Mission Continuity Management Team (MCMT) Meeting November 22, 2013 Mary Vassar, RN, MS

1. Mission Continuity Management Team (MCMT) MeetingNovember 22, 2013Mary Vassar, RN, MS

2. Background • BASIC is a 24/7 clinical, academic and research enterprise • Over 30 FTE – faculty, staff and post-doc trainees • 5 basic science laboratories with over $8 million in annual research funding • Housed on first and second floors of Building 1

3. How we started on Continuity Planning • Needed to be a dynamic process, not a document that is thrown together because approval is needed by the University • Needed to involve people throughout our organization working as a team -- rather than “Me” sitting at my computer working in a vacuum and writing a text book plan that would read perfectly to any outside reviewer

4. Action Items Prioritized Conducted Vulnerability Assessment for Research Labs: Action Item #1: Preserve Animal Colonies: coordinate plan with LARC to identify care needs and prioritize most irreplaceable animals in the event of loss of boarding capacity.

5. Action Items Prioritized Conducted Vulnerability Assessment for Research Labs: Action Item #2: Preserve Irreplaceable Specimens: 1) coordinate identification of high priority frozen specimens and cubic feet of space needed for off-site storage; 2) pre-event identification of on-site irreplaceable specimens for emergency relocation in the event of back-up power failure. Can’t prioritize at the time of the event.

6. Planning Elements for Preservation of Irreplaceable Frozen Specimens • Likely hazards to mitigate • Essential response capabilities and dependencies • Communications • Continuity of operations • Development of job action sheets • Process for addressing gaps • Exercise to test the plans and training procedures

7. Objectives for Day of the Exercise • Test emergency specimen relocation procedures to determine if: • Appropriate actions are identified in the plan & procedures • Necessary resources (BASIC & external/upstream) identified • Appropriate staff (BASIC & external/upstream) identified • Likely scenarios and logistical considerations addressed? • What type of training will other staff (new hires, lab, clinical and admin) need – i.e., beyond reading the procedures to implement? • How much time will it take to train other employees? • How frequently will staff need to practice to maintain familiarity with the procedures? • We are confident that we have done everything feasible to assure samples can be salvaged in non-catastrophic emergencies? • Hotwash to evaluate what worked and what didn’t and update and improve the Continuity Plan to integrate exercise outcomes.

8. Goal: Save high priority frozen specimens! Baseline - Prior to Planning and Exercise • What back-up procedures do we have for -80 freezers? • Bldg 1 back-up generator plugs • Dry ice from hospital supply or call Air Gas

9. The Exercise Scenario • Two years of drought in California • Water reservoir volumes are critically low, and statewide communities are rationing water use.

10. Saturday July 21, 2012 Statewide Power Reserves @ <1%

11. Saturday July 21st @ 8 PM: CA ISO Declared First Ever Stage 3 Emergency and Rolling Blackouts Initiated 16 Million Residential and Commercial Customers without Power. National Weather Service issued Excessive Heat Warning through Tuesday. San Francisco Los Angeles

12. Sunday July 22, 2012 • Nearly all BASIC lab faculty and staff are out-of-town at the Annual Meeting of the National Neurotrauma Society in Phoenix through Wednesday.

13. Sunday July 22, 2012 – 2 PM • Amity, Ellen, Xioakui and Tim are also going to Phoenix on a 6 PM flight as they all have poster sessions on Monday or Tuesday. • They all planned to meet at the lab to ride BART to the airport together and check the freezers due to concerns from news reports about rolling blackouts. • Lab temp is over 90 degrees & all freezers alarming

14. Sunday July 22, 2012Exercise Begins • 2:15 pm - Participants relocate to Freezer Bay • Participants have 45 minutes to work through the response plan. Creative problem solving is encouraged during play, however, decisions must be based on reality of the scenario and expected resources. • Facilitator will be providing scenario injects as you work through the response plan. • Remember to document times, problems, actions and decisions etc. We expect gaps to be identified, we aren’t expecting perfection.

16. Goal: Save high priority frozen specimens! Post Planning and Exercise • What back-up procedures do we have for -80 freezers? • Bldg 1 back-up generator plugs (power diverted to patient care bldgs) • Dry Ice from hospital Supply (allocated to patient care services) • Air Gas Delivery (overwhelmed & allocated to patient care services) • CO2 back-up system in the freezers (requires batteries and liquid CO2). • Dry ice chest with weekly delivery—(research requests will be low priority for allocating dry ice in a disaster) • Spare -80 Freezer is staged at Oyster Point (result of planning research and exercise) • For future action – send duplicate samples to remote biorepository

17. Responding kit

18. Specimen Preservation Decision Tree Yes Check Periodically Generators on? No Keep Door Closed CO2 Backup Yes Notify PI No “Save Me Box” Strategy Put in Dry Ice Chest

19. Freezer Disaster Logs

20. “SAVE ME” Freezer Boxes • Tissue specimen from current Projects • 1 set of cut tissues per project • Inventory updated periodically

21. “Save Me” Box Strategy • Implement only when Generators and CO2 do not activate. • Place in dry ice box (assure weekly delivery has arrived) • Place in Cooler with dry ice and relocate to Oyster Point • Located in the lower left hand corner of each freezer.

22. Importance of Details!

23. How do I access the freezer at Oyster Point’s Biorepository? • In an emergency, contact UCSF Police at 476-1414 • Request to go down the Oyster Point call out list • (Otherwise call Anthony Meno at (415) 476-5907, https://clsdsb2b.ucsf.edu) • Directions to OP • 101 South. • Take the Oyster Point Blvd East exit, and go east to Gull Drive. • At Gull Drive, turn right. • At Forbes, turn left, then an immediate right into the parking lot. • Park in a visitor spot in the lot at 612 Forbes in South San Francisco. • Come to the 612 Forbes door.  Ring the "Air Phone" button and someone will answer- six desks here have access to the air phone.  Someone will buzz you in.  Please sign in. • Freezer ID: • Property Number#072000185 • Model Number# ULT-25869SIA

24. Conclusions • Planning process has been critical to improving our ability to preserve research specimens • Conducting exercise (not just tabletop) made staff recognize how the details of the structures and processes need to be tested under a variety of scenarios • Experiences from Hurricanes Katrina, Irene and Sandy, 2011 Japan Earthquake and Fike Lab fire have increased faculty and staff awareness/buy-in for the importance establishing a culture of preparedness

25. Conclusions • There is a struggle to prioritize the time required for department staff and faculty to do effective planning and training on top of existing workloads • Support from Esther and UC Ready planning application have provided time saving tools and resources to get the work on our Continuity Plan done.

26. For more details: vassarm@neurosurg.ucsf.edu Thanks Everybody!