WAPC Executive Director Medical/Clinical Leadership Report May 2020 CALL CENTER COMMUNICATIONS AND INFRASTRUCTURE (CI): WAPC has taken 3,481 calls regarding Covid-19 From 1/22 until 3/11, when the DOH Activation line was answered in our center, we took 2,689 calls for the DOH and 187 calls for the Local Health Jurisdictions After 3/11, 605 calls have been taken on Afterhours and regular PC lines IT/COMMUNICATION: Not all remotes are alike! All poison center staff, administrative and call room, are working remotely. o Administrative staff are using a combination of personal computers and poison center laptops to VPN into their desks in the center; all are using personal cell phones. o Most call center staff working remotely have been provided with a poison center workstation and phone, they VPN into a virtual desktop. o Virtual desktops had not yet been set up for the newer call center staff (normally they would not be working remotely for another year) and we were short on equipment. John quickly purchased phones and computers from Amazon and additional computers from Best Buy. These staff VPN into the physical workstations in the call room. o CSW were provided with phones and workstations and VPN into a physical workstation in the call center. CALL CENTER STAFFING (CS): CC Staff Remote Update: All CC staff, and Afterhours Contracted Student Workers (CSW), transitioned to remote workstations except one as of March 18th, 2020. This staff person worked safely in our office until 5/1, when she was able to secure home internet. We initiated this transition a week prior to Governor Inslee’s official “Stay At Home Order” on 3/23/2020, anticipating this order as well as wanting to ensure safety of our employees while continuing to provide our essential emergency 24/7 healthcare services, given the remote capabilities we already had in place for most of our CC staff. LHJ After Hours Program: Due to the increased calls coming in on the Afterhour’s lines, we increased CSW coverage by 8 hours a week. CC Staff Years of Service Recognition: o March: Stephanie Garland PharmD CSPI: 2 years; Jared O’Connor MPH: 4 years o April: Amanda Lynn PharmD CSPI: 13 years; Lorelei Madriaga CSPI: 38 years Virtual All-Hands Meetings: April 14 and 15, 2020 PATIENT MANAGEMENT (PM): Medical Direction Hours for April and May: These numbers include Phillips on-site and remote as Assoc. Med Director. UW Medicine, Seattle Children’s Hospital and Madigan Med Tox teaching hours are included in parentheses (x). Note: All Medical Direction including Rotator Education/Teaching transitioned to remote virtual activities as of March 17, 2020 due to Covid-19 pandemic and public health orders. Medical Director: 2019 NPDS Fatality Abstracts Completed and submitted – 38 total Week Off Site On site Total Comments King County Medical Society Avg = 51 hrs 3/1-3/8/20 3 40(6) 49 Lead Stakeholder Mtg per week for 3/9-3/15/20 24 24(6) 54 ACMT Annual Scientific Mtg March; EMS and Trauma Steering 3/16-3/21/20 0 40 (9) 49 Committee (Virtual) Avg = 53.5 3/22-3/29/20 0 48(3) 51 hrs per week 3/30-4/5/20 0 56(6) 62 for April 4/6-4/12/20 0 48 48 4/13-4/19/20 0 48 48 4/20-4/26/20 0 48 48 4/27-4/30/20 0 40 40 Page | 2 WAPC Vision: A region where poisoning and drug exposure are no longer the leading cause of unintentional death. Real time Virtual Medical Director to Real time MD to CC SPI Education 4/30/20 Call Center (CC) Staff Education 4/8/2020: Video Conferencing Virtual Education with SPI: -4-23-2020 QUALITY MANAGEMENT (QM): See May 2020 QMI Dashboard (attached ) Additional QM Activities to Support Remote Learning and Training were developed (such as the real time education above and the video conferencing education). o See the following attachments for additional information . Additional QMI activities . Coding . Remote CSPI supervision of PIP Also developed was a process for e-filing o Sample sent item to Mara to e file. The email had the following subject: [e file] [staff name] [MD SPI EDUCATION & QA] [Communication folder] . E file (tells Mara what we want) . Staff name (tells Mara who this is regarding) Page | 3 WAPC Vision: A region where poisoning and drug exposure are no longer the leading cause of unintentional death. MD SPI EDUCATION & QA (all caps tells Mara that when she saves the PDF this will be the title) . Communication folder (tells Mara where to file it) Specific items saved (also e filed by Mara) to show remote supervision of staff o MD to SPI education- this is not specific to a person and includes whoever is online at the time, usually occurs via Instant Message Chat Room. It is one of the ways we provide education AND show that the medical director is aware of what is going on. o Quality Control- This is specific to an individual and examples, not every instance, should be saved to show that we are aware of what is going on and are actively providing feedback via Instant Message (since we are focusing on working remotely). We are initiating the interaction to assist with call handling for a specific individual. o Supervision by CSPI- This is where we show that ALL staff have support when they ask for assistance. We save all instances as these are process specific and not individual SPI. This shows when staff ask their peers for assistance they get help even though they are working remotely. PUBLIC HEALTH EDUCATION: March and April 2020: Western Washington: 12 education events were completed reaching 378 residents. Eastern Washington: 7 education events were completed reaching 460 residents. Total: o 19 total events o 838 total residents o 1,295 Mr. Yuk stickers distributed Our public education and community outreach underwent significant transformation in March and April due to the COVID-19 pandemic. All in-person presentations and outreach events were cancelled from mid-March to the foreseeable future. Meghan and Alex quickly shifted to setting up and providing virtual education, while Jared focused on emergency response in Spokane. Despite disruptions and new routines, our educators have maintained and grown our services to Washington communities. In-person Education Our educators were very busy with in-person education at the beginning of March, prior to the public health measures restricting in-person events: Jared visited Seattle during the first week of March, which enabled him to present on opioids and drugs of abuse to the Issaquah School District. Alex attended this presentation to better learn the talking points and identify areas for updating. With Emma Gossard, our partner at the American Lung Association, Alex launched the newly revised E-Cigarette TOT to Stilly Valley Health Connections (located in Arlington). Meghan and Jared attended this presentation to offer feedback. Meghan participated in a Resource Fair for ~150 parents/caregivers and kids at Stafford Elementary, located in Tacoma. Her booth shared general poison prevention tips and distributed Mr. Yuk stickers and magnets. Alex and Jared completed a Central and Eastern Washington circuit during the second week of March. They presented to ESD 105 in Yakima, Walla Walla County Department of Community Health, and Benton-Franklin Health District in Tri-Cities. Topics included vaping, cannabis, and opioids. Page | 4 WAPC Vision: A region where poisoning and drug exposure are no longer the leading cause of unintentional death. Meghan presented the E-Cigarette TOT at the 2020 Communities for Families Community Summit (in Sumner). Audience members included teachers, school administrators, nurses, and local youth-serving organizations. Virtual Education After increased public health measures resulted in the cancellation of all education events, our educators quickly shifted to virtual education. Meghan and Alex reached out to existing and new community partners to reschedule cancelled events as webinars, as well as to provide education on new topics. King County Library System: Meghan and Alex formed a partnership with KCLS, and are providing a webinar every Thursday to any interested individuals (registration is not limited to KCLS members). Their first webinar consisted of a new presentation on preventing poisoning during the COVID-19 pandemic. This presentation explained why risk of poisoning is increased during the pandemic, then provided prevention tips with cleaners, hand sanitizer, medications, and intentional use. Other KCLS webinar topics included cannabis use in older adults, medication management, and lead poisoning prevention (a second new presentation). Upcoming webinars with KCLS will be our Vaping 101 and Cannabis 101 presentations. Adult Family Homes Council of Washington: Meghan and Alex co-presented two webinars on cannabis use in older adults to members of the Adult Family Homes Council. Meghan will present on medication management to council members in June. Spokane Regional Health District: Alex provided a virtual version of the Cannabis TOT to members of Spokane Regional Health District. This was our first attempt at a virtual training of this size – the training lasted 3 hours. While Alex received positive feedback from attendees, we will generally keep future trainings and presentations under two hours to maximize accessibility. Au pair presentation: Meghan and Alex co-presented to an au pair audience in Seattle. The presentation covered general poison prevention with additional focus on poison risks during the COVID-19 pandemic. Upcoming webinars: Alex and Jared will be presenting a series of three webinars with ESD 105 in May covering cannabis, vaping, and opioids. Alex is also working with Prevention Works in Seattle to schedule a cannabis training in June.