We think you have liked this presentation. If you wish to download it, please recommend it to your friends in any social system. Share buttons are a little bit lower. Thank you!
Presentation is loading. Please wait.
Published byJoseph McFarland
Modified over 3 years ago
© Copyright, The Joint Commission Improving Emergency Management Standards Where to go from here? Robert A. Wise, M.D. VP –Division of Standards & Survey Methods The Joint Commission
© Copyright, The Joint Commission Overview New Standards for 2008 and 2009 Review of debriefing of recent disasters What are next challenges?
© Copyright, The Joint Commission A Brief History of Emergency Management Standards Pre-2001 Standards –Legacy Standards –Disaster Based (before all hazard) –Emphasis on response phase –Minimal community planning 2001 Standards –Heavily influenced by DoD and VA –Growing international/domestic threats HVA, All Hazards, 4 phases, Community coordination, hospital leadership
© Copyright, The Joint Commission 2008 Standards Developed after reviewing 5 years of disasters
© Copyright, The Joint Commission Debriefed Multiple Hospitals & Communities: Sample of Debriefings First - Tropical Storm Allison – June/2001 9/11 – September 2001 Power Outage – Summer 2003 San Diego Wild Fires – Summer 2003 Hurricane Isabel – Fall 2003 SARS (Asia/Toronto) - Spring 2003 Multiple hurricanes in Gulf and Florida- 2004-05 Katrina/Rita - 2005
© Copyright, The Joint Commission Communications –With staff; suppliers; EOC Supplies –Unclear inventory, lack of reliable supplier Security –Protection of assets (drugs, fuel, vaccine); –Ability to maintain operations Staff –Housing; pay; family; mental health; safety; leadership Utilities –Fuel; electricity; water (potable and others); sewage - others (ventilation, medical gases) Clinical Activity –Vulnerable populations, changing patient needs; ongoing assessment; – (altered standards of care) 6 Critical Parameters Became structure of 2008 standards
© Copyright, The Joint Commission 2008 Standards Overview Planning to Manage Consequences (EC.4.11) Emergency Operation Plan (EC.4.12) Critical Parameters –Communications (EC.4.13) –Supplies (EC.4.14) –Security (EC.4.15) –Staff (EC.4.16) –Utilities (EC.EC.4.17) –Clinical Activity (EC.4.18) Exercises & CQI (EC.4.20)
© Copyright, The Joint Commission Expanded and New Requirements Highlight in RED postponed from 1/08 to 1/09 In that dialog with field, suggests the state of preparedness of the country
© Copyright, The Joint Commission EC.4.11 Managing Consequences of Emergencies Hazard Vulnerability Analysis (HVA) –Broad review of threats –In sync with community –Prioritize events Communicates to community, needs & vulnerabilities –Recognizes unresponsive communities remain For each event in HVA, define –Mitigation activities –Preparedness activities –Response strategies –Recovery strategies
© Copyright, The Joint Commission EC.4.11 Managing Consequences of Emergencies EP#9 - Document inventory of onsite assets & resources; to include –PPE –Staffing –Water, fuel –Medical, surgical, pharmaceuticals EP#10 -Methods for monitoring quantities of assets and resources during emergency Scope, objectives, performance of emergency management planning is annually evaluated
© Copyright, The Joint Commission EC.4.12 Develop Emergency Operations Plan (EOP) Develop & maintain Emergency Operations Plan Emergency Operations Plan (EOP) –Establishes ICS consistent with communitys –Identifies staff reporting relationships –EP#6 – The Plan identifies capacity and establishes response efforts in 6 critical areas when organization cannot be supported by community for at least 96 hours –Evacuation is an acceptable strategy but reallocation preferred –Identifies alternative sites for care
© Copyright, The Joint Commission Striving for more…. 24 hrs 48 hrs 96 hrs 0 hrs 72 hrs Normal - Generator Fuel Curtail services – curtail services, discharge patients Normal – Clinical Supplies Normal – Water (Sanitary) Conserve resources – save water (sponge baths, waste disposal). Conserve resources – shut down floors, cancel elective surgeries
© Copyright, The Joint Commission EC.4.13 – Emergency Communications Internal planning with staff, external authorities, patients and families Communicating with suppliers and services during emergency
© Copyright, The Joint Commission EC.4.14 – Managing resources and assets Potential sharing of resources and assets with HCOs outside of community Transporting patients with supplies and staff to alternative care site
© Copyright, The Joint Commission EC.4.15 Managing safety/security Identifies role of community security and coordination with agencies
© Copyright, The Joint Commission EC.4.16 – Defines & manages staff roles Roles and responsibilities are defined for all critical areas Training for roles Communication to physicians and other licensed independent physicians and to whom they report
© Copyright, The Joint Commission EC.4.17 Managing utilities Identifies alternative means of providing fuel for building operations or essential transport
© Copyright, The Joint Commission EC.4.18 Managing services Clinical services of vulnerable population served by organization Mental health services of patients Mortuary services Documenting and tracking patient clinical information
© Copyright, The Joint Commission EC.4.20 EOP: Scope of Exercises EP#3 - One exercise is escalated to evaluate performance when community cannot support the organization
© Copyright, The Joint Commission EC.4.20 EOP: Scope of Exercises EP#11-13 - 6 critical functions monitored Exercises are critiqued Completed exercises are critiqued through multi-disciplinary process EOP modified in response to critiques Improvements to EOP are evaluated during next exercise Strengths/weaknesses are communicated to responsible multidisciplinary team
© Copyright, The Joint Commission And the disasters continue…
© Copyright, The Joint Commission Disasters Debriefed Since 2005 Southern California wild fires - 2007 Hurricane Gustav 8/2008 Hurricane Ike – 9/2008
© Copyright, The Joint Commission What is Important? Preserving Communitys Medical Care Maintain medically frail in community Preserve hospital beds for seriously ill
© Copyright, The Joint Commission The Threat to Medical Care -Decrease supply of hospital alternatives -Increase demand for hospital beds Long Term Care (only segment with expected resiliency) Home Care closed Dialysis Center closed (no generators) Threat of loss of Ventilators/Oxygen Physician Offices closed Outpatient Pharmacy closed Discharged patients (wouldnt leave)
© Copyright, The Joint Commission Debriefing of 2 nd Assault San Diego –Wild fires – 2003 –Wild fires - 2007 New Orleans –Hurricane Katrina & Rita – 2005 –Hurricane Gustav– 2008 Houston –Tropical Storm Allison – 2001 –Hurricane Rita – 2005 –Hurricane Ike - 2008
© Copyright, The Joint Commission Most important improvements Resilience of other healthcare providers Able to protect surge capacity Improve decision to evacuate or shelter in place Handling of 6 critical parameters Communication with: Staff Citizens HCO Community Focus of Second Debriefings
© Copyright, The Joint Commission Some Highlights from Debriefings San Diego – Hospital Association Houston - Hospital New Orleans – Charity/University reps
© Copyright, The Joint Commission Coordination of Emergency Planning San Diego – County level Texas – Regional level New Orleans- cooperation of public hospitals
© Copyright, The Joint Commission Communication Systems –Reverse 911 – landline –AlertSanDiego – registration of cell phones –211 – where to seek services; could register –Emergency Alert System (EAS) – ongoing communication to population – when to return home –RSAN Roam Secure Alert Network- 2008 purchase –WebEOC – hospitals –Local media –New Orleans – minimal new city sponsored communication to citizens
© Copyright, The Joint Commission Staff, Families, and Pets San Diego & Houston –Able to handle pets off-site and even horses (San Diego) –Houston- needed food, water,leash, and crate –Set up help for children and elderly of staff but needed to bring own supplies New Orleans – Public hospital –No pets or support of family –Given time to make other arrangements
© Copyright, The Joint Commission Security Not an issue in any cities though New Orleans public hospital security now equipped & trained with assault-style rifles Houston – hired extra security – implemented armbands for family – dedicated security for childcare (since Allison)
© Copyright, The Joint Commission Evacuation Not needed in Houston –Increase expectation that LTC can shelter in place San Diego did successfully evacuate 3 hospitals and many LTC facilities New Orleans – no evacuation
© Copyright, The Joint Commission Special Needs Walgreens and CVS brought in pharmacy trucks and access to national network Community told to bring pill bottles Much more attention paid to oxygen – who needed it, where it was needed; rationing was required Dialysis remains a national problem – patients refused transporting to distant site
© Copyright, The Joint Commission What Determined Best Results? Second disaster similar to first (wild fire/hurricane) Systematic improvement driven by after-action Improvement with community-wide communication –Reverse 911, 211, WebEoc Improved coordination of multiple facilities –Government-based better than system inside of system Hospitals are integral part of community planning
© Copyright, The Joint Commission Conclusion Debriefings and Org discussions Significant improvement possible in 3 years (same disaster) Community-based communication better and important Need to harden multiple parts of delivery system –Long Term Care –Access to pharmacy –Increase use of shelter for special needs Community planning is preferred over aggregation of hospitals Inadequate experience: – With less warning of disaster e.g. terrorist attacks –When evacuation not possible (quadrant 4) – e.g.. Pandemic Unknown results of disasters with –No warning e.g. terrorist attacks –Evacuation not possible e.g.. pandemic
© Copyright, The Joint Commission Questions? Rwise@jointcommission.org
Sheltering for Disabilities and Special Needs enABLED in Emergencies Conference 2009.
Planning for Resiliency. Primary Reference Emergency Management Principles and Practices for Healthcare Systems, The Institute for Crisis, Disaster and.
Emergency Management CSHE Los Angeles Chapter 2013 Annual.
Hospital Emergency Management
Continuity of Operations (COOP) Planning McDonnell A Tuesday 1:30 – 2:45 Emergency Preparedness 101: Personal, Organizational, and Community Don Sheldrew.
The role of Public Health Nurse Leaders during the Post Recovery Phase of Hurricane Katrina Adriene Jones-Gill, RN, MN Charlotte M. Parent, RN, MHCM.
Through the Eyes of the Surveyor. There are gaps! Emergency Preparedness is now a focus!
Biggest Pitfalls and Best Practices in Emergency Management Healthcare Engineering Consultants Strategies for the 2011 Emergency Management Standards.
Emergency Management Working Group January
Hospital Pandemic Influenza Planning by Ed Lydon, CVPH.
A Brief Overview of Emergency Management Office of Emergency Management April 2006 Prepared By: The Spartanburg County Office of Emergency Management.
Technologys Role in Emergency Management 24 February 2012.
2007 San Diego Wildfires: Lessons Learned Wilma J. Wooten, M.D., M.P.H. Public Health Officer County of San Diego Health and Human Services Agency.
Community Preparedness Citizen Corps and Civil Air Patrol Working Together September 4 th, 2009 Penny S. Burke Community Preparedness Division Citizen.
BIOTERRORISM: SOUTH CAROLINA RESPONDS. OBJECTIVES l To understand the response to a bioterrorist act through use of the unified incident command system.
1 Industry Brief Apr Outline How is Alberta preparing? How is Alberta preparing? Albertas Health Response Albertas Health Response Albertas Operational.
The Day After The Shakeout Place your Counties Logo Here MT DES Exercises.
2010 Hurricane Season Update Office of Emergency Management Preston Cook, Manager June 8, 2010.
Module 3: Developing Plans
Module 3 Develop the Plan Planning for Emergencies – For Small Business –
Emergency Planning for At-Risk Groups How your agency can be involved.
2014 National Patient Safety Goals
Verizon Florida, LLC Hurricane Season Preparation PSC Workshop – May 1, 2008.
FLORIDA FIRE CHIEFS’ ASSOCIATION STATE EMERGENCY RESPONSE PLAN OVERVIEW Statewide Emergency Response Committee.
Vulnerable Populations and Public Health Emergencies Lessons from Hurricane Katrina LuAnn E. White, PhD, DABT Tulane Center for Applied Environmental Public.
Legal Issues in Hospital Preparations for Disaster Response – “Operational Considerations” Knox Andress, RN, FAEN Designated Regional Coordinator Louisiana.
© Copyright, The Joint Commission National Emergency Management Summit Joe Cappiello, BSN, MA VP, Accreditation Field Operations The Joint Commission.
© Copyright, The Joint Commission 2015 National Patient Safety Goals.
1 NM Behavioral Health Collaborative New Mexico Behavioral Health Plan for Children, Youth and Their Families March 2007.
Tom Lenart & John Field CT DEMHS Region 2. Department of Emergency Services and Public Protection (DESPP) Commission on Fire Prevention and Control.
Alachua County Continuity of Government (COG) Alachua County Emergency Operations Center (EOC) 19 February hrs.
Planning for the Future Disaster Recovery Plan / Business Continuity Plan Jim Zukowski, Ed.D. Texas State Board of Dental Examiners 2006 Annual ConferenceAlexandria,
Floridas Disaster Management. The 2004 Hurricane Season Tropical Storm Bonnie and Hurricanes Charley, Frances, Ivan and Jeanne occurred in a six-week.
It Takes a Healthcare Village Presentation Objectives Show attendees that the hospitals cannot take care of all patients in a disaster Identify key decision.
Business Continuity Disaster Planning
Lisa Sandt Director of Planning & Economic Development Lee-Russell Council of Governments (LRCOG)
Memorial Hermann Healthcare System Clinical Integration & Disease Management Dan Wolterman April 15, 2010.
October 27, 2005 Contra Costa Operational Area Homeland Security Strategic and Tactical Planning and Hazardous Materials Response Assessment Project Overview.
HOMELAND SECURITY ADVISORY SYSTEM. Established after the terrorist attacks on America September 11, 2001.
All-Hazard Emergency Planning for Colleges and Universities
Emergency Operations Activation Levels
Emergency Services Division. Founded in 1944, BCFS is a system of non-profit health and human service corporations Programs and services are offered.
1 Home Health Care: The Invisible Workforce with a Major Role in Disaster Preparedness Barbara B. Citarella RN, MS, CHS-III RBC Limited Zachary Goldfarb,
Animal Emergency Management and Animal Emergency Response Missions Webinar 1 Introduction to Animal Emergency Management.
Sarah B. Laditka, Ph.D. Health Services Policy and Management
1 Allocation of Ventilators in an Influenza Pandemic Statewide Videoconference March 16, 2007 Pandemic Influenza Preparedness Planning Guthrie Birkhead,
DEMOGRAPHICS Disability Communities SETRAC South East Texas Regional Advisory Council.
Writing an Emergency Operations Plan Why do we need to plan? Spring 2008.
© 2017 SlidePlayer.com Inc. All rights reserved.