1. HAYwood REGIONAL MEDICAL CENTER Electrical Fire & Hospital Evacuation
NC Emergency Management Association Conference
Greg Shuping- Haywood County Emergency Management
Marty Stamey- Hospital Operations & Emergency Management

2. Hospital Demographics
Main Structure- 7 Story, 190,000sf
169 Bed Facility
17 Bed Emergency Department
16 Bed Behavioral Health Unit
County Population 60,000

3. Hospital Census Prior to the FIRE
TOTAL- 75
PCU- 16
ICU- 3
Women’s Care- 4
Active Labor- 2
Med Surg.- 18
BHU- 16
ED- 16
IVC- 4

4. June 19, 2014
18:28
Pull Station Fire Alarm received at the 911 Center.
Upgraded to a full alarm assignment based on multiple callers reporting heavy smoke from the electrical room.
18:33
First units arrive, smoke showing from rear loading dock area.

5. June 19th, 2014 Incident Command established by Fire Department
Hospital, EM, EMS, Law Enforcement leadership at the command post to ensure effective decision-making.
Accountability an issue with such a large building.
High stress and chaotic environment for the first minutes.

7. June 19, 2014 18:53 19:30 Fire Under Control
Small Fire confined to the Electrical Room area, but with HUGE consequences to Hospital Operations.
Additional Hospital administration arriving.
Hospital Command Post established in another building behind the main structure.
19:30
H.I.C.S. established and initial briefing given by Hospital CEO.
Fire Department returns control of the building back to Hospital Administration.

9. Initial Response Highlights
Initial Response Command Post already identified in response plans and exercises.
We had recently conducted a disaster drill at the hospital!
Immediate notification of County Emergency Management & EMS performed upon notification of “smoke showing”.
Allowed a good transition from first responders to hospital administration control.
Incident occurred after most scheduled surgeries and other outpatient services were complete.

10. 19:40 20:25 20:33 21:45 Emergency Department Diversion
Code Black- Power Failure
20:33
Code Silver- Patient Evacuation Decision
21:45
EMS resources on scene
11 units
Buncombe County Mass Casualty Bus on Standby.

11. Hospital Evacuation Immediate Evacuation vs. Phased Evacuation
Decision to completely evacuate at 20:45
Evacuation Numbers/Destinations
Harris- 18 adults, 2 newborns, 4 BHU
Mission- 2 acute adults & 7 from ED
Homestead- 1
13 Remaining BHU patients to Rutherfordton, Balsam Center and Kings Mountain
25 patients discharged

12. Hospital Evacuation Notification to area hospitals of a FULL DIVERSION
Public and Family Notifications (perception issues)
EMS resource management- All patients & staff moved by 03:10 hours the following morning.
Final BHU patient evacuations complete at 08:00 hours.

13. 1 meg generator to power 500 ton chiller

14. 2- 2 meg generators on scene to power the hospital

15. The NEXT MORNING
Establishing a mobile Emergency Department in the parking lot.
Resources needed to make this happen?
Mobile Tractor Trailer units (SMAT, MED 1, etc.)
Additional supporting tents (SMAT, DPR cache, etc.)
Restrooms, medical supplies, pharmacy, X-ray, labs, etc.
SIGNS
Public Information
Emergency Lighting
Staffing
06:10- Decision to deploy MED-1

19. Relationships Prior to the Incident
Local Emergency Planning Committee
Monthly Emergency Services team meetings with hospital administration
Multiple Exercises and consolidated training throughout the years.
Attrition at Hospitals, especially in key positions.

22. Completely out of main hospital for 3 weeks.
June 19- July hour operational periods at the command post.
August 17- Final electrical testing and return of primary hospital power. External support demobilized.
August 22- Hospital ICS terminated.

26. Communications Score of 3.58
Internal
I. Communications
YES NO
N/A
Was the appropriate staff notified when emergency measures initiated? (Code announced or paged) 8 2
Were emergency communications set up? 11 1
Were community emergency response agencies efforts incorporated/ coordinated? 10
Did the hospital communicate with patients and families during the emergency? 9 3
Did the hospital communicate to the media during the emergency?
Comments: Extensive effort and emphasis was placed on up-to-date information
Communications x x x x x Score
(Circle One) Poor Fair Good Very Good Excellent
Communications Score of 3.58

27. Resources/Assets Score of 4.0
Internal
II. Resources/Assets
YES NO
N/A
Did hospital have enough supplies on hand? (medical, pharmaceutical, emergency) 10 1 2
Did hospital manage support activities appropriately? (housing, transportation, communication, stress debriefing)
Did hospital obtain additional resources from another entity? (Corporate, another hospital, health department, etc.) 12
Resources/Assets x x x Score
(Circle One) Poor Fair Good Very Good Excellent
Resources/Assets Score of 4.0

28. Safety/Security Score of 3.91
Internal
III. Safety/Security
YES NO
N/A
Was adequate security provided? 12
Were emergency vehicles and personnel able to have access to all areas, equipment, and supplies required?
Were unauthorized personnel kept away from the areas? 11 1
Did facility take steps to identify and address hazards created by this event?
Safety/Security x x x x Score
(Circle One) Poor Fair Good Very Good Excellent
Safety/Security Score of 3.91

29. Staff Management Score of 3.78
Internal
IV. Staff Management
YES NO
N/A
Were provisions for the management of staff, including distribution and assignment of responsibilities and functions, adequate? 11 1
Was there adequate staffing and call-in response? 10 2
Was staff competent to perform assigned duties?
Was staff support needed, provided and adequate?
Staff Management x x x x Score
(Circle One) Poor Fair Good Very Good Excellent
Staff Management Score of 3.78

30. Utilities Management Score of 3.25
Internal
V. Utilities Management
YES NO
N/A
Were any of the following disrupted?
Electricity ( or Emergency Generator)
Water
Fuel
HVAC
Medical Gas/Vacuum Systems
Other (Specify): 12 8 7 4 5
If any of the above were disrupted, were the appropriate actions taken? Describe:
Numerous generators brought on site and wired in, outside support from CHS and DLP, periodic downtimes during testing and repairs Details in HICS documentation X
Utilities Management x x x x x Score
(Circle One) Poor Fair Good Very Good Excellent
Utilities Management Score of 3.25

31. Patient Clinical & Support Activities Score of 3.82
Internal
VI. Patient Clinical & Support Activities
YES NO
N/A
Were provisions for the management of patient including scheduling of services, control of patient information, admission, transfer, and discharge adequate? 10 2
Were all patients accounted for, triaged, and prioritized?
Was all necessary medical treatment readily available and adequate?
Was patient transfer plan effective?
Was temporary shelter needed? 5
If temporary shelter was needed but inadequate, please describe:
Was alternate care site needed?
If alternate care site was needed, was site identified and was it available, accessible and adequate?
If alternate care site was not identified, available, accessible or adequate, please describe: Local Hospitals
Patient Clinical & x x x x x Score
Support Activities
(Circle One) Poor Fair Good Very Good Excellent
Patient Clinical & Support Activities Score of 3.82

32. Overall Score for Incident from Internal Responses
3.74

33. Communications Score of 4.80
External
I. Communications
YES NO
N/A
Was the appropriate staff notified when emergency measures initiated? (Code announced or paged) 5
Were emergency communications set up?
Were community emergency response agencies efforts incorporated/ coordinated?
Did the hospital communicate with patients and families during the emergency? 1 4
Did the hospital communicate to the media during the emergency?
Communications x x Score
(Circle One) Poor Fair Good Very Good Excellent
Communications Score of 4.80

34. Resources/Assets Score of 4.4
External
II. Resources/Assets
YES NO
N/A
Did hospital have enough supplies on hand? (medical, pharmaceutical, emergency) 2 3
Did hospital manage support activities appropriately? (housing, transportation, communication, stress debriefing) 4 1
Did hospital obtain additional resources from another entity? (Corporate, another hospital, health department, etc.) 5
Resources/Assets x x Score
(Circle One) Poor Fair Good Very Good Excellent
Resources/Assets Score of 4.4

35. Safety/Security Score of 5.0
External
III. Safety/Security
YES NO
N/A
Was adequate security provided? 5
Were emergency vehicles and personnel able to have access to all areas, equipment, and supplies required?
Were unauthorized personnel kept away from the areas?
Did facility take steps to identify and address hazards created by this event?
Safety/Security x x Score
(Circle One) Poor Fair Good Very Good Excellent
Safety/Security Score of 5.0

36. Staff Management Score of 4.67
External
IV. Staff Management
YES NO
N/A
Were provisions for the management of staff, including distribution and assignment of responsibilities and functions, adequate? 3 2
Was there adequate staffing and call-in response?
Was staff competent to perform assigned duties?
Was staff support needed, provided and adequate?
Staff Management x x Score
(Circle One) Poor Fair Good Very Good Excellent
Staff Management Score of 4.67

37. Utilities Management Score of 4.67
External
V. Utilities Management
YES NO
N/A
Were any of the following disrupted?
Electricity ( or Emergency Generator)
Water
Fuel
HVAC
Medical Gas/Vacuum Systems
Other (Specify): 5 1 4
If any of the above were disrupted, were the appropriate actions taken? Describe:
The disruption only occurred due to the actual incident.
Temporary generators and security lighting was in place
Utilities Management x x Score
(Circle One) Poor Fair Good Very Good Excellent
Utilities Management Score of 4.67

38. Patient Clinical & Support Activities Score of 3.67
External
VI. Patient Clinical & Support Activities
YES NO
N/A
Were provisions for the management of patient including scheduling of services, control of patient information, admission, transfer, and discharge adequate? 2 3
Were all patients accounted for, triaged, and prioritized?
Was all necessary medical treatment readily available and adequate?
Was patient transfer plan effective? 1
Was temporary shelter needed?
If temporary shelter was needed but inadequate, please describe:
Was alternate care site needed?
If alternate care site was needed, was site identified and was it available, accessible and adequate?
If alternate care site was not identified, available, accessible or adequate, please describe:
The establishment of an alternative site was based upon the decision to divert patients to Harris Regional Hospital and Mission Hospital in Asheville.
Patient Clinical & x x Score
Support Activities
(Circle One) Poor Fair Good Very Good Excellent
Patient Clinical & Support Activities Score of 3.67

39. Overall Score for Incident from External Responses
4.47

40. Haywood Regional Medical Center
Questions
Thank You!