A Large-Scale Points-of-Dispensing Exercise for First Responders and First Receivers in Nassau County, New York

Abstract

Points of dispensing (PODs) are vital for responding to events that require mass chemoprophylaxis, such as bioterrorist attacks or pandemic influenza. This article evaluates the operational success of a large-scale dispensing drill for first responders and first receivers, focusing on differences in functioning of PODs by practice discipline and POD model. PODs were operated by either first responders (EMS, fire, or police) or first receivers (hospitals). Facilities could operate a centralized POD model, a decentralized POD model, or a combination, or "hybrid," model. Evaluation consisted of having evaluators at every POD, conducting a survey of POD individuals, and reviewing retrospectively the medications dispensed during the drill. Throughput counts, satisfaction with POD functioning, and errors in medication dispensing at each site are reported by practice discipline and facility model. During the drill, 23 PODs successfully processed more than 4,000 individuals. Centralized PODs and first responder facilities had faster throughput times than hybrid and hospital facilities, but hospital facilities had a lower incidence of medication error. Nominal differences in patient satisfaction were found. Assessing a combination of throughput, medical errors, and patient satisfaction with first responders and first receivers as points of dispensing can provide valuable insight into the feasibility of providing chemoprophylaxis to first responders and first receivers in advance of POD operations for the general public.