Cities Readiness Initiative (CRI)

Kansas Public Health Emergency Preparedness (PHEP)

Cities Readiness Initiative (CRI)

BP 11 Grant

Dispensing Throughput Drill Instructions

The purpose of this document is to provide a template for the questions asked during the CDC web-based, DSNS Data Collection System for submission of DSNS Drill and Exercises. Each CRI jurisdiction is required to complete at least three of the eight different DSNS drills during the grant year.

Directions:

1. Complete the following drill form by answering each question completely.
2. Submit this document to your CRI regional coordinator for your exercise credit.
3. Your regional coordinator will enter this information into the web-based, DSNS Data Collection System for exercise credit. The regional coordinator should print and/or save the final drill summary page during this process, as this will be the only chance to do so and provide a copy of the summary page to County and State coordinatorsby fax, mail, or email for grant documentation purposes.

Note: Target Capabilities List (TCL) References

Staff CategoriesTime for Assembly

EOCWithin 2-hours of notification

RDSWithin 6-hours from approved request

PODsWithin 3-hours of notification

PICLocation dependent – see targets for locations (EOC, RDS, POD)

SecurityLocation dependent – see targets for locations (EOC, RDS, POD)

Dispensing Throughput
Enter Answer or Select Box
Name of County / Enter County Name

1. What was the drill start date and time?

Note: Date entries (mm/dd/yyyy) must be between August 10th of the starting year and July 15th of the ending year, but not greater than the current date. Time entries are in the form of hh:mm AM/PM

1. What was the drill end date and time?

1. Is this dispensing throughput drill being performed as part of a larger HSEEP standard operational response exercise or a stand-alone drill?

/ Larger HSEEP Standard Operational Response
Stand-Alone Drill
If Larger Exercise:

1. What is the name:
2. What is the start and end date:
3. Operational category of exercise:
4. Exercise Type: Functional Full-scale

1. Was this a real world event?

/ No
Yes
Bioterrorism Event
NSSE
Natural Disaster
Outbreak of Disease
Pandemic/Seasonal Influenza
Other:

1. What was the extent of notice for this drill?

/ No Notice
Partial Notice
Full Notice

1. Was the POD fully staffed and functional to meet the needs of a real world event?

/ Yes
No

1. How many people/vehicles were processed through the POD?

Note: If people/vehicles are looping through during the exercise, count each time they enter the POD.

1. How many individuals did you collect throughput times for?

Note: If people/vehicles are looping through during the exercise, count each time they enter the POD

1. What type of POD was used in the drill?

/ General/Traditional/Open
Closed

1. Is this a walk through or drive through POD?

/ Walk Through
Drive Through

1. Does this POD include Head of Household dispensing (picking up for multiple members in the household)?

Note: If you select Yes, please indicate what the authorized number of multiple regimens dispensed to Head of Households is or you may select Unlimited. / No
Yes
Authorized # of Multiple Regiments allowed:
Unlimited

1. Does this POD use a medical or non-medical model for dispensing?

/ Medical
Non-Medical

1. What type of medical countermeasure was dispensed at the POD? (Check all that apply)

/ Oral Medication
Injection

1. What type of dispensing occurred at your POD?

/ Traditional/Assisted (>3 Steps)
Express (2-3 Steps)

1. What type of dispensing data would you like to provide about your Traditional/Assisted, Express?

/ Time at each step/station
Time to complete overall process

1. For each step (up to 9 enterable) what function(s) were in the (first, second, etc) step of your POD.

Note: You must enter at least 1 station (functional) type. Please enter a number in the blank for each station indicating which step it is in rather than entering an X. / Greeting/Entry
Forms Distribution
Briefing
Triage
Mental Health Screening and Counseling
Medical Evaluation
Drug Triage
Dispensing
Form Collection and Exit

1. How many clients went through each step?

/ See tables below. Select only one option.

1. How much time, in minutes, did it take for each person to go through each step or from beginning to end?

/ See tables below. Select only one option.

Option 1: Throughput Data Table for Entry and Exit Times (“front door to back door”)

# of People (50 min) / Entry Time (in minutes) / Exit Time (in minutes) / # of People (50 minimum) / Entry Time (in minutes) / Exit Time (in minutes)
Person 1 / Person 26
Person 2 / Person 27
Person 3 / Person 28
Person 4 / Person 29
Person 5 / Person 30
Person 6 / Person 31
Person 7 / Person 32
Person 8 / Person 33
Person 9 / Person 34
Person 10 / Person 35
Person 11 / Person 36
Person 12 / Person 37
Person 13 / Person 38
Person 14 / Person 39
Person 15 / Person 40
Person 16 / Person 41
Person 17 / Person 42
Person 18 / Person 43
Person 19 / Person 44
Person 20 / Person 45
Person 21 / Person 46
Person 22 / Person 47
Person 23 / Person 48
Person 24 / Person 49
Person 25 / Person 50

Option 2: Throughput Data Table for Each POD Step

Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 1
Forms Distribution / Person 1
Briefing / Person 1
Triage / Person 1
Mental Health Screening and Counseling / Person 1
Medical Evaluation / Person 1
Drug Triage / Person 1
Dispensing / Person 1
Form Collection and Exit / Person 1
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 2
Forms Distribution / Person 2
Briefing / Person 2
Triage / Person 2
Mental Health Screening and Counseling / Person 2
Medical Evaluation / Person 2
Drug Triage / Person 2
Dispensing / Person 2
Form Collection and Exit / Person 2
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time(enter time in minutes)
Greeting/Entry / Person 3
Forms Distribution / Person 3
Briefing / Person 3
Triage / Person 3
Mental Health Screening and Counseling / Person 3
Medical Evaluation / Person 3
Drug Triage / Person 3
Dispensing / Person 3
Form Collection and Exit / Person 3
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 4
Forms Distribution / Person 4
Briefing / Person 4
Triage / Person 4
Mental Health Screening and Counseling / Person 4
Medical Evaluation / Person 4
Drug Triage / Person 4
Dispensing / Person 4
Form Collection and Exit / Person 4
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 5
Forms Distribution / Person 5
Briefing / Person 5
Triage / Person 5
Mental Health Screening and Counseling / Person 5
Medical Evaluation / Person 5
Drug Triage / Person 5
Dispensing / Person 5
Form Collection and Exit / Person 5
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 6
Forms Distribution / Person 6
Briefing / Person 6
Triage / Person 6
Mental Health Screening and Counseling / Person 6
Medical Evaluation / Person 6
Drug Triage / Person 6
Dispensing / Person 6
Form Collection and Exit / Person 6
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 7
Forms Distribution / Person 7
Briefing / Person 7
Triage / Person 7
Mental Health Screening and Counseling / Person 7
Medical Evaluation / Person 7
Drug Triage / Person 7
Dispensing / Person 7
Form Collection and Exit / Person 7
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 8
Forms Distribution / Person 8
Briefing / Person 8
Triage / Person 8
Mental Health Screening and Counseling / Person 8
Medical Evaluation / Person 8
Drug Triage / Person 8
Dispensing / Person 8
Form Collection and Exit / Person 8
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 9
Forms Distribution / Person 9
Briefing / Person 9
Triage / Person 9
Mental Health Screening and Counseling / Person 9
Medical Evaluation / Person 9
Drug Triage / Person 9
Dispensing / Person 9
Form Collection and Exit / Person 9
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time(enter time in minutes)
Greeting/Entry / Person 10
Forms Distribution / Person 10
Briefing / Person 10
Triage / Person 10
Mental Health Screening and Counseling / Person 10
Medical Evaluation / Person 10
Drug Triage / Person 10
Dispensing / Person 10
Form Collection and Exit / Person 10
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 11
Forms Distribution / Person 11
Briefing / Person 11
Triage / Person 11
Mental Health Screening and Counseling / Person 11
Medical Evaluation / Person 11
Drug Triage / Person 11
Dispensing / Person 11
Form Collection and Exit / Person 11
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 12
Forms Distribution / Person 12
Briefing / Person 12
Triage / Person 12
Mental Health Screening and Counseling / Person 12
Medical Evaluation / Person 12
Drug Triage / Person 12
Dispensing / Person 12
Form Collection and Exit / Person 12
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 13
Forms Distribution / Person 13
Briefing / Person 13
Triage / Person 13
Mental Health Screening and Counseling / Person 13
Medical Evaluation / Person 13
Drug Triage / Person 13
Dispensing / Person 13
Form Collection and Exit / Person 13
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 14
Forms Distribution / Person 14
Briefing / Person 14
Triage / Person 14
Mental Health Screening and Counseling / Person 14
Medical Evaluation / Person 14
Drug Triage / Person 14
Dispensing / Person 14
Form Collection and Exit / Person 14
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 15
Forms Distribution / Person 15
Briefing / Person 15
Triage / Person 15
Mental Health Screening and Counseling / Person 15
Medical Evaluation / Person 15
Drug Triage / Person 15
Dispensing / Person 15
Form Collection and Exit / Person 15
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 16
Forms Distribution / Person 16
Briefing / Person 16
Triage / Person 16
Mental Health Screening and Counseling / Person 16
Medical Evaluation / Person 16
Drug Triage / Person 16
Dispensing / Person 16
Form Collection and Exit / Person 16
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 17
Forms Distribution / Person 17
Briefing / Person 17
Triage / Person 17
Mental Health Screening and Counseling / Person 17
Medical Evaluation / Person 17
Drug Triage / Person 17
Dispensing / Person 17
Form Collection and Exit / Person 17
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 18
Forms Distribution / Person 18
Briefing / Person 18
Triage / Person 18
Mental Health Screening and Counseling / Person 18
Medical Evaluation / Person 18
Drug Triage / Person 18
Dispensing / Person 18
Form Collection and Exit / Person 18
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 19
Forms Distribution / Person 19
Briefing / Person 19
Triage / Person 19
Mental Health Screening and Counseling / Person 19
Medical Evaluation / Person 19
Drug Triage / Person 19
Dispensing / Person 19
Form Collection and Exit / Person 19
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 20
Forms Distribution / Person 20
Briefing / Person 20
Triage / Person 20
Mental Health Screening and Counseling / Person 20
Medical Evaluation / Person 20
Drug Triage / Person 20
Dispensing / Person 20
Form Collection and Exit / Person 20
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 21
Forms Distribution / Person 21
Briefing / Person 21
Triage / Person 21
Mental Health Screening and Counseling / Person 21
Medical Evaluation / Person 21
Drug Triage / Person 21
Dispensing / Person 21
Form Collection and Exit / Person 21
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 22
Forms Distribution / Person 22
Briefing / Person 22
Triage / Person 22
Mental Health Screening and Counseling / Person 22
Medical Evaluation / Person 22
Drug Triage / Person 22
Dispensing / Person 22
Form Collection and Exit / Person 22
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 23
Forms Distribution / Person 23
Briefing / Person 23
Triage / Person 23
Mental Health Screening and Counseling / Person 23
Medical Evaluation / Person 23
Drug Triage / Person 23
Dispensing / Person 23
Form Collection and Exit / Person 23
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 24
Forms Distribution / Person 24
Briefing / Person 24
Triage / Person 24
Mental Health Screening and Counseling / Person 24
Medical Evaluation / Person 24
Drug Triage / Person 24
Dispensing / Person 24
Form Collection and Exit / Person 24
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 25
Forms Distribution / Person 25
Briefing / Person 25
Triage / Person 25
Mental Health Screening and Counseling / Person 25
Medical Evaluation / Person 25
Drug Triage / Person 25
Dispensing / Person 25
Form Collection and Exit / Person 25
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 25
Forms Distribution / Person 26
Briefing / Person 26
Triage / Person 26
Mental Health Screening and Counseling / Person 26
Medical Evaluation / Person 26
Drug Triage / Person 26
Dispensing / Person 26
Form Collection and Exit / Person 26
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 27
Forms Distribution / Person 27
Briefing / Person 27
Triage / Person 27
Mental Health Screening and Counseling / Person 27
Medical Evaluation / Person 27
Drug Triage / Person 27
Dispensing / Person 27
Form Collection and Exit / Person 27
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 28
Forms Distribution / Person 28
Briefing / Person 28
Triage / Person 28
Mental Health Screening and Counseling / Person 28
Medical Evaluation / Person 28
Drug Triage / Person 28
Dispensing / Person 28
Form Collection and Exit / Person 28
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 29
Forms Distribution / Person 29
Briefing / Person 29
Triage / Person 29
Mental Health Screening and Counseling / Person 29
Medical Evaluation / Person 29
Drug Triage / Person 29
Dispensing / Person 29
Form Collection and Exit / Person 29
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 30
Forms Distribution / Person 30
Briefing / Person 30
Triage / Person 30
Mental Health Screening and Counseling / Person 30
Medical Evaluation / Person 30
Drug Triage / Person 30
Dispensing / Person 30
Form Collection and Exit / Person 30
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 31
Forms Distribution / Person 31
Briefing / Person 31
Triage / Person 31
Mental Health Screening and Counseling / Person 31
Medical Evaluation / Person 31
Drug Triage / Person 31
Dispensing / Person 31
Form Collection and Exit / Person 31
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 32
Forms Distribution / Person 32
Briefing / Person 32
Triage / Person 32
Mental Health Screening and Counseling / Person 32
Medical Evaluation / Person 32
Drug Triage / Person 32
Dispensing / Person 32
Form Collection and Exit / Person 32
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 33
Forms Distribution / Person 33
Briefing / Person 33
Triage / Person 33
Mental Health Screening and Counseling / Person 33
Medical Evaluation / Person 33
Drug Triage / Person 33
Dispensing / Person 33
Form Collection and Exit / Person 33
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 34
Forms Distribution / Person 34
Briefing / Person 34
Triage / Person 34
Mental Health Screening and Counseling / Person 34
Medical Evaluation / Person 34
Drug Triage / Person 34
Dispensing / Person 34
Form Collection and Exit / Person 34
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 35
Forms Distribution / Person 35
Briefing / Person 35
Triage / Person 35
Mental Health Screening and Counseling / Person 35
Medical Evaluation / Person 35
Drug Triage / Person 35
Dispensing / Person 35
Form Collection and Exit / Person 35
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 36
Forms Distribution / Person 36
Briefing / Person 36
Triage / Person 36
Mental Health Screening and Counseling / Person 36
Medical Evaluation / Person 36
Drug Triage / Person 36
Dispensing / Person 36
Form Collection and Exit / Person 36
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 37
Forms Distribution / Person 37
Briefing / Person 37
Triage / Person 37
Mental Health Screening and Counseling / Person 37
Medical Evaluation / Person 37
Drug Triage / Person 37
Dispensing / Person 37
Form Collection and Exit / Person 37
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 38
Forms Distribution / Person 38
Briefing / Person 38
Triage / Person 38
Mental Health Screening and Counseling / Person 38
Medical Evaluation / Person 38
Drug Triage / Person 38
Dispensing / Person 38
Form Collection and Exit / Person 38
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 39
Forms Distribution / Person 39
Briefing / Person 39
Triage / Person 39
Mental Health Screening and Counseling / Person 39
Medical Evaluation / Person 39
Drug Triage / Person 39
Dispensing / Person 39
Form Collection and Exit / Person 39
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 40
Forms Distribution / Person 40
Briefing / Person 40
Triage / Person 40
Mental Health Screening and Counseling / Person 40
Medical Evaluation / Person 40
Drug Triage / Person 40
Dispensing / Person 40
Form Collection and Exit / Person 40
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 41
Forms Distribution / Person 41
Briefing / Person 41
Triage / Person 41
Mental Health Screening and Counseling / Person 41
Medical Evaluation / Person 41
Drug Triage / Person 41
Dispensing / Person 41
Form Collection and Exit / Person 41
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 42
Forms Distribution / Person 42
Briefing / Person 42
Triage / Person 42
Mental Health Screening and Counseling / Person 42
Medical Evaluation / Person 42
Drug Triage / Person 42
Dispensing / Person 42
Form Collection and Exit / Person 42
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 43
Forms Distribution / Person 43
Briefing / Person 43
Triage / Person 43
Mental Health Screening and Counseling / Person 43
Medical Evaluation / Person 43
Drug Triage / Person 43
Dispensing / Person 43
Form Collection and Exit / Person 43
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 44
Forms Distribution / Person 44
Briefing / Person 44
Triage / Person 44
Mental Health Screening and Counseling / Person 44
Medical Evaluation / Person 44
Drug Triage / Person 44
Dispensing / Person 44
Form Collection and Exit / Person 44
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 45
Forms Distribution / Person 45
Briefing / Person 45
Triage / Person 45
Mental Health Screening and Counseling / Person 45
Medical Evaluation / Person 45
Drug Triage / Person 45
Dispensing / Person 45
Form Collection and Exit / Person 45
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 46
Forms Distribution / Person 46
Briefing / Person 46
Triage / Person 46
Mental Health Screening and Counseling / Person 46
Medical Evaluation / Person 46
Drug Triage / Person 46
Dispensing / Person 46
Form Collection and Exit / Person 46
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 47
Forms Distribution / Person 47
Briefing / Person 47
Triage / Person 47
Mental Health Screening and Counseling / Person 47
Medical Evaluation / Person 47
Drug Triage / Person 47
Dispensing / Person 47
Form Collection and Exit / Person 47
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 48
Forms Distribution / Person 48
Briefing / Person 48
Triage / Person 48
Mental Health Screening and Counseling / Person 48
Medical Evaluation / Person 48
Drug Triage / Person 48
Dispensing / Person 48
Form Collection and Exit / Person 48
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 49
Forms Distribution / Person 49
Briefing / Person 49
Triage / Person 49
Mental Health Screening and Counseling / Person 49
Medical Evaluation / Person 49
Drug Triage / Person 49
Dispensing / Person 49
Form Collection and Exit / Person 49
Station Name (if applicable) / # of People (min 50) / Start Time (enter time in minutes / End Time (enter time in minutes)
Greeting/Entry / Person 50
Forms Distribution / Person 50
Briefing / Person 50
Triage / Person 50
Mental Health Screening and Counseling / Person 50
Medical Evaluation / Person 50
Drug Triage / Person 50
Dispensing / Person 50
Form Collection and Exit / Person 50

Revised October 31, 2012