Operational evaluation of high-throughput community-based mass prophylaxis using Just-in-time training

Area of Science:

• Public Health
• Emergency Preparedness
• Health Workforce Management

Background:

• Community-based mass prophylaxis requires significant staffing, potentially exceeding local health workforce capacity.
• Just-in-time (JIT) training and computer modeling are proposed as complementary solutions for managing workforce demands during public health emergencies.

Purpose of the Study:

• To evaluate the feasibility and effectiveness of JIT training for non-health-care workers in a mass prophylaxis setting.
• To validate computer modeling of workforce requirements against observed operational data from a high-throughput point of dispensing (POD) exercise.

Main Methods:

• A high-throughput POD exercise was conducted in Multnomah County, Oregon, utilizing JIT training for staff, 84% of whom were non-health-care workers.
• Computer modeling was employed post-exercise to replicate observed staff utilization, patient flow, and queue dynamics.
• Patient processing times and staff allocation were monitored throughout the exercise.

Main Results:

• The POD successfully processed 500 patients per hour, demonstrating the feasibility of JIT training for non-medical staff.
• Post-exercise modeling accurately reflected observed staffing levels and queue formation, including a significant medical evaluation queue.
• Variations in patient processing times were noted, impacting staff reallocation and highlighting areas for modeling refinement.

Conclusions:

• JIT training is a viable strategy for rapidly equipping non-health professionals to staff high-throughput antibiotic dispensing clinics.
• Computer modeling can effectively predict staffing needs and operational challenges in mass prophylaxis settings.
• Observed staff underutilization suggests potential for increased efficiency and higher throughput in future dispensing operations.