HEALTHCARE DISASTER PLANNING FORUM Meeting Summary December 6, 2012

Transcription

1 HEALTHCARE DISASTER PLANNING FORUM Meeting Summary December 6, 2012 NOTE: SEE PAGE 4 FOR INFORMATION THAT HAS CHANGED SINCE THE DEC 6 TH HEALTHCARE FORUM. Present: (28) representing: County: PH Preparedness, Emergency Medical Svcs, Auxiliary Communications Svc, Fire & Emergency Svcs Hospitals: Healdsburg, Kaiser, Palm Drive, Sonoma Valley, St Joseph Memorial, Sutter Clinics: Alliance Medical Center, Sonoma County Indian Health Project, Sonoma Valley Community Health Centers, West County Health Centers SNFs: Apple Valley Rehabilitation, Cloverdale Healthcare, Creekside Rehabilitation, Fircrest Care & Rehabilitation, Friends House, Parkview Gardens, Santa Rosa Convalescent, Sonoma Acres Convalescent, Spring Lake Village, Summerfield Healthcare Center, Others: American Red Cross Sonoma, City Santa Rosa Fire, Santa Rosa Junior College (ACS site), Sonoma Developmental Center (ACS site) Facilitator: Karen Holbrook, Deputy Health Officer ACCOMPLISHMENTS since last meeting: MedNet monthly drills Satellite monthly drills CAHAN Quarterly drill 09/17/2012 Great Shakeout Statewide TTX with Virtual Joint Information Center (VJIC) training 10/18/2012 Great Shakeout Statewide Functional 11/01/2012 NHICS SNFs Training & TTX 11/15/2012 Great Shakeout State EX (limited play with few partners) Today Healthcare Coalition Questionnaire (due 12/14/12) RESOURCES for Healthcare Partners: Public Health website for Healthcare Disaster Planning Forum resources: county.org/health/topics/preparedness.asp CAHAN contact County CAHAN Administrator, at CAHAN@sonoma county.org EMSystems contact Theresa Lombardi, Coastal Valleys EMS Agency, , theresa.lombardi@sonoma county.org GETS/WPS/TPS sign up at Action Items: Ann Cadgene will send out the MRC Volunteer list to all hospitals, clinics, and SNFs on a monthly basis. If available, members will send photos of 10/18/2012 Statewide Exercise to Christine Love. Ann Cadgene will add Terry Scannell from Creekside to the HCDPF Distribution list. Christine Love will send members the Healthcare Coalition Questionnaire draft after today s discussion and submit by 12/14/12. DISCUSSION 10/18/2012 Statewide Exercise Functional Exercise Christine Love After Action Report o All partners were sent a draft After Action Report. Partners should review AAR and send comments to Chris Love. Comments from the Forum: o While working with EMSystems drills and emergency messages, only one person representing each facility needs to respond. Facilities should coordinate internally to decide who will respond for the facility on EMSystems. o While working with CAHAN, it was noticed that alerts continued to be received even after the person acknowledged receipt of the message. Participants commented that this system is not user friendly. o Healdsburg District Hospital has had staff turnover and is training new staff on emergency preparedness. They would like to be invited to watch other healthcare partners drill. Kaiser, Memorial, and Sutter will plan to invite Healdsburg to future drills. Medical Reserve Corps volunteers o Healthcare facilities should not contact Medical Reserve Corps volunteers directly for duty. MRC volunteers must be deployed through Public Health in order to cover them under the County s liability and workers compensation programs. Facilities should contact Public Health Preparedness if they need Medical Reserve Corps volunteers for drills or actual events. Public Health will contact the volunteers, track any information, and send a confirmed list to the healthcare facility. o All hospitals, clinics, and SNFs requested that the MRC active list be sent to them on a monthly basis. 1

2 Rainbow guide o The use of this guide during the functional exercise did not go well. It was noted that some numbers listed in the Rainbow Guide were for regular staff desk phones and those staff were not aware of their number being an emergency contact number. o Rainbow Guide to be revised in 2013 after the AAR is written. Chris is asking for feedback from partners. Communications o Facilities were asked to send all Situational Reports and Resource Request forms to the DOC. There are multiple communication channels in place for facilities to get their information to the DOC. Facilities can use the most efficient system available and should ask for a confirmation that their submittal was received. o West County Clinics and Santa Rosa Memorial Hospital encountered radio/frequency problems. They weren t able to be part of roll call because of isolated logistics problems. They expressed that radio communications are not functional right now and that emergency communications is vulnerable as a result. o In comparison to other exercises, this exercise had the best documentation and it was felt that we had the right people assigned to the right roles. o If you wish to share any photos from this exercise, please send them to Chris Love. Healthcare Forum Work groups: Hospital Mini Forum Bryan Cleaver o Proposed Hospital mini forum has not yet started. Bryan described potential planning topics and products the hospital mini forum might work on. o We might use the all hospitals HVA done in April 2012 as a way to focus on gaps. o Mini forum meetings could rotate to different hospitals to increase familiarity among participants. o Propose to meet every two months to develop plans and new products or systems focused on specific needs of hospitals. o Since smaller hospitals have different problems, we could give special attention to those concerns. o Recommendation was made to meet via WebEx and take one policy or plan at a time, and decide what would work. The group should get to know each other and share best best practices, plans including multi casualties, call back staffing, and identify tackling scenarios. Considerable sharing of plans, procedures, and AARs has already occurred. o Mini forum could review the internal linkages at hospitals between departments or staff who have different disaster response roles (eg: Emergency Dept and Safety Coordinator) or attend different disaster planning meetings (eg: Healthcare Forum and Emergency Medical Care Committee). o Theresa Lombardi of EMS will schedule the first meeting after the Holidays. Clinic Mini Forum Christine Love o This group started meeting by phone and webex in September and met 7 8 times in preparation for the Statewide exercises. They mostly discussed clinics role as field treatment sites. They will re start these meetings after the holidays. SNF Mini Forum Christine Love o This meeting was scheduled to start in August, but only one facility dialed in. PH will re start this group after the holidays, again with the telephone/webex meeting format. Training & Exercise Group (Gabe Kearney, Jane Barry, Clark Austin, Terry Scannell) o This group will begin to meet in January and Chris Love will send out an invitation in January. o The group will make arrangements for trainings already budgeted in the current HPP grant year (DMS Patient Tracking Tags & START Triage, ICS , PPE Don & Doff, Individual Crisis Intervention and Peer Support Training/Exercise). Additional trainings may be planned, including: continuity of operations facility lockdown, etc. o Creekside would like to add Terry Scannell to this committee. Healthcare Partnership Guide Work Group (Jerry Martin, Joan Rowe, Clark Austin) o This group will develop the Healthcare Forum mission, roles, goals, and description into a Partnership Guide pamphlet. Draft pamphlet to be presented to Healthcare Forum at a future meeting for edits, approval, and final distribution. o Chris will send out an inviting this group to meet in January. ACS Surge Planning (Malissa Opulencia, Karen Holbrook, Joe Clendenin, SRJC, Sutter Warrack, SDC, Jim Burr) o Chris Love will schedule a date in January and send out an invitation o This committee will review: Surge bed capacity, staffing, training, assessment, transportation, security, medical and non medical supplies needs for ACS Location of alternate care site large enough to accommodate a large patient surge, preferably the size of two football fields that is clear of utilities. 2

3 Map out the ACS sites, provide aerial photos, and periodically update this information Develop MOU s as needed Consider scenarios including: Hospital in rubble and patients need to be moved Assignment of MRC volunteers Scope, care, and mechanisms of the ACS operation Lab surge capacity at SRJC and the skill sets needed. SRJC staff becoming MRC volunteers, if needed Process for prioritizing resources Santa Rosa Memorial Hospital power outage lessons learned Jerry Martin & Kent Coxon Background: Thursday, 11/15/2012 at 9:28 am, Santa Rosa Memorial Hospital lost power. PG & E power to the hospital was lost 4 separate times in a 24 hour period. The emergency generators kicked in every time but there is a 10 second delay (allowed by Title 22). Trauma patients and surgical OB patients were not diverted until the 2nd outage that evening. The phones were out in the Admin and Support Services across the street (Montgomery Dr.) Additionally about 1,000 businesses and residents were affected by the outages. CT scanners, lab analyzers and other equipment went down but came back up shortly to normal with each outage. Staff were not working in the dark but there were a few areas in the hospital not supported by emergency power such as the public restrooms, where flashlights and signage were placed. We have purchased battery style camp lanterns since the event. Medication refrigerators were on emergency power, but the remote temperature monitoring systems went down so staff had to manually record temps twice a day. The influenza vaccine was in a medication refrigerator in the Employee Health office across the street. By the 4th PG&E outage the next morning that hospital management staff felt more comfortable operating the hospital command center. Outcome: Staff had learned much from the October 18, 2012 Functional Exercise and was able to apply their knowledge. SRMH management team was prepared to open a Command Center. Cases were delayed, but no one was hurt. Patients were transported to the closest trauma center in Napa. Everyone was receiving EMS reports. Comments: o This was a unique event and we were able to put into play what we have been practicing. o Looking back, EMS should have gone to SRMH sooner. o Sutter Hospital s flight path to SRMH is very close and transport worked well until we ran out of hospital space. The next trauma center close to SRMH is Napa. We need to figure out what to do when we no longer have access to an aircraft. One hospital connection was missed that resulted in a 20 minute delay. o SRMH did a good job. Communication was good between management, staff, and other hospitals. It took Kent 15 seconds to send out the blast message on SRMH status. This information should be shared between other healthcare facilities because they could potentially also be impacted. During the outage, other hospitals were kept informed of SRMH situation. Kent will work with Bryan to write an AAR. o Kaiser had an incident the day before where they lost their power and paging system. They were unable to communicate with their Rohnert Park clinic. During this incident, they found the need to order other emergency equipment. o City Healdsburg encountered a PGE blowout that occurred next to Healdsburg Hospital. Since they buy their power, this was handled as first priority and didn t create any problems. From these incidents, we found these questions need answering: What point in time do you call all clear to resume power? When you re transporting by helicopter, what pads should you use? Disaster Council Meeting Highlights Brentt Blaser, County Dept of Fire & Emergency Services October 18 th Great ShakeOut Exercise: This was our first county wide collaborative exercise since 2002, and we had 34 cities and other agencies participating. COPS The Op Area EOC used the COPS (Common Operating Picture System) software for the first time. This system is set up like a dashboard displaying a scrolling list of ongoing incidents in the larger event. COPS is used only in the County EOC and is meant to help all EOC staff have current incident information. Some of the EOC face to face interaction was lost. More program development and training needed. Also need to plan for common operating picture info sharing when technology or power fails and when there is job turnover of trained staff. VJIC The Op Area EOC also tested a Virtual Joint Information Center (VJIC) for the first time. The VJIC is a secured Google website where PIOs from any agency can share and view public message information or contact PIOs at other facilities or agencies. Passwords to the website are granted by County Dept of Fire & Emergency Svcs and PIOs had been encouraged to register in advance. During the exercise, many PIOs wanted to register, which took up a fair amount of the EOC PIO s time and slowed down PIO information exchange. It is expected that over time as more PIOs register, they will access information more quickly and effectively. The VJIC is not meant to be used for posting Situational Report information, though some facilities posted their status here. More training will be needed. VJIC was very successful for most participants. 3

4 Homeland Security and UASI Grants: Homeland Security funding is trending downward while UASI is getting more funding. Public Health Lab is applying for UASI funds for a piece of lab equipment. Regional logistics planning for earthquakes continues. Functional Needs Support Services: County Risk Management is working with the ADA transition team for county planning across departments. Will be using new DOJ and FEMA guidances and lessons learned from Hurricane Sandy. Healthcare Coalition Questionnaire Chris Love Healthcare coalitions across the country are being asked to complete a questionnaire designed to identify the composition, infrastructure, operations, accomplishments, and challenges of healthcare coalitions nationwide. The survey is to be completed online by December 14 th, 1pm. Chris filled in a draft questionnaire and passed around copies at today s Forum. If you get a chance to review it today and provide input, please write your comments onto the draft questionnaire and sign off on the roster sheet that you have reviewed. Chris will revise the draft questionnaire today and send to Forum partners by . Please reply by Dec 13 th if you have any input. Peg Plan Agreements status Chris Love Partners need to turn in their signed agreement by the end of December. Unused funds will be rebudgeted after January. Six facilities have not signed their agreement yet check with Chris to see if your facility has completed Peg paperwork. Radio Project status John Wise/Ann Cadgene Effective January 1, 2013 The Federal Communication Commission is requiring narrow banding of Public Service radios. All of the radios purchased with HPP funds were originally programmed with REDCOM dispatch frequencies, which are part of the public safety band, so they need to be either narrow banded or deleted. At the same time, facilities have been bringing in their radios to have the new Health public safety frequencies programmed in by Sheriff s Communications Unit. Currently about half of the radios are re programmed. The dispatch frequencies have been eliminated altogether (later we can look into purchasing scanners for facilities that might still need to monitor dispatch activity, if this is an HPP grant priority) and the new Health Net frequencies have been added. What we didn t expect was that the ham frequencies have been deleted. The Sheriff s Dept felt that their technicians were at risk of liability for working on radios that would be issued to health facilities without verifying that they are ham licensed. While this might be debatable, it was not possible for Sheriff to take on this liability. Instead, we will try to buy a replacement ham radio for each facility. NOTE: THIS INFORMATION HAS CHANGED SINCE THIS MEETING. PUBLIC HEALTH MET WITH SHERIFF AND COUNTY EMERGENCY SERVICES AND DECIDED TO FOCUS ALL EFFORT FIRST TO CONTINUING WITH THE HEALTH NET SYSTEM, GETTING ALL FACILITIES SET UP AND ANTENNAS INSTALLED. AFTER THAT WE WILL REVIEW BENEFIT OF RESTORING HAM RADIOS. SEE SEPARATE FROM CHRIS LOVE ON THIS SUBJECT. Kaiser Medical Center would like their Packet Radio package. Other hospitals were not interested in obtaining their package now and will wait until we finish with the radio problems. Flu Season update Karen Holbrook In the United States, overall it is an early Flu season. We are seeing high levels of flu in patients in the East, South and Midwest. In California there has been some but not a lot of flu activity; there have been two deaths but not in children. In Sonoma County, we are starting to see laboratory confirmed cases. Our vaccines are a good match for the strain of flu that is circulating. The take home message is to get vaccinated. Dr. Silver has sent out a health order for health care facilities to vaccinate their health care personnel. There has been some media attention on a scientist saying that flu vaccine in general is less effective than advertised and that better studies are needed to develop better vaccines. Although not 100% effective, flu vaccine is the best tool we have at this time. Transitions: Karen Holbrook New addition to Department of Health Services Lynn Silver Chalfin County Health Officer New addition to Department of Health Services Karen Holbrook, Deputy Health Officer Retiring from Department of Health Services/EMS Kent Coxon Retiring from Department of Health Services/PHP Ann Cadgene Roundtable County Sonoma Indian Health Project Our radios were turned into Sheriff Communications today for reprogramming. Healdsburg District Hospital We are preparing for our Community Disaster Preparedness Fair in June. American Red Cross and all our City partners as well as our local vendors that supply us with emergency supplies are invited. County Sonoma/ACS Jeremy extended an invitation to partners that need assistance with their radios. 4

5 West County Health Center Our facility was awarded UASI money to purchase a disaster trailer. Sonoma Valley Community Health Center We have changed to a new Electronic Medical Record System. We have hired Denise Dyer as our new PPO. Kaiser Permanente Medical Center We recently had a drill where staff participated and we found that our system worked and everything ran smoothly. Calling 911 and MHOAC used to be a mind boggling process, but Kent has smoothed this out and has been very helpful during disasters. We will miss him. We are very appreciative of the communication efforts across all sectors. Parkview Gardens This is my first meeting and I have much to learn. County Sonoma/EMS (Kent Coxon) It has been a pleasure working with this group and appreciated the support from Public Health Preparedness. Santa Rosa Junior College We are glad to be involved in this committee again and we are working on the ACS site. American Red Cross Sonoma They were able to watch the Disaster Medical Action Team in action recently. This medical team includes our own doctors and we were able to see how they set up and do not have to rely on anyone. Palm Drive Our hospital is going through many transitions. We hired a new Disaster Preparedness Coordinator. Friends House We are excited about our transitions. Effective 5/1/2012, we have a new management company. We are also in a transitioning phase. We attended the NHICS Training on Nov 1 st. Sutter Medical Center We are looking to hire a Safety Officer. Spring Lake Village We attended the NHICS Training in Cloverdale. It was great and we learned a lot. We have now entered into our master plan phase for disaster planning. Next Meeting February 21, :30 am to 12:00 pm North Coast Builders Exchange 1030 Apollo Way, Santa Rosa, CA Attachments 1. Acronyms & Abbreviations for Health & Medical Emergency Preparedness RESOURCES FOR HPP PARTNERS: Public Health website for Healthcare Forum resources: county.org/phpreparedness Subscribe for updates. CAHAN contact County CAHAN Administrator at: CAHAN@sonoma county.org EMSystems contact Theresa Lombardi, Coastal Valleys EMS Agency, , theresa.lombardi@sonoma county.org GETS/WPS/TPS sign up at: PH Website for Registration for Events/Trainings/ and Exercises county.org/health/ph/phpreparedness Sonoma County Health Radio Net: bruce.robbins@sonoma county.org; HPP Peg Plan: claire.etienne@sonoma county.org HPP Program Administration: Christine.love@sonoma county.org 5