1. Hospital Evacuation Plan Managing the Worst-Case Scenario

2. Why Do We Need a Plan? Joint Commission Requirements Joint Commission Requirements Safety of our patients Safety of our patients When the environment cannot support care, treatment, and services When the environment cannot support care, treatment, and services  Continuity of care Element of preparation Element of preparation

3. Activation Levels Level 1 – Alert for potential evacuation Level 1 – Alert for potential evacuation Level 2 – Limited area / horizontal Level 2 – Limited area / horizontal Level 3 – Limited area / vertical Level 3 – Limited area / vertical Level 4A – Large area / building Level 4A – Large area / building Level 4B – Entire single campus Level 4B – Entire single campus –East or West Level 4C – Entire Longwood Area Evacuation Level 4C – Entire Longwood Area Evacuation –Both East and West Campuses

4. Types of Evacuation Emergency Evacuation - Fire, Explosion Emergency Evacuation - Fire, Explosion –Immediate departure due to life or safety threat Urgent Evacuation - Flood, Utility Failure Urgent Evacuation - Flood, Utility Failure –Commence within four hours Planned Evacuation Planned Evacuation –At least 48 hours to prepare 4 4

5. GO Kits Unit / Team Leader vests Unit / Team Leader vests Clipboards / checklists Clipboards / checklists Mobility triage tape Mobility triage tape GO pouches GO pouches Re-sealable medication bags Re-sealable medication bags Chemical light sticks Chemical light sticks Chalk / tape for evacuation marking Chalk / tape for evacuation marking Pens / markers Pens / markers Job Action Sheet GO Pouch Patient Form GO Kit

6. Patient Movement Flow Horizontal movement Horizontal movement –From unit to Patient Holding Area –Horizontal Movement Team Vertical movement Vertical movement –From Holding Area to Patient Loading Area –Vertical Movement Team Patient loading Patient loading Movement to onward destination Movement to onward destination Placement at onward destination Placement at onward destination Unit Horizontal Movement Team Holding Area Vertical Movement Team Loading Area Transport To Onward Destination

7. Patient Mobility Levels Ambulatory Ambulatory Wheelchair Wheelchair Non-Ambulatory Non-Ambulatory –Lowest acuity –Moderate acuity –Critical care –Interrupted procedure –Arm-carry Behavioral Health Behavioral Health

8. Patient Movement Sequencing By mobility level By mobility level Focus on efficiency Focus on efficiency First, move the ambulatory First, move the ambulatory –Ambulatory elderly and behavioral health may be moved faster as wheelchair patients Discharge-eligible patients Discharge-eligible patients Wheelchair patients Wheelchair patients Non-ambulatory patients Non-ambulatory patients –From lowest to highest acuity

9. Evacuation Sleds NO LIFTING. Uses roll and drag method only. NO LIFTING. Uses roll and drag method only. –Stairwell braking system for safe mobilization of lightweight or heavier patients by any staff member. Allows for all staff to be utilized in an evacuation. Allows for all staff to be utilized in an evacuation. Regular sled (36x87 in), holds 800lbs Regular sled (36x87 in), holds 800lbs Bariatric sled (48x87 in), holds 800lbs Bariatric sled (48x87 in), holds 800lbs Compact and durable -- efficient storage options. Compact and durable -- efficient storage options.  helps protect person while transporting.  holds IV bags, oxygen  and other small devices.  Stored on each floor and in distribution

10. MedSled

11. Special Situations & Critical Care Mothers and babies together Mothers and babies together Specialty care patients Specialty care patients Airborne infectious isolation patients Airborne infectious isolation patients Morbidly obese patients Morbidly obese patients Ventilated patients Ventilated patients Orthopedic w/equipment Orthopedic w/equipment Patients undergoing procedures Patients undergoing procedures

12. Staff Assignments On-duty personnel remain until released On-duty personnel remain until released Manpower is allocated by the Command Center Manpower is allocated by the Command Center

13. What is Your Role?

14. Evacuation Management Incident Command Operations Section Chief Medical Care Branch Director Inpatient UL Patient Tracking UL Security Branch Director Access Control UL Crowd Control UL Traffic Control UL Law Enforcement Interface Evacuation Branch Director Horizontal Movement UL Patient Holding UL Vertical Movement UL Patient Loading UL Tracking/Accountability UL Staging Manager -Personnel Staging Team -Vehicle Staging Team -Equipment/Supply Staging Team -Medication Staging Team

15. Maintaining Continuity of Care Clinical staff Clinical staff Equipment and supplies Equipment and supplies –Surge Area Supply Cart –Oxygen –Biomedical equipment –Supplies, linen, portable lighting –Patient comfort and privacy items

16. Emergency Response Manual Now On-line Emergency Response Manual now on the portal in PPGD Emergency Response Manual Emergency Response Manual