RESPONSE TO HURRICANE IRENE

Size: px

Start display at page:

Download "RESPONSE TO HURRICANE IRENE"

Delphia Reynolds
5 years ago
Views:

RESPONSE TO HURRICANE IRENE NORTH SHORE-LIJ HEALTH SYSTEM MARK SOLAZZO Executive Vice President and COO MARK JARRETT, MD Chief Quality Officer Session C26: These presenters have nothing to disclose 0

1 RESPONSE TO HURRICANE IRENE NORTH SHORE-LIJ HEALTH SYSTEM MARK SOLAZZO Executive Vice President and COO MARK JARRETT, MD Chief Quality Officer Session C26: These presenters have nothing to disclose 0 Objectives Describe the steps necessary to ensure the safety of patients, employees and the community during multiple emergency hospital evacuations Discuss the role of the Emergency Command Center and the vital aspects of ongoing internal and external communication 1 1

2 Early Warning & Planning Tuesday, Hours System Administration is notified of an increasingly high probability of a hurricane landfall on Long Island System Administration authorizes that an advisory notice be sent to all employees Public Safety s Emergency Management Division establishes conference calls with all critical infrastructure divisions Emergency Management briefs the following entities: Executive Directors Department Heads of Materials Management, IT & Telecommunications, Facilities & Engineering, Risk Management All departments are to begin activating emergency plans Hours to Landfall: Actions Begin Wednesday, Hours 24/7 surveillance of weather & hurricane 4-hour weather updates are issued Critical infrastructure departments are briefed twice daily Hospital evacuations are under evaluation Emergency purchasing and leasing begins System Administration places the Health System on a Level 1 HICS Health System EOC is opened Rapid discharge and surge plans are under review Employees advisories are upgraded to alerts Employees are advised to begin personal readiness actions 3 3 2

72 Hours to Landfall Thursday, 8.25.11 0800 Hours HIC

3 72 Hours to Landfall Thursday, Hours HICs Level 2 is ordered and all weather reports are confirming a L.I.-NYC landfall Evacuations appear likely to occur at SIUH North and South sites All critical infrastructure needs and requests are being filled All municipal emergency management agencies are consulted EOC initiates 24/7 staffing model Facilities leadership orders a stop work order on all construction sites All sites are to be secured within 24 hrs Union labor issues are considered Vendors and contractors are asked to provide their staffing models Employee alerts are increased to twice per day Executive conference calls occur every 4 hrs

system hospitals and Emergency Management Headquarters in Syosset Emergency generators are disbursed based on assessments by facilities and

4 48 Hours to Landfall Friday, Decision has been made to evacuate SIUH North & South and begin evacuating Southside Hospital, as well Emergency purchases begin to arrive at system hospitals and Emergency Management Headquarters in Syosset Emergency generators are disbursed based on assessments by facilities and engineering leadership Hospitals are asked to prepare staffing models and submit them to Emergency Management Hospitals are instructed to begin rapid discharges and surge plans are to be activated Executive leadership have suspended all elective surgeries through Tuesday

6 24-36 Hours to Landfall Final checks are being made with all system partners at our sites All equipment requested by the sites have been delivered A decision has been made to evacuate Southside Hospital Many nursing homes are seeking assistance in evacuations as well as area hospitals NS-LIJ staff is sent to these facilities to coordinate, evaluate and facilitate evacuations and/or sheltering Hours Out SIUH evacuations are completed Resources had been shifted east earlier as the need declined in Staten Island Southside evacuations completed NSHS begins to take additional evacuees from nursing homes in Nassau and Queens NSHS coordinates additional evacuations in Rockaway and to sites outside the Health System NSHS begins to take patients who refuse special needs sheltering Patient tracking and patient medical evaluations are the primary operations sector duties

7 During the Storm All transportation services and deliveries are suspended Facility damage assessments are conducted regularly Monitoring of utilities is constant, many facilities go to generator power Staff attendance shows no significant absentee rates No facilities are closed to emergencies, including the evacuated facilities Patients continue to arrive in Emergency Departments All NSHS Hospitals are reporting normal operations Post Storm There are no patient deaths that are the result of the storm The NSLIJ health system: Evacuated 947 patients Accepted an additional 245 evacuated patients from non-health system facilities Risk management and Finance have been dedicating time to recovery efforts including FEMA reimbursements and insurance claims

8 Summary 947 patients were evacuated from Southside Hospital and Staten Island University Hospital All evacuated inpatients were safely transported prior to the storm Southside Hospital and SIUH and both continued to keep their Emergency Departments open throughout the storm Post storm, all of the evacuated patients were safely discharged or transported back to their original facility depending on their medical condition 70 nursing home patients from seven different facilities in the Rockaways and Long Beach were accommodated at: North Shore University Hospital s Stern Center for Extended Care and Rehabilitation in Manhasset Long Island Jewish Medical Center Franklin Hospital Summary (cont d.) Nassau University Medical Center also accepted many patients from Long Beach Medical Center, which was also evacuated. North Shore-LIJ ambulances assisted Saturday evening with the transport of 125 patients from city nursing homes to Park Slope Armory and New York Methodist Hospital in Brooklyn, and Metropolitan Hospital Center in Manhattan. This was at the request of New York State Health Commissioner Nirav Shah, MD, and the New York City Office of Emergency Management In addition, numerous individuals who lost power in their homes showed up during the storm at North Shore-LIJ hospitals seeking shelter from Hurricane Irene

9 Opportunities Summary (cont d.) Train additional NS-LIJ staff as adjunct faculty to the Emergency Operations Center NS-LIJ will continue to expand our Ready -Set Go emergency preparedness initiative Continue to enhance employee communications Planning and Preparation Effective Strategies/Best Practices Early planning sessions and conference calls allowed time for leadership to make critical decisions. Mandatory TQLT meeting on Thursday proved effective in getting management focused on task at hand. Early assessment of facility vulnerabilities helped to visualize the threat to the hospitals. Early assessment of resources allowed time to increase par levels where indicated. Transfer of NICU patients immediately following evacuation order allowed for their safe and orderly transfer with and to the appropriate level of care. Implementation of HR Emergency Situation & Inclement Weather Policy effectively ensured adequate staffing levels

10 Planning and Preparation (cont d.) Opportunities for Improvement Existing forms used to categorize patients transportation needs, demographic information, and evacuation information proved difficult to work with Patient Care Units Managers were provided the next day with a more user-friendly form adapted from GNYHA Recommendations Improve the status reporting form in the Evacuation Plan using the adapted GNYHA format as a guide Stay Teams Evacuation Processes To address concerns that area residents may seek shelter and medical care during the storm, Stay Teams were expanded to include sufficient clinical staff to provide patient care, if needed Staffing plans were developed for the following to cover through Sunday night Dietary, sleeping, and parking arrangements were made to accommodate staff

11 Evacuation Processes (cont d.) Effective Strategies/Best Practices Coordinated effectively with the System to secure appropriate beds and transportation for all patients Patient relations created an effective chain of communication between hospital and patient family/friends Utilizing social networking, hospital website and HEICS hotline to communicate scheduling decisions with staff Patient safety was maintained throughout the evacuation process No patient or staff injuries Efficiently distributed four day supply of medication to transferred patients Evacuation Processes (cont d.) Effective Strategies/Best Practices Having a preexisting agreement (coalition) with other Staten Island facilities for mutual support in a disaster Have expanded Stay Teams in place to provide emergency medical care for surrounding community Provided printed information regarding nearest shelter location and directions for both North and South sites

12 Evacuation Processes (cont d.) Opportunities for Improvement Gaps in communication in patient transfer process Infrequent communication updates with on-duty staff No process in place to inform family members that were present during evacuation Improved tracking process for equipment loaned to other facilities The Main Conference Room at North Site was not conducive to implementation of Incident Command System Incident Command structure was not fully developed Key HEICS roles were not assigned No order of succession designated for relief of individuals in key roles Better communication with departments about labor pool use/function Better utilize staff support function as described in HEICS structure Recommendations Evacuation Processes (cont d.) Make better use of radio and Spectralink phones to communicate vertically among all levels of staff Better utilize technology to track patients and equipment Expedite relocation of Primary EOC to McGinn Education Center Incorporate a family reception/information area into the evacuation plan Designate areas for HEICS Sections with communication capabilities for each section Develop the role of EOC Manager to coach the Command staff during plan activations

13 Recommendations Evacuation Processes (cont d.) Resume ongoing education on the incident command structure for hospital leadership Provide more frequent communication updates with on-duty staff Provide education to unit staff regarding evacuation triage and transport needs Establish mechanism to assign physician and PCUM teams to expedite evacuation process Train staff on new processes and evaluate effectiveness in an exercise Recovery Effective Strategies/Best Practices Coordinated effectively with the System to quickly verify building integrity and resume occupancy Department and unit management communicated needs to aid in return to normal operations Patient repatriation process considered factors including patient condition and family needs and availability of proper level of care Patient repatriation process took into account patient needs, family requests, and availability of services at receiving facilities Setting priority order of re-opening departments and resuming services

Opportunities for Improvement Information regarding transferred patients was not easily accessible Equipment tracking and retrieval process could be better coordinated Recommendations Recovery (cont

14 Opportunities for Improvement Information regarding transferred patients was not easily accessible Equipment tracking and retrieval process could be better coordinated Recommendations Recovery (cont d.) Develop an evacuation database and improve Series application to populate this data base as patients are transferred Create process for identifying and tracking equipment as it is loaned to other facilities

L8: Emergency Preparedness

These presenters have nothing to disclose L8: Emergency Preparedness North Shore LIJ Health System Mark J. Solazzo Executive Vice President Chief Operating Officer James Romagnoli Vice President Protective