Hospital Emergency Management The safety officer wrote the disaster plan! What am I supposed to do?

Hospital emergency management has changed over the past few years... Until recently, hospitals planned response to mass casualty disasters (Alert 1), fire, and a few natural disasters (tornado, earthquake) that could impact the facility.

emergencies that looks like this… Now hospitals conduct an annual hazard vulnerability analysis and come up with a list of emergencies that looks like this… This list takes into account probability impact on institution institutional preparedness

Emergency Management has evolved beyond response planning. It includes: Mitigation Preparedness Response and Recovery

Because of the numbers and kinds of emergencies that can impact a hospital, most begin planning with a basic infrastructure...

JCAHO and NFPA 99 require an “all-hazards” incident command structure that... Can be coordinated with the command system in the community Uses the same terminology as the community ICS Is flexible enough to allow activation and deactivation of components, based on the specific event

Both JCAHO and NFPA also require a structure that explicitly allows for the management of... Patient care Staff/family support Logistics of critical supplies Media Security

What is HEICS? An “all-hazards” command structure A universal link with outside resources

HEICS provides... A dependable chain of command Improved communication through common language Flexibility Prioritization of tasks Organized documentation system Effective mutual aid planning The Fayette County Healthcare Emergency Planning Committee has adopted HEICS. As a result, all acute care hospitals will begin using the HEICS structure.

HEICS Tools Organization chart Job Action Sheets Forms

Basic Units of HEICS Organization PI Officer Safety Officer Security Officer Liaison Incident Commander Section Chiefs Directors Unit Leaders Officers + = Command Center

Five sections…one mission... To respond to the emergency at hand. Command Center Logistics Planning Finance Operations

Command Center Defines the mission and ensures its completion.

Logistics Provides for a working environment and adequate materials to meet the overall medical objective.

Planning Determines and provides for the continuance of each medical objective. Prompts and drives all HEICS officers to develop short- and long-range action plans.

Finance Provides funding for present medical objective and stresses facility-wide documentation to maximize financial recovery and reduction of liability.

Operations Carries out the medical objective to the best of the hospital’s ability.

Job Action Sheets Your disaster response job descriptions Tell you What you are going to do When you are going to do it To whom you are going to report it after you have done it. Universal titles and missions allow emergency responders from a variety of agencies to communicate.

HEICS Forms Used with job assignments Can be altered in any way necessary Documentation = $$$

The Language of Emergency Management Liaison HEICS Logistics All Hazards Approach Command Center Finance Operations Planning Labor Pool

Future changes... To specific disaster plans (to reflect HEICS structure) Emergency code names (to make consistent with other hospitals and emergency responders) JCAHO Emergency Management standards

Advance planning for Medical Care Director Establishing an Operations Section Center, including locations and staffing Assessing staffing, supply, equipment needs in patient care settings. Emergency inpatient discharge. (See Nursing Unit Leader.) Communicating with patient care areas. (See Communications Unit Leader.) The Operations Chief will require written plans for:

Advance planning for Medical Staff Director The Operations Chief will require written plans for: Establishing a physician labor pool. (See Medical Staff Unit Leader.) Credentialing volunteer medical staff. (See Medical Staff Unit Leader.) Assessing physician staffing needs and assigning physicians.

Advance planning for In-Patient Areas The Operations Chief will require written plans for: Assessing inpatients for early discharge. (See Nursing Staff Unit Leader.) Establishing alternate inpatient care sites within the facility. Assessing staffing, supply, equipment needs in patient care settings.

Advance planning for Treatment Areas Establishing emergency treatment areas, including location and staffing. Assessing staffing, supply, and equipment needs in treatment areas. (See Medical Care Director.) Assessing security needs in treatment areas. Moving patients through treatment areas to discharge or admission.(See Transportation Leader.) The Operations Chief will require written plans for:

Advance planning for Ancillary Services The Operations Chief will require written plans for: Inventorying available blood supply. Evaluating ancillary services’ capacity to perform services required by emergency. Tracking patients to ensure results reporting. (See Patient Tracking Officer.) Assessing staffing, supply, and equipment needs.)

Advance planning for Human Services The Operations Chief will require written plans for: Establishing Human Services Center, including location and staffing. Implementing emergency discharge procedures. (See Nursing Staff Unit Leader.) Establishing staff rest, nutrition, and sleeping areas, including location and staffing. Keeping staff updated regarding emergency status. (See Situation-Status Unit Leader.) Establishing staff psychological support and debriefing areas, including location and staffing. Establishing a dependent care area, including location and staffing. Identifying dependents. Assessing materials and supply needs.

The Planning Chief will require written plans: Advance planning for Situation-Status Unit Maintenance and recovery of computer systems Security of medical records The Planning Chief will require written plans:

Advance planning for Labor Pool The Planning Chief will require written plans for: Establishing the labor pool, including location and staffing Registration and credentialing of volunteer staff

Advance Planning for Logistics of Critical Supplies The logistics section chief will require a written plan and procedures for procuring, handling, and distributing... Pharmaceuticals Medical supplies Food supplies Linen Water Critical Equipment

Advance planning for Communications Logistics Other areas/departments within hospital Other facilities External agencies Alternative communications plan for all major communication systems The logistics section chief will require a written plan and procedures for communicating with… In addition, the chief will require an...

Advance planning for Transportation Logistics Patients Staff Equipment to or from other facilities Staff to and from hospital during bad weather Critical supplies The logistics section chief will require a written plan and procedures for transportation of...

Advance planning for Medical Staff Unit The Planning Chief will require written plans for: Establishing a physician labor pool, including location and staffing Registration and credentialing of volunteer medical staff

Advance planning for Nursing Unit The Planning Chief will require written plans for: Emergency Inpatient discharge Patient Tracking Release of Patient Information Recalling Nursing Staff