摘要：Objectives. To describe results of points of dispensing (POD) medical countermeasure drill performance among local jurisdictions. Methods. To compare POD setup times for each year, we calculated descriptive statistics of annual jurisdictional POD setup data submitted by over 400 local jurisdictions across 50 states and 8 US territories to a Centers for Disease Control and Prevention (CDC) program monitoring database from July 2012 to June 2016. Results. In data collected from July 2012 to June 2015, fewer than 5% of PODs required more than 240 minutes to set up, although the proportion increased from July 2015 to June 2016 to almost 12%. From July 2012 to June 2016, more than 60% of PODs were set up in less than 90 minutes, with 60 minutes as the median setup time during the period. Conclusions. Our results yield evidence of national progress for response to a mass medical emergency. Technical assistance may be required to aid certain jurisdictions for improvement. Public Health Implications. The results of this study may inform future target times for performance on POD setup activities and highlight jurisdictions in need of technical assistance. Rapid deployment of life-saving medicines and supplies known as medical countermeasures (MCMs) is important for minimizing morbidity and mortality during mass medical emergencies. Since 1999, the federal government has maintained a comprehensive supply of MCMs available for rapid deployment in response to large-scale disasters. 1–3 Responding to the need for enhanced community-level preparedness capacity, in 2004, the Centers for Disease Control and Prevention (CDC) introduced the Cities Readiness Initiative (CRI) to support more than 400 local jurisdictions across the 50 states in the development of strategies to rapidly dispense MCMs to populations within 48 hours (Figure A, available as a supplement to the online article at http://www.ajph.org ). 1–3 In 2008, the CDC created operational drills to test MCM delivery performance on tasks essential for response to a natural or man-made disaster requiring rapid and mass deployment of preexposure prophylaxis protocols, postevent treatments, or other life-saving medical supplies. Each drill focused on crucial steps necessary for dispensing MCMs to a jurisdiction’s entire community within 48 hours. Jurisdictions identified optimal strategic locations (referred to as points of dispensing, or PODs) for rapidly dispensing MCMs to cover the maximum target population in the shortest time. 2 Drills included the following: staff notification, acknowledgment, and assembly; site activation, acknowledgment, and availability; facility setup; pick list generation; and dispensing throughput. 2,4 The CDC required annual submission of performance data on a minimum of 3 different drills selected from the 5 drill types by jurisdictions’ local health department emergency preparedness staff. 3 Detailed descriptions of each drill and results from the first-year pilot have been previously published. 4 Our analysis builds on this previous work and focuses on 1 particular drill, the facility setup. The goal of the facility setup drill is to evaluate the time required to completely set up the materiel, layout, and supplies necessary to receive and dispense MCMs at PODs. 2,4,5 Although no official standard length of time is required, in 2007, the Department of Homeland Security (DHS) suggested that a target of 240 minutes or less would maximize setup efficiency. 6 In 2012, the CDC extended drill requirements to 8 US territories or freely associated states also funded for emergency preparedness activities: American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Puerto Rico, Republic of Marshall Islands, Republic of Palau, and US Virgin Islands. The term “jurisdiction” will be used throughout this article to refer to any entity that submitted POD setup data. We describe local jurisdictions’ drill performance for POD setups across the nation from July 2012 to June 2016. Results of this study may inform future target times for performance on POD setup activities and highlight jurisdictions in need of technical assistance.
