Hospital emergency preparedness: Push-POD operation and pharmacists as immunizers

Objective: To describe Montefiore Medical Center's participation in a point-of-distribution (POD) exercise in which pharmacists were drilled on the ability to provide immunizations in the face of an emergency. Setting: New York City on October 9, 2007. Summary: Rapid and appropriate response to a terrorism event can limit morbidity and mortality. After the events of September 11, 2001, the New York City Department of Health and Mental Hygiene (DOHMH) recognized the need to develop a uniform procedure in the case of a potential health disaster. During the fiscal year occurring between September 1, 2006, and August 31, 2007, DOHMH requested that all citywide hospitals participate in a POD drill. All participating hospitals were required to have a team of five health professionals, including one pharmacist, one physician, two nurses, and another member of the institution. The drill was to be conducted within a 4-hour interval to simulate a situation of mass prophylaxis using influenza as a surrogate vaccine or pharmaceutical agent needed in the event of a public health emergency. Main outcome measure: Number of health care workers immunized in 4-hour period. Results: During the 4-hour period, the team was able to immunize 942 heath care workers. Predicting a 24/7 operation in the event of a biological terrorism event, the Push-POD operation would have the capacity to immunize 12,000 health care workers - the approximate population of the hospital - in 48 hours. This exercise was replicated for the 2008 influenza program, and the results were identical. Conclusion: By allowing pharmacists to expand their scope of practice, New York State will inevitably see a drastic improvement in its adult immunization rates for influenza and pneumococcal vaccinations through greater public awareness and expanded vaccine access.