Utilizing a Regional Medical Operations Center

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Utilizing a Regional Medical Operations Center

• The power of collaboration..

State of Virginia Department of Public
Health May 2007
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Why a Regional Medical Approach ?

• Shared Concerns
• Liability Issues
• Medical Surge Capacity
• Degradation of Care
• Facility Integrity
• Patient/Staff Safety
• Coordination of Response
• Financial Issues
• Cost-Benefit Analysis
• Proper Resource Allocation

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Vital Statistics

• Regional Population 4.5 million (2000
  Census)
• Counties/Sq Miles 9 Counties/ gt9500
• ED visits per year 1.75 Million
• Healthcare facilities 99
• 15 Trauma Centers
• 2 Pediatric
• 55 Acute Care
• 44 LTAC/Specialty

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The Region

• Could contain cities of New York, Washington,
  Boston, San Francisco, Seattle, Minneapolis and
  Miami
• 36th largest state in US
• Slightly larger than Israel
• 22nd largest economy in world

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Medical Needs are Different.
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Associated Risk Potential

• Damaged Housing Businesses
• Disrupted Communications
• Utility Outages
• Displaced Individuals
• Economic Loss
• Mass Casualties

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Medical Infrastructure Risk

• Loss of Power
• Loss of HVAC
• Loss of Medical Gases
• Increased Medical Surge
• Loss of Facility Infrastructure
• Decreased Man Power
• Decreased Supply/Nutritional Assets
• Quality of Care Issues
• Evacuation

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Hurricane Katrina August 2005
Tropical Storm Allison June 2001
Hurricane Rita September 2005
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How do you prepare for this?
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Regional Hospital Preparedness Council
Regional Hospital Preparedness Council

• Evolution
• Hospital Planning Group
• Houston Area Hospital Emergency Management
  Collaborative
• Federal funding
• Regional Hospital Preparedness Council

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Regional Hospital Preparedness Council

• Members
• All Hospitals in 9 county region
• Offices of Emergency Management
• DSHS Region 6/5S
• Local Health Departments
• Blood Bank
• VA/National Disaster Management System
• Nursing Home Coalition
• Harris County Medical Society
• Harris County Medical Examiner
• Schools of Nursing
• Houston Area Chaplaincy
• Greater Houston EMS Council
• Department of Public Safety Regional Liaison
  Officer 2A
• Southeast Texas Trauma Regional Advisory Council
  (RAC)
• Houston-Galveston Area Council (H-GAC)

Regional Hospital Preparedness Council
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Regional Hospital Preparedness Council

• Purpose
• Regional Planning and Preparedness
• Coordinated Health Care Response
• Multi-disciplinary Plan Implementation
• ICS Compliant
• Hospital focused
• Cross jurisdictional

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Getting Started

• Understand Components of Emergency Management
• Initiate Memorandums Of Agreement
• Regional Hazard Vulnerability Analysis
• Identify Resources
• Develop Database
• Build Relationships with Key Stakeholders
• Identify Medical Coordinating Entity

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Planning Goals

• Enhance coordination
• Eliminate duplication
• Avoid unfounded assumptions
• Think out of the box
• Develop a living document
• Train exercise
• Learn from mistakes
• Developing relationships

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Response Operations

• Command and Control
• Integration and Collaboration
• Incident Action Planning
• Flexibility
• Well stocked tool box

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Recovery Operations

• Joint After Action Reports
• Regional and Individual Corrective Action Plans
• Repatriation
• Reimbursement
• Return to Standard Operations

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Unified Command

• Advantages
• A single set of objectives
• A collective approach
• Improved information and coordination
• Joint priorities and restrictions
• Mutual voice
• Single Incident Action Plan

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Catastrophic Medical Operations Center

• Mission
• Identify and meet the healthcare needs of the
  region
• Protect and maintain medical infrastructure of
  all regional healthcare facilities
• Provide appropriate transfer to healthcare
  facilities based on capacity and capability
• Coordinate unique requirements of special needs
  population
• Maintain patient tracking records

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CMOC Command Structure
Mass Care
Non-9-11
Long Term/Rehab
Epidemiology
Pediatrics
Mass Transit
Dialysis
Air Ambulance
Mental Health
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Local to Federal Span
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Outcomes of a Regional Medical Response

• Robust, Coordinated All-hazards Approach
• Formalized Unified Command Structure
• Interoperability
• Redundant Communication
• Standardized Approach
• Facility retains identity
• Regional partnership response

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Accomplishments

• Transportation and transfer of 919 patients into
  healthcare facilities during Hurricane Katrina
• 29 healthcare facilities evacuated during
  Hurricane Rita
• 121 Nursing Home evacuations during Hurricane
  Rita
• Coordination of 34 Counties and 2 States
• Transportation and transfer of an additional
  2400 patients into healthcare settings
• Hospital diversion rate 0
• Post event QA 0.08 error rate

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Lori Upton, RN BSN MS CEN laupton_at_texaschildrensho
spital.org