1. North Central Wisconsin
Healthcare Emergency Readiness Coalition
NCW HERC
NCW HERC Workshop: Emergency Operations Plan (EOP) Review and Development
Presented
October 10, 2018

2. Division of Quality Assurance (DQA) serves as the state survey agency that oversees Wisconsin’s certification process on behalf of CMS. DQA has provided information and background on the CMS rule, and the provider specific tools were produced independently and are intended for advisory purposes only.  
None of the tools or assistance provided by NCW HERC guarantees any outcome during survey visits. Facilities are solely responsible for meeting CMS requirements.
Disclaimer

3. Objectives
Identify methods, resources and assets to strengthen your EOP  1
Conduct an annual review of your EOP 2
Collaborate with peers to identify best practice 3
Leave with heading for improvements and WORK TO DO. 4

4. Logistics/Crowd Participation
Brief review and break out
Reference your EOP
Share the good stuff!
Share your struggles
Ask questions and get something out of this!

5. Who's in Attendance? Hospitals Fed Qualified Health Centers
Ambulatory Surgical Centers
Community Mental Health Center
Comp. Outpatient Rehab Facilities
End Stage Renal Disease Facilities
Hospice
Intermediate Care Facility
Organ Procurement Organization
Physical/Speech Therapy Outpatient
Rural Health Clinics
Home Health Agencies
Long Term Care & Skilled Nursing Home Facilities
Who's in Attendance?

6. Disaster Statistics
In preparation of Hurricane Florence at least 40 hospitals and at least 10 skilled nursing facilities were evacuated ahead of the storm.
At least 135 residents of nursing homes within the Houston area perished during Hurricane Harvey. 
Beaver Dam bomb maker.
Over 1,850 nursing homes have failed to have emergency evacuation plans in place between 2011 and the present time. 
CMS reports that there were 3,770 violations of weekly and monthly power generator inspections in nursing home facilities.
The Gerontological Society of America cited in a 3-year study that there was a 218% increase in mortality of residents with severe dementia within 30 days and a 158% increase in mortality within 90 days of an evacuation from gulf coast.

7. Why? Legal and Moral Responsibility Save lives and property
Insurance reductions
Effective Response
Why?

9. Who? Emergency Planner/ Coordinator/ Manager
Local Emergency Planning Committee

10. CO-S-TR CO Command Control Communication Coordination S Staff Space
Special TR
Tracking
Triage
Treatment
Transportation

11. Essential Functions of an EOP
Communication
Resources and Assets
Safety and Security
Staff Responsibilities
Utilities Management
Patient and Clinical Support Activities
Regular Testing and Evaluation

12. Resources CMS EP Checklist:
CMS Rule Core Elements:
ASPR TRACIE EOP Management Tools:
FEMA EOP Guide for EOPs
DHS CMS Preparedness Toolkits

13. Risk Assessment/ Planning
Hazard Vulnerability Assessment (HVA)
NCW HERC Regional Review
Triggers for Activation
Continuity of Operations
Feb 2019

14. Breakout Discussion #1 (15 min)
What are my top 10 threats?
What are my triggers to activate the EOP?
Who activates the EOP?
What are my essential services to continue?

15. Communication Internal and External Partners
Communication Plan (Risk Communication)
Redundancy
Expanding an incident
NCW HERC's role in the tiered response
EMResource
Virtual Operations Support Team

16. Breakout Discussion #2 (15 min)
How do I communicate internal activation?
How do I notify external partners of activation?
What are my primary and redundant means of communication?
Are external partners aware of role in response in my EOP?
How do I communicate to the public? Public Information Officer?
How do I communicate resource needs?
Do I formally engage the HERC?

17. Resources/Assets & Utility Management
Subsistence Needs
Food & Water
Medical & Pharmaceuticals
Linens
Alternate Sources of energy
Waste management!!!!
Contracts, Vendors and MOUs
Conservation of Resources
Shelter in Place
Evacuate
Large Patient Influx

18. Breakout Discussion #3 (15 min)
What contracts do I have established with vendors?
What is my plan if the vendors are unable to provide?
What MOUs do I have established with partners I may need stuff from?
Do you have generators? What are they capable of running? How long and they run?
What agreements do I have with partners I may need to collaborate with in evacuation?
What conservation strategies have been identified?

19. Patient & Clinical Support
Incident Command Structure(ICS)
Staff Tracking
Surge staff
Patient Tracking
Volunteers
Records/ Documentation
Security

20. Breakout Discussion #4 (15 min)
What staff are responders?
What staff are command?
How will staff be assigned in ICS?
How does your facility account for patients?
How does your tracking change in an emergency?
How is information protected or preserved? How can it be accessed to be shared?
What measure are taken to protect patients and staff?

21. Testing, Review & Evaluation
Training
Incident command
Onboarding
Testing
Exercising
Exercise Evaluation Guides (EEGs)
After Action Reports (AARs)

22. Breakout Discussion #5
What is your process for training staff needed to respond? Managers and key decision makers?
How often are refreshers?
What does your outlined incident command depth chart look like?
How do you prioritize exercising?
What are your highest priority drills and exercised need related to your HVA?

23. Closing Comments and Discussion

24. Thank you!
For questions related to this workshop, please via phone at