CSC Indicators and Triggers for a Large, Urban Health Department:

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1 CSC Indicators and Triggers for a Large, Urban Health Department: The Chicago Perspective January 15, 2013 Suzet M. McKinney, DrPH, MPH Deputy Chicago Department of Public Health

2 Chicago Department of Public Health Established in 1835 Public health authority for the 3 rd largest city in the U.S. 2 nd largest municipal health department in the U.S. Charged with protecting the health of the city s nearly 2.8 million residents, workers and visitors

3 CDPH Approach to Emergency Response City/County, state and federal governments all have a role in emergency planning and response, but. All events are local Local public health agencies are expected to develop capacity to respond

4 CDPH Role in Emergency Response To lead the City s response to all threats of public health significance How do we do this? Monitoring disease trends (surveillance); Training and preparing the workforce to respond to all-hazards disasters; Fostering partnerships with other city agencies, state and federal governments, hospitals and other area public health/allied health partners; Leveraging resources (human, financial, etc); Working to affect improvements in education, training and communications capability. Provide event-specific information, resources and guidance to our partners during emergency events

5 Chicago Healthcare System Coalition for Preparedness and Response (CHSCPR) 36 Hospitals, full-service, specialty, and VA 125 Long Term Care Facilities Chicago Department of Public Health Chicago Fire Department/EMS Cook County Medical Examiner American Red Cross Illinois Department of Public Health Metropolitan Chicago Healthcare Council Other not- for- profit organizations (CHUG, PPERS) New this year: Primary care, surgi centers, peds

6 Chicago Healthcare System Coalition for Preparedness and Response (CHSCPR) Built upon a model of collaboration among city hospitals and healthcare organizations Facilitated by the Metropolitan Chicago Healthcare Council (MCHC) Governed by an Executive Committee made up of CDPH, MCHC and co-chairs of working committees Reviews, analyzes work of the committees Makes decisions about future work, initiatives and policies

7 Healthcare System Capabilities (pre- 2012) NIMS At-risk populations Education and Preparedness Training Exercises, Evaluation and Corrective Action Interoperable Communications Medical Evacuation/Shelter in Place HaVBED ESAR-VHP Fatality Management Alternate Care Sites Mobile Medical Assets Pharmaceutical Caches Personal Protective Equipment Decontamination

8 Healthcare System Capabilities (2012) Healthcare system preparedness Healthcare system recovery Emergency operations coordination Fatality management Information sharing Medical surge Responder safety and health Volunteer management

9 CSC Planning and Activities Pediatric Critical Care and Transport Stakeholder Summit (April 2010) Discussion of Peds scarce resources Scenario, discussion and action steps Peds Disaster Planning Workshop (April 2010) Lessons learned, ED surge, vent management, ethical dilemmas Public Health Scarce Resources TTX (April 2011) Pre-positioning of assets in hospitals and long-term care facilities (ongoing)

10 CSC Planning and Activities Hospital pandemic influenza exercise crisis standards of care module (2012) Identified preliminary CSC planning in hospitals Crisis Standards of Care project at Harvard NPLI (2012) Developed planning tools to advance CSC planning Core planning group development (2013) Planning stakeholder engagement meetings (2013) CSC Stakeholder s conference (Fall 2013)

11 Situational Awareness CDPH facilitates situational awareness and information flow across all response partners and healthcare orgs Public health Emergency management Facilitates situational awareness and information sharing with city leadership (conference call) Public health Hospitals HAN (alerts, treatment recommendations) Situational awareness conference calls HCRS radios WebEOC for hospitals (currently exploring)

12 Data Sources Epidemiological Data ESSENCE I-NEDSS Hospital Data Bed availability Syndromic surveillance S/A via survey (HAN) or phone conference EMS Data

13 Other Data Sources BioWatch Intelligence information Law enforcement Emergency management Media reports

14 Operational Changes Conventional Contingency Crisis Business as usual Situational awareness, as needed (PH-> EM -> healthcare) Review plans and policies, emergency plan activation as needed Verify resource inventory Verify contracts and purchasing vehicles Constant information flow (HAN, conference calls) Activation of CSC plans, COOP plans Emergency cache activation (hospitals, LTCs) Emergency procurements, MOUs and mutual aid agreements Activation of ESAR-VHP, medical evacuation, alternate care sites, alternate power sources, etc.

15 Guidance on Triggers Surge capacity Normal surge Proximity to extending beyond capacity Availability of other surge resources (ACS, LTCs) Supply chain/resources Ability to obtain additional resources Communication capability Compromised? Limited?

16 Guidance on Triggers Epidemiology Increased cases of unusual clusters of disease, Demand for care (EDs overrun, hospitals on bypass) Emergency response systems Compromised capacity Staffing levels Availability of healthcare volunteers

17 Questions? Chicago Department of Public Health

18 facebook.com/chicagopublichealth CityofChicago.org/Health