Second National Emergency Management Summit

1. Second National Emergency Management Summit Full Building Evacuation Presented by: Scott Aronson, MS Principal  860-793-8600 saronson@phillipsllc.com

2. Evacuation From a Healthcare Facility Is the EXCEPTION, Not the Rule

3. It Could Be More Dangerous

4. However, “Just in Case” • 2007 CA Wildfires • 2006 MA and NY hospitals & nursing homes • 2005 Hurricanes Katrina & Rita • 2004 Florida Hurricanes

5. Preplanned Methodology • Prepare patients within units / departments • Move to an internal Holding Area • Transport from the Holding Area to receiving facilities, or discharge

6. Key Components of the Plan • Activation of FBE Plan – Staff Awareness • Activation of a Labor Pool • Establishment of Internal Holding Areas • Coordination of Transportation (internal & external) • Patient Preparation on Units • Evacuation Path of Travel • Determination of Receiving Sites • Patient Tracking (internal and external)

9. Decision Making • Full Building Evacuation or Internal “Surge/Relocation” • Should staff call-backs go into effect (remember staff burnout)? • Are we transporting directly to EMS transports or can internal Holding Areas be utilized to stabilize and track? • Is this a regional incident or are we going to have local and state assets supporting us? • Is the building infrastructure impacted (earthquake, flooding, internal explosion, no power) • How does this affect means of travel? Vertical? • Are area healthcare facilities prepared for a surge? Was this initial thinking just completed without Incident Command in place?

13. Patient Preparation – On Unit • Complete top portion of the Patient Evacuation Tracking Form • Department-specific Plan should include: • Package chart (including MAR, face sheet & nursing notes) – customized for unique records in depts. – i.e. baby chart • Package with personal belongings (i.e. glasses, dentures, hearing aids, etc.) • Evacuation Stairs and Elevators specific to the unit • Medications and Supplies that MUST go • Special Considerations: • Intra-aortic Balloon Pump Patient • Ventricular Assist Device Patient • Non-ambulatory Bariatric Patient • Special Precautions • Staff to Patient Ratio (suicide risk; aggressive/violent; complex equipment)

15. Holding Areas • Holding Areas cleared prior to evacuation initiating

19. Green Holding Pick-up Behavioral Holding Pick-up Route 8 Yellow Holding Pick-up Police Roadblock Bus Staging – Blessed Sacrament Church - Roberts Street Red Holding Pick-up Ambulance Staging – Opticom Parking Lot - Grand Ave.

20. Priority of Evacuation • Consider: • Ambulatory • Non-ambulatory, low to mid acuity (stable) • Non-ambulatory, high acuity/high intensity • Non-ambulatory, unstable high acuity/high intensity/non-ambulatory bariatric • Consider (Behavioral Health): • Low Risk • High Risk - Suicidal • High Risk – Aggressive • Consider bypassing the Holding Area with those that should not be mixed with the general population

21. Once a Unit is Evacuated • Once evacuation of the unit / department is completed • Check unit / department to ensure evacuation is complete – YELLOW TAGS • Account for all staff • Direct all staff to report to the Labor Pool (or they may be leaving with patients) • Report evacuation status to the Command Center and the Holding Area • Deliver Patient Destination form to Command Center