Transportation and Distribution of Strategic National Stockpile Supplies in a Public Health Emergency

In the event of a public health emergency in the United States, it is important that public authorities are equipped to distribute medical supplies to every person in need as quickly as possible. Federal guidelines state that all persons in an area affected by a public health emergency should receive their medical countermeasures within 48 hours of the emergency’s declaration. While the CDC has determined a general dispensing plan for each state and county to follow, it is ultimately up to the state and county to formalize and implement detailed plans. A body of academic literature focuses on optimizing the placement and operation of Points of Dispensing (PODs), which are mass dispensing locations the public visits to receive countermeasures. However, very few papers have considered the logistics associated with moving countermeasures from state receiving areas to county-level PODs. This research addresses this gap through service network design and transportation modeling. Specifically, the feasibility of a multi-tiered distribution model is evaluated for a case study region representative of a US state comprised of a mix of urban and rural areas

The National Criteria for Evacuation Decision-Making in Nursing Homes

Explains the key factors nursing home administrators and healthcare workers must consider in deciding whether to evacuate patients or to shelter them in place during natural disasters. Includes guidelines for drawing up emergency management plans

The SNS logistics network design : location and vehicle routing.

Large-scale emergencies caused by earthquake, tornado, pandemic flu, terrorism attacks and so on can wreak havoc to communities. In order to mitigate the impact of the events, emergency stockpiles of food, water, medicine and other materials have been set up around the US to be delivered to the affected areas during relief operations. One type of stockpile is called the Strategic National Stockpile (SNS). The SNS logistics network is designed to have multiple stages of facilities, each of which is managed by different levels of governmental authorities - federal, state and local authorities. The design of a logistics network for delivery of the SNS materials within a state are explored in this dissertation. There are three major areas of focus in this dissertation: (1) the SNS facility location model, which is used to determine sites for locating Receiving, Staging and Storage (RSS) and Regional Distribution Nodes (RDNs) to form a logistics network to deliver relief material to Points of Demand (PODs), where the materials are directly delivered to the affected population; (2) the SNS Vehicle Routing Problem (VRP), which is used to assist the SNS staff in determining the numbers of various types of trucks, and the routing schedules of each truck to develop an operational plan for delivering the required relief materials to the assigned PODs within the required duration; (3) the location-routing analysis of emergency scenarios, in which the facility location model and the VRP solution are integrated through the use of a computer program to run on several assumed emergency scenarios. Using real data from the department of public health in the Commonwealth of Kentucky, a transshipment and location model is formulated to determine the facility locations and the transshipment quantities of materials; a multiple-vehicle routing model allowing split deliveries and multiple routes per vehicle that must be completed within a required duration is formulated to determine the routing and scheduling of trucks. The facility location model is implemented using Microsoft Solver Foundation and C#. An algorithm combining the Clark and Wright saving algorithm and Simulated Annealing is designed and implemented in C# to solve the VRP. The algorithm can determine whether there is shortage of transportation capacity, and if so, how many of various types of trucks should be added for optimal performance. All the solution algorithms are integrated into a web-based SNS planning tool. In the location-routing analysis of emergency scenarios, a binary location model and an algorithm for solving VRP solution are integrated as a computer program to forecast the feasibility of distribution plans and the numbers of required trucks of various types. The model also compares the costs and benefits of direct and indirect shipment. A large-scale emergency scenario in which a specific type of vaccine is required to be delivered to the entire state of Kentucky is considered. The experiments are designed based on the real data provided by the Kentucky state government. Thus the experimental results provide valuable suggestions for future SNS preparedness planning

Ambulance Emergency Response Optimization in Developing Countries

The lack of emergency medical transportation is viewed as the main barrier to the access of emergency medical care in low and middle-income countries (LMICs). In this paper, we present a robust optimization approach to optimize both the location and routing of emergency response vehicles, accounting for uncertainty in travel times and spatial demand characteristic of LMICs. We traveled to Dhaka, Bangladesh, the sixth largest and third most densely populated city in the world, to conduct field research resulting in the collection of two unique datasets that inform our approach. This data is leveraged to develop machine learning methodologies to estimate demand for emergency medical services in a LMIC setting and to predict the travel time between any two locations in the road network for different times of day and days of the week. We combine our robust optimization and machine learning frameworks with real data to provide an in-depth investigation into three policy-related questions. First, we demonstrate that outpost locations optimized for weekday rush hour lead to good performance for all times of day and days of the week. Second, we find that significant improvements in emergency response times can be achieved by re-locating a small number of outposts and that the performance of the current system could be replicated using only 30% of the resources. Lastly, we show that a fleet of small motorcycle-based ambulances has the potential to significantly outperform traditional ambulance vans. In particular, they are able to capture three times more demand while reducing the median response time by 42% due to increased routing flexibility offered by nimble vehicles on a larger road network. Our results provide practical insights for emergency response optimization that can be leveraged by hospital-based and private ambulance providers in Dhaka and other urban centers in LMICs

Generic Continuity of Operations/Continuity of Government Plan for State-Level Transportation Agencies, Research Report 11-01

The Homeland Security Presidential Directive 20 (HSPD-20) requires all local, state, tribal and territorial government agencies, and private sector owners of critical infrastructure and key resources (CI/KR) to create a Continuity of Operations/Continuity of Government Plan (COOP/COG). There is planning and training guidance for generic transportation agency COOP/COG work, and the Transportation Research Board has offered guidance for transportation organizations. However, the special concerns of the state-level transportation agency’s (State DOT’s) plan development are not included, notably the responsibilities for the entire State Highway System and the responsibility to support specific essential functions related to the State DOT Director’s role in the Governor’s cabinet. There is also no guidance on where the COOP/COG planning and organizing fits into the National Incident Management System (NIMS) at the local or state-level department or agency. This report covers the research conducted to determine how to integrate COOP/COG into the overall NIMS approach to emergency management, including a connection between the emergency operations center (EOC) and the COOP/COG activity. The first section is a presentation of the research and its findings and analysis. The second section provides training for the EOC staff of a state-level transportation agency, using a hybrid model of FEMA’s ICS and ESF approaches, including a complete set of EOC position checklists, and other training support material. The third section provides training for the COOP/COG Branch staff of a state-level transportation agency, including a set of personnel position descriptions for the COOP/COG Branch members

Handbook of Emergency Management For State-Level Transportation Agencies, MTI Report 09-10

The Department of Homeland Security has mandated specific systems and techniques for the management of emergencies in the United States, including the Incident Command System, the National Incident Management System, Emergency Operations Plans, Emergency Operations Centers, Continuity of Government Plans and Continuity of Operations Plans. These plans and systems may be applied to the state-level transportation agency�s disaster response systems to enhance efficiency and effectiveness. Specific guidance and management techniques are provided to aid emergency planning staff to create DHS-compliant systems

Locating fire-stations: an integrated approach for Belgium

This paper demonstrates the potential of a decision-support system developed for Belgium by a consortium of universities and a private firm, in the framework of a public call by the Ministry of the Interior. The system is designed to provide the Belgian emergency management administration with a complete decision-aid tool for the location of fire-stations. The originality of the project is that it includes a risk-modeling approach developed at a national scale. This analysis involves a multiscale GIS system which includes a thorough representation of the physical, human and economic spatial realities, a risk modeling approach, an adequate optimal location and allocation model (taking into account both queuing and staffing problems). The final result is an interactive operational tool for defining locations, equipment allocations, staffing, response times, the cost/efficiency trade-off, etc. which can be used in an assessment as well as a prospective context. It has numerous functionalities including rapid modification of the modeling conditions to allow for quick scenario analysis, multiscale analysis, and prospective analysis.ocation-allocations, GIS, fire-stations, Belgium

A taxonomy for emergency service station location problem

The emergency service station (ESS) location problem has been widely studied in the literature since 1970s. There has been a growing interest in the subject especially after 1990s. Various models with different objective functions and constraints have been proposed in the academic literature and efficient solution techniques have been developed to provide good solutions in reasonable times. However, there is not any study that systematically classifies different problem types and methodologies to address them. This paper presents a taxonomic framework for the ESS location problem using an operations research perspective. In this framework, we basically consider the type of the emergency, the objective function, constraints, model assumptions, modeling, and solution techniques. We also analyze a variety of papers related to the literature in order to demonstrate the effectiveness of the taxonomy and to get insights for possible research directions

Optimal allocation of defibrillator drones in mountainous regions

Responding to emergencies in Alpine terrain is quite challenging as air ambulances and mountain rescue services are often confronted with logistics challenges and adverse weather conditions that extend the response times required to provide life-saving support. Among other medical emergencies, sudden cardiac arrest (SCA) is the most time-sensitive event that requires the quick provision of medical treatment including cardiopulmonary resuscitation and electric shocks by automated external defibrillators (AED). An emerging technology called unmanned aerial vehicles (or drones) is regarded to support mountain rescuers in overcoming the time criticality of these emergencies by reducing the time span between SCA and early defibrillation. A drone that is equipped with a portable AED can fly from a base station to the patient's site where a bystander receives it and starts treatment. This paper considers such a response system and proposes an integer linear program to determine the optimal allocation of drone base stations in a given geographical region. In detail, the developed model follows the objectives to minimize the number of used drones and to minimize the average travel times of defibrillator drones responding to SCA patients. In an example of application, under consideration of historical helicopter response times, the authors test the developed model and demonstrate the capability of drones to speed up the delivery of AEDs to SCA patients. Results indicate that time spans between SCA and early defibrillation can be reduced by the optimal allocation of drone base stations in a given geographical region, thus increasing the survival rate of SCA patients