CT REGION 4 LONG TERM CARE MUTUAL AID PLAN (LTC-MAP) Scott Barry / Scott Aronson www.phillipsllc.com Funded by: State of Connecticut Homeland Security Grant Program (HSGP) AGENDA General Introduction Timeline and Key Dates Plan Overview Data Collection Process and Website Emergency Reporting
Who is Russell Phillips & Associates? Since 1976 Fire, Emergency Management & Life Safety Code Compliance Exclusively for Healthcare 1,300 Healthcare Clients (representing more than 2,200 healthcare facilities) Provides SOC, Emergency Management & Fire Safety Services to more than 24 hospitals and 179 LTC facilities in CT Reviewers of Local & National Disasters 9/11, Tropical Storm Allison (Houston), Katrina, California Wildfires, Joplin and Springfield Tornado, Tropical Storm Irene, etc. National Committees Advisors on The Joint Commission Committee for Healthcare Safety NFPA 99-12 Healthcare Emergency Mgmt. Technical Committee NFPA 101 Voting Member Recent Incidents Tornados in Tuscaloosa & Moulton, AL (4/27), Joplin, MO (5/21) and Springfield, MA (6/1) Snowstorm/Power Failure New England Oct/Nov 2011 Hurricane/Tropic Storm Irene & Flooding Aug. 2011 7,000 patients/residents evacuated in NY alone Johnson Memorial Hospital Evacuation Earthquake in the Northeast US Blizzard January 12, 2011
Evacuation Case Study 105 103 9:00pm / Winter Northeast 1 Nurse, 2 Maint. & 1 Aide Respond 412 105 103 413 PT / OT 424 422 423 Break Room
You Must Be Ready Internally Incident Command System (HICS/HEICS/ICS) Full Building Evacuation Plan Get the patient to the sidewalk Influx of Patients / Surge Capacity Plan Acuity and Significant Diagnosis is a known entity Internal Emergency Operations Plan All other disaster-specific specific response protocols Isolation for 96 hours or greater
PLAN OVERVIEW Healthcare Participants Nursing Homes of Region 4 (and CCRCs) Stakeholders Hospitals EMS / Fire / PD Local Office of Emergency Mgmt. Local Public Health Department Suppliers Region 4 DPH / DEMHS / DSS
Plan Operation is 1 st within your town/city. Additional Support will come from your Region then other regions in a widespread disaster. Hospitals & Nursing Homes
Timeline & Dates Kick-Off May 2, 2012 Special Expertise Groups July 2012 Surge/Transportation Evac /Groups July / August 2012 Task Force Review Task Force Final Approval Data Collection Complete at On-site Visit WebEx August Data Entry by September Education/Tabletop October / November 2012 Full Scale Exercise Spring 2013 OVERVIEW Place and support the care of evacuated patients Provide supplies/equipment as necessary Assist with transportation of supplies / staff / evacuated patients Provide staffing support (whether a facility is evacuating or isolated)
RESPONSIBILITIES OF MEMBERS Memorandum of Understanding (MOU) Number and Type of Patients Type: What are you qualified to care for Surge Capacity Levels 10% of licensed beds Planning Purposes (not mandated) Activation of Command Center at Facility RESPONSIBILITIES OF MEMBERS Attendance/Participation at Meetings and Exercises Documentation: Resident Emergency Evacuation Form Patient / Medical Record and Equipment Tracking Sheet Influx of Patients Log
RESPONSIBILITIES OF MEMBERS Any additional State DPH or Joint Commission (where applicable) requirements Like to like evacuation: Level of Acuity Variable: Staff, meds and equipment going with patient Intent to ultimately link to other LTC-MAPs CT Regions 1, 2, 3, 5 MassMAP Region 2 Rhode Island Index Algorithms Overview Actions of Disaster Struck Facility (DSF) Patient Accepting Facility (PAF) / Lender Plan Activation & Communications Transportation of Patients Medical Records & Patient Information Staff, Pharma, Supplies, Equipment In need of or transportation of MOU Attachments
Scenario-based Focus Scenario 1: Single Facility / Regional Operations are intact Shelter-in in-place Evacuation Scenario 2: Single Facility / Regional Operations Challenged (ice storm, hurricane) Scenario 3: Multiple Facilities / Regional Operations Challenged Facility and Region ALGORITHM 1.1: Resource Requirements Avoid Evacuation 1.2: Evacuation Single or Multiple Facility 1.3: Evacuation Region Overwhelmed 1.4: Alert Notification System Activation Process 1.5: Communications Loop
Actions of Disaster Struck Facility Communication with 911 Number of patients to be transferred Specialized services requested Charge Nurse Criteria / Type of Transport (see Transportation Survey) Documentation What will go with them (Medical Records / Medications) Tracking Tools Actions of Patient Accepting Facility Patient under care of Patient Accepting Facility Communicate receipt of patients with the Disaster Struck Facility (if able) or a designated Long Term Care Coordinating Center
PATIENT CARE Summary of Care Categories Patient Care Levels Customization for all patient care levels Provides the DSF or LTC Coordinating Center the type of care that each facility can deliver Maintains patient continuity of care
Pt care level
Long Term Care (LTC) Coordinating Center * 12 Responders Required (Primary and Back-ups) JG3 Function of the LTC Coordinating Center Assist and coordinate patient placement Support patient tracking - Close the loop Assist with obtaining staff, supplies and equipment Assist with transportation of staff, supplies and equipment Interaction with local, county and state agencies Consistent media statement (with appropriate EOC) ENSURE EVERYONE IS ACCOUNTED FOR
Slide 30 JG3 Be sure you can talk in detail about "Closing the Loop" What tools do we have that can faciliate this ect Ie. Influx log, Diaster tag Jim Garrow, 4/29/2012
JG4
Slide 31 JG4 Be sure to mention that this is an example of Region 3 Moving forward an activation plan needs to be developed for Region 1 Jim Garrow, 4/29/2012
Section 5: Transportation Disaster Struck Facility will provide: Total requiring bariatric transport (Non- ambulatory and > 400lbs for EMS > 500lbs for JG5 Buses) Total requiring CCT / ALS / BLS Transport BLS for Transfer to Nursing Home Total Wheelchair Van/Bus Total for Standard Ground Transport Discharge to Home: Total Wheelchair Van/Bus Total for Standard Ground Transport JG6
Slide 33 JG5 Verify what they consider Bariatric! Is it all weight based. Stress if they are using bariatric beds/ commodes that they need to request bariartic transport very early in the incident. Ask your EMS providers how many bariatric ambulances they have in the region. I would be surprised if it is more that 6 Jim Garrow, 4/29/2012 Slide 34 JG6 Really work this! it is a great tool for them. Is this a hand out for them. I did workshops for them a few months back on Tranportation surveys and surge.most facilities should have accomplished this already. Jim Garrow, 4/29/2012
Section 6: Medical Records, Meds, Identification/Tracking Medical Record including MAR/Face Sheet New Chart started at Patient Receiving Facility Medications and Controlled Substances JG7 Wristband (or permanent marker) Name DOB or MR# (if applicable) Code Status (if currently on wristbands) Regional Patient Tracking (Complement Existing Systems)
Slide 36 JG7 Explain that in Joblin the LTC Facilities were using marking the resident names on their forarms Jim Garrow, 4/29/2012
Attachment E Forms JG8 Resident Emergency Evacuation Tracking Form Patient/Medical Record and Equipment Tracking Sheet Controlled Substance Receiving Log Influx of Patients Log Pharma / Supplies / Equip Request Form Section 7: Staff, Pharmaceuticals, Supplies, Equipment www.mutualaidplan.org for the Management of Coordinated through LTC Coordinating Center for Medical needs Non-medical needs are coordinated with local EOC or State EOC
Slide 37 JG8 Have handouts of Resident Emergency Evacuation Tracking Form Patient/Medical Record and Equipment Tracking Sheet Influx of Patients Log Jim Garrow, 4/29/2012
ANNEX I: MEMORANDUM OF UNDERSTANDING Introduction and Background Definitions Participation Patient Care Responsibility Payment for Services and Assistance Requests for Emergency Assistance Loans of Equipment, Materials, Supplies, Staff Legal Elements
Emergency Reporting Information Key contact during event Beds status and type Operational issues and specifics Transportation vehicles, capacity & deployment time Staff: numbers / type and deployment time Resources & assets you can provide Resources & assets you may need
As you type your facility s name, options will be offered in the dropdown menu
When you select the impact level for your facility, new description fields will appear as needed.
Data Collection from Members - Ensure Plan Success Transportation Survey 24/7 Contacts & General Facility Info Categories of Care Supplies / Equipment Transportation Vehicles (owned) Key Vendors for Supplies and Equipment Special Expertise Committees Clinical Group Categories for Type of Care Rendered Facility-specific Data Collection Clinical Information: Medical Information Accompany Patient Meds and Controlled Substances Resident Emergency Evacuation Form
Special Expertise Committee Transport/Supplies/Comm. Communication Redundancies Transportation Capability and Coordination Including Tracking Summary of Equipment and Supplies Data Collection Supply Capability Type and Available From (local / outside region) On-site Visit / Data Collection Eight (8) Facility Visits over Four (4) Days Two (2) visits per day for 3 hours each 3-44 Facilities will go to each location Presentation on critical actions to activate the plan Conduct surge capacity tour Complete the Transportation Evacuation Survey Workgroup on data collection / use of the website WebEx Session to support data collection
Timeline & Dates Kick-Off May 2, 2012 Special Expertise Groups July 2012 Surge/Transportation Evac /Groups July / August 2012 Task Force Review Task Force Final Approval Data Collection Complete at On-site Visit WebEx August Data Entry by September Education/Tabletop October / November 2012 Full Scale Exercise Spring 2013 Scott Barry / Scott Aronson Russell Phillips & Associates, LLC California / Connecticut / New York / Ohio / Rhode Island 860-793-8600 sbarry@phillipsllc.com / saronson@phillipsllc.com www.phillipsllc.com