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NC Emergency Management Association Conference Greg Shuping- Haywood County Emergency Management Marty Stamey- Hospital Operations & Emergency Management.

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Presentation on theme: "NC Emergency Management Association Conference Greg Shuping- Haywood County Emergency Management Marty Stamey- Hospital Operations & Emergency Management."— Presentation transcript:

1 NC Emergency Management Association Conference Greg Shuping- Haywood County Emergency Management Marty Stamey- Hospital Operations & Emergency Management

2 Hospital Demographics  Main Structure- 7 Story, 190,000sf  169 Bed Facility  17 Bed Emergency Department  16 Bed Behavioral Health Unit  County Population 60,000

3 Hospital Census Prior to the FIRE TOTAL- 75 PCU- 16 ICU- 3 Women’s Care- 4 ○ Active Labor- 2 Med Surg.- 18 BHU- 16 ED- 16 ○ IVC- 4

4 June 19, 2014  18:28 Pull Station Fire Alarm received at the 911 Center. Upgraded to a full alarm assignment based on multiple callers reporting heavy smoke from the electrical room.  18:33 First units arrive, smoke showing from rear loading dock area.

5 June 19 th, 2014 Incident Command established by Fire Department Hospital, EM, EMS, Law Enforcement leadership at the command post to ensure effective decision-making. Accountability an issue with such a large building. High stress and chaotic environment for the first minutes.

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7 June 19, 2014  18:53 Fire Under Control Small Fire confined to the Electrical Room area, but with HUGE consequences to Hospital Operations. Additional Hospital administration arriving. Hospital Command Post established in another building behind the main structure.  19:30 H.I.C.S. established and initial briefing given by Hospital CEO. Fire Department returns control of the building back to Hospital Administration.

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9 Initial Response Highlights  Initial Response Command Post already identified in response plans and exercises. We had recently conducted a disaster drill at the hospital!  Immediate notification of County Emergency Management & EMS performed upon notification of “smoke showing”. Allowed a good transition from first responders to hospital administration control.  Incident occurred after most scheduled surgeries and other outpatient services were complete.

10  19:40 Emergency Department Diversion  20:25 Code Black- Power Failure  20:33 Code Silver- Patient Evacuation Decision  21:45 EMS resources on scene ○ 11 units Buncombe County Mass Casualty Bus on Standby.

11 Hospital Evacuation  Immediate Evacuation vs. Phased Evacuation Decision to completely evacuate at 20:45  Evacuation Numbers/Destinations Harris- 18 adults, 2 newborns, 4 BHU Mission- 2 acute adults & 7 from ED Homestead Remaining BHU patients to Rutherfordton, Balsam Center and Kings Mountain 25 patients discharged

12 Hospital Evacuation  Notification to area hospitals of a FULL DIVERSION  Public and Family Notifications (perception issues)  EMS resource management- All patients & staff moved by 03:10 hours the following morning.  Final BHU patient evacuations complete at 08:00 hours.

13 1 meg generator to power 500 ton chiller

14 2- 2 meg generators on scene to power the hospital

15 The NEXT MORNING  Establishing a mobile Emergency Department in the parking lot. Resources needed to make this happen? ○ Mobile Tractor Trailer units (SMAT, MED 1, etc.) ○ Additional supporting tents (SMAT, DPR cache, etc.) ○ Restrooms, medical supplies, pharmacy, X-ray, labs, etc. ○ SIGNS ○ Public Information ○ Emergency Lighting ○ Staffing  06:10- Decision to deploy MED-1

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19 Relationships Prior to the Incident  Local Emergency Planning Committee  Monthly Emergency Services team meetings with hospital administration  Multiple Exercises and consolidated training throughout the years.  Attrition at Hospitals, especially in key positions.

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22 Completely out of main hospital for 3 weeks. June 19- July hour operational periods at the command post. August 17- Final electrical testing and return of primary hospital power. External support demobilized. August 22- Hospital ICS terminated.

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26 I. CommunicationsYESNON/A Was the appropriate staff notified when emergency measures initiated? (Code announced or paged) 822 Were emergency communications set up? 111 Were community emergency response agencies efforts incorporated/ coordinated? 102 Did the hospital communicate with patients and families during the emergency? 93 Did the hospital communicate to the media during the emergency? 111 Comments: Extensive effort and emphasis was placed on up-to-date information Communications 1x1 2x2 3x2 4 x 3 5 x 4 Score (Circle One) Poor Fair Good Very Good Excellent 3.58 Communications Score of 3.58 Internal

27 II. Resources/AssetsYESNON/A Did hospital have enough supplies on hand? (medical, pharmaceutical, emergency) 1012 Did hospital manage support activities appropriately? (housing, transportation, communication, stress debriefing) 1011 Did hospital obtain additional resources from another entity? (Corporate, another hospital, health department, etc.) 12 Resources/Assets 1 2 3x2 4 x7 5 x2 Score (Circle One) Poor Fair Good Very Good Excellent 4.0 Resources/Assets Score of 4.0 Internal

28 III. Safety/SecurityYESNON/A Was adequate security provided? 12 Were emergency vehicles and personnel able to have access to all areas, equipment, and supplies required? 12 Were unauthorized personnel kept away from the areas? 111 Did facility take steps to identify and address hazards created by this event?111 Safety/Security 1 2x2 3x1 4 x4 5 x4 Score (Circle One) Poor Fair Good Very Good Excellent 3.91 Safety/Security Score of 3.91

29 Internal IV. Staff ManagementYESNON/A Were provisions for the management of staff, including distribution and assignment of responsibilities and functions, adequate? 111 Was there adequate staffing and call-in response? 102 Was staff competent to perform assigned duties? 111 Was staff support needed, provided and adequate?102 Staff Management 1 2x2 3x2 4x4 5 x2 Score (Circle One) Poor Fair Good Very Good Excellent 3.78 Staff Management Score of 3.78

30 Internal V. Utilities ManagementYESNON/A Were any of the following disrupted?  Electricity ( or Emergency Generator)  Water  Fuel  HVAC  Medical Gas/Vacuum Systems  Other (Specify): If any of the above were disrupted, were the appropriate actions taken? Describe: Numerous generators brought on site and wired in, outside support from CHS and DLP, periodic downtimes during testing and repairs Details in HICS documentation X Utilities Management 1x1 2x2 3x1 4x4 5 x1 Score (Circle One) Poor Fair Good Very Good Excellent 3.25 Utilities Management Score of 3.25

31 Internal VI. Patient Clinical & Support ActivitiesYESNON/A Were provisions for the management of patient including scheduling of services, control of patient information, admission, transfer, and discharge adequate? 102 Were all patients accounted for, triaged, and prioritized? 102 Was all necessary medical treatment readily available and adequate? 102 Was patient transfer plan effective? 102 Was temporary shelter needed? 552 If temporary shelter was needed but inadequate, please describe: Was alternate care site needed? 102 If alternate care site was needed, was site identified and was it available, accessible and adequate? 102 If alternate care site was not identified, available, accessible or adequate, please describe: Local Hospitals Patient Clinical & 1x1 2x1 3x1 4 x4 5 x4 Score Support Activities 3.82 (Circle One) Poor Fair Good Very Good Excellent Patient Clinical & Support Activities Score of 3.82

32 Overall Score for Incident from Internal Responses 3.74

33 External I. CommunicationsYESNON/A Was the appropriate staff notified when emergency measures initiated? (Code announced or paged) 5 Were emergency communications set up? 5 Were community emergency response agencies efforts incorporated/ coordinated? 5 Did the hospital communicate with patients and families during the emergency? 14 Did the hospital communicate to the media during the emergency?5 Communications x 1 5 x 4 Score (Circle One) Poor Fair Good Very Good Excellent 4.80 Communications Score of 4.80

34 External II. Resources/AssetsYESNON/A Did hospital have enough supplies on hand? (medical, pharmaceutical, emergency) 23 Did hospital manage support activities appropriately? (housing, transportation, communication, stress debriefing) 41 Did hospital obtain additional resources from another entity? (Corporate, another hospital, health department, etc.) 5 Resources/Assets x3 5 x2 Score (Circle One) Poor Fair Good Very Good Excellent 4.4 Resources/Assets Score of 4.4

35 External III. Safety/SecurityYESNON/A Was adequate security provided? 5 Were emergency vehicles and personnel able to have access to all areas, equipment, and supplies required? 5 Were unauthorized personnel kept away from the areas? 5 Did facility take steps to identify and address hazards created by this event?5 Safety/Security x2 5 x3 Score (Circle One) Poor Fair Good Very Good Excellent 4.6 Safety/Security Score of 5.0

36 External IV. Staff ManagementYESNON/A Were provisions for the management of staff, including distribution and assignment of responsibilities and functions, adequate? 32 Was there adequate staffing and call-in response? 32 Was staff competent to perform assigned duties? 32 Was staff support needed, provided and adequate?32 Staff Management x1 5 x2 Score (Circle One) Poor Fair Good Very Good Excellent 4.67 Staff Management Score of 4.67

37 External V. Utilities ManagementYESNON/A Were any of the following disrupted?  Electricity ( or Emergency Generator)  Water  Fuel  HVAC  Medical Gas/Vacuum Systems  Other (Specify): If any of the above were disrupted, were the appropriate actions taken? Describe: (1)The disruption only occurred due to the actual incident. (2)Temporary generators and security lighting was in place 5 Utilities Management x1 5 x2 Score (Circle One) Poor Fair Good Very Good Excellent 4.67 Utilities Management Score of 4.67

38 External VI. Patient Clinical & Support ActivitiesYESNON/A Were provisions for the management of patient including scheduling of services, control of patient information, admission, transfer, and discharge adequate? 23 Were all patients accounted for, triaged, and prioritized? 23 Was all necessary medical treatment readily available and adequate? 23 Was patient transfer plan effective? 113 Was temporary shelter needed? 32 If temporary shelter was needed but inadequate, please describe: Was alternate care site needed? 32 If alternate care site was needed, was site identified and was it available, accessible and adequate? 32 If alternate care site was not identified, available, accessible or adequate, please describe: The establishment of an alternative site was based upon the decision to divert patients to Harris Regional Hospital and Mission Hospital in Asheville. Patient Clinical & 1 2 3x1 4 x2 5 Score Support Activities 3.67 (Circle One) Poor Fair Good Very Good Excellent Patient Clinical & Support Activities Score of 3.67

39 Overall Score for Incident from External Responses 4.47

40 Questions Thank You!


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