1. Supply Chain Logistics

2. Supply Chain Mechanics Storage Roche GSK DOH Hospital Storage INSPECTOR Patient

3. Distribution Channels • Direct from source • DOH as hub-and-spoke • Primarily AIR and HIGHWAY distribution

4. Supply chain activation • Efficient use of inventory • Prevent wastage • Assure constant, available stock

5. Supply chain activation • Information based on seasonal incidence • Weekly census information • Past information from previous outbreaks • 1-week operational stock at hand • mid-week re-evaluation • Minimum 2-day operation stock at hand

6. Checkpoint systems • Batch number logging at acquisition and storage • Batch number logging upon delivery and receiving at hospital • Batch number checking upon inspection prior to release for hospital use (ID representative supervised) • FIFO • Lot number logging upon giving to patient

7. Breaks in the supply • Damaged, contaminated batch contingencies • Emergency deployment contingencies • Maintaining inventory buffer • Referral systems

8. Manpower Logistics • Orderlies • Effective mobilization of patients • Security • Peace and order • Maintenance • Cleanliness and sanitation

9. ER Setup

10. Components • Receiving bay • Kiosk with immediate triaging system • Specialized patient information sheet • Referral for companions to non-urgent for check-up • Evaluation section (2nd floor) • Final arbiter for quarantine • Non-quarantined patients sent back to main ER

11. Traffic Flow • One way – ED serves as ENTRY point only • Stamping of companions • Clearance checks for H1N1 patients/suspects • Strict 1 patient, 1 companion rule

12. Additional measures • Remove television from ED • Include information posts for concerned parties regarding H1N1 • Access to paging systems and direct notification systems (i.e. text) for status of patient