How Your Hospital Emergency Preparedness Plan Will Unfold in a CBRNE Incident

1
How Your Hospital Emergency Preparedness Plan
Will Unfold in a CBRNE Incident

• Tuesday, May 17, 2005
• 100 PM - 200PM

2
Leadership Series

• Leadership Challenges
• Leadership Tools
• Hospital Emergency Preparedness Plan
• Legal and Financial Issues
• (All presentations and handouts can be found at
  www.wha.org)

3
Every Disaster Is Local

• Despite all the preparations at the State or
  National level,
• Every disaster is LOCAL.
• What matters most to your community is not the
  state and national response...
• what will save lives is the response of your
  hospital

4
Every Hospital Must Be Ready

• Our approach in Wisconsin is that each hospital
  can be the epi-center of an incident
• Each hospital must be prepared to respond alone
  at least for the first few hours
• What does it mean to be READY?

5
Critical Benchmarks

• The federal government, through our granting
  agency, HRSA (Health Resources and Services
  Administration), has established Critical
  Benchmarks (goals) and Sentinel Indicators
  (measures) for the state
• These measures are also known as Minimum Levels
  of Readiness

6
Minimum Level of Readiness

• We have established these Minimum Level of
  Readiness Indicators at the individual hospital
  level
• There are two types of indicators
• Capacity Indicators
• Capability Indicators

7
Capacity Indicator

• This indicator means that the hospital has in
  place the resources that will allow it to respond
  to a mass casualty incident
• A resource may be a plan, e.g. to create
  inpatient surge capacity beds
• A resource may be equipment, supplies, e.g.
  airborne infection isolation rooms

8
Capability Indicator

• This indicator means that the hospital has in
  place the ability and proficiency to respond to a
  mass casualty incident
• A tested plan and staff, who know how to deploy
  and staff these surge capacity beds
• Functional equipment, such as medical PAPRs and
  proficiency on how and when to use them

9
Goal

• Every hospital to be at 100 compliance with
  Capacity Indicators by August 31, 2006
• Every hospital to be at 90 compliance with
  Capability Indicators by August 31, 2006

10
Administrative Indicators

• Each hospital has
• a contact person with the Regional HRSA Board
• a signed a Memorandum of Understanding to share
  supplies, equipment and staff
• an Emergency Management Plan and a Emergency
  Managament Committee that meets regularly

11
Post Incident Evaluation

• Each hospital has
• a protocol to evaluate each exercise performed
• a protocol to periodically evaluate its Emergency
  Management Plan

12
Surveillance

• Each hospital has
• a protocol for the reporting unusual
  occurrences of illness or injury
• a protocol to implement enhanced surveillance,
  when requested

13
Activation of Regional Response

• Each hospital
• knows how to activate the need for mutual
  assistance
• is familiar with the 3 Clinical Decision
  Thresholds (slow developing incidents)

14
Infection Control

• Each hospital
• can provide for the isolation of infectious
  patients
• can provide care for a surge of infectious
  patients
• has increased inventories of personal protective
  equipment

15
Response

• Each hospital
• can implement the Incident Command System
• has adopted at least the top 8 positions of the
  Incident Command System
• knows how to communicate with the Emergency
  Operations Center

16
Surge Capacity

• Each hospital has the ability
• to open a Triage Center
• to increase its capacity to treat both inpatients
  and outpatients

17
Security

• Each hospital has a security plan
• Lockdown procedures
• Internal and external traffic control
• Communications
• Staffing

18
Decontamination

• Each hospital
• has Level C decontamination equipment
• can decontaminate at least 4 patients within 20
  minutes
• can decontaminate at least 2 non-ambulatory
  patients in 20 minutes

19
Indicators in Process

• Each hospital
• can distribute pharmaceuticals from the Interim
  Pharmaceutical Stockpile to its staff and family
  members
• has a protocol to augment and credential needed
  staff
• has the ability to track patients from the field
  to the hospital to transfer hospitals

20
Indicators In Process

• Each hospital has 4 levels of communications
  technology redundancy
• Landlines
• UHF/VHF radio
• Satellite telephone
• HAM radio
• Clinicians at hospitals can recognize behavioral
  health symptoms, resulting from a mass casualty
  incident

21
Accomplishment of Indicators

• Capacity will be built over the grant period
• It is time-limited
• It will need to be up-dated periodically
• Capability occurs through exercise
• It is on-going

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So What Is Expected To Happen?
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Refer to the Flow Charts
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Flow Chart 1

• Types of Incidents

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Flow Chart 2

• Mass Casualty Incident All Hazards
• Incident Command System

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Flow Chart 3

• Mass Casualty Incident All Hazards
• GREEN Patients

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Flow Chart 4

• Mass Casualty Incident All Hazards
• Hospitals

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Flow Chart 5

• Mass Casualty Incident Nerve Agent

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Flow Chart 6

• Identification of
• an Outbreak of Infectious Disease

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Flow Chart 7

• Response to an
• Outbreak of Infectious Disease

31
Your Responsibility As Leaders

• The critical plan is your hospital Emergency
  Management Plan
• Wisconsin Hospital Emergency Preparedness Plan
  (WHEPP) contain guidelines for adapting your plan
  for mass casualty incidents

32
Capacity

• The HRSA Hospital Preparedness Program is
  assisting with funding to help build your
  CAPACITY
• 2 more years of substantial funding
• Sustainment budget expected thereafter

33
Capability

• Capability will only be accomplished with your
  support
• Exercise, exercise, exercise
• Evaluate and learn from exercise
• Exercise with others
• Learn from one another

34
Next Month

• Legal and Financial Issues
• Health Law Manual can be found at www.wha.org
• Seminars are
• June 6 Country Springs Hotel, Waukesha
• June 7 Plaza Hotel and Suites, Eau Claire
• June 8 Stoney Creek Inn, Mosinee

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Comments and Questions
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Contact Information

• Bill Bazan
• VP Metro Milwaukee
• Wisconsin Hospital Association
• 414-431-0105 bbazan_at_mailbag.com

37
Contact Information

• Dennis J. Tomczyk
• Director, Hospital Bioterrorism Preparedness
• Wisconsin Division of Public Health
• 608-266-3128 tomczdj_at_dhfs.state.wi.us