Title: Hospital Emergency Operations Plan Workshop Updating the Hospital and Rural Medical Center EOP for the Use of Volunteers in Medical Surge
1Hospital Emergency Operations Plan
WorkshopUpdating the Hospital and Rural Medical
Center EOP for the Use of Volunteers in Medical
Surge
AGENCY LOGO
2Acknowledgements
- This workshop was developed by the Mesa County
Health Department as part of the National
Association of City and County Health Officials
(NACCHO) Advanced Practice Centers (APC) Program
(Blueprint Project.) - It takes into account new information in light
of - Emergency Support Function 8 (ESF8) Planning
- Homeland Security Exercise and Evaluation Program
(HSEEP) - Hospital Incident Command System (HICS) and
- National Health Security Strategy (NHSS).
- California Emergency Medical Services Authoritys
Clinic Emergency Preparedness Project is
acknowledged for providing a framework from which
a Hospital Emergency Operations Plan template
could be created. - Contributions of Family Health West Hospital,
Fruita, Colorado in the review and revision of
this information.
3Objectives
- Participants will understand the importance and
process needed for All Hazard emergency
operations planning in Hospitals. - Participants will understand the phases of
Emergency Management. - Participants will understand how an incident
command leadership structure is an integrated
component of the Hospital emergency operations
planning . - Participants will understand the major components
needed to write an effective hospital emergency
operations plan. - Participants will understand why volunteer use in
medical surge is critical to writing an effective
plan for rural hospitals.
4Why is this an issue today?
I knew this would happen!
- Terrorism
- Disasters
- Other
- What keeps you awake at night?
- What often happens?
- What are you unprepared for?
- What can be done to plan for these situations?
FEMA News Andrea Booher
5How does terrorism/disasters affect the
healthcare system?
- Produces mass casualties
- Murrah Building in Oklahoma City
- Suicide bombers in Middle East
- Olympic Park Bombing in Atlanta
- Twin Towers in New York
- Hurricane Katrina
- Virginia Tech School Shooting
- Mexican Hat, Utah Bus rollover
(AP-Associated Press)
6How does terrorism/disasters affect the
healthcare system?
- Produces a redirection of resources and change in
preparedness activities - Smallpox planning for hospitals and health
departments - H1N1 Strategic National Stockpile (SNS)
vaccines and drug caches, mass dispensing plans - Surge capacity planning
- Agro-chemical/oil and gas chemical regulatory
compliance issues
7Havent we done this before?
- Pre-1950s Civil Defense Era.
- Fire Protection Era (1960s-1970s)
- Disaster Planning Era (1970s)
- Emergency response for hospitals used to mean a
disaster plan, fire plan, utility failure plan. - Current (post- 9-11) all-hazards expectations
(public/partners) community integration, address
all aspects of patient care issues, records and
data tracking/security, supply status tracking,
surge resource tracking. - Result more complex planning due to a more
complex response.
8Hospital planning preparedness
- County Mass Casualty Plan
- Surge capacity planning (H1N1)
- Aligns with EOP plans at city/county level
- NIMS/ICS compliance
- Homeland Security compliance funding
- HPP deliverables
- LPHA grants and deliverables
9Hospital planning preparedness
- State Hospital Associations Emergency planning,
HSEEP , state-level hospital coordination
systems. - 9-11 and heightened expectations for increased
integration in surge capacity and response. - Tendency towards credentialing and accreditation
- Credentialing for surge staff/volunteers
- National trends toward accreditation schools and
health departments. - What will be the future relationship between
CMS-CoPs and Joint Commission Standards?
10Chemical incidents planning considerations
- What measures must be planned in advance to
safely evacuate/ treat patients contaminated with
toxic chemicals? - Does your hospital have the capability to
decontaminate? - What antidote medications might be important if a
chemical terrorist attack occurred?
11Definitions
- Capacity amount or availability of resources and
ability of staff, training, and depth. - Capability type of services in terms of
emergencies, partnerships, and readiness. - Vulnerability susceptibility to failure due to
inadequate resources, training, equipment, or
planning. The goal is to decrease vulnerability. - Readiness/Preparedness a direct result of the
adequacy of planning and the potential of those
plans to create results in the area of training
and resources.
12What is an incident?
- Any event that overwhelms existing resources to
deal with that event. - Weather tornadoes, flooding, severe storms
- Terrorism
- Infrastructure failures affecting operations for
a prolonged period - Hazardous materials incident
- Large volume of patients
- Pandemic
13Incident implications
- Transportation
- Electrical
- Telephone
- Water
- Fuel
- Structural
- Communications
14Incident implications
- Incidents restrict and overwhelm resources,
communications, transportation and utilities. - Individuals and communities are cut off from the
outside support.
15What is your goal in an incident?
- RESPONSE manage victims (treat, triage,
transfer, disposition). - RECOVERY operational, financial, and return to
normal operations.
16All Hazards approach to planning
- A conceptual framework for organizing and
managing emergency protection efforts.
17Who is involved in All Hazard response efforts?
- Federal
- Tribal
- State
- Local
- Emergency Management
- Public Works
- Fire/Rescue
- EMS
- Hospitals
- Public Health
18All Hazard steps
- Planning
- Training
- Exercising
- Policies procedures
- Resource requirements
- Resource upgrade
19Major Incident Operations
- 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
20Emergency Operations Plan
- Introduction
- Procedures Operations
- HICS Job Action Sheets
- Specific Departmental Tools
- Forms/Resources
21Emergency Operations Plan-Part 1
- Introduction
- General overview of ltHospital Namegt and
facilities/support. - Purpose/Policy
- Provide continuous quality improvement.
- Provide coordination and integration.
- Scope
- Addresses Joint Commission and CMS Conditions of
Participation (CoPs.)
22All Hazards Emergency Operations
- Mitigation
- Removing/lessening the conditions that lead to
incidents. - Preparedness
- Readiness for the unavoidable.
- Response
- Decreasing the severity/intensity of an incident.
- Recovery
- Getting back to normal.
23Mitigation
- Hospital Hazard Vulnerability Analysis (HVA)
- Multiple Tools Available
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26Mitigation
- Hazard identification
- Hazard Assessment (HVA)
- Structural code compliance
- Equipment and maintenance
27Preparedness
- Plan development
- Training courses
- Exercises
- Employee education and competencies
- Public education
28Response
- Alerting
- Assessment
- Mobilizing- Healthcare partners and ESF8
- Implementing plan
- Activate systems (HICS, EOC)
- Control, Set priorities-Infection etc.
- Communication and situational awareness
29Recovery
- Those activities undertaken by a hospital after
an emergency or disaster occurs to restore
minimum services and move towards long-term
restoration.
30Recovery
- Return to normal
- Detailed damage assessment
- Care and shelter continues
- Funding assistance
- Remove debris
31Part 2- Specific procedures operations
- Patient Flow
- Triage
- Treatment Areas
- Security Activities
- Entry Egress
- Visitors Access
32Procedures operations
- Communications
- Telephone
- Back-up systems
- Radio (VHF/800)
- Satellite phone
- Walkie Talkies
- HAM radio
- Fax
33Procedures operations
- Patient admissions, triage, disaster tags,
registration process - Elective procedures
- Discharge of patients
34Procedures operations
- News Media
- Public Information Officer (PIO)
- Strategic location
- Joint Information Center (JIC)
35Procedures operations
- Hotline
- Family of victims, visitors, outpatients
36Procedures operations
- Supplies equipment
- Essential supplies
- Pharmaceuticals
- Medical supplies
- Equipment
- Food
- Water
- Linen
- Utilities
37Procedures operations
- Morgue
- DOAs
- Others that expire
38Procedures operations
- Evacuation
- Authority
- Transportation
- Location
- Evacuation routes
- Practice/Test
39Procedures operations
- Continuing and/or reestablishing operations
- Off site care (Alternate Care Sites, or ACS)
40Procedures operations
- Essential utility alternatives
- Electrical
- Water
- Medical gas
- Waste disposal
- Fuel
41Procedures operations
- Isolation decontamination
- Plan procedure
- Equipment
- Training
42Procedures operations
- Orientation education
- Annual plan evaluation
43Emergency Operations PlanPart 3- HICS Job Action
Sheets
44HICS Job Action sheets
- Incident Command
- Operations
- Logistics
- Finance and Administration
- Planning
- Others
45HICS Job Action sheets
- One for each position.
- Embodies title, mission/function and duties.
- Adjusted to meet hospital needs.
46Emergency Operations PlanPart 4 Specific
department tools
47Specific departmental plans
- Emergency Department
- Security
- Maintenance
- Nursing floors
- Admission policy registration
- Emergency triage
- Evacuation
- Communications
- Emergency Operations Center
48Emergency Operations PlanPart 5-forms/resources
49Forms/Resources
- Help drive positions
- Documentation aid
- Financial recovery
- Decreases liability
- Enhances tracks communication
50Emergency Management
- A successful interface needs
- Planning
- Training
- Exercising
51 According to Joint Commission1
- Emergency Management is now its own accreditation
manual chapter. - All Standards and Elements of Performance from
2009 are incorporated into the 2010 Emergency
Management chapter. - This new chapter contains some standards that
were in HR, EC and MS sections. - Critical Access Hospital requirements are similar
to other types of hospitals in most counties.
1 http//www.jointcommission.org/
52Emergency Operations Plan
- Emergency Operations Plan (EOP) describes
response procedures - Written plan
- Capabilities to self-sustain for up to 96 hours
EM.02.01.01 - As well as
- Recovery strategies and surge capabilities.
- Initiation and termination of response and
recovery phases. - Defines authorities and community relationships
- Alternative care sites, alternate EOC.
- Actual implementation is documented.
53Emergency Operations Plan
54Emergency Operations Plan
- Addresses Twelve Critical Access Hospital Joint
Commission Components - Planning EM.01.01.01
- The EOP EM.02.01.01
- Communication EM.02.02.01
- Resources Assets EM.02.02.03
- Safety Security EM.02.02.05
- Staff responsibilities EM.02.02.07
- Utilities Management EM.02.02.09
- Patient, clinical support activities EM.02.02.
11 - Volunteer Management EM.02.02.13
- Volunteer Credentialing EM.02.02.15
- HVA and Evaluation EM.03.01.01
- Plan Evaluation EM.03.01.03
55Emergency Operations Plan
- EM.01.01.01 Planning (8 measures)
- The critical access hospital engages in planning
activities prior to developing its written
Emergency Operations Plan. - EM.02.01.01 The Plan (8 measures)
- The critical access hospital has an Emergency
Operations Plan. - EM.02.02.01 Communication (15 measures)
- As part of its Emergency Operations Plan, the
critical access hospital prepares for how it will
communicate during emergencies. - EM.02.02.03 Resources Assets (9 measures)
- As part of its Emergency Operations Plan, the
critical access hospital prepares for how it will
manage resources and assets during emergencies.
56Emergency Operations Plan
- EM.02.02.05 Safety and Security (9 measures)
- As part of its Emergency Operations Plan, the
critical access hospital prepares for how it will
manage security and safety during an emergency. - EM.02.02.07 Staff Responsibilities (9 measures)
- As part of its Emergency Operations Plan, the
critical access hospital prepares for how it will
manage staff during an emergency. - EM.02.02.09 Utilities Management (7 measures)
- As part of its Emergency Operations Plan, the
critical access hospital prepares for how it will
manage utilities during an emergency. - EM.02.02.11 Patient, clinical support
activities (8 measures) - As part of its Emergency Operations Plan, the
critical access hospital prepares for how it will
manage patients during emergencies.
57Emergency Operations Plan
- EM.02.02.13 Volunteer Management (9 measures)
- During disasters, the critical access hospital
may grant disaster privileges to volunteer
licensed independent practitioners. - EM.02.02.15 Volunteer Credentialing (9 measures)
- During disasters, the critical access hospital
may assign disaster responsibilities to volunteer
practitioners who are not licensed independent
practitioners, but who are required by law and
regulation to have a license, certification, or
registration. - EM.03.01.01 Vulnerability Assessment and
Evaluation (3 measures) - The critical access hospital evaluates the
effectiveness of its emergency management
planning activities. - EM.03.01.03 Evaluating the Plan (17 measures)
- The critical access hospital evaluates the
effectiveness of its Emergency Operations Plan.
58Use of volunteers in medical surge
- 18 Elements of Performance (EPs) of Joint
Commission Standards address use of volunteers. - Medical Surge exercises that are HSEEP-compliant
must address the use of volunteers in surge
activities. - How deep is your hospital in each staff skill
area? By department? Supervisor? Facility?
Occupation? Specialty?
59For Volunteer Licensed Independent Practitioners
and Volunteer Practitioners
- Section 1 Disaster Privileges
- Section 2 Credentials Verification
- Section 3 Volunteer Oversight
- Section 4 Cessation of Volunteers
60Use of volunteers
- What can they do?
- What cant they do, unless supervised?
- What shouldnt they do?
- Who can they be?
- Can spontaneous unassigned volunteers (SUVs) be
used? - What are the most likely scenarios?
- Who can and cannot supervise volunteers?
61Review The Emergency Operations Plan
- Covers all of the All Hazards phases of Emergency
Management - Mitigation
- Planning
- Response
- Recovery
- As well as communications with ESF8 partners
62Where do I start?
- ltHospital Namegt
- has
- Emergency
- Operations Plan
- (a base plan to start with).
- Departmental Plans (ED, Triage, Admissions,
Evacuation, Security. - Email lthospital point of contactgt to receive the
plans electronically.
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64Center for HICS Education Training-
www.hicscenter.org
- Guidebook
- Training Resources
- Job Action Sheets
- Forms
- Internal (13) External (14) Scenarios
65ltPresenter POC informationgt