LBJ CHIEF OF STAFF EMERGENCY PROCEDURES

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2016 LBJ CHIEF OF STAFF EMERGENCY PROCEDURES

I. Overview LBJ Chief of Staff Emergency Procedure Updated April 2016 Table of Contents II. III. IV. Emergency Action Plan Staffing Plan by Service (RIDE OUT / RECOVERY) Resources V. Monthly Call Schedule (Updated with Current Month) LBJ Chief of Staff Page 1

I. Overview The intent of this plan is to provide the operating, reporting and communication procedures that will be utilized by the LBJ located UTHealth faculty and staff during a severe weather event located in the Houston or surrounding areas. Such severe weather events include but are not limited to, hurricanes, severe thunderstorms, and flooding. In the event of a severe weather event, the LBJ Hospital Medical Staff s primary responsibilities include providing appropriate coverage and caring for patients. The administrative staff s primary responsibility is providing timely and informative updates. II. III. Emergency Action Plan a. Upon issuance of a severe weather watch or warning, the procedures for Severe Weather/Emergency Management will initiate. b. Responsibilities include: i. The LBJ Chief of Staff will contact the Administrative Director who will contact the administrative support staff to provide updates. ii. The Communications Specialist will prepare Severe Weather/Emergency Communications correspondence as required and distribute accordingly. Information provided will include: 1. Updates to facility closures 2. Teleconference times and information 3. Other information as designated by the LBJ Chief of Staff or Administrative Director iii. All services will be prepared to activate RIDE OUT and RECOVERY plan (see III for details). 1. RIDE OUT the phase of the severe weather event in which traveling on area roads is hazardous. 2. RECOVERY the phase of the severe weather event in which the main threat has dissipated. iv. Each individual has a responsibility to remain safe and aware of their own surroundings. While roadways and conditions may be safe around LBJ Hospital or other locations, individuals must evaluate their own neighborhoods and make decisions based on their best judgment. See IV. Resources for other contact information. Staffing Plan by Service (RIDE OUT/RECOVERY) a. In a severe weather event, the following services will be required to have appropriate faculty and resident coverage during the RIDE OUT portion. This will be based on the monthly call schedule. The services will identify RECOVERY teams that will be prepared to relieve the RIDE OUT teams once conditions allow. See figure II.1 for details. b. The following is a list of services required to RIDE OUT. 1. Emergency Medicine/Trauma 2. Internal Medicine/Hospitalists/ICU 3. Family Medicine LBJ Chief of Staff Page 2

4. Pediatrics 5. Anesthesia 6. Surgery 7. OB/GYN 8. Radiology/Pathology c. All other services not listed above do not require RIDE OUT procedures but are expected to provide normal coverage during the RECOVERY phase of severe weather. d. Specific to hurricane severe weather incidents: 1. As hurricanes are identified in the Gulf of Mexico, all services must provide their most current call schedules to Medical Staff Services Office in order to ensure everyone is aware of which individuals will be on site for RIDE OUT. 2. The services will also provide the planned numbers of Faculty and Residents, along with names and contact numbers to cover both the RIDE OUT and RECOVERY portions of the hurricane event. 3. The Chief of Staff or Vice Chief of Staff will be part of the incident command and will RIDE OUT on site. e. The Community Health Program Clinics and outpatient clinics at LBJ will be closed based on a decision by Harris Health. Figure II.1. Medical Staffing Plan by service. Medical Staffing Plan By Service RIDE-OUT (R/O) RECOVERY Service SERVICE CHIEF # of FACULTY # of RESIDENTS COMMENTS # of FACULTY # of RESIDENTS COMMENTS Chief of Staff Chief of Staff/Vice Chief of Staff Anesthesiology Service Chief / Assistant Chief 1 3* Part of Incident Command R/O * and/or CRNA's. Will be part of the R/O team Comm. Health Programs Chief of Staff/Vice Chief of Staff 0 0 CHP's will be closed in a disaster Emergency Medicine Service Chief / Assistant Chief Varied Varied Family Medicine Service Chief / Assistant Chief 1 2 2 Attending s plus Mid-levels, and Residents total to cover Adult and Pedi EC as part of the R/O team Service Chief 2 Residents Surgery General Service Chief / Assistant Chief 1 3 Service Chief - E-1 1 PGY5 1 PGY3 1 PGY1 E-2 LBJ Chief of Staff Page 3

PGY-3- Ophthalmology Service Chief / Assistant Chief 0 1 Only available by phone. No in-house coverage. Orthopaedics Service Chief / Assistant Chief 1 1 Senior Resident 1 Junior Resident (those scheduled to be on call within 24 hours of expected landfall) 1 1 Senior Resident 1 Junior Resident Otolaryngology Service Chief / Assistant Chief 0 0 Otorhinolaryngology is not considered essential service during disasters Trauma Service Chief / Assistant Chief 0 0 Trauma will be covered by in-house surgical team 1 Resident in-house if there are any patients in the hospital/service. Urology Service Chief / Assistant Chief 0 1 1 Faculty / 2 Residents will be available by phone at all times for phone consults/emergencies - permitting they can get to the hospital if needed. 2 general medicine teams will be inhouse. The team on call the 24 hour period before the storm is predicted to make land fall and the next call team. Medicine Service Chief / Assistant Chief 2 2 Teams The teams will consist of the attending on service, and only the upper level residents, no interns. Only one of the 2 attending s on call will need to remain in-house Geriatrics/Palliative Service Chief / Assistant Chief 0 0 Covered by GIM Neurology Service Chief / Assistant Chief 1 1 Available Via Phone Psychiatry Service Chief / Assistant Chief 0 0 OB/GYN Service Chief / Assistant Chief 2 8 Oral Maxilofacial Surgery Service Chief / Assistant Chief 0 0 Psychiatry is not considered essential service during disasters (2 Residents at each level) Bases of operation will be BT and MHH. They will not be inhouse at LBJ during disaster. LBJ Chief of Staff Page 4

There will be one pathologist on site with access to clinical pathology consultation Pathology Service Chief / Assistant Chief 1 0 (if needed) via phone *all faculty in pathology will probably have to be on standby. it depends on the schedule and when a disaster comes. Pediatrics Service Chief / Assistant Chief 2 1 Fellow 2 Residents 1 Intern 1 Faculty for NICU 1 Fellow NICU for R/O 1 Resident NICU for R/O 1 FacultyPedi Ward/Newborn Nursery for R/O 1 Resident Pedi Ward/Newborn Nursery for R/O 1 Interns for Pedi Ward/Newborn Nursery for R/O 2 1 Faculty for NICU 1 Fellow for NICU 1 Resident for NICU 1 Intern for NICU 1 Faculty for PediWard/Newborn nursery 1 Resident for PediWard/Newborn Nursery 1 Intern for the Pedi Ward/Newborn Nursery Newborns will be discharge early, with mother who can discharge. The newbornswill have a early follow-up clinic approintment as a walk- in. Pediatric patients will be discharged, if possible with parent(s). The pediatric patients will have early follow-up appointment as walk-in NICU patients, in the Level 2 NICU, will be discharged, with parent(s), if possible. The Level 2 NICU patients will have an early follow-up appointment as walk in PM & R Service Chief / Assistant Chief 0 0 Not in house at LBJ Radiology (Diagnostic Imaging) Service Chief / Assistant Chief 1 2 Will be in-house as part of the R/O team Gyn/Oncology Service Chief / Assistant Chief 0 0 we would not plan to have any faculty or fellows remain inhouse at LBJH as part of the R/O team Oncology Service Chief / Assistant Chief 0 0 we would not plan to have any faculty or fellows remain inhouse at LBJH as part of the R/O team Medicine - Specialties Pulmonary/Critical Care Medical Director 1 1 Fellow In-House GI Medical Director 1 1 Fellow In-House Renal Medical Director 1 1 Fellow In-House Cardiology Medical Director 1 1 Fellow In-House Hematology Medical Director 0 0 Phone coverage LBJ Chief of Staff Page 5

ID Medical Director 0 0 Phone coverage Rheumatology Medical Director 0 0 Phone coverage Endocrine Medical Director 0 0 Phone coverage LBJ Chief of Staff Page 6

IV. Resources a. UTHealth Employees and students in Texas Medical Center i. 1.866.237.0107 ii. www.uthealthemergency.org b. UTHealth Employees and Students in Harris Health Facilities i. 1.888.305.2979 c. Each individual i. Radio Stations: KILT-AM 610, KILT-FM 100.3, KPRC-AM 950, or KTRH- AM 740 ii. Television Stations: KHOU 11, KHCW 39, KPRC 2, KRIV 26, KTRK 13, KXLN 45 and KTMD 47. iii. Major Houston roadway conditions: https://traffic.houstontranstar.org/layers/ V. Monthly Call Schedule LBJ Chief of Staff Page 7