Canterbury Primary Response Earthquakes Sept/Feb/June

1. Canterbury Primary ResponseEarthquakes Sept/Feb/June Dr Phil Schroeder Primary Care Coordinator Canterbury Primary Response Group Kelly Robertson Nurse Leader Canterbury Primary Response Group

2. Pre-historic Lessons

3. Managing It

4. Emergency Planning: Whole of Health Response

5. Canterbury Primary Response Group Agencies and Funders • Ministry of Health • Canterbury District Health Board • Hospital & Secondary Care • Community and Public Health • St John • City Council & Civil Defence • Aid Agencies e.g. Red Cross • Mental Health NGOs • Private Hospitals • Hotels • Media & Communications Primary • Primary Health Organisations • General Practice • 24HS & After Hours Clinics • Pharmacy • District Nursing + Home Care • Plunket • Maori Community Health • Allied Health Workers • Rest Homes • Radiology & Laboratories

6. Canterbury: the safest of havens.

8. Canterbury and NZ 2010 and NZ 2009

9. September 4th 2010: Magnitude 7.1 • Mass casualties/injuries but no fatalities. • Building damage Selwyn, Kaiapoi, ChCh and CBD. • Liquefaction Kaiapoi and ChCh. • Power out for up to one week. • Water, Sewage out for several days – months.

10. Lessons September 4th 2010 “7.1” Selwyn Quake LUCKY?

11. Emergency Planning Relationships

12. Emergency Planning: Mandate Given 17th February • Health Emergency • Influenza Pandemic • Infectious Outbreak eg. SARS • Non Health Emergency • Earthquake • Flood or Tsunami • Rugby World Cup • Health Non-Emergency • Measles Outbreak • Noro-virus Community Outbreak

13. 12:5122ND FEBRUARY 2011

14. February 22nd 2011: Magnitude 6.3 • Vertical acceleration quake among highest ever recorded. • Mass casualties with 181 fatalities. • Building damage ChCh and in particular CBD with monumental collapse. • Liquefaction ChCh. • Power out for up to two months plus. • Water, Sewage out for months.

23. The Response Phase - Immediate • Pegasus Health 24Hr Surgery • Staff safety • Patient safety • Building safety • Continuity of services

24. The Response Phase - Immediate cont: • General Practice • Staff safety • Patient safety • Building safety • Continuity/cessation of services

25. The Coordinated Primary Care Response • Incident Centre coordination • Assessment of GPs and Pharmacy’s ability to provide service • Support for affected services • Staff and practice welfare

26. Practice and Pharmacy Status Definition

27. Practice and Pharmacy Status

28. Providing Care • Affect on Staff • Personally affected but continued to work • Affected services struggling with limited resources • The clean up • Lack of essential services • Safety of vaccines

30. Providing Care cont… • Decreased ability to perform at peak – “earthquake brain” • Increased risk of misdiagnosis • Coping with own stress with aftershocks in the work environment • Loss of business due to patients relocating

31. Providing Care cont… • Affect on Patients • Access to service • Less people presenting but longer consultations required • Health not priority due to disruption of homes and livelihood • Relocating – loss of continuity of care

33. Staff Support • Ongoing……….. • Funding options to support patient care • HR support/Pastoral care • Counseling support for staff • Regular communication to General Practice and Pharmacies • Buddy system • Locum relief

35. Issues for Pharmacy - Business Continuity • Co-location • Relocation • Insurance Limitations

36. Issues for Pharmacy - Business Continuity

38. Issues for Pharmacy - Business Continuity

39. Issues for Pharmacy - Business Continuity

40. Issues for Pharmacy - Business Continuity

42. Critical Issues February 2011 Day One Day Three Day Six • General Practice • Comms Building • Power Computers • Portaloos • Pharmacy • Comms Building • Power Stock • Portaloos Stock • District Nursing • Building • Cordon Access • Cordon Access • Primary Coord • Comms Building • Comms Building • Comms

44. Critical Issues February 2011 Day One Day Three Day Six Day Ten • General Practice • Comms Building • Power Computers • Portaloos • Portaloos • Pharmacy • Comms Building • Power Stock • Portaloos Stock • Portaloos • District Nursing • Building • Cordon Access • Cordon Access • Fuel Staffing • Primary Coord • Comms Building • Comms Building • Comms • Roles

45. Rural Canterbury • Day Three • Rural Canterbury • Day One • Rural Canterbury • Day Six • Rural Canterbury • Day Ten Critical Issues February 2011 • Situation: Survey 100% Open. • Situation: Survey 100% Open. • Situation: Survey 100% Open. • Situation: Some Minor Building Damage. NO Loss Power, Water, Sewage • Problems: • 1) Huge numbers displaced patients and unprecedented consult rates. • Problems: • 1) Ongoing huge numbers displaced patients and ongoing high consult rates. • Problems: • 1) Rising numbers displaced patients and consult rates. • 2) Fuel needing farming coop. • 3) Resupply medication and courier issues. • Action: Practice Survey 100% Rural Practices Open.

46. Earthquake Response February 2011 Day One Day Three Day Six Day Ten • General Practice • 33% • 79% • 85% • 96% • Pharmacy • 21% • 80% • 83% • 94%

47. Earthquake Response February 2011 Red Practices: Major Issues 7% Day 15: 103 Open = 96% 1 Relocating 2 Closed Amber Practices: Serious Issues 34% Green Practices: Minor or no issues 59%

48. Earthquake Response February 2011 Day 15 Week 8 3% 7% Week 8: 105 Open = 99% 8 Relocated 1 Closed 31% 34% 66% 59%

49. Earthquake Response February 2011 General Practice Pharmacy 17% 3% Week 8 34% 31% 49% 66%

50. Canterbury Quakes: Sept, Feb, June