1. U N I V E R S I T Y O F V I R G I N I A H E A L T H S Y S T E M Emergency Management Working Group 9 September 2013 Please remember to silence your cell phone.

2. U N I V E R S I T Y O F V I R G I N I A H E A L T H S Y S T E M Agenda Update: UVa Hotline Exercise (previously known as Snow Line Exercise) Review impromptu evacuation drill from last meeting Review, briefly discuss “The Great 5/6W Flood” TTX - Evacuation Planning

3. U N I V E R S I T Y O F V I R G I N I A H E A L T H S Y S T E M UVa Hotline Exercise – 25 Sep 2013 Why is this important? March 2013 Snow Storm two significant problems Problems: Approval vs Coordination; UVaHS ability to proactively record Snowline message for our employees In April, a policy review concluded that UVaHS will coordinate our plans to avoid conflict with academic side In May, UVa agreed for us to work with ITC and Siemens to modify and test the recording system Before Snowline Exercise Planning in June 2013 Two Snowlines 6 Fon Lines Press 1 or 2 6 Fon Lines Press 1 or 2 Recorders (ea channel has 36 lines) Recorders (ea channel has 36 lines) Recorders (ea channel has 36 lines) For Snowline Exercise in June 2013 For UVa Hotline Exercise in Sep 2013

4. U N I V E R S I T Y O F V I R G I N I A H E A L T H S Y S T E M Impromptu Evacuation Exercise from July Mtg Three problems noted related to employee and patient safety –Packaging –Hookup –Slack in lanyard Educational video developed with help from Cville Fire Dept –http://www.youtube.com/watch?v=UdWcrn9Ieiwhttp://www.youtube.com/watch?v=UdWcrn9Ieiw

5. U N I V E R S I T Y O F V I R G I N I A H E A L T H S Y S T E M “The Great 5 and 6 West Flood” Tom Berry, thb2p, Emergency Services Director

6. U N I V E R S I T Y O F V I R G I N I A H E A L T H S Y S T E M An overview 47 hour operation Hospital Command Center activated 2 units evacuated (56 patients) 12 surgeries postponed and rescheduled Patient care opns continuous Patient safety always paramount Family support a priority 7 Command Center huddles 1 Command Center message with 4 updates Response and recovery phases simultaneous Incident Action Plan developed and continually refined Coordination, collaboration, and communication unmatched

7. U N I V E R S I T Y O F V I R G I N I A H E A L T H S Y S T E M 25 August 2013 2000 1” water pipe breaks in 6W ceiling 6W staff uses towels/linen to “sand bag” 5W becomes soaked Affects floors down to 3 Evac to 5/6N and other MC units begins 2030: Hospital Command Center (HCC) requested 2110: HCC open (+1) 2150: 56 patients relocated 2300: HCC Huddle #1 (+3) 12 people in attendance Initial IAP completed Assess-Plan-Comm-Respond Tube Sys, Pyxis, Fons, C.Monitoring Determine rooms down OR impact > Service recovery Tr Hold Notify IP&C, Risk Mgt Recover automation Prepare f/ 0730 huddle Continue clean up 0230: HCC skeleton crew 0600: HCC full-scale (+10) 0730: HCC Huddle #2 (+11.5) Strategic guidance given Operational objectives developed – Plan to decompress – Capacity grid – Service recovery – Logistics: fons, supply, pyxis, pharm 1000: HCC Huddle #3 (+14) Full scale HCC w/ 45 people Main effort = response/relocation spt 1200: HCC Huddle #4 (+16) Main effort = relocation spt & recovery Units begin to “normalize” IP&C/Facilities provide forecast of units 1245; OR sub-IMT plans for Tues with eye on Wed CCS sub-IMT fully integrated into HCC 1315: 7N opens … 8C patients transition 1330: Sr Leadership visits patients/families impacted 1500: HCC Huddle #5 (+19) 1800: HCC goes virtual 26 August 2013 27 August 2013 0600 HCC no longer virtual 0900: HCC Huddle #6 (+37) Re-assess IAP OR sub-IMT looks to Thurs 1200: HCC Huddle #7 (+40) OR sub-IMT finalizes Thur EPIC/Lab sub-IMT Service/Spt sub-IMT – IP&C/Facilities – Supply chain – Pharmacy – Risk Mgt/Claims sub-IMT 1500: HCC Huddle #8 (+44) 1800: HCC closes (+47) The Operational Timeline

8. U N I V E R S I T Y O F V I R G I N I A H E A L T H S Y S T E M Thoughts Tactical – Operational – Strategic Doers and Enablers Sub-Incident Management Teams The three C’s (coord/collab/coop) “When in charge, take charge” “What If” 5N and 6N unavailable Elevators not available Thursday versus Sunday night Operations complex warm Current Status – Facilities Update

9. U N I V E R S I T Y O F V I R G I N I A H E A L T H S Y S T E M Kudos 5 West 6 West Directors, Acute and CC Bed Coordination Center Nursing Supervisors Infection Prev and Control Facilities Patient Transport Medical Transport Environ Services Receiving Units Medical Directors Administrators Sr Mgt Who Else??

10. U N I V E R S I T Y O F V I R G I N I A H E A L T H S Y S T E M TTX – Evacuation Planning

11. U N I V E R S I T Y O F V I R G I N I A H E A L T H S Y S T E M 1 inch domestic water line breaks in 6W ceiling Causes evacuation of 5 and 6 W to 5N, 6N, and other floors This results in decrease of 30 beds available for bed placement After units have relocated and while EVS is responding to 5 and 6 W –Another pipe breaks on 4W –This requires 4W and later 3W to evacuate 47 patients to other hospitals in the region and State –Blood Bank is impacted and requires discontinuation of services The Hospital Command center (HCC) is already established Admin on-Call and Administration directs establishment of Family Care Center Use flip charts to document a plan so we can update the annex in our Emergency Operations Plan Scenario

12. U N I V E R S I T Y O F V I R G I N I A H E A L T H S Y S T E M Questions // Comments Thank you or your time and participation! Next meeting is 11 Nov 2013