To: WATrac Co-Management. From: WATrac Advisory Group. Date: November 6, 2013

Transcription

1 T: WATrac C-Management Frm: WATrac Advisry Grup Date: Nvember 6, 2013 In December 2011, the WATrac Advisry Grup recmmended the frmatin f a Patient Tracking wrkgrup and charged them with develping a pilt prject t evaluate the usability f the WATrac Patient Tracking mdule. The wrkgrup, cmprised f representatives frm healthcare, emergency medical services, and public health in PHEPR regins 1, 3, 5, and 6, began meeting in March During the curse f the pilt prject regins 1 and 3 fund it necessary t discntinue active participatin. At the September 9, 2013 meeting f the WATrac Advisry Grup the wrkgrup prvided their decisins and recmmendatins fr the use f the WATrac Patient Tracking mdule. The backgrund and cmplete decisins and recmmendatins f the wrkgrup are included here as Addendum 1. Highlights f wrkgrup recmmendatins: 1. Statewide implementatin f the WATrac Patient Tracking mdule shuld begin during Fiscal Year 14; July 1, 2014 June 30, Prir t rllut in their regin, each regin will be required t cmplete a set f decisins regarding hw they will crdinate usage and prvide access t the mdule. 3. Implementatin shuld fllw a regin-wide apprach. If all cunties in the regin are unable t reach agreement n the necessary decisins, rllut can prceed with a minimum f 75% f the cunties in the regin. The wrkgrup fund the mdule t be user friendly and t capture the data necessary t track the lcatin and status f patients during an emergency, thereby facilitating family reunificatin. The WATrac Advisry Grup apprved the decisins and recmmendatins f the wrkgrup and is nw recmmending statewide implementatin f the mdule t c-management f the system; WA Department f Health (DOH) and Public Health Seattle and King Cunty (PHSKC). Implementatin f the mdule will require extensive planning and crdinatin with each f the regins rlling ut the mdule. The timeline fr cmplete statewide implementatin f the Patient Tracking mdule will be highly dependent n the ability f each regin t crdinate internally and t make decisins necessary t track patients. A draft implementatin utline is included as Addendum 2. Success f this implementatin will require cllabratin with a brad audience f healthcare and emergency respnders. A plan fr cmmunicating with these grups and establishing patient tracking partnerships will be develped upn apprval f statewide implementatin. Page 1

2 Addendum 1 Patient Tracking Wrkgrup Recmmendatins and Decisins The wrkgrup began meeting in March The bjectives f the grup were t: Evaluate usability f the WATrac Patient Tracking mdule Make decisins fr cnfiguring the mdule t supprt the needs f Washingtn healthcare Determine the decisins that all regins wuld need t make prir t using the mdule Frmulate recmmendatins t the Advisry Grup fr statewide usage f the mdule Participating members f the wrkgrup are: Anne Newcmbe Cassie Gleckler Chris Badger Chris Rck Cindy Mirn Cynthia Denny Eileen Newtn Glria Durant Heather Gding Lt Jsh Pearsn Martina Niclas Onra Lien Paula Hme Rbert Sabarese Sally Abbtt Sctt Fster Harbrview Medical Center Puget Sund Bld Center West Pierce Fire & Rescue Multicare Gd Samaritan Tacma Pierce Cunty Health Dept. Harbrview Medical Center FHS - St. Jseph Medical Center FHS - St. Francis Hspital Nrth Regin EMS and TCC Seattle Fire Department, Medic One Nrth Regin EMS & TCC Public Health Seattle & King Cunty Swedish Medical Center MHS - Tacma General Hspital Washingtn State Dept. f Health Tacma Pierce Cunty Health Dept. Access t WATrac Patient Tracking Access t Patient Tracking is prvided t staff f hspitals and ther healthcare agencies, public health jurisdictins, emergency management agencies and emergency medical services t supprt respnse fr a mass casualty incident. Permissin t view data held in Patient Tracking is granted nly t the level required by the persns need-t-knw, exclusively fr emergency respnse purpses. There are varying levels f access in Patient Tracking. Healthcare supervisrs and staff respnsible fr entering patients int the mdule will see all patient data. Other staff assisting with family reunificatin will see nly a patients name, age, and current lcatin. At rganizatins that d nt prvide a direct healthcare respnse rle, staff will see the name f the incident, number f patients, and the facilities and services active in the incident. N prtected health infrmatin can be viewed by thse withut a need-t-knw. If smene withut access t patient recrds requires additinal infrmatin abut a particular patient, the infrmatin can be prvided, if apprpriate, by a liaisn r ther persn with access t patient infrmatin. See Attachment 1, Permissin Descriptins, fr details n each permissin level. PT Wrkgrup Recmmendatins & Decisins Page 2

3 Definitins The wrkgrup develped several definitins that are carried ver t the recmmendatins f the grup. All definitins are in reference t the actins carried ut while using the WATrac Patient Tracking mdule r fr crdinating the use f the mdule nly. These definitins are nt intended fr brader usage r t replace any existing definitins. 1. Crdinating Agency - An agency that prvides crdinatin, leadership, expertise, and decisin making during a health and medical respnse. 2. Patient - an individual wh requires assessment and/r treatment as a result f their invlvement in an incident as defined by lcal plans Patient tracking - the prcess fr dcumenting and fllwing infrmatin abut a patient including the patient s physical lcatin and ther limited infrmatin abut the patient such as cnditin, dispsitin, and identifying infrmatin MCI Incident Type - When a Patient Tracking Incident is initiated in WATrac, invlved receiving facilities and transprting services are added t the incident. Facilities and services will see all patients added t an incident t which they have been added. 5. Nn-MCI Incident Type - A facility that has been added t an incident will see nly thse patients that are enrute, arrived, r discharged frm their facility. Services that have been added t an incident will see nly patients that they have transprted. 6. Emergency - Any sudden and usually unfreseen event that requires crdinatin r respnse beynd the rutine in rder t save lives, prtect prperty, safeguard public health, r t lessen r avert the threat f a disaster. Emergencies are incidents that threaten public safety, health and welfare. They range widely in size, lcatin, cause, and effect. The definitin f an emergency, the agencies invlved, and the prcedures used, vary by jurisdictin and are usually set by the gvernment agencies respnsible fr emergency planning and management. Washingtn State, in RCW , says: (6)(a) "Emergency r disaster" as used in all sectins f this chapter except RCW shall mean an event r set f circumstances which: (i) Demands immediate actin t preserve public health, prtect life, prtect public prperty, r t prvide relief t any stricken cmmunity vertaken by such ccurrences, r (ii) reaches such a dimensin r degree f destructiveness as t warrant the gvernr declaring a state f emergency pursuant t RCW Disasters - The Wrld Health Organizatin (WHO) defines disaster as a serius disruptin f the functining f a cmmunity r a sciety causing widespread human, material, ecnmic r envirnmental lsses which exceed the ability f the affected cmmunity r sciety t cpe using its wn resurces (ISDR). Disasters can be defined by: Quantitative analysis number f peple killed r injured, ecnmic lsses Access t Resurces given the same event, a smaller city r cunty may be verwhelmed while a larger city r cunty with greater resurces can easily manage Overall Impact there may be few deaths r injuries but enrmus ecnmic lss 1 Puget Sund Reginal Catastrphic Preparedness Grant Prgram Page 3

4 Recmmendatins f the Wrkgrup 1. Statewide implementatin f the WATrac Patient Tracking mdule shuld begin in Fiscal Year 14; July 1, 2014 June 30, Implementatin shuld fllw a regin-wide apprach. It will be necessary fr individual agencies r individual cunties within multi-cunty regins t secure buy-in frm the entire public health regin in rder t begin implementing the mdule. 3. Reginal Decisins - Each regin requesting implementatin f Patient Tracking will be required t cmplete the decisins listed belw. A Cncept f Operatins template is available t assist with these decisins. a. Identify which agency will be respnsible fr verseeing patient tracking, the crdinating agency fr patient tracking in the regin. Pssible respnsibilities: i. Mnitr healthcare system and ppulatin impacts ii. Identify/anticipate resurce needs iii. Assist with family reunificatin iv. Crdinate centralized patient tracking infrmatin v. Supprt crdinated public infrmatin vi. Serve as the single pint f cntact b. Identify which agencies have a need t be prvided access t WATrac Patient Tracking. Determine if they need edit r view nly access. i. See Attachment 2, Agency Access fr a list f agencies and their pssible respnsibilities. ii. Identify the rles and respnsibilities f the participating agencies. c. Define reginal circumstances fr activating and deactivating WATrac Patient Tracking. What circumstances will prmpt the creatin f an incident? Sme ptins t cnsider: i. A mass casualty incident (MCI) ii. Evacuatin f a healthcare facility iii. Circumstances that activate the DMCC r similar patient distributin prcess. iv. Mre than ne facility will receive patients v. Multiple incident lcatins When is an incident deactivated? Optins t cnsider: i. All patients have been mved frm the incident scene ii. N new patients have been entered int the system fr X hurs iii. General management f the incident has been deactivated iv. All patients have been transferred t a permanent facility r discharged d. Determine when and hw patient tracking will be initiated, i.e. in the field r at the receiving facility. e. Determine hw lng a patient will be tracked. 4. The lcatin where WATrac Patient tracking begins will be determined by each participating regin; at a receiving facility, r in the field. (This is based n varying preferences and capabilities f EMS reginally.) 5. Data entry in the field will be dne by direct data entry int the website. Handheld mbile cmputers cannt be used due t current sftware cnfiguratin and resurces necessary t upgrade the sftware. PT Wrkgrup Recmmendatins & Decisins Page 4

5 6. All patients being tracked in the WATrac Patient Tracking mdule will have a unique identifier, such as a wristband, applied in the field by EMS and wrn thrughut the incident. 7. Any unique identifier assigned t a patient in the field will be entered int WATrac at the receiving facility, if nt dne previusly. 8. Regins actively participating in the wrkgrup will be given the first ptin f when they will begin implementing the mdule thrughut their regin. 9. The wrkgrup hspitals will cnduct interagency drills during the remainder f FY13 t gather additinal input t assist with statewide implementatin. Decisins made by the wrkgrup After cmpleting thrugh discussin and evaluatin f the mdule and cnducting practice data entry, the wrkgrup cmpleted these decisins t supprt effective implementatin f Patient Tracking fr statewide usage and cllabratin during emergencies and disasters. 1. The lcatin where patient tracking begins will be determined by each participating regin; at a receiving facility, r in the field. 2. Data entry in the field will be dne by direct data entry. Handheld data entry devices cannt be used due t sftware requirements. 3. Participating regins will identify the reginal crdinating agency; i.e. the agency that prvides crdinatin, leadership, expertise, and decisin making during a health and medical respnse. 4. Washingtn has a transparent tracking system and will lean mre tward using the MCI prcess in an event rather than nn-mci. See Definitins abve. 5. As the ESF8 lead, public health shuld have full access t patient tracking data. 6. As a chartered disaster relief rganizatin, the American Red Crss shuld be given access t Patient Tracking data t assist with family reunificatin and patient identificatin. 7. Assigning access t Patient Tracking shuld be dne at the agency level after the initial agency accunt is activated by a System Administratr. 8. The fields n the Patient Search page will be: a. First Name b. Last Name c. Date f Birth d. Apprximate Age e. Gender f. Race 9. ID bands must be used t identify patients in all Patient Tracking incidents. 10. Expectatins f EMS fr use f PT: a. Put a unique identifier band n all patients b. If time is available enter basic identifying infrmatin c. EMS shuld have access t patient data (enter and view) t fllw up n their patients 11. Healthcare facilities will enter patient data as quickly as pssible after receipt f the infrmatin 12. The recmmended minimum data fields will be filled-in as available: a. Unique identifier Triage Number (required) b. Triage level c. Current lcatin/status d. Date & time e. Gender f. Age (apprximate) g. Name (if available) PT Wrkgrup Recmmendatins & Decisins Page 5

6 13. Other than fr the State tracking ut-f-state patients, incidents will be deactivated after tw weeks with n activity. The incident can be reactivated if there is a need fr fllw-up. 14. Prvide training t all Ambulatry Care agencies and Nursing Hmes s they have WATrac Specialists and access t PT. Outstanding Decisins 1. Nn-Standard Placehlders r randm fictitius names will nt be used t identify unidentified patients. What is the recmmendatin fr a statewide standard fr entering unidentified patients? Suggestins a. Each facility will fllw their existing internal standards fr disaster patient naming. (T prepare fr rapid patient thrughput during an emergency r disaster, sme facilities may have develped prcesses fr standardized, temprary patient naming with an updating prtcl nce identificatin, r true annymity, is cnfirmed.) b. Use identificatin uncnfirmed check bx t indicate unidentified/uncnfirmed patient name. 2. What is the definitin f the disaster threshld? 3. Hw is emergency defined, related t use f the Patient Tracking mdule? See definitins 4. What is the cmmunity threshld fr MCI r Nn-MCI? a. Is it agency specific r reginal? b. Need t set decisin pints fr determining an MCI PT Wrkgrup Recmmendatins & Decisins Page 6

7 WATrac Patient Tracking Permissin Grup Details Attachment 1 Permissin Grup Descriptin Capabilities Apprpriate WATrac Permissin Patient Tracking System Administratr Manages cnfiguratin, implementatin, and technical supprt fr the use f the Patient Tracking mdule. Perfrms all system settings and usage functins assciated with the Patient Tracking mdule. System Administratr Patient Tracking Incident Administratr Administratin f all aspects f incidents within their gegraphical area f respnsibility. Perfrms all usage functins assciated with the Patient Tracking mdule. WATrac Reginal Administratr ESF8 Respnder + Alerting Patient Tracking DMCC Crdinatr Guides patient distributin fr hspitals within their daily r enhanced areas f respnsibility, as utlined in the WATrac DMCC prcedures. Will view flw f patients but des nt add r edit patients. Can add & edit incidents, initiate incidents using Alert Manager, add facilities & services, and view all infrmatin n the patients tab. Can exprt data fr reprts. DMCC Patient Tracking incident Crdinatr Assists with incident initiatin and crdinatin and mnitrs patient mvement. May prvide reprts f incident status. Can add & edit incidents, add facilities & services, and view all infrmatin n the patients tab. Can view all incidents and all patients. Can exprt data fr reprts. ESF8 Respnder + Alerting ESF8 Respnder Patient Tracking Agency Administratr At the facility level this persn is respnsible fr verseeing the accuracy f patient tracking and ensuring that internal prcesses are fllwed. Can add, edit, and track patients and cmplete patient surveys. Can assign Patient Tracking permissin t user s accunts. Can exprt data fr reprts. WATrac Specialist Patient Tracking Agency Staff Enters patient tracking data fr their agency. Can add, edit, track, and search fr patients and cmplete patient surveys. Agency Supervisr Agency Staff Cmmand Center Specialist Cmmand Center Staff Patient Tracking Search Prvides supprt fr family reunificatin and situatinal awareness fr healthcare partners. Can view the Search Patients tab t search fr patients. Bed/Status Updating(+Reprting) Nursing Hme MAP Cmmand Center Specialist Cmmand Center Staff Healthcare Status Only Patient Tracking Incident Overview Respnse partners that need basic infrmatin abut the number f patients and the facilities and services invlved. Can see nly the verview tab. Cannt access patient infrmatin. Healthcare Netwrk Crdinatr Bed/Status Updating (+Reprting) Nursing Hme MAP Cmmand Center Specialist Cmmand Center Staff Healthcare Status Only Page 7

8 WATrac Agency Access Attachment 2 Participating agency: an agency respnsible fr entering, updating, r viewing patient tracking infrmatin in rder t crdinate, make critical decisins, r prvide supprt fr the respnse. Access t Patient Tracking is prvided t staff f hspitals and ther healthcare agencies, public health jurisdictins, emergency management agencies and emergency medical services t supprt respnse fr a mass casualty incident. Permissin t view data held in Patient Tracking is granted nly t the level required by the persns need-t-knw, exclusively fr emergency respnse purpses. Supprt agency: an agency that receives patient tracking infrmatin frm a liaisn such as a reginal lead r EOC Liaisn; they have n direct access t system data Participating Agencies: DMCC Crdinatin f patient mvement Receiving Facilities: Hspitals and Alternate Care Facilities Entering and tracking patients as they arrive, are transferred, r are discharged EMS and Ambulance Services Situatinal awareness Entering patient infrmatin Lcal Public Health and/r Lcal Emergency Management Situatinal Awareness Supprt fr call center and Family Assistance Center peratins T assist with identificatin f missing persns State Department f Health Situatinal Awareness Crdinatin f multi-jurisdictinal respnses T track patients that are mved ut f state Supprt fr call center and Family Assistance Center peratins Medical Examiner/Crner/Mrgue sites? May nly need t be a supprt agency T assist with fatality identificatin American Red Crss T assist with identificatin f missing persns T assist with family reunificatin Supprt Agencies: Law Enfrcement T assist with identificatin f missing persns Lcal Emergency Management if nt listed abve Public Infrmatin Officers Lcal/State Gvernment Vlunteers frm rganizatins such as Salvatin Army, chaplain service T assist with welfare checks and family reunificatin Page 8

9 WATrac Addendum 2 Patient Tracking Statewide Implementatin Draft Wrkplan Outline Octber 2013 Initial Cmmunicatins spaced ver 4-6 weeks What is Patient Tracking Wrkgrup backgrund Rll-ut plans Audience - public health, hspital, EMS, and emergency management agency cntacts, WATrac Reginal Leads, and Healthcare Calitin Leads Invitatin t each PHEPR regin t schedule an in-persn meeting and demnstratin Send t WATrac Reginal Leads Fllw-up within 1-2 weeks t determine pssible date, audience, etc. As each PHEPR regin sets a date, prvide cmplete instructins fr setting up the intrductry meetings Send t WATrac Reginal Leads and thers that have been identified as meeting crdinatrs Prvide assistance as needed Audience / Cntacts Hspitals Emergency Managers/Safety Officers ED Managers Directr f Nursing Educatin & Training Manager EMS Medical Services Officer Training & Exercise Manager Operatins Chief Lcal Public Health Lcal/Reginal Emergency Respnse Crdinatr Administratr Training & Exercise Manager State Public Health PHEPR Prgram Directr Emergency Preparedness Directr Cuntermeasures & Training Manager Medical Surge & Healthcare Calitin Crdinatr Emergency Management Directr Training & Exercise Manager Operatins Chief Patient Tracking Implementatin Wrkplan DRAFT Page 9

10 WATrac Reginal Intrductin t Patient Tracking In-persn intrductry meetings Schedule in-persn meetings fr each regin expressing interest Mdule demnstratin Review f participatin requirements and necessary decisins Q&A Meeting participatin encurage representatin frm all cunties; all sectrs Hspitals EMS fire and private Public Health Emergency Management Materials Final wrkgrup decisins & recmmendatins Summary f necessary reginal decisins (Cncept f Operatins template) FAQ WATrac - HIPAA disclsure in emergency situatins Any statement available frm legal cunsel Permissins descriptin & matrix - identifying patient tracking participants Identify partnerships and allies Develp a rle fr strng leaders in each regin Build reginal cntacts fr each participating agency Webinar meetings Reginal demnstratins and intrductry meetings shuld be dne in-persn t stimulate discussin and cllabratin Fllw-up discussins with regins will be cnducted via webinar. In-persn meetings can be held fr fllw-up if vernight travel is nt required r if finances allw travel. Reginal Implementatin Implementatin will be n a reginal basis. If all cunties in the regin are unable t reach agreement n the decisins, rllut can prceed with a minimum f 75% f the cunties in the regin. Cunties may pt ut f participatin, but will be unable t use the mdule until decisins and training have been cmpleted. PHEPR Regins 5 and 6 have cmpleted the necessary decisins and will be given first ptin fr implementatin. Reginal decisins All regins must determine hw they will crdinate usage and prvide access t the mdule Cncept f Operatins template will be prvided Assistance and examples will be available Decisins will be cmpleted befre reginal access is setup Reginal participants and cntacts All participating agencies will be identified cncurrently with the decisin making prcess Create accunts fr thse withut existing accunts Patient Tracking Implementatin Wrkplan DRAFT Page 10

11 WATrac Identify individuals within each agency that will serve as the PT pint f cntact If apprpriate t the healthcare sectr, determine wh the PT Agency Administratr will be Agency decisins Necessary internal crdinatin and usage decisins, examples f pssible decisins Wh shuld be given access; t what permissin level PT may cntain PHI; is an internal apprval prcess fr granting access necessary Wh will be respnsible fr data entry Wh will be the PT Agency Administratr r their backup Training Initial in-persn training will be prvided in each regin fr the PT Agency Administratrs One sessin cnducted fr eligible healthcare sectrs Train the trainer frmat Initial in-persn training will be prvided in each regin fr the PT Incident Administratrs & PT Incident Crdinatrs Fllw-up training In-huse training Reginal training Drill schedule Cnducted by PT Agency Administratrs r as determined by each regin Vides, cheat sheets, and user guides available Scenaris fr in-huse practice will be prvided Scenaris fr interagency drills and practice will be prvided Each regin will be requested t establish a drill schedule t stay familiar with the mdule Assistance can be prvided by the WATrac team fr reginal exercises utilizing PT Patient Tracking Implementatin Wrkplan DRAFT Page 11