Site Considerations for Points of Dispensing (PODs) Following a Biological Terrorist Attack: Integrated Role of Transportation Planning and Medical Service

摘要

Points of Dispensing (PODs) are commonly considered as a means of dispensingmedication or prophylaxis following a biological attack or disease outbreak. The abilityto quickly dispense post-exposure prophylaxis (PEP) using multiple PODs has thepotential to save a large proportion of those who were exposed, while failure in the PEPdispensing campaign could have dire public health consequences. While pre-eventplanning is critical to ensure a successful POD implementation, much of the planningefforts to facilitate timely PEP dispensing have been focused on staffing needs and theinternal structure within PODs, and less attention has been placed on the logisticalchallenges of operations that occur outside of PODs. This study proposed to considerexternal process (e.g., parking and traffic control) of POD planning with the internalprocess (e.g., staffing and equipment allocation for medical service) in an integratedmanner. A VISSIM-based modeling tool was developed to implement this concept bysimulating the entire process of POD operation. The interaction of vehicles movements,patients’ behavior, and internal medical service procedures was successfully modeledthrough VISSIM’s Component Objective Model (COM) programmable interface. Bygenerating detailed performance measures (e.g., traffic and people queue), impacts ofplanning assumptions and implementation strategy on the effectiveness of POD planningcan be studied. A case study was conducted to evaluate a POD plan in West Roxbury,Massachusetts using the developed modeling tool. This tool was able to identify thebottlenecks in POD operation and provide insights for future improvement.