Disaster Management for Long Term Care Facilities Workshop

Transcription

1 Disaster Management for Long Term Care Facilities Workshop Tulsa, Oklahoma 11/17/2009 OKC, Oklahoma 12/3/2009 Michael Murphy OKC/Tulsa MMRS Director

2 Overview What is Medical Surge? Reality Check Proposed Process LTC Role

3 Medical Surge: The 800 lb. Gorilla

4 What is the definition of Medical Surge?

5 What is the definition of Medical Surge? Were not sure anyone really has the answer..

6 Background: The federal government began talking about surge after the Sarin attacks 1996

7 Background: The federal government began talking about surge after the Sarin attacks 1996 Post 9/11: Anthrax scenarios of 250,000

8 Background: The federal government began talking about surge after the Sarin attacks 1996 Post 9/11: Anthrax scenarios of 250,000 Followed closely by smallpox and the smallpox hospital

9 Background: The federal government began talking about surge after the Sarin attacks 1996 Post 9/11: Anthrax scenarios of 250,000 Followed closely by smallpox and the smallpox hospital Katrina MSCC and HRSA/ASPR requirements

10 Background: The federal government began talking about surge after the Sarin attacks 1996 Post 9/11: Anthrax scenarios of 250,000 Followed closely by smallpox and the smallpox hospital Katrina MSCC and HRSA/ASPR requirements Last, but not least, Avian Flu and now H1N1

11 Background: Through all of that, not a clear definition just proposed numbers and different ways of dealing with it. Shuttered Hospitals Alternative Care Centers MEMS STDS (HRSA) 500 Beds/million

12 How Others Deal with Medical Surge.

13 Reality Check #1: There is no switch. (Busy Hospital) (Alternative Care Centers)

14 Reality Check #2: They are still coming. Houston Example

15 Reality Check #3: Will the Hospitals Really Close? Doubtful

16 Reality Check #4: Alternative Care Centers Probably Won t Always Make a Difference.

17 Alternative Care Centers: WE GOT STUFF

18 Alternative Care Centers: WE GOT STUFF WE GOT PLANS

19 Alternative Care Center WE SORT- OF, KINDA, WOULD HAVE SOME STAFF WE HOPE WOULD ALL THE RESOURCES MAKE A DIFFERENCE?

20 Reality Check #5: The Response Community Cannot Solve This Problem Alone

21 The response community really hasn t been tripping over themselves to provide direction and leadership

22 We Can t Define IT But We Know There are Different Types of Surge.

23 Daily Surge THE DIVERT WARS

24 Seasonal Surge STACKED EMERGENCY DEPARTMENTS

25 Mass Casualty Surge System Intact

26 Evacuee/Shelter Surge

27 Surge: System Compromised PMAC--Katrina Sacred Heart--Ivan

28 Surge: Mild Pandemic

29 Surge: Pandemic with High Mortality and Morbidity

30 Basic Concept Stressed System

31 Basic Concept Stressed System Augment System

32 Basic Concept Stressed System Augment System Expand System Internally

33 Basic Concept Stressed System Augment System Expand System Internally Facility Expands Externally

34 Basic Concept Stressed System Augment System Expand System Internally Facility Expands Externally

35 NEHC Basic Concept Stressed System Augment System Expand System Internally Facility Expands Externally Triage Use of System Home Care Modified Stds.

36 NEHC Basic Concept Stressed System Augment System Expand System Internally Facility Expands Externally Triage Use of System Home Care Modified Stds. Out of System Care (warehouse)

37 Great So What Has All This Got To Do With LTC s?

38 LTC s Are Part Of The System Stressed System Augment System Expand System Internally Facility Expands Externally Home Care Out of System Care (warehouse)

39 Basic Premise Best place for sick or injured patients to be treated is within the existing health care infrastructure Rely heavily upon an existing healthcare infrastructure-based response that utilizes existing resources and space to create alternate areas of care

40 Capacity During Hurricane Gustav, the LTC system in the state was queried about current capacity.

41 Capacity During Hurricane Gustav, the LTC system in the state was queried about current capacity. The response was 1300 beds without any staff augmentation

42 Capacity During Hurricane Gustav, the LTC system in the state was queried about current capacity. The response was 1300 beds without any staff augmentation Over 2000 beds if additional staff could be provided.

43 NDMS LTC S Already Have Surge Experience 2005-Around 100 patients flown into Oklahoma City The vast majority of the Hospital Patients were LTC Patients 2008-Patients received from Gustav some LTC

44 Lets Go Back to IT Daily Surge Seasonal Surge System Intact Evacuee/Shelter System Compromised Mild Pandemic/Infectious Disease Severe Pandemic/Infectious Disease

45 Lets Go Back to IT Daily Surge--normal Seasonal Surge maybe discharge System Intact empty via discharge Evacuee/Shelter--resourceresource System Compromised--resource Mild Pandemic/Infectious Disease--discharge Severe Pandemic/Infectious Disease--resource

46 Evacuee/Shelter Use of personnel for assistance at shelter Expertise in caring for patients Use of specialized equipment/services Supplies/movement devices Showers/baths Pharmacy Movement of patients to LTC for temporary care

47 System Compromised LTC may be compromised/damaged Deflation of Hospital system with discharge to LTC Movement of LTC patients within system

48 Severe Pandemic/Disease Whatever needs to be done Bed space Staff Triage Centers Home Care Coordination

49 Response Actions RULE #1: Don t become part of the problem Evacuation Infectious Disease Precautions RULE #2: Take care of your patients, staff and self Power/Water Provisions Plan

50 Issues to Addressed The Incident Itself Weather, Flood, Quake, Illness The Consequences of the Incident Power/Water Absenteeism The System Response Recovery Discharge/Transfer Reimbursement

51 Catastrophic Health Emergency Plan (CHE) State of Oklahoma Statute to address a truly catastrophic public health incident Enacted by the Governor, approved by the legislature Provides the Commissioner of Health with broad powers. Very high trigger level

52 Modified Standards of Care Providing care during a catastrophic incident accompanied by a surge of patients may exceed available resources and require adjustments in normal resource management and triage The goal of response will be to optimize the use of available resources in relation to demands in order to provide a reasonable level of healthcare to those affected by the incident.

53 Questions/Comments?

54 Michael Murphy