1. Emergency Management Working Group 10 November 2014 Please remember to silence your cell phone.

2. 1.Introductions 2.Emerging Diseases 3.Bi-monthly Review 4.2014 EOP Update 5.Upcoming Training and Exercises 6.Closing Comments Agenda

3. Emerging Infectious Diseases: Ebola Emerging Diseases

4. Updates: Travel Screening in place Travelers from impacted areas are identified Communication local Health Departments Monitoring occurs Onset of Symptoms—result in a coordinated admission UVA and VCU as designated hospitals for Virginia Hospitals will rule in or out Ebola Confirmed cases will be sent to federal biosafety facilities If no space, UVA and VCU will care for confirmed cases CDC site visit on November 18

5. UVA Health System Mission Ensure UVAHS staff are safe as they safely care for Person Under Investigation (PUI) for Ebola or other emerging infectious diseases following appropriate infection prevention procedures Team member safety Safety of other medical center staff Safety of other patients and visitors Safety of the community Ensure patients are provided exceptional care

6. Pillars of the UVAHS Ebola Preparedness Plan: Educate Appreciate Isolate Communicate Care

7. Planning Timeline May 2014: Emerging Infectious Diseases Committee Formed for MERS-CoV Multidisciplinary team includes Emergency Management, Infection Control and Prevention, Hospital Epidemiology, Emergency Department, Transfer Center, Bed Coordination Center, Patient Relations, MICU, EMS, Employee Health, Student Health, Environmental Services, Public Relations July 2014: MERS-CoV tabletop exercise August 2014: Emerging Infectious Diseases Committee planning expanded to incorporate Ebola Developed screening tool Preparedness planning September 2014: Ebola plan tested with “rule out” of patient with Ebola- like symptoms admitted to MICU

8. Ebola Plan: Emergency Management Website

9. Phases of the Ebola Emergency Response Plan: Situational Awareness Phase 1: ≤2 patients Phase 2: 3-4 patients Phase 3: 5-10 patients Phase 4: >10 patients Tiered Response Plan SituationalAwarenessSituationalAwareness Phase 1 Phase 2 Phase 3 Phase 4

10. Review of Plan Educate Identify and train staff involved in care of an Ebola patient (e.g. MD, LIP, RN, RT, EVS) Targeted areas will include ED, UVA Medical Transport, select MICU staff, select PICU staff, select EVS, select RT, select consult services Not all staff and faculty will need to be trained Checklists and observation of donning and doffing PPE is essential Appreciate (Identify Potential Cases) Uniform Travel Screening Tool is in place in ED, Transfer Center, and Bed Center Roll-out for use throughout the Health System is underway

11. Review of Plan Isolate Designated rooms in ED and MICU are identified Include anterooms and toilets Plan is to minimize patient movement and contact Transfer protocols from non-ED locations to the MICU are defined Maintain entry/egress logs, monitor room traffic Personal Protective Equipment (PPE) that will be in use: Impervious gown Impervious shoe/leg covers Double gloves Fit tested N95 mask Full face shield Head cover

12. Review of Plan Communicate Emergency management system Public health authority notification Health System communications Care UVAHS lab testing (point of care, minimize central lab testing) VDH/DCLS Ebola testing (same-day turnaround) Anticipated medical needs for an Ebola patient (fluids and electrolytes) Care plans for EMS, ED, MICU already defined Environmental hygiene plans being tested Waste management plan is solidified Decedent affairs is involved

13. Active Preparations 1.Education began in September and will be continuous 2.Continue developing and refining operations and care plans as new information and protocols emerge 3.UVA Children’s Hospital Plan is being discussed and developed 4.Clarify plans of other regional hospital and care sites (urgent care centers) 5.EMS (and Medic 5) transfer protocols are being further defined 6.Education/coordination with UVAHS ambulatory practices underway 7.UVA (employee, student, etc.) returning traveler protocols in place 8.Phase 2-4 planning is next

14. Potential Scenarios Ebola Identified “in the field” Emergency Department Ambulatory Care Transfer Request

15. Exercises Great Shakeout Training UMA Clinic WPV Training Ebola PPE Training HAZMAT Decon Equipment Checks Actual Events None recorded Bi-monthly Update

16. ̶ Inclement Weather Annex ̶ Hospital Command Board 2014 EOP Update

19. ̶ Evacuation (11/14/2014) ̶ Inclement Weather Webinars (11/24-29/14) ̶ Active Shooter Drill (December…) Upcoming Training and Exercises

20. Thank You Next Meeting: January 12 2015