Alternate Care Facility Planning Strategy Northern Virginia Emergency Response System

1. Alternate Care Facility Planning StrategyNorthern Virginia Emergency Response System Dan Hanfling, MD Director, Emergency Management and Disaster Medicine Inova Health System Richmond, VA December 2008

2. NVHA

3. From the files of Dr. David Goodfriend, Loudoun County Health Dept.

4. Planning ProcessInitial Steps Develop subcommittee under auspices of the MMRS (NVERS) Steering Committee • Co-Chair, Northern VA Hospital Alliance • Co-Chair, Loudoun County Health Director • NVHA Planner • Health Departments • No VA EMS Council • Emergency Management • Legal/Regulatory • Northern VA Medical Society

5. Planning ProcessEstablish Basic Assumptions • The most appropriate location for the delivery of acute medical care is in the hospital. • A primary role will be to accept patients within the established scope of care so as to free up beds in the hospital for more critical patients. • There will be a shortage of necessary health and medical resources and as a result standards of care will be altered across the health care spectrum.

6. Surge Capacity Planning ‘Conventional’ Surge Capacity ‘Conventional’ Standard of Care ‘Contingency’ Surge Capacity ‘Contingency’ Standard of Care ‘Crisis’ Surge Capacity ‘Crisis’ Standard of Care

7. Creating a Systems Approach Proposed Taxonomy • ACF – Triage (Community Based) • Telephone Triage • Integration of Outpatient Resources • ACF -T • ACF – Healthcare (ACF-HC) • ACF-Isolation (ACF-Iso) • ACF-Palliative Care (ACF-PC)

8. NVERS NVHA Inova MAC

9. Planning ProcessNext Steps • Local versus Regional ACF-T, ACF-HC • Emergency Management vetting process • Scope of Services • Site selection/’Stuff’ procurement • Staffing plan models (contractual?) • Fiduciary/Regulatory/Legal requirements • Test/Drill/Exercise

10. Dan Hanfling, MD Inova Health System dan.hanfling@inova.com 703-776-3002