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______________________________ MEETING THE DISASTER CHALLENGE ENHANCING COMMUNITY CLINIC

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ENHANCING COMMUNITY CLINIC & HEALTH CENTER PREPAREDNESS ... CA EMSA Grant Funded Project Cheryl Starling, EMSA Bio-Terrorism Coordinator. PROJECT BACKGROUND: ... – PowerPoint PPT presentation

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Title: ______________________________ MEETING THE DISASTER CHALLENGE ENHANCING COMMUNITY CLINIC


1
______________________________ MEETING THE
DISASTER CHALLENGEENHANCING COMMUNITY CLINIC
HEALTH CENTER PREPAREDNESS AND RESPONSE
____________________________________________
THE WILSON GROUP
GLOBAL VISION CONSORTIUM
  • Clinic Emergency Preparedness Project (CEPP)
  • California Primary Care Association
    (CPCA),Emergency Medical Services Authority
    (EMSA)

2
WELCOME CLINIC EMERGENCY PREPAREDNESS
PROJECT _________________________________________
  • ATTENDEES
  • Emergency Planners
  • Clinicians
  • Administrators
  • Clinic Consortia Staff
  • STATEWIDE PARTICIPATION
  • June 18, 04 - San Francisco Training
  • June 24, 04 - Eureka, Rural Northern Coast
    Training
  • June 29, 04 - Pasadena, Los Angeles County
    Training

3
MEETING THE DISASTER CHALLENGE ENHANCING
COMMUNITY CLINIC HEALTH CENTER PREPAREDNESS
RESPONSE___________________________________

4
  • INTRODUCTION
  • _________________________________
  • OVERVIEW
  • ? Goals Objectives
  • ? Agenda
  • ? Project Background
  • ? Review of Handouts

5
ENHANCING COMMUNITY CLINIC HEALTH
CENTER PREPAREDNESS RESPONSE
Building a Foundation of Capabilities Tools,
Templates, Plans, Supplies, Training
Commitment Leadership
Mandates/Legislation
New Goals, Roles
MEETING THE DISASTER
CHALLENGE
Risk Threat/ Lessons Learned
Collaboration, Partnership
OTHER DISASTERS
EARTHQUAKE
TERRORISM
6
TRAINING GOALS BUILDING THE BRIDGE ______________
___________________
External PARTNERS
CLINIC Internal Staff
  • Government
  • Hospitals / Community
  • Corporate(Business)
  • Schools
  • Utilities
  • Clients / Staff / Volunteers
  • ERT
  • EOC
  • Emergency Planning Committee
  • Director

Joint Mission No Lag Time No Gaps
7
A THREE LEVEL EMERGENCY MANAGEMENT APPROACH TO
PLANNING
CLINIC EOP TEMPLATE Identify Essential
Functions, Revise Plans, Identify New Roles,
Create SOPS Delegation of Authority Lines of
Succession
PROVIDE ENHANCED CLINIC CAPABILITY Intensive
Support - Communications EOC- Coordinated,
Intensive, and Sustained Plans for Training
BUILD A PLANNING FOUNDATION State, Regional,
Operational Local Jurisdiction Partner
Teams (Support Operational Area, State, Federal
Plans Initiatives)
8
PLANNING FOR EMERGENCY OPERATIONS
INTEGRATING STRATEGIES
  • PLANNING
  • ASSESSMENTS, RECOMMENDATIONS REVIEW
  • Directed at Leadership, Supporting Agencies,
    Partners

PLANNING FACILITATING PARTNERSHIPS NETWORKS
Access to Information From State, Regional,
Operational, Local Jurisdictions
REVISIONS OF EXISTING PLANS INTEGRATED EOP
TEMPLATE
  • EOC RESPONSE PLAN
  • SOP ENHANCEMENTS
  • SEMS
  • Alternate Communication
  • Information Flow to Local Jurisdictions, Regions,
    State
  • PLANNING TRAINING EVALUATION
  • Consistent With Legislation
  • State OES Policies Laws

9
NEW CLINIC RESPONSE CAPABILITY
  • Facilitates Rapid Disaster Response
  • Immediate Response to Clients Staff
  • Timely Activation Efficient Decisions
  • Organizes Community Efforts
  • Strengthens Coordination with Government
  • Facilitates Access to Mutual Aid to Supply
    Personnel
  • Promotes Community Self-Sufficiency Decision-
    Making

10
GOALS / OBJECTIVES _________________________
___
  • Minimize Community Clinic Losses
  • Prevent Further Casualties Losses
  • Rescue / Recovery
  • Provide Triage Medical Operations
  • Evacuate Injured
  • Open Communications
  • Reduce Property Loss
  • Minimize Clinic Interruptions
  • Minimize Life Style Impact
  • Minimize Impact From Disaster
  • Less Stress on Community

11
  • TRAINING OBJECTIVES
  • _______________________________________
  • Participants Will
  • Understand Basics of Emergency Management
    Clinic Roles
  • Understand How to Use Templates, Power-point
    Presentation Other Tools
  • Understand Strategies for Initiating, Developing
    Sustaining Clinic Emergency Management Program

12
CLINIC EOP TRAINING Provides Realistic
Solutions _____________________________________
  • Increased Response Effectiveness Risk Reduction
  • Access To Resources How To Maximize Resources
  • Staff with Military or Police Background
  • Executive Directors
  • Staff Person at Consortia Level
  • Operations Staff (who are more available than
    clinical staff)
  • Community-Wide Emergency Response Coordination
  • Clinic Leverage in Community Response Plans

13
PROJECT BACKGROUND How Clinics Became
Involved ________________________________________
14
PROJECT BACKGROUND How Clinics
Became Involved __________________________________
________________
- CPCA Emergency Preparedness Planning Nora
OBrien, CPCA Regional Advocate - CA EMSA Grant
Funded Project Cheryl Starling, EMSA
Bio-Terrorism Coordinator
  • CLINIC EMERGENCY PREPAREDNESS PROJECT
    (CEPP)
  • To Increase Clinic Preparedness in 3
    Pilot Regions of State
  • San Francisco
  • Rural Northern Coast
  • Los Angeles County

15
  • EMSA / CEPP Partnership
  • CLINIC TEMPLATE TRAINING
  • - Joint Effort Developing Deliverables
    Objectives
  • __________________________________________
  • To Establish / Strengthen Relationships With
    Local Disaster Planning Community.
  • Develop a Template All Hazards Emergency
    Preparedness Plan.
  • Identify Clinic Emergency Best Practices
  • Develop a Risk Communication Template.

16
CEPP FACILITATESDeliverables
Objectives_______________________________________
_______
  • Address Mental Health Issues in Disaster Response
  • Involve CCHC Personnel in Drills Exercises
  • Define Roles of CCHC Consortia in Disaster
    Response
  • Create Train-the-Trainer Curriculum
  • Determine Civil Liability Issues CCHC Personnel
    Disaster Response

17
  • RISK, THREAT, LESSONS LEARNEDUnexpected Roles
    For Clinics
  • _________________________________________________
  • CLINIC CONSORTIA EMERGENCY RESPONSE
  • SUCCESSES CHALLENGES

18
CLINICS RESPOND _______________________________
________________ TERRORISM Changing Face
of Disaster Risk 9/11 --------------------
EARTHQUAKES Northridge 1/17/94 Loma Prieta
9/17/89
19
____________________________________________
THREATS CHAOS
EMS PUBLIC HEALTH SYSTEM IN TURMOIL
Hospital Closures Evacuations
People in the Park
CLINIC
Transport Provider Delays
20
SCENARIOS
WHAT IF.... ... Event Destroys Clinic
Community Partners? Clinic Buildings - Closed
for Normal Business Activities As Result of
Catastrophic Event? ... Event Creates Mass
Casualties Including Clinic Employees? ...
Extensive Fires Flooding Occurs Near Clinics
With No Access to Community Resources?
21
CLINIC IMPACT
  • MAJOR THREAT IMPLICATIONS
  • Lack of Coordination County, City, Clinics
  • Limitations in Clinic Disaster Plan
  • Does not address coordination of personnel,
  • supplies, resources within county.
  • Limitation in Identifying Accessing Clinic
  • Resources in County / Operational Area

22
EXTENDED MEDICAL RESPONSE
REALITY _________________________________
_____________
Week 1
Week 2
Week 3
Week 4
Week 5
Week 6
Incident Impact
Convergence on Hospitals, Clinics
Environmental Health Demands
Public Health Demands
Mental Health Demands
POTENTIAL EVENTS
EOC Closures
Sewer Disruption
HAZMAT
Clinic Evacuation
Water Power Loss
Vendor Problems
People In the Park
Hospital Evacuation
Aftershocks
Communicable Diseases
EMS Disruption
Debris Dead Bodies
Search Rescue
Secondary Incident
Infectious Diseases
Federal Response
23
REALITY MUTUAL AID - Over Time Delays
Day 1
Day 2
Day 3
Day 4
Day 5
Day 6
Evacuation of People
72 hours or longer
Resources/ Supplies In
Nurses/ Physicians
Mobile Vans
EOC Support
Military Resources
Self-Sufficiency Window
24
WHAT WE HAVE CHAOS
WHAT WE NEED COHESIVENESS
25
  • DISASTER RESPONSE CLINIC LESSONS LEARNED
  • CHALLENGE OF NEW ROLES - Experience
    Highlights
  • ___________________________________________
  • San Ysidro, San Diego Fires
  • North East Valley Health Corporation - Northridge

26
CRISIS CHALLENGES CLINIC IMPACT
__________________________________
Loss of Staff by Injury / Death
Loss of Operational Capacity
Threat of Hospital Evacuation -
Loss of Credibility With Public/Clients
Limited Documentation Reimbursement Issues
Loss of Public Health Safety
27
LESSONS LEARNEDEMERGENCY IMPACT
Clinics__________________________________________
_
  • INFLUX of PATIENTS -
    Congregate at Clinic
  • ______________
  • Regular patients will report to familiar location
  • County or hospitals may send non-acute patients
    to clinics in emergency
  • Patients may delay visiting doctor until very ill
    (could be unwitting carriers of biological agent)

Community Expectations
28
The Local ChallengeYou are on the front line.
WARNING
29
KEY EMERGENCY MANAGEMENT CONCEPTS_______________
___________________________
EOP TEMPLATE INTRODUCTION
BUILDING A FOUNDATION FOR
EMERGENCY RESPONSE /RECOVERY
____________________________________

CRISIS / EMERGENCY MANAGEMENT PHASES

EMERGENCY PREPAREDNESS COMMITTEE

EOP / ICS / SEMS
EOC / ERT / IM
OPERATIONAL AREA
30
(No Transcript)
31
CLINIC EMERGENCY OPERATIONS PLAN
___________________________________
  • GOALS, OBJECTIVES POLICY
  • MITIGATION - Assessment Tools
  • PREPAREDNESS - Key Clinic Roles
    Responsibilities Continuity of
    Operations Resources/ Integration

  • Community- Wide Response
  • Training Maintenance
  • RESPONSE - Initial Actions
  • Emergency Management Organization
    EOC Management Operations
  • RECOVERY - Recovery Tools,
    Restoration Critical
  • Services, Documentation After- Action
    Reports

32
KEY CONCEPTS Emergency Management Cycle -
Standardized____________________________
RECOVER Financial Relief, Restoration
MITIGATION Codes, Standards, Designs, Best
Practices
Mitigate
Recover
Prepare
PREPAREDNESS Risk Management, Evaluate
Positions Set Goals, Plans, Drills, Build on
Existing Resources
Respond
RESPONSE Activation of Additional Resources,
Temporary Shelter Support, Coordination,
Communication
33
EOP TEMPLATE INTRODUCTION KEY TERMS
  • CEPP Clinic Emergency Preparedness Project
  • EOP Emergency Operations Plan
  • EOC Emergency Operations Center
  • ICS Incident Command System

34
EOP TEMPLATE INTRODUCTION KEY
TERMS _________________________________
  • EMERGENCY PREPAREDNESS COMMITEE (EPC)
  • Guides development maintenance of clinics
    emergency management program development of its
    emergency operations plan
  • EMERGENCY RESPONSE TEAM (ERT)
  • Consists of clinic staff who will fill core
    positions of EOC manage clinics emergency
    response

35
EOP TEMPLATE INTRDUCTION KEY TERMS
  • ALTERNATE SITES/FACILITIES
  • - Locations other than primary facility where
    clinic operations will continue during an
    emergency
  • EMERGENCY OPERATIONS CENTER (EOC)
  • Location at which management can coordinate
    department activities during an emergency.
  • Managed using ICS
  • EOC may be established in primary clinic facility
    or at an alternate site.

36
INTRODUCTION KEY TERMS _______________________
_______
  • MULTI-HAZARD APPROACH
  • Evaluates all threats including impacts from all
    natural man-make disasters, including
    technological threats, terrorism, state of
    war.

37
Cornerstones of California Response
STANDARDIZED EMERGENCY MANAGEMENT SYSTEM
(SEMS) Four Major Elements

--------------------------------------------------
-
  • INCIDENT COMMAND SYSTEM (ICS)
  • MULTI-AGENCY OR INTER-AGENCY COORDINATION
  • CALIFORNIAS MUTUAL AID SYSTEM
  • OPERATIONAL AREAS

38
EOP TEMPLATE INTRODUCTION KEY
TERMS _________________________________
  • STANDARDIZED EMERGENCY MANAGEMENT SYSTEM (SEMS)
  • Mandatory System Established by Government Code
    Section 8607 (A) for Managing Response of
    Government Agencies to Multi-agency
    Multi-jurisdiction Emergencies in CA
  • Incorporates Use of ICS

39
EOP TEMPLATE INTRODUCTION KEY
TERMS __________________________
  • OPERATIONAL AREA
  • An intermediate level of state emergency
    organization, consisting of county all
    political subdivisions within county area.
  • Clinics will coordinate their disaster response
    with
  • MEDICAL HEALTH OPERATIONAL AREA COORDINATOR
    (MHOAC)

40
EOP TEMPLATE INTRODUCTION KEY
TERMS ______________________________
  • STANDARD OPERATING PROCEDURES (SOPs)
  • Pre-identified operating procedures that are
    basis for how organization operates
  • SOPs - used routinely for day to day operations
    operations response to emergency situations
  • SOPs are presented in form of checklists or Job
    Action Sheets

41
3.5 EOP TEMPLATE - EOC ORGANIZATIONICS
Chart ROLES FUNCTIONS ________________________
___________

42
EMERGENCY OPERATIONS PLAN Emergency Operations
Center ______________________________ 3.5.1
EOP TEMPLATE COMMAND STAFF      Manages
coordinates emergency response         
         SAFETY OFFICER (RISK MANAGER)         
        Ensures all emergency response operations
conducted in safe manner          SECURITY
OFFICER                  Provides security for
all facilities.  Controls personnel access to
facilities in accordance with policies
established by the EOC Director.
43
OPERATIONAL AREA Funnels Information Access
for Mutual Aid___________________________________
____________
FEDERAL FBI, FEMA
STATE REGION EOC
City EOCs
CLINICS
Operational Area EOC
Clinic Field Sites
Private Sector Vendors
Hospitals
Community at Large
Transport Provider EOCs
Special Districts
Fire Depts.
44
COMMUNICATION INFORMATION
FLOW _____________________________________________
______
City EOCs
CLINICS
Staging Areas
MEDICAL OPERATIONS
HEALTH CARE
Federal/State/Region OES/EMSA
Hospitals
EOC OPERATIONAL AREA (County)
Ambulances
Mutual Aid Counties
Special Districts
Fire
Police
Private Vendors
Schools
Nursing Facilities
Utilities
Community Resources/ General Population
Red Cross
45
CLINIC EOC ACTIVATION EVOLUTION _________________
____________________
Operations Logistics Planning Finance
EOC DIRECTOR/IM
CLINIC EOC ACTIVATION
ERT Deployment
Alert/Notification ERT
ERT Mobilization
46
EOC PLANNING Health Care Situation
Analysis
HOSPITALS/ CLINICS
TRANSPORT PROVIDERS
  • ___________
  • ___________
  • ___________
  • ___________

EVACUATION AREAS
  • ___________
  • ___________
  • ___________
  • ___________
  • ___________
  • ___________
  • ___________
  • ___________

STAGING AREAS
FBI INSTRUCTION
  • ___________
  • ___________
  • ___________
  • ___________
  • ___________
  • ___________
  • ___________
  • ___________

RED CROSS SHELTERS
MUTUAL AID RESOURCE REQUESTS
  • ___________
  • ___________
  • ___________
  • ___________

PRESS RELEASES
  • ___________
  • ___________
  • ___________
  • ___________
  • ___________
  • ___________
  • ___________
  • ___________

47
VISUALIZE INFORMATION PATH
State Emergency Operations Center (EOC)
Regional EOC
Operational Area EOC
Local Jurisdiction EOC
Clinic EOC
Command Management/ IM /EOC Director
Operations
Planning
Logistics
Finance
Command Posts
48

III. USING CLINIC TOOLS TEMPLATES
_____________________
EMERGENCY PREPAREDNESS

BUILDING A
FOUNDATION __________________________________
EFFECTIVE RESPONSE
RECOVERY
The Wilson Group Global Vision Consortium
49
PREFACE HOW TO USE THIS TEMPLATE
  • PURPOSE
  • Assist clinics to develop maintain emergency
    management programs to guide their response to
    all emergencies
  • Fill-in-the-blank format
  • Includes planning language, procedure, policies,
    forms
  • Tools can provide a jump-start
  • Provides useful resources to refine or extend
    program Builds on capability

50
  • PREFACE HOW TO USE TEMPLATE
  • Template emphasizes coordination with
    government emergency management.
  • _______________________________________________
  • Clinics to coordinate preparedness response to
    emergencies with MEDICAL/HEALTH OPERATIONAL AREA
    COORDINATOR
  • Contact information for local officials
  • Standard emergency management system (SEMS)
    concepts

51
  • PREFACE HOW TO USE TEMPLATE
  • TEMPLATE REQUIRES ACTIVE IMPLEMENTATION EFFORT
  • _______________________________________________
  • Read template
  • Appoint EMERGENCY PREPAREDNESS COMMITTEE
  • Set priorities create work plan
  • Recognize importance of training, drills update
    plan information

52
PREFACE HOW TO USE THIS TEMPLATEREGULATORY
ACCREDITATION REQUIREMENTS_____________________
___________
  • Developers of template took into account
    environment of care Standards of Joint Commission
    on accreditation of healthcare organizations.
  • However, use of template does not guarantee that
    plans programs based upon it will meet JCAHO or
    government regulatory requirements for clinic
    emergency preparedness.

53
PREFACE HOW TO USE THIS TEMPLATE_______________
_______________
  • Specifically, we recommend that clinic leadership
    initiate development of their emergency
    management program.
  • Read this template
  • Appoint an EMERGENCY PREPAREDNESS COMMITTEE to
    manage development of their emergency program
  • Set priorities create work plan for developing
    plans preparing staff
  • Recognize importance of training, drills,
    keeping plan info. up-to-date
  • Clinic need to work with consortia to develop
    program

54
PREFACE HOW TO USE THIS TEMPLATE
  • TERMINOLOGY
  • Given diversity of clinic community roles
    organization, it was not possible to develop
  • a single template that would apply completely to
    organizational, operational
  • environment of every clinic.
  • CLINIC Full Range of Non-profit Community
    Clinics, Free Clinics, Heath Centers
  • CLINIC CONSORTIA County Based or Regional
    Association of Clinics

55
EOP TEMPLATE UMBRELLA BASIC PLAN
___________________________________
  • Used Before, During After Disasters
  • Easy to Use Readable
  • Answers Questions
  • Who should use plan?
  • When should EOP be used?
  • Why should EOP be used?

56
EOP TEMPLATE INTRODUCTION -
POLICY_________________________
  • Clinic able to respond to disaster, suspected
    case of bio-terrorism or other emergency that
    protects health safety of patients, visitors,
    staff, coordinated with community-wide response
    to large scale disaster.
  • All employees know prepared to fulfill duties
    responsibilities team effort to provide best
    possible emergency care in any situation.
  • Each supervisor - each level of organization will
    ensure employees aware of responsibilities.
  • Clinic will work in close coordination with
    civil authorities health care providers to
    ensure community-wide coordinated response to
    disasters.

57
EOP TEMPLATE INTRODUCTION -
SCOPE_____________________________
  • Within plan, DISASTER - any emergency event which
    overwhelms or threatens to overwhelm routine
    capabilities of Clinic
  • ALL-HAZARDS EOP - emergency management program
    designed to respond to natural man-made
    disasters.
  • Plan describes POLICIES PROCEDURES - to
    mitigate, prepare for, respond to, recover from
    emergencies.
  •      CCR Title 22 Disaster plan complies with
    California Code of Regulations, Title 22,
    Division 5, Section 78423 Disaster Plan.
  •     JCAHO Development / implementation of plan
    complies with sections of JCAHO Environment of
    Care standards related to emergency preparedness.
    Refer to Appendix A for checklist of JCAHO
    requirements.

58
EOP TEMPLATE 1.1 MITIGATION
  • Clinic - undertake HAZARD MITIGATION activities
    to lesson severity impact of potential
    emergency.
  • Mitigation begins to identify potential
    emergencies that affect organizations
    operations or demand for services, followed by
    implementing strategy that supports perceived
    areas of vulnerability within organization.
  • During mitigation phase, Director staff will
    identify specific internal external hazards
    take steps to reduce level of threat they pose by
    mitigating hazards or reducing their potential
    impact on clinic.

59
EOP TEMPLATE I.
HAZARD MITIGATION ______________________________
  • Clinic will conduct survey of facilities at least
    annually or following disaster that damaged
    clinic facility complete structural /
    non-structural hazard mitigation checklist in
    APPENDIX D.3
  • Based on results of hazards assessment, clinic
    will establish a plan priorities for mitigating
    structural non-structural hazards

60
EOP TEMPLATE MITIGATION1.2 HAZARD
VULNERABILITY ANALYSIS
  • Clinic will conduct hazard vulnerability analysis
    to identify opportunities to minimize losses in
    disaster focusing on emergencies that may occur
    within facility as well as external to facility
    in surrounding community.
  • Tools for conducting vulnerability analysis are
    provided in APPENDIX D.
  • Clinic will re-visit hazard vulnerability
    assessment yearly to address new concerns
    challenges.

61
EOP TEMPLATE MITIGATION - 1.2 Refers to
D.1 HAZARD VULNERABILITY ANALYSIS Sample Human
Events

62
EOP TEMPLATE MITIGATION HAZARD VULNERABILITY
ANALYSIS PROCESS
  • Multiply ratings for each event in area of
    probability, risk preparedness.
  • Total values, in descending order, will represent
    the events most in need of organization focus
    resources for emergency planning.
  • Determine value below which no action is
    necessary.
  • Acceptance of risk is at discretion of
    organization.

63
EOP TEMPLATE MITIGATION -1.2 Refers to D.1 THE
WORKSHEETS
  • Worksheet 1 HVA Site Tool (3 pages)
  • Used by most clinic facilities for California
    region.
  • Worksheet 2 Could be used in other states,
    depending upon geographical or geological area.
  •  

Note Joint Commission (JCAHO) says that you do
not have to prepare for an event that will not
have an effect upon your facility.
64
EOP TEMPLATE MITIGATION -1.2 Refers to
Appendix D.2
65
1. 2 Refers to Appendix D.2
66
EOP TEMPLATE MITIGATION - 1. 2 Refers to
Appendix D.2
67
EOP TEMPLATE MITIGATION - 1. 2
Refers to Appendix D.2
68
EOP TEMPLATE MITIGATION - 1. 2
Refers to Appendix D.2
69
EOP TEMPLATE MITIGATION1.4 RISK
ASSESSMENT_______________________
  • Hazard Vulnerability analysis will assess
    likelihood of disasters their likely severity.
  • Clinic will identify hazards that could not be
    eliminated determine their likelihood of
    occurrence severity of their consequences.
  • Assessment of remaining risks will influence
    emergency response roles clinic adopts for itself
    preparation required to meet roles.

70
EOP TEMPLATE MITIGATION1.5 INSURANCE
COVERAGE________________________________
  • Chief Financial Officer of clinic will meet with
    insurance carriers to review all policies
    understand facilitys coverage for relocation to
    another site, loss of supplies equipment,
    structural nonstructural damage to facility.
  • Determine value of insurance for clinic.
  • CFO will assess clinic coverage for floods or
    earthquakes.
  • If coverage is absent or inadequate, clinic will
    evaluate if it is financially sound to acquire
    it.
  • Clinics located in special flood hazard areas
    must have flood insurance to be eligible for
    assistance.

71
EOP TEMPLATE MITIGATION1.6 CLINIC EMERGENCY
RESPONSE ROLES
  • Based on findings of risk assessment, clinic will
    take following steps to define disaster
  • response roles for which it should prepare
  • Assess pre-disaster medical care environment
    role clinic performs in providing health services
  • Assess clinic resources including availability of
    staff to respond ability of clinic to survive
    intact.
  • Discuss findings with MEDICAL HEALTH
    OPERATIONAL HEALTH COORDINATOR
  • Obtain community input
  • Obtain input from clinic staff especially medical
    nursing directors, safety officer, Chief
    Operating Officer
  • Present recommendations to Board of Directors for
    ratification

72
EOP TEMPLATE MITIGATION 1.6 CLINIC
EMERGENCY RESPONSE ROLES
  • Clinic may play variety of roles in responding to
    disasters including
  • Providing emergency medical care,
  • Providing temporary shelter expanding primary
    care services to meet increased community needs
    created by damage to other health facilities
  • Clinic may provide mental health services to
    disaster victims serve as conduit for
    information dissemination to affected communities
  • Refer to APPENDIX E for list of potential roles
    planning preparedness requirements for meeting
    those roles
  • As part of mitigation program, clinic will
    identify response roles it will prepare to
    perform following a disaster
  • Decision will involve input from clinic
    management staff, clinic Board of Directors,
    community government emergency officials

73
EOP TEMPLATE Application of Concepts OVERVIEW
TABLE OF SECTIONS Introduction
1. Mitigation 2. PREPAREDNESS
3. Response 4. Recovery 5.
Appendices
74
EOP TEMPLATE PREPAREDNESS
EMERGENCY PREPAREDNESS Rationale________________
______________
STAFF PATIENT SAFETY COMMUNITY
PATIENT CARE RESPONSIBILITY
LICENSING ACCREDITATION MANDATES
BUSINESS IMPERATIVE
75
  • EOP TEMPLATE PREPAREDNESS
  • 1 INTRODUCTION
  • Preparedness activities build organization
    capacity to manage effects of emergencies should
    one occur.
  • During this phase, clinic Director, EPC staff
    will develop operational capabilities improve
    effectiveness of clinics response to
    emergencies.
  • Specifically, EPC will
  • Develop/update emergency plans including
    Emergency Operations Plan
  • Develop update agreements with other community
    medical providers with civil authorities
  • Train emergency response personnel
  • Conduct drills exercises

76
EOP TEMPLATE PREPAREDNESS ___________________
___________________
  • 2.2 EMERGENCY OPERATIONS PLAN
  • EOP is an all hazards plan that will guide
    staff to provide for an efficient systematic
    response to any type of disaster.

77
EOP TEMPLATE PREPAREDNESS 2.4.6 ACQUIRING
RESOURCES
  • Clinic will develop procedures for augmenting
    supplies, equipment personnel from variety of
    sources
  • Prior agreements with vendors for re-supply
  • Stockpiles of medical supplies
  • Operational Area assistance to clinics
  • From other clinics, hospital or other health
    providers
  • Consortium coordinated clinic assistance to
    clinics

78
EOP TEMPLATE PREPAREDNESS 2.4 INTEGRATION WITH
COMMUNITY-WIDE RESPONSE
  • Clinic will notify civil authorities of emergency
    impacting clinic coordinate response to
  • community-wide disasters with medical health
    response of Operational Area. See
  • APPENDIX J.3 disaster contacts - agencies
    individuals
  • 2.4.1 COORDINATION WITH GOVERNMENT RESPONSE
    AGENCIES
  • Clinic will ensure response - coordinated with
    decisions actions of civil authorities
    medical care agencies involved.
  • To ensure coordination, clinic staff will
  • A. Meet with Operational Area officials to
    define clinics role in emergency response
  • Determine which response roles - expected by
    officials which are beyond systems response
    needs or clinics response capabilities.
  • See APPENDIX E clinic response roles /
    responsibilities for potential clinic roles.

79
EOP TEMPLATE PREPAREDNESS 2.4 INTEGRATION
WITH COMMUNITY-WIDE RESPONSE b. Participate
in planning, training exercises sponsored by
medical response agencies. c. Develop
reporting communications procedures to ensure
integration with Operational Area
response. d. Define procedures for requesting
obtaining medical resources for evacuating /
transporting patients. NOTE In some area,
clinic consortium will coordinate completion of
these tasks while in others, clinics will be
responsible for taking initiative in completing
these tasks.
80
EOP TEMPLATE PREPAREDNESS 2.4 COORDINATION
  • OPTIONS FOR MUTUAL ASSISTANCE
  • Information Sharing
  • Referral / diversion of patients to nearby
    clinics
  • Provision of space support
  • Provision of medical supply, pharmaceutical
    clinical/non-clinical staff support
  • Examples referral /diversion of patients to
    nearby hospitals

81
  • EOP TEMPLATE PREPAREDNESS 2.4.3 COORDINATION
  • 2.4.3.2 LIMITATIONS
  • During area-wide disaster, patient transfers
    access to ambulances may need to be coordinated
    through medical/health authorities of operational
    area, overriding other agreements.
  • Developing arrangements for receipt / referral of
    disaster victims requires
  • planning
  • Alert Notification
  • Sharing of medical information
  • Patient Tracking
  • Contingencies that impact ability of either party
    to meet terms of agreement

82
EOP TEMPLATE PREPAREDNESS 2.4.4 RELATIONSHIP
TO CLINIC CONSORTIUM
  • Clinic Clinic Consortium Will Define Emergency
    Response Relationship
  • In PREPAREDNESS PHASE, Consortium role could
    include
  • Resource acquisition including grant funding,
    group purchasing shared equipment
  • Training technical assistance
  • Coordinated planning
  • Exercise coordination
  • In RESPONSE/ RECOVERY PHASES, Consortium role
    could include
  • Information gathering dissemination to other
    clinics or 0perational Area
  • Resource acquisition

83
EOP TEMPLATE PREPAREDNESS 2.4.4 RELATIONSHIP
TO CLINIC CONSORTIUM
  • Public Information
  • Technical Assistance
  • Financial Recovery Assistance
  • Although clinic consortia- not expected to play
    central operational role in coordinating
  • disaster response of clinics, they can provide
    services including
  • Nature of emergency
  • Impact of emergency on clinic operations
  • Current operational status of clinic
  • When clinic expects to become fully operational
  • Clinic resource needs

84
EOP TEMPLATE PREPAREDNESS 2.4.4 RELATIONSHIP
TO CLINIC CONSORTIUM _____________________________
_______________
C. Clinic reporting to clinic consortium does
not take place of reporting to medical / health
authorities of Operational Area, which should
occur first if operational area EOC is
open. D. Clinic reporting to clinic
consortium does not necessarily constitute a
request for resources or other assistance.
85
EOP TEMPLATE PREPAREDNESS 2.5.1 CLINIC
DIRECTOR RESPONSIBILITIES _______________________
____________
  • Ensures program constantly in state of readiness
  • Provides guidance policy direction response and
    recovery
  • Main roles
  • Acts as bridge to outside world  
  • Disseminates information
  • Acts as spokesperson
  • Activates the EOP by assigning the IM / EOC
    Director

86
EOP TEMPLATE PREPAREDNESS ROLES
RESPONIBILITIES______________________________
  • 2.5.1 CLINIC DIRECTOR
  • is responsible, directly or through delegation,
    for development of EOP for directing response
    to emergencies
  • Execute development implementation of disaster
    plan
  • Assign staff duties responsibilities based on
    job action sheets. See APPENDIX.
  • Activate clinics emergency response
  • Develop criteria for direct evacuation of
    staff, patients, visitors
  • Ensure continuity of care maintenance of
    medical management of all patients in care of
    clinic during a disaster.

87
EOP TEMPLATE PREPAREDNESS 2.5.2 MEDICAL
DIRECTOR________________________________________
  • Directly or through delegation, will have
    following emergency responsibilities
  • Serves as leader co-leader of ERT
  • Assigns clinical staff to medical response roles
    (triage, treatment, decontamination)
  • Provides clinicians with updates from CDC
    Health Department on standards for detection
    diagnosis, treatment of chemical
    bio-terrorism agents
  • Contacts local health department to determine
    local system for bio-terrorism updates.
  • Monitors ltname of local systemgt for updates.
  • Determines clinical staffing needs in cooperation
    with the Nursing Director.

88
EOP TEMPLATE PREPAREDNESS 2.5.3 - NURSING
DIRECTOR
  • May be assigned following roles
  • Monitors for Bio-Terrorism
  • Provides clinicians with updates from CDC NHD
    of standards or detection,diagnosis, treatment
    of chemical Bio-Terrorism agents
  • Determines clinical staffing needs in cooperation
    with Medical Director
  • Performs other duties delegated by Medical
    Director or IM consistent with training scope
    of practice

89
EOP TEMPLATE PREPAREDNESS 2.5.5 ALL
CLINIC STAFF
  • TAKE FOLLOWING STEPS TO FACILITATE RESPONSE TO
    CLINIC EMERGENCIES BY ITS STAFF WHEN THEIR HOMES
    FAMILIES MAY BE IMPACTED
  • PROMOTE STAFF HOME EMERGENCY PREPAREDNESS (See
    Appendix I).
  • IDENTIFY CHILDCARE RESOURCES LIKELY TO REMAIN
    OPEN FOLLOWING A DISASTER

90
EOP TEMPLATE PREPAREDNESS 2.5.5 - ALL CLINIC
STAFF
  • All Clinic staff shall
  • Familiarize themselves with evacuation procedures
    routes for their areas. See APPENDIX H 1.1
  • Become familiar with emergency response
    procedures for fire, HAZMAT other emergencies.
    See APPENDIX H Section 3.14
  • Understand role responsibility in clinic plans
    for response recovery
  • Participate in training/exercises
  • Make suggestions on how to improve planning
  • Prepare family home for disasters

91
EOP TEMPLATE PREPAREDNESS 2.5.5 Refers to
APPENDIX F.3 EMERGENCY RESPONSE/RECOVERY TEAM
JOB ACTION SHEETS
  • LIST OF POSITIONS
  • Clinic Director
  • Incident Manager
  • Public Information Officer
  • Legal Counsel
  • Liaisons
  • Safety Officer
  • Security Officer
  • Operations Section Chief
  • Planning Intelligence Section Chief
  • Logistics Section
  • Finance Administration Section

92
EOP TEMPLATE PREPAREDNESS 2.5.5 Refers to
Appendix F.3 EOC JOB ACTION SHEETS CLINIC
DIRECTOR
  • Line of Authority
  • Line of authority flows from Clinic Executive
    Director then to Incident Manager, finally to
    the Section Chiefs in the EOC.
  •  
  • Responsibility and Duties
  • Clinic Executive Director EOC Incident Manager
    should confer during major emergencies, providing
    guidance policy direction for emergency
    response recovery strategy assessment,
    including
  • Identifying operations still at risk
  • Establishing clinic operations restoration
    priorities
  • Authorizing expenditure of funds for emergency
    acquisitions for additional personnel
    expenditures, as needed

93
EOP TEMPLATE PREPAREDNESS 2.6 INITIAL
COMMUNICATIONS NOTIFICATIONS___________________
_________________
  • Clinic will compile/maintain internal contact
    list for staff
  • Name, position title, home phone, cell, pager,
    preferred method of contact during off hours.
    Refer to APPENDIX
  • List will be kept off-site on key employees
  • List should be treated as sensitive because of
    personal contact info.
  • Clinic should distribute laminated wallet-sized
    cards with contact info. for key staff.
  • Clinic will compile/maintain external contact
    list. Refer to APPENDIX (utilities, repair)
    (hospitals/clinics,media)

94
EOP TEMPLATE PREPAREDNESS 2.6.2 EXTERNAL
NOTIFICATION
  • Clinic will compile maintain external contact
    list of phone numbers of key
  • vendors, stakeholders, resources, emergency
    response agencies.
  • APPENDIX J.2___ lists routine emergency
    contact numbers for basic support services for
    clinic operations (e.g., utilities, repair
    services, etc.)
  • APPENDIX J.3___ lists contact information for use
    - response to disasters (e.g., government
    response entities, nearby hospitals clinics,
    media, etc.)

95
EOP TEMPLATE PREPAREDNESS 2.6.2 Refers to
APPENDIX J.2 CONTACT LISTS VENDORS / FUNDING
SOURCES / COMMUNITY LIAISONS
  • Clinic Consortium
  • Electricity
  • EMS Provider
  • Fire Service
  • Gas or Propane
  • Information Technology Support
  • Law Enforcement
  • Medical Supply and Equipment
  • Vendor
  • Repair
  • Maintenance
  • Telephone
  • Equipment Provider
  • Equipment Repair
  • Service Provider

96
EOP TEMPLATE PREPAREDNESS 2.6.2 Refers to
APPENDIX J.3 CONTACT LIST DISASTER RESPONSE
OFFICIALS
  • County EOC
  • Med/Health Op Area Coordinator
  • Division of Epidemiology Bio-terrorism Emergency
    Number
  • CDC Emergency Response Office
  • Nearest Hospital Emergency Department
  • Nearest Clinic / Medical Group
  • Local EMS Agency
  • Health Department (general)
  • Name of Countygt County Medical Society
  • Name of Countygt Office of Emergency Services
    Director
  • Amateur Radio
  • Media Television
  • Media Radio
  • Media Newspaper

97
EOP TEMPLATE PREPAREDNESS 2.6.3 PRIMARY
COMMUNICATIONS
  • Refer to APPENDIX K.1 for list of communications
    resources available to clinic.
  • Primary means - local telephone
  • If telephone fails, clinic staff will notify
    provider by whatever means available including
    telephones in another area, cell phones,
    messenger, E-Mail, or pay phones
  • Clinic will keep change for pay phones in its
    disaster supplies
  • Clinic has installed standard telephone jacks
    that bypass electronic phone system.
  • Jacks - used for fax machines for telephones
    that do not require electricity to operate.

98
EOP TEMPLATE PREPAREDNESS 2.6.3 Refers to
APPENDIX K.1 COMMUNICATIONS EQUIPMENT
INVENTORY
  • Clinic Phone System
  • Fax Machines
  • Analog telephone jacks
  • Analog telephones
  • Cellular telephones
  • Satellite telephones
  • Computer
  • Email
  • Telemedicine
  • Videoconference camera and video-monitor
  • Radio-based
  • Amateur Radio
  • Handheld radios
  • Other Radios
  • EMS Ambulance
  • Hospital Status Radio
  •  

99
EOP TEMPLATE PREPAREDNESS 2.6.4 ALTERNATE
COMMUNICATIONS METHODS___________________________
__________
  • In addition to telephone, clinic maintains radio
    communications equipment.
  • Refer to APPENDIX K.2 for procedures for
    operating county specific radio/communications
    system.
  • Radio - located in clinic area used by trained
    staff.
  • Clinic maintains Amateur Radio System or
    alternate communication system - located in
    clinic area used only by trained staff.
  • Clinic maintains Amateur Radio System or
    alternate communication system - located in
    clinic agreement with local Amateur Radio group
    to respond to clinic when requested.

100
EOP TEMPLATE PREPAREDNESS 2.6.4 ALTERNATE
COMMUNICATIONS TOOLS_____________________________
_____________
  • Amateur radios, FAX, Cell Phone, Internet/E-Mail,
    Public Pay Phones, Voice Messaging. See APPENDIX
    for communication resource list.
  • HANDHELD RADIOS (WALKIE-TALKIE) for internal
    communications in both routine emergency
    situations
  • If telephone radio communications are
    unavailable, RUNNER will be employed to take
    messages to from Clinic appropriate agencies
    rendering assistance.
  • Clinic EOC - provisions for receiving TELEVISION
    RADIO broadcasts to remain up to date on
    official GOV. announcements

101
EOP TEMPLATE PREPAREDNESS 2.7.2 ALTERNATE
FACILITIES
  • Identify/use existing facilities if possible
    Consider creative alternatives
  • Ensure sufficient space equipment
  • Provide reliable logistic support services
  • Ensure ability to sustain operations for 30 days
  • Consider pre-positioning assets resources
  • Ensure appropriate physical security access
    controls

102
EOP TEMPLATE PREPAREDNESS 2.7.1 CONTINUITY
OF OPERATIONS
  • POLICY Clinic will maintain or restore services
    to community as rapidly as possible following
    emergency that disrupts services.
  • As soon as safety of patients, visitors, staff
    has been assured, clinic will give priority to
    providing or ensuring patient access to medical
    care.
  • GOALS Completing following tasks increases
    likelihood that emergency will not disrupt clinic
    operations, if disruption occurs, operation can
    be restored.
  • Protect essential facilities, equipment, records,
    assets
  • Reduce or mitigate disruption to operations
  • Identify designate principals support staff
    to e relocated succession delegations of
    authority for execution of Plan
  • Facilitate decision-making through establishment
    of lines of succession delegation

103
EOP TEMPLATE PREPAREDNESS 2.7 COOP
___________________________________
104
EOP TEMPLATE PREPAREDNESS 2.7 COOP
On-Going Requirements
  • Essential Functions Personnel, Equipment,
    System and Space Requirements
  • Successor Plan, Delegation of Authority, and Team
    Assignments
  • Primary Secondary Contact Lists
  • Primary Alternate Site Vulnerability Analysis
  • Deployment Information Storage Locations
  • Transportation Alternate Facility Activities
    Equipment Systems
  • Emergency Operating Records
  • COOP Maintenance Team
  • Vendor List

105
EOP TEMPLATE PREPAREDNESS 2.8.1
PREPAREDNESS SURGE
  • Clinic Director, Nursing, /or Medical Director
    will review Op Area plans
  • How surge capacity will be increased
  • Patient transportation policies/procedures
  • Procedures for augmenting medical care - Op Area
    plans for accessing distributing contents of
    National Pharmaceutical Stockpile
  • Develop surveillance process to provide early
    indications of potential for patient surge that
    may result from Bio-Terrorism (appointment
    patterns, walk-in clinic utilization, news
    report, groups of patients ill at same time)

106
EOP TEMPLATE PREPAREDNESS 2.8.1.5 SURGE
PATIENT FLOW SITE PLANNING
  • Periodically review patient flow identify areas
    on clinic grounds that can be converted to triage
    sites patient isolation areas
  • Evaluate appropriateness of use of cafeteria,
    break rooms other spaces for patient holding or
    treatment areas
  • Designate sites available for isolating victims
    of a chemical/bio-terrorist attack
  • Ensure triage isolation sites should have
    controlled access
  • Store cots, blankets for holding shelter

107
EOP TEMPLATE PREPAREDNESS
2.9.2 PHARMACEUTICALS / MEDICAL SUPPLIES /
MEDICAL EQUIPMENT Clinic will determine level of
medical supplies pharmaceuticals to stockpile
will stockpile only those items likely to use in
response or in day-to-day operations. All stored
items will be rotated. Clinic will identify
primary secondary sources of medical supplies
pharmaceuticals develop estimates of expected
time required for re-supply in disaster
environment. NATIONAL PHARMACEUTICAL
STOCKPILE NOTE IN BIO-TERRORIST EVENT, IF
MASS QUANTITIES OF PHARMACEUTICALS ARE NEEDED,
COUNTY WILL REQUEST MOBILIZATION DELIVERY OF
NATIONAL PHARMACEUTICAL STOCKPILE THROUGH CA.
CDC HAS ESTABLISHED NATIONAL PHARMACEUTICAL
STOCKPILE (NPS)
108
EOP TEMPLATE PREPAREDNESS 2.9.2.3 NATIONAL
PHARMACEUTICAL STOCKPILE
  • In Bio-terrorist event, if mass quantities of
    pharmaceuticals are needed then Op Area (Co.)
    will request mobilization delivery of National
    Pharmaceutical Stockpile (NPS)
  • CDC has established NPS as repository of
    antibiotics, chemical antidotes, life support
    med, IV adm., life support meds, IV sets, airway
    maint.
  • Clinic leadership should be informed of local
    level plan what role, if any, they might be
    expected to play in distribution of assets

109
EOP TEMPLATE PREPAREDNESS 2.9.2.4 PERSONAL
PROTECTIVE EQUIPMENT
  • Clinic will take measures to protect its staff
    from exposure- infectious agents hazardous
    materials
  • Clinic will obtain maintain a minimum of PPE
  • CDC OSHA have determined that in event of a
    Bio-Terrorist attack
  • Healthcare workers will have access to be
    trained on use of personal protective equipment.
  • Licensed medical personnel support personnel
    are assigned to respond to care for victims of
    WMD

110
EOP TEMPLATE PREPAREDNESS 2.9.2.4 RESPONSE TO
BIO-TERRORISM EVENT
  • Suggested PPE for level C
  • N95 HEPA mask
  • TYVEK Coverall with hood and booties
  • TYVEK booties
  • Face shield
  • Nitrile Gloves
  • Protective equipment is located in ____________,
    will be accessed by _______________ or
    ____________ when ______________.

111
EOP TEMPLATE PREPAREDNESS 2.10 Mental Health
  • Clinic Administrator will establish DISASTER
    MENTAL HEALTH COORDINATOR. See APPENDIX M for a
    checklist of actions for the Mental Health
    Coordinator
  • Develop an internal clinic mental health
    disaster response plan
  • Serve as member of Emergency Preparedness
    Committee ERT
  • Coordinate with local jurisdiction Operational
    Area (county) to identify community resources
    define procedures for implementation

112
  • EOP TEMPLATE PREPAREDNESS
  • 2.10.1 MENTAL HEALTH PREPAREDNESS
  • ___________________________________________
  • e. Coordinate local jurisdiction Operational
    Area (county) for community resources
    procedures for access to resources
  • f. Develop maintain resource list of community
    mental health resources to augment response of
    clinics mental health team. Establish MOUs when
    possible.
  • g. Identify mental health disaster communication
    needs
  • h. Work with clinic PIO to develop info.
    (brochures, PSAs, etc.) used in response
  • i. Acquire maintain following resources stored
    with other disaster supplies labeled Mental
    Health Supplies
  • Contact information for disaster mental health
    resources updated annually
  • Master copy of one or more brochures with
    information about typical survivor responses to a
    disaster with Clinic or Mental Health Agency
    contact phone numbers

113
  • EOP TEMPLATE PREPAREDNESS
  • 2.10.1 MENTAL HEALTH PREPAREDNESS
  • A limited amount of brochures for immediate use
  • Culturally appropriate brochures in several
    languages of clinics service populations
  • Basic office supply go box with pens, paper
    clips, tape, note pads available to staff
  • Paper, crayons other items for children
  • Cell phone or calling cards available for staffs
    use
  • Disaster forms to document contacts
  • Copies of local resource directory agency
    directory for referrals

114
EOP TEMPLATE PREPAREDNESS 2.10.2 REFERS TO
APPENDIX M MENTAL HEALTH COORDINATOR
RESPONSIBILITIES
P R E P A R E D N E S S
  • Assume role of Clinic Mental Health Coordinator
  • Develop internal Clinic Mental Health Disaster
    Response Plan
  • Coordinate with Local Jurisdiction Operational
    Area (County)
  • Identify mental health disaster communications
    needs
  • Promote mental health clinic preparedness
  • Promote clinic awareness of importance of mental
    health prevention / awareness

115
EOP TEMPLATE PREPAREDNESS 2.10.2 REFERS TO
APPENDIX M MENTAL HEALTH COORDINATOR CHECKLIST
P R E P A R E D N E S S
  • Establish maintain comprehensive city
    county-wide mental health resource list
  • Use emergency information management
    communications systems
  • Develop mental health resource list
  • Coordinate with local mental health officials
    mental health managers
  • Coordinate with mental health facilities to
    develop disaster preparedness

116
EOP TEMPLATE PREPAREDNESS 2.9 DISASTER MEDICAL
RESOURCES ________________________________________
_____
  • 2.8.1 PERSONNEL
  • - Clinic will rely on existing staff for response
    to emergencies.
  • - MEASURES TO BE TAKEN TO ESTIMATE STAFF
    AVAILABILITY
  • Identify clinical staff with conflicting practice
    commitments
  • Identify staff with distance other barriers
    that limit their ability to report to clinic
  • Identify staff likely to be able to respond
    rapidly to the clinic
  • Clinic will develop roster of bi-lingual staff by
    language

117
EOP TEMPLATE PREPAREDNESS 2.11 PUBLIC
INFORMATION / RISK COMMUNICATIONS
  • INCIDENT MANAGER will appoint PUBLIC INFORMATION
    OFFICER (PIO) to coordinate release of clinic
    information internally externally to media
    community.
  • PIO will ensure development of disaster public
    information plan to guide clinic information
    disseminaiton response to media community
    inquiries following disasters.
  • PURPOSE OF PLAN - to ensure information is
    communicated to communities served by clinic to
    communicate
  • Information on nature status of emergency
  • Appropriate actions for protection, seeking
    health care services obtaining needed
    information
  • Reducing anxiety among community members
  • Information on status of clinic its ability to
    deliver services

118
EOP TEMPLATE PREPAREDNESS 2.11 PUBLIC
INFORMATION / RISK COMMUNICATIONS
  • Plan will include provisions for
  • COORDINATION WITH OPERATIONAL AREA PUBLIC
    INFORMATION OFFICER
  • Ensure most up-to-date information to ensure
    consistency of information released.
  • Address information needs of clinics publics
    when providing information stakeholders
    include community, patients, staff, volunteers
  • Provisions for employee meetings, internal
    informational publications, press releases
    other programs intended to disseminate accurate
    information regarding impact deal with
    misinformation.

119
EOP TEMPLATE PREPAREDNESS 2.11 PUBLIC
INFORMATION / RISK COMMUNICATIONS
  • Clinic will incorporate disaster preparedness
    information into normal
  • communications education program for staff
    patients including
  • Home family preparedness. See appendix I for
    guidelines
  • Information on clinic emergency preparedness
    activities
  • Information dissemination channels include
    newsletters, pamphlets, health education
    in-service education classes internet postings

120
EOP TEMPLATE PREPAREDNESS 2.12 Refers to
Appendix G PURPOSE OF TRAINING
  • Training for members of the ERT ensures
  • Know role responsibilities
  • Possess skills knowledge needed to perform
    respective functional responsibilities
  • Understand disaster management processes to
    achieve effective coordination / communications

121
EOP TEMPLATE PREPAREDNESS 2.12.1.1 EMPLOYEE
ORIENTATION
  • Instructed how to assist patients staff in
    evacuation of premises.
  • Instructed in location use of oxygen (licensed
    staff)
  • Shown location use of medical emergency
    equipment (medical staff staff trained on AED).
  • Instructed on emergency codes used in clinic, how
    called initial actions. (See APPENDIX H.2
    emergency code examples).
  • Instructed on actions to be taken during fire
    other emergency drills.
  • Annual training updates on emergency
    preparedness, including elements of plan

122
EOP TEMPLATE PREPAREDNESS 2.12.1.2 CLINICIAN
BIO-TERRORISM TRAINING
  • Medical Nursing staff will receive training on
    procedures to treat respond to patients
    infected - Bio-terrorism agent.
  • Recognition of potential epidemic or
    bio-terrorism events
  • Information about most likely agents, including
    possible behavioral responses of patients
  • Infection control practices
  • Use of personal protective equipment
  • Reporting patient management
  • Behavioral responses of patients to biological
    chemical agents

123
EOP TEMPLATE PREPAREDNESS 2.12.1.2 CLINICIAN
BIO-TERRORISM TRAINING
B. Staff training will include - Roles
responsibilities in bio-terrorism event -
Information skills required to perform their
assigned duties during bio-terrorism event -
Awareness of backup communications systems used
in bio- terrorism event - Location / how to
obtain supplies during bio-terrorism
event. C. Staff physicians will receive
updates as new information becomes
available. D. Mental Health Team training
124
EOP TEMPLATE PREPAREDNESS 2.12.2 DRILLS
EXERCISES
  • 2.12.2.2 Exercises should include response
    issues in scenarios
  • Clinic evacuation
  • Bio-terrorism
  • Mental health response
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