News
The Region 2 RESPTC Workshops the Region's High-Consequence Infectious Disease Patient Transport Conops with Key Partners
November 16, 2023
Introduction of CONOPS:
On November 16th, 2023, NYC Health + Hospitals/Bellevue (Bellevue) and the NYC Department of Health and Mental Hygiene (DOHMH) co-hosted a workshop to review and discuss the Concept of Operations (CONOPS) for the transfer of a patient with a likely or confirmed infection with a high-consequence infectious disease (HCID). Bellevue is the Regional Emerging Special Pathogen Treatment Center (RESPTC) for the U.S. Department of Health and Human Services Region 2, comprised of New York, New Jersey, Puerto Rico, and the US Virgin Islands. The workshop was well attended with representatives from federal agencies such as the Administration for Strategic Preparedness and Response (ASPR), local and state Departments of Health, hospital associations, the National Emerging Special Pathogen Training and Education Center (NETEC), EMS agencies, and Special Pathogen Treatment Centers (SPTCs) from jurisdictions across the region. Over the course of the full-day workshop, participants discussed the process and several scenarios about how a patient would move from various locations in the region to the RESPTC at Bellevue. In addition to the capabilities at Bellevue, the six SPTCs in the region can treat patients with HCIDs in their biocontainment units.
Overview of Region 2 HCID patient transport CONOPs:
Starting in June 2023, the Region 2 CONOPS steering committee has held meetings with key stakeholders from each jurisdiction to update the existing CONOPS plan, last done in 2019. When a suspected special pathogens patient is identified at a frontline facility, that facility will immediately notify their local and state health departments. In conversations with the local and state health departments, it will be determined if patient transport to Bellevue or a closer state SPTC is necessary. If the conditions for patient transport are met, the sending jurisdiction will notify the NYC DOHMH. The NYC DOHMH will then notify Bellevue to begin preparations for an incoming special pathogens patient. FDNY is the primary transport agency within a 2-hour driving distance from NYC and for further distance transports, provisions would be made for the patient to be transferred via ground ambulance or medical air flight to John F. Kennedy Airport, from where they will be brought by FDNY to Bellevue.
Objectives for the Workshop:
The objectives of this workshop were to bring the players from local and state health departments, emergency managers and directors of infectious disease programs at regional healthcare facilities, and representatives from EMS agencies to validate the inter- and intra-jurisdictional stakeholder notifications and communication protocols and identify planning gaps for the transport of a suspected or confirmed HCID patient within Region 2. In addition, it was an opportunity for the key stakeholders to network and establish relationships with one another. To frame the discussions, the workshop covered an overview of the recent updates to the CONOPS, a discussion about the National Special Pathogen System of Care (NSPS) and the varying levels of care for HCID across the nation, and several activities to facilitate discussion on the plan and systems in place.
CONOPS Activity:
In the afternoon, attendees participated in scenario-based discussions to play through a patient journey. Participants were grouped based on organization and jurisdiction as they executed their roles in the exercise. Two scenarios were exercised in which participants discussed how and when a patient would be transferred from their jurisdiction to Bellevue as the regional center. Players discussed the pros and cons of transport out of jurisdiction, the complexities of patients and movement, particularly from rural areas of the region, and the larger impacts on the healthcare delivery system when a special pathogen patient is identified. Throughout the workshop, players worked to find areas for further improvement and discussed how the CONOPS could be better refined to improve the inter-jurisdictional coordination required to support the safe care of patients with HCIDs.
Preparedness Networking:
Aside from working through the exercise, one major success from the November 16th event was the opportunity for in-person (and virtual) connections which allowed stakeholders to familiarize themselves with their HCID patient transfer counterparts. Participants from all jurisdictions not only discussed the plan with their counterparts from across the region but were able to meet and interact with their colleagues at all levels of healthcare and government. Each participant brought a unique perspective to the meeting and represented a unique role within the CONOPS. Through networking, participants discussed and fostered relationships that will continue to enhance the region’s readiness for a special pathogen patient.
Conclusion:
Thanks to the dedication and leadership of the Region 2 RESPTC’s CONOPS steering committee –composed of Mary Foote, Andrew Wallach, Vikramjit Mukherjee, Nang Kyaw, Laura Hillard, and Melissa Cairo - in close collaboration with key regional stakeholders, the regional HCID patient transport CONOPs has been updated and reviewed to ensure the special pathogen preparedness of the region, bringing in lessons learned from recent responses including COVID-19 and mpox. Participants will be able to bring back insights gained at the workshop to further improve their jurisdictional plans with a better understanding of their role within the regional plan. The Region 2 patient transport workshop helped foster collaboration and began the process of breaking down the various barriers to patient transportation to best serve Region 2. This work is possible thanks to ASPR’s vision to empower and resource the development of the region’s HCID patient care and transport plans in a safe, equitable manner.