Pandemic Influenza Planning Checklist for
the Physician Office
An influenza
pandemic will present unique challenges to the delivery of health care,
producing case numbers likely to be far in excess of the capacity and
capability of systems to cope in conventional ways.
It
is important that you develop a preparedness plan now to ensure that your
practice can respond to an influenza pandemic in a coherent, effective and
coordinated way to maintain service continuity. The Canadian Medical Protective
Association in their March 2008 Information Sheet on public health emergencies
and catastrophic events noted: “Physicians are encouraged to prepare themselves
and their practices for a possible pandemic/catastrophic event.” Your planning
for a pandemic will also help you respond to other communicable disease
situations.
To help prepare your office for a health emergency the
Canadian Medical Association has worked with provincial medical associations to
produce this practical tool, the Pandemic Influenza Planning Checklist for the
Physician Office. Given the variety of health care settings and provincial
policies the checklist can be adapted to meet unique needs.
To
help in developing your plan important links to key websites at the
international, national and provincial level are included in the checklist,
however due to the dynamic nature of local policies, you will need to add links
to local contacts and documents and other information pertinent to your plan.
During
an influenza pandemic physicians will be on the front lines of response. Please
take some time now to prepare to protect yourself, your family, your staff and
practice and your patients. Download and save the Checklist to complete
and update it electronically.
Identify
someone to coordinate pandemic influenza planning for your office.
Remember to
update the checklist annually or after each wave of pandemic influenza.
Key
contacts and websites
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Identify
someone to coordinate pandemic influenza planning for your office
Name
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Maintain up-to-date contact list of staff and volunteers and develop a
plan for communication during a pandemic or other health emergency.
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Local
medical officer of health & public health unit
Name
Phone
Email
Fax
Website
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Local
hospital and emergency services
Name
Contact #
Name
Contact #
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Provincial
Ministry of Health (Emergency Management Unit)
Contact #
Email
Website
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Government of Canada
Pandemic Influenza Information
Line: 800 454 8302
Pandemic Influenza website: http://www.influenza.gc.ca/index_e.html
Public Health Agency of Canada
(PHAC)
Emerging Respiratory Infections
for Health Professionals
World Health Organization, Epidemic
and Pandemic Alert & Response
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Pandemic
Influenza Plans
Federal: Canadian
Pandemic Influenza Plan for the Health Sector
Appendix G:
Clinical Care Guidelines and Tools
Appendix F: Infections Control
Guidelines
Provincial:
Local
public health unit pandemic information:
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Canadian
Medical Association
Website: Influenza: www.cma.ca/h1n1
Provincial
Medical Association
Website:
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Staffing
issues
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Provide annual influenza vaccination to all office personnel.
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Determine minimal staffing level required during pandemic influenza
crisis.
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Prepare a staffing contingency plan presuming
20%–25% of your staff will be sick during the peak period. Include potential outside sources of human
resources (i.e., nursing agencies, community organizations).
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Make
plans to ensure your family will
be looked after during a pandemic so you may continue to work.
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Encourage staff to develop their own family plans.
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Discuss with
physician colleagues how you can cover for each other if you need to take
time off.
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Education
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Acquaint
yourself and your staff with current clinical information about the
recognition, treatment and prevention of influenza. Reference material is
available at:
Federal:
·
See Government of Canada,
PHAC, and Canadian Pandemic Influenza Plan
contacts as noted above.
Provincial:
Local:
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Educate
all staff about routine infection prevention and control practices. Reference
material is available at: Additional
references on page 5
Federal:
Part B Recommendations and
Tools, Section III Recommendations for Ambulatory Care
Canada, Communicable Disease Report 25S4, 1-142. 1999. Ref Type:
Report
Provincial:
Local:
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Provide education
materials on pandemic influenza to patients. Reference material is available
at:
Provincial:
Local:
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Surveillance
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Identify
key information sources for influenza activity.
Federal: Pandemic Influenza Flu Detection and
Surveillance
Provincial:
Local:
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Designate someone to monitor and distribute public
health advisories to staff.
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Monitor and review influenza activity in your
practice.
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Report unusual cases of influenza-like illness and
influenza to local medical officer of health.
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Triage
and patient management
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Determine procedures to contact patients during a
pandemic to reschedule routine visits or direct to an alternative point of
care.
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Determine procedures for patient care management
at height of pandemic. It is expected that influenza will circulate for 6–8
weeks and may come back for a second wave.
(e.g., telephone triage, separate time blocks for
influenza and non-influenza care)
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Check
local pandemic influenza plans for recommended disposition of patients with
influenza-like illness. (e.g., home with self-care guide, home care,
alternate treatment site).
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Check
provincial and federal pandemic plans for recommended use of antiviral
medication.
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Check
with your local public health unit for plan to disseminate antiviral
medication and vaccines locally.
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Infection
control
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Wall mount alcohol-based hand sanitizer dispensers
at office entrance for patient use.
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Separate reception staff from patients by a
minimum of 1 metre or, if possible, with Plexiglas.
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Post signs asking patients with influenza-like
illness symptoms to inform reception personnel.
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Provide
a surgical mask to symptomatic patients. Check public health advisories about use of N95 masks.
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Separate patients with influenza-like illness by
at least 1 metre from other patients, or, if possible, direct to a separate
waiting room (and examination room).
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Post respiratory hygiene and cough etiquette signs
in the waiting area.
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Provide hand hygiene material in waiting areas,
examination rooms and wash rooms.
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Ensure all staff are informed of and follow
routine infection prevention and control practices.
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Wash
or sanitize your hands before and after each patient encounter. Strict adherence to hand washing/hand antisepsis
recommendations is the cornerstone of infection prevention and may be the
only preventative measure available during a pandemic.
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Assign
staff who have recovered from pandemic influenza to care for influenza-like illness patients.
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Maintain
at least 2 week supply of soap, hand sanitizers, paper towels, surgical masks
and cleaning supplies.
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Clean
and disinfect examination and waiting rooms daily.
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Financial
planning
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Determine potential financial resource needs
during pandemic (e.g., line of credit etc., staffing requirements and
supplies).
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Put method in place to document extra costs
associated with a pandemic, which may be offset by compensation.
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Additional
resources:
Canadian
Medical Association. Caring in a Crisis: The Ethical Obligations of Physicians
and Society During a Pandemic: 2008 Feb 23. Available: http://policybase.cma.ca/dbtw-wpd/CMAPolicy/PublicB.htm
(accessed 2008 Sept 15).
College
of Physicians and Surgeons of Ontario. Infection Control in the Physician’s
Office, 2004 edition. Available:http://www.cpso.on.ca/Publications/publications.htm
(accessed 2008 Sept 15).
BC
Centre for Disease Control. Guidelines for Infection Prevention and Control in
the Physician’s Office, 2004. Available: http://bccdc.org
(accessed 2008 Sept 15).
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