Hospital Emergency Management

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

2. 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.

3. 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

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

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

6. 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

7. 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

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

10. 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.

11. HEICS Tools • Organization chart • Job Action Sheets • Forms

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

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

14. Command CenterDefines the mission and ensures its completion.

15. LogisticsProvides for a working environment and adequate materials to meet the overall medical objective.

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

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

18. OperationsCarries out the medical objective to the best of the hospital’s ability.

20. 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.

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

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

23. 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

24. Advance planning forMedical 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:

25. Advance planning forMedical Staff Director • 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. The Operations Chief will require written plans for:

26. Advance planning forIn-Patient Areas • 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. The Operations Chief will require written plans for:

27. Advance planning forTreatment 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:

28. Advance planning forAncillary Services • 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.) The Operations Chief will require written plans for:

29. Advance planning forHuman Services The Operations Chief will require written plans for: • 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. • 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.)

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

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

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

33. Advance planning forCommunicationsLogistics • 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...

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

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

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