Individuals working in public health are keenly aware that recruiting and training volunteers is crucial for an effective response to a large-scale disaster. Unfortunately, most public health agencies simply do not have enough trained staff or a vast inventory of trained volunteers to effectively respond to such an event. Consequently, training volunteers “off the street” will be crucial—but time consuming—in a disaster. The volunteers may serve in a variety of functions, but a primary role is to assist with mass dispensing or vaccination clinics, which also are called point of dispensing (POD) sites. A POD usually is located in one of several predetermined sites that can accommodate large numbers of people, traffic, and parking (eg, a local high school gymnasium) for mass distribution of medications or other supplies.
Some emergency response planners have expressed frustration when considering how to conduct volunteer management at each POD.1 The current plan that many public health agency planners have is to conduct intensive volunteer training at each POD site.1 However, if a disaster is widespread and multiple POD sites must be activated and staffed, a major logistical problem will occur with this type of planning. Each POD will have to conduct intensive just-in-time personnel tasks with limited staff and equipment resources, including volunteer registration, credentialing, identification badging, training in basic incident command system, and other training specific to the response. In addition, experienced staff and trainers must be present at each POD to coordinate and implement the just-in-time training. Severe disruptions also may occur at each POD when dozens, possibly hundreds, of volunteers arrive throughout the operational period, causing additional traffic and parking congestion, including disruptions to the mass clinic operations.
VOLUNTEER STAGING AND TRAINING AREA (VSTA) CONCEPT
At the 2007 Public Health Emergency Preparedness Summit in Washington, DC, the authors took part in a roundtable discussion about our initial concept of rethinking volunteer management by creating a volunteer staging and training area (VSTA) for use during a large-scale disaster (Fig. 1). In a 2002 report by the Points of Light Foundation and the Volunteer Center Network, a set of recommendations was developed for managing volunteers. Among the recommendations was the establishment of a volunteer staging area, outside the immediate disaster area.2 Similar concepts have been used by some volunteer organizations, such as the American Red Cross, during disasters. This approach allows these organizations to manage large numbers of volunteers and obtain certain economies of scale when providing training to emergent volunteers.
Volunteer staging and training area (VSTA) concept in relation to supplying various point of distribution (POD) sites within a community with newly trained volunteers
To create one or several VSTA sites, a large training area (eg, a community center or high school gymnasium not being used as a POD) is needed. The VSTA would be set up to register and credential volunteers, to provide identification badges, and to conduct a basic briefing, including a brief overview of incident command system and POD operations. Additional benefits of using a VSTA include the following:
• Reducing stress on POD management staff by eliminating most of the complex just-in-time training about POD functions with inexperienced volunteers. Of note, there is an expectation that an orientation to each dispensing site would be conducted at each POD when new shifts of volunteers report for duty.
• Reducing the need for large training areas at each POD site, thus freeing up space for increased clinic operations.
• Providing for continuous training of new volunteers at a remote site that will not distract mass clinic operations. Stations within the VSTA can be set up to provide hands-on training and practice for radios, patient forms, and other advanced POD operations, such as training for giving inoculations. The continuous recruitment and training of volunteers also can help ensure a fresh supply of volunteers and thus minimize burnout of POD staff. Operational shift periods for POD volunteers and staff could be reduced from current plans of 12-hour staff shifts to possibly 8-hour shifts.1
• Minimizing transportation and parking issues because volunteers in training and their vehicles would not be taking up space at each POD. In addition, volunteers reporting for duty could be taken to each POD from the VSTA by bus or carpool.
• Registering and issuing identification to volunteers at a VSTA would reduce the number of staff and equipment needed to conduct these operations at each POD, which can also save money on equipment and software purchases.
• Video training can accomplish some basic training (eg, basic overview of POD operations, incident command system), and can be running continually at a VSTA using PowerPoint or video.
• Identifying issues and problems at the VSTA can prevent these issues from surfacing in a POD and impairing operations. For example, if volunteers are unsure of their roles and responsibilities, then they can ask for clarification or repeat certain training components, thus avoiding bottlenecks in a POD or distracting mass clinic staff and operations by asking frequent questions.
• Matching volunteers with specific skills to PODs in need of those skills can be better handled. For example, if a POD in the northern part of a city is short of skilled vaccinators, logistics personnel can send those needed volunteers from the VSTA to the POD. Or, if one POD is having difficulty with traffic and parking, then additional volunteers can be sent from the VSTA to assist with traffic control.
OTHER CONSIDERATIONS FOR A VSTA
Writing a VSTA into a local public health emergency response plan will have implications for logistics planning. Logistics personnel will need to coordinate preparing and setting up the VSTA in advance of any dispensing operations. Depending on the size of a community or region, multiple VSTA sites may need to be considered, in addition to the mass dispensing sites. The VSTA will need a particularly large parking lot, including volunteers to assist with traffic control and parking. Planners also will want to negotiate transportation options for volunteers from the VSTA to each POD. Trained staff will need to operate the VSTA, and they will need a system to register volunteers, check credentials (eg, if medical professionals are volunteering for specific health-related tasks), and issue identification badges. Planners will need to partner with their communication specialists to create media messages for recruiting and directing potential volunteers to arrive at the VSTA(s) rather than POD sites.
In addition to the considerations regarding the VSTA, the POD sites supported by the VSTA will require proper planning and a predesignated staff to ensure sufficient throughput as the first wave of volunteers is being trained. This initial force could be any group or combination of public health department staff, Medical Reserve Corps volunteers, or first responders who are pretrained and ready to assemble a POD and initiate dispensing operations. VSTA exercises, if conducted with such objectives in mind, also can serve as a way to conduct large-scale advance recruiting, credentialing, and training of interested volunteers. This would help create a pool of registered volunteers who can periodically participate in public health drills, exercises, and actual emergency events.
CONCLUSIONS
Emergency response planners may wish to incorporate a VSTA into their strategic national stockpile and mass dispensing plans. Although a VSTA may create additional work in advance of conducting mass clinic operations, the concept can significantly reduce the stress and added chaos of registering and training new volunteers at every mass clinic site.
The VSTA concept still needs to be exercised and refined by jurisdictions that choose to use this approach. In addition, computer modeling is useful for further developing VSTA plans and estimating how this training approach would change POD operations. Multiple modeling tools are available through the Centers for Disease Control and Prevention Web site.3
In summary, the use of a VSTA to train mass dispensing volunteers should improve the overall mass dispensing plans and volunteer management. When a large-scale public health disaster occurs, training new, off the street volunteers can be managed effectively and efficiently under this model.
Authors' Disclosures The authors report no conflicts of interest.
