-hand with the use of retail health care clinics. Keep an eye on this one.

I've also talked about this on Mitigation Journal podcast #92
Check out this link to Ready Illinois. They have a guide published "Emergency Preparedness Tips for those with Functional Needs".

I'll be reading it later this week and I've added it to my shared items under Emergency Service News in the sidebar. Let me know what you think.

Stretching Vaccine Supply

Stretching Vaccine Supply is an important issue for those involved with pandemic planning. The supply of anti-viral agents, both oral and injected, is a major issue among planners at all levels. In fact, the limits of anti-viral agents have pushed the need for non-pharmacological interventions such as face masks or other protective clothing.

Here is a story from MSNBC outlining the results of a recent study suggesting that flu vaccine given at half-strength can be effective.

Let's not get carried away...this is not an indication that we have all the vaccine we could need, nor should we abandon our non-pharm efforts. The fact still remains that, while this vaccine may be effective at half strengths levels, we still need to match the H's and N's of the circulating strain. Additionally, we will continue to contend with all the logistical issues of ineluctable and oral anti-viral agents.


Keeping pets safe from holiday hazards

Keeping pets safe from holiday hazards can become a full-time job. Given the possibilities that could cause serious illness or death of the family pet, heightened vigilance during the holiday season will be worth the effort.

CNN is reporting on the little know dangers to pets from everyday foods and provides a list of surprising items that can cause serious illness or death to domestic animals such as dogs and cats.

Don't miss my latest series "Pets in Disasters" on Mitigation Journal podcast for more information on protecting pets in crisis and evacuation situations. The series starts with edition number 89.


Holiday Food Safety

The Wisconsin Department of Health is offering tips for safe food handling during the holidays ( They site some common sense tips for keeping you and your family safe from foodborne disease...just good practice for all seasons.

The holiday recommendations and the Home Safety Tips both start off with...clean hands and clean surfaces!

This material would make a great health and safety topic for all personnel.


Hospitals, Hotels, Malls - Soft Targets

We've been reading about the terrorist attacks in India and the relationship to soft targets. I talked about the need to identify and plan for attacks on soft targets in all communities on Mitigation Journal podcast this week. MSNBC has a nice article on the topic as well (

A hard target is one that has some level of security protection that reduces the chances of an intentional fire service terms; fire alarm systems "harden" a location against fire. Soft targets are locations that lack the deterrent from such events. Can you imagine if terrorist were to attack hospitals or hotels in the United States in the same fashion as in India?

It's important to understand that open structures with multiple access/egress points, isolated utility and services corridors and large crowds are potential target hazards for multi-patient, mass casualty events. Remember, we're not just talking terrorism here...gang activity can cause collateral damage as well as structural collapse, fires, panic situations, and of course, intentional events.

If you have MCI plans; do they reflect differences between an MCI occurring as a result of a bus crash on the highway and a multiple shooting at a movie theater? Everyone should take the time to review response plans and understand the needs of the location will necessitate alteration in your response plan.

Smallpox Vaccine Lasts Longer

According to a new study as reported in Medical News Today, ( the smallpox vaccine may last longer than we thought. Smallpox vaccine was thought to have little or no protective benefit after twenty or thirty years. According to this study, people vaccinated over 40 years ago have antibodies and may not even need a booster. You may recall that several trials of smallpox vaccination were stopped after adverse effects and deaths.

Keeping in mind that the last case of smallpox occurred in the late 1970's and routine vaccination stopped around the same time; anti-terrorism experts have been concerned that we humans lack any ability to protect ourselves and that vaccine stockpiles will not be adequate. Although this is only one is still good news.