Building a Hospital Emergency Plan: Working with Facilities to Update Operations Plans

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Building a Hospital Emergency PlanWorking
with Facilities to Update Operations Plans

• Eric M. Weller, MA, NREMT
• EMS Program Manager
• South Central College
• North Mankato, Minnesota

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Objectives

• Participants will understand the importance and
  process needed for All Hazard Planning in
  Hospitals.
  
• Participants will understand the phases of
  Emergency Management.
  
• Participants will understand how an incident
  management leadership structure is an integrated
  component of the Hospital Emergency
  Operations/Disaster Plan.
• Participants will understand the major components
  needed to write an effective hospital emergency
  management plan.
  

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Why Is This an Issue Today?

• Terrorism
• Disasters
• Other?
• Regulators
• Public Perspective

FEMA News Andrea Booher
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How Does Terrorism/Disasters Affect the
Healthcare System?

• Produces mass casualties
• Murrah Building in Oklahoma City
• Sarin in Tokyo subways
• Suicide bombers in Middle East
• Olympic Park Bombing in Atlanta
• Twin Towers in New York
• Hurricane Katrina
• Virginia Tech School Shooting

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How Does Terrorism/Disasters Affect the
Healthcare System?

• Produces A Redirection of Resources and Change in
  Preparedness Activities
  
• Smallpox Planning for hospitals and health
  departments
  
• Strategic National Stockpile (SNS) Vaccines and
  Drug Caches, Mass Dispensing Plans
  
• Surge Capacity Planning
• Hurricane Survivors Camp Ripley

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Hospitals Planning Preparedness

• Hospitals must be prepared for mass
  casualties/influx of patients from
  
• Blast injuries
• Penetrating wounds
• Thermal burns
• Major trauma in general including hypovolemic
  shock and orthopedic injuries
  
• And now..Pandemic

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Chemical Incidents Planning Considerations

• What measures must be planned in advance to
  safely evacuate/ treat patients contaminated with
  toxic chemicals?
  
• Does the capability to decontaminate exist in
  your hospital?
  
• What antidote medications might be important if a
  chemical terrorist attack would occur?

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What is a Disaster?

• Any event that overwhelms existing resources to
  deal with that event
  
• Weather tornadoes, flooding, severe storms
• Terrorism
• Riots
• Hazardous materials incident
• Large volume of patients
• Pandemic

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Disaster Implications

• Restrict and overwhelm resources, communications,
  transportation and utilities
  
• Individuals and communities are cut off from the
  outside support

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Disaster Implications

• Transportation
• Electrical
• Telephone
• Water
• Fuel
• Structural
• Communications

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What is your GOAL in a Disaster?

• RESPONSE manage victims (treat, triage,
  transfer, disposition)
  
• RECOVER operational, financial, and back to
  normal operations

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Integrated Emergency Management

• A Conceptual Framework for Organizing and
  Managing Emergency Protection Efforts

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Integrated Emergency ManagementCan it be
obtained?

• Federal
• Tribal
• State
• Local
• Emergency Management
• Public Works
• Fire/Rescue
• EMS
• Hospitals
• Public Health

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Integrated Emergency Management Building Blocks

• Planning
• Training
• Exercising
• Policies Procedures
• Resource Requirements
• Resource Upgrade

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Hospital Major Incident Management

• Disruption of normal process of health care
  delivery
  
• Displacement of day-to-day patient management of
  casualties
  
• Distraction of health care providers from usual
  workflow

• Addition of mental health burden
• Disruption of supply chain
• Disruption of communication systems
• Fiscal disruption

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Comprehensive Emergency Management

• Mitigation
• Preparedness
• Response
• Recovery

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Mitigation

• Those activities that a hospital undertakes in
  advance to lessen the severity and impact of a
  potential emergency or critical incident

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Mitigation

• Hazard Identification
• Hazard Assessment (HVA)
• Structural Code Compliance
• Equipment Maintenance

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Preparedness

• Those activities a hospital undertakes to build
  capacity and identify resources that may be used
  should an emergency occur.

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Preparedness

• Plan development
• Training courses
• Exercises
• Employee education
• Public Education
• codeReady

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Response

• Those activities a hospital undertakes
  immediately before, during and after a emergency
  or disaster occurs

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Response

• Alerting
• Assessment
• Mobilizing
• Implementing plan
• Activate systems (HICS, EOC)
• Set priorities
• COMMUNICATE

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Recovery

• Those activities undertaken by a hospital after
  an emergency or disaster occurs to restore
  minimum services and move towards long-term
  restoration

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Recovery

• Return to normal
• Detailed damage assessment
• Care and shelter continues
• Funding assistance
• Remove debris

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Emergency Management

• A successful interface
• needs..
• Planning
• Training
• Exercising

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Emergency Management PlanThe Components.

• Introduction
• Procedures Operations
• HICS Job Action Sheets
• Specific Departmental Plans
• Forms/Resources

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Emergency Management PlanPART 1 Introduction
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Introduction

• Objectives
• Goals
• Responsibility

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Introduction

• Hazardous Vulnerability Analysis (HVA)
• Multiple Tools Available

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Introduction

• Integration Exercising
• What is the plan?
• Command Structure
• Adoption of HICS
• Cooperative Planning
• Who do you work with?

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Emergency Management PlanPart 2 Procedures
Operations
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Procedures Operations

• Activation/Initiation
• Who has authority?
• Personnel Notification
• How are they notified?
• Identification of Personnel
• Picture ID

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Procedures Operations

• Emergency Operations Center (Hospital Command
  Center HCC)
  
• Location
• Who is there
• Information Center
• Communication

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Procedures Operations

• Patient Flow
• Triage
• Treatment Areas
• Security Activities
• Entry Egress
• Visitors Access

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Procedures Operations

• Communications
• Telephone
• Back-up Systems
• Radio (VHF/800)
• Satellite Phone
• Walkie Talkies
• HAM Radio
• Fax

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Procedures Operations

• Patient Admissions, Triage, Disaster Tags,
  Registration
  
• Process
• Elective Procedures
• Discharge of Patients

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Procedures Operations

• News Media
• Public Information Officer (PIO)
• Strategic Location
• Joint Information Center (JIC)

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Procedures Operations

• Hotline
• Family of Victims, Visitors, Outpatients

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Procedures Operations

• Supplies Equipment
• Essential Supplies
• Pharmaceuticals
• Medical Supplies
• Equipment
• Food
• Water
• Linen
• Utilities

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Procedures Operations

• Morgue
• DOAs
• Others that Expire

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Procedures Operations

• Evacuation
• Authority
• Transportation
• Location
• Evacuation Routes
• Practice/Test

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Procedures Operations

• Continuing and/or Reestablishing Operations
• Off Site Care (Alternate Care Sites ACS)

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Procedures Operations

• Essential Utility Alternatives
• Electrical
• Water
• Medical Gas
• Waste Disposal
• Fuel

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Procedures Operations

• Isolation Decontamination
• Plan Procedure
• Equipment
• Training

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Procedures Operations

• Orientation Education
• Annual Plan Evaluation

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Emergency Management PlanPART 3 HICS Job
Action Sheets
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HICS Job Action Sheets

• Incident Command
• Operations
• Logistics
• Finance/Admin
• Planning
• Others

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HICS Job Action Sheets

• One for Each Position
• Embodies Title, Mission/Function and Duties
• Adjusted to Meet Hospital Needs

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Emergency Management PlanPart 4 Specific
Department Plans
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Specific Departmental Plans

• Emergency Department
• Security
• Maintenance
• Nursing Floors
• Admission Policy Registration

• Emergency Triage
• Evacuation
• Communications
• Emergency Operations Center

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Emergency Management PlanPart 5 Forms/Resources
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Forms/Resources

• Help Drive Positions
• Documentation Aid
• Financial Recovery
• Decreases Liability
• Enhances tracks communication

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Where Do I Start??

• Eric has
• Emergency Management Plan (base plan to start
  with)
  
• Departmental Plans (ED, Triage, Admissions,
  Evacuation, Security
  
• Email Eric for them electronically

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Center for HICS Education Trainingwww.hicscent
er.org

• Guidebook
• Training Resources
• Job Action Sheets
• Forms
• Internal (13) External (14) Scenarios

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Eric.weller_at_southcentral.edu507.389.7319