Emergency Preparedness in the Workplace Presented By: Jacob M. McCarty, MPH, MPA March 9 th, 2018 1 Disclosure Jacob McCarty Financial Affiliations: Jacob McCarty is currently compensated to serve as the President & COO for Innovations Health Systems. 2 Background Current President & COO Innovations Health Systems Hospital CEO Children s Hospital of Northern California (CHONC) Previous Hospital CEO Kindred Hospital San Francisco Bay Area Hospital COO Kindred Hospital Westminster Administrative Residency Kindred Healthcare, Inc. Education & Credentials University of California, Davis BA University of Southern California (USC) MPA, Healthcare Administration University of California, Berkeley MPH, Public Health 3 1
About Innovations Health Systems Innovations Health Systems (IHS), LLC is a diversified healthcare company focused on providing high acuity care and products to medically fragile Californians. IHS owns and operates the Pediatric Recovery Network for catastrophically injured and severely disabled, machine dependent children, and is currently building California s first congregate living health community for catastrophically injured and severely disabled, machine dependent adults. 4 Emergency Preparedness in the Workplace 5 What is Emergency Preparedness to Me? 6 2
Emergency Preparedness Definitions 7 What is Emergency Preparedness? Preparedness is defined by DHS/FEMA as "a continuous cycle of planning, organizing, training, equipping, exercising, evaluating, and taking corrective action in an effort to ensure effective coordination during incident response." This cycle is one element of a broader National Preparedness System to prevent, respond to, and recover from natural disasters, acts of terrorism, and other disasters. Image retrieved from: https://www.dhs.gov/topic/plan-and-prepare-disasters 8 Key Definitions Emergency Immediate threat to health, life, property, or the environment Disaster An event that overwhelms local resources beyond those generally needed to respond to emergencies situations. Almost always affects the Public s Health and Well Being. Disasters can be natural, man made or complex. FEMA expects local jurisdictions to manage without additional assets for 72 hrs. Catastrophe Any natural or man made event that results in extraordinary levels of mass casualties, damage, or disruption that severely affects environment, economy, government functioning (Cabinet Office, nd.d) 9 3
Emergency Disaster Catastrophe Images retrieved from: https://www.thesun.co.uk/news/4127619/giant crane collapses in reading on an old primark as hundreds of shoppers are evacuated from city centre/, https://northdallasgazette.com/2015/08/29/10 years after hurricane katrina a look back at how 9 key players responded/ 10 Types of Disasters Images retrieved from: https://www.eqgroup.com/flood-insurance/, http://thinkingsidewayspodcast.com/tag/1918-flu-pandemic/, https://www.mirror.co.uk/news/uk-news/victim-911-identified-16-years-10949175 11 Turning Point Question Pulse Check #1 How many of you feel confident that the organization in which you work for has a competent and comprehensive strategy to effectively manage most emergency situations specific to your geographic location? A) I feel 100% confident B) I am about 75% confident C) I am about 50/50 on our organization s strategy D) I have no idea. 12 4
Why is this Information Important to Medical Professionals? Organizationally Professionally Personally 13 Image retrieved from: http://alumnihealthcarestaffing.com/ Historical Context Image retrieved from: : http://training.fema.gov/hiedu/docs/chapter%201%20-%20intro%20to%20crisis,%20disaster%20and%20risk%20mgmt%20concepts.doc 14 Natural Disasters Bring Changes to Emergency Management: 1960s Image retrieved from: https://www.cheatsheet.com/entertainment/john-f-kennedy-movies.html/?a=viewall 15 5
Increasing National Focus on Emergency Management: 1970s Image retrieved from:: http://training.fema.gov/hiedu/docs/chapter%201%20- %20intro%20to%20crisis,%20disaster%20and%20risk%20mgmt%20concepts.doc 16 FEMA in Trouble 1989 1992 Image retrieved from: : http://training.fema.gov/hiedu/docs/chapter%201%20-%20intro%20to%20crisis,%20disaster%20and%20risk%20mgmt%20concepts.doc 17 The FEMA/Witt Revolution: 1993 2001 Image retrieved from: http://training.fema.gov/hiedu/docs/chapter%201%20-%20intro%20to%20crisis,%20disaster%20and%20risk%20mgmt%20concepts.doc 18 6
Terrorism as the Major Focus: 2001 Image retrieved from: http://www.ibtimes.co.in/remembering 9 11 16th anniversarythese images twin towers attack still haunt world 741628 19 Post 9/11 Defense Spending 20 Creation of the Department of Homeland Security (DHS): 2005 21 7
Hurricane Katrina: 2005 Largest and 3 rd strongest hurricane ever recorded in U.S. 1,836 people died Displaced 770,000 residents CNN (2013). Retrieved from: https://www.cnn.com/2013/08/23/us/hurricane-katrina-statistics-fast-facts/index.html 22 Leading Up to the Katrina Disaster 23 Post Katrina Six Major Statutes Enacted Post Katrina Emergency Management Reform Act of 2006 SAFE Port Act of 2005 The Pets Evacuation and Transportation Standards Act of 2006 The Federal Judiciary Emergency Special Sessions Act of 2005 The Student Grant Hurricane and Disaster Relief Act The John Warner National Defense Authorization Act for Fiscal Year 2007 (Bea, Hogue, Halchin, Schwemle, 2006) 24 8
Post Katrina Emergency Management Reform Act 2006 (Fema, 2017) 25 Natural Disaster Economic Trends Long Term: 1900 2011 26 Natural Disaster Trends Short Term: 1980 2014 27 9
Natural Disaster Economic Trends Short Term: 1980 2014 (The Watchers, 2016) 28 Trial and Error Case Study: Hurricane Katrina 29 Trial and Error Case Study: Hurricane Katrina 30 10
Five Days at Memorial Sheri Fink, MD, PhD (Beaumont, 2014) 31 Turning Point Question Pulse Check #2 When considering all types of disasters (i.e. man made, natural, or complex) which one of the following do you fear the most? A) Terrorist attack B) 6.0+ Magnitude Earthquake C) Hurricane/Flood D) Forest Fire 32 Emergency Preparedness in the Workplace Today 33 11
Hospital Emergency Operations Plan Main Components (California Hospital Association, 2017) 34 Emergency Operations Plan Hazard Vulnerability Analysis (HVA) (California Hospital Association, 2017) 35 Hospital Incident Command System (HICS) Org Chart (California Hospital Association, 2017) 36 12
Community Response We are part of the national system: Individual Hospital Hospital System Community/County State Federal 37 Federal State Local Coordination President FEMA HHS, CDC, VA, etc. Governor s Office State Emergency Management Office State DOH Federal Local Official Local OEM LHD State Local Fire Police Volunteer Org and Vol Hosp Other 38 Thinking Outside the Box Optional EOP Support Tools Color Coded Flip Chart Synopsis: 39 13
Thinking Outside of the Box Optional EOP Support Tools Internal Emergencies External Emergencies 40 Thinking Outside of the Box Optional EOP Support Tools Comprehensive Contact List 41 CMS Emergency Preparedness Final Rule 42 14
CMS Emergency Preparedness Final Rule Effective Date November 15, 2017 Purpose To establish national emergency preparedness requirements to ensure adequate planning for both natural and man made disasters, and coordination with federal, state, tribal, regional and local emergency preparedness systems. (Centers for Medicare and Medicaid Services, 2018) 43 CMS Emergency Preparedness Final Rule (Centers for Medicare and Medicaid Services, 2018) 44 Joint Commission Standards for Emergency Preparedness vs. CMS Joint Commission Requires two active drills per year Requires log information during an incident so surveyors have reference point CMS Requires one active drill and one table top Tracking information during an incident that involved the outside community (Everbridge, 2015) 45 15
46 Individual Emergency Preparedness 47 Personal Emergency Preparedness Kit Image retrieved from: www.redcross.org/get-help/prepare-for-emergencies/be-red-cross-ready/get-a-kit 48 16
Final Thoughts on Personal Preparedness 49 Final Thoughts on Personal Preparedness 50 Multiple Choice Questionnaire #1. Continuity of operations planning is important for: A) Businesses B) Governments C) Schools D) All of the Above #2. Which one of the following is NOT a major component to the CMS Final Rule? A) Risk Assessment and Planning B) Communication Plan C) Color Coded Flip Charts D) Training & Testing #3. Which of the following is true regarding how to conduct a Hazard Vulnerability Analysis (HVA)? A) Must be specific to geographic location B) Must be done quarterly C) Should include as many risk events as possible D) HVA is not required 51 17
References Beaumont, P. (2014). Five Days at Memorial by Sheri Fink review. Retrieved February 21, 2018, from https://www.theguardian.com/books/2014/feb/17/five-daysmemorial-sheri-fink-review Chetwynd, E. (2017). CMS emergency preparedness final rule comes with penalties. Retrieved February 21, 2018, from https://www.everbridge.com/cmsemergency-preparedness-final-rule-comes-penalties/ Definitions: emergencies. (n.d.). Retrieved February 21, 2018, from http://www.who.int/hac/about/definitions/en/ Emergency Operations Plan (EOP). (n.d.). Retrieved February 21, 2018, from https://www.calhospitalprepare.org/emergency-operations-plan Emergency-Prep-Rule. (2018). Retrieved February 21, 2018, from https://www.cms.gov/medicare/provider-enrollment-and- Certification/SurveyCertEmergPrep/Emergency-Prep-Rule.html Get a Kit. (n.d.). Retrieved February 21, 2018, from http://www.redcross.org/get-help/prepare-for-emergencies/be-red-cross-ready/get-a-kit Hazards Vulnerability Analysis. (n.d.). Retrieved February 21, 2018, from https://www.calhospitalprepare.org/hazard-vulnerability-analysis Hospital Incident Command System (HICS). (n.d.). Retrieved February 21, 2018, from https://www.calhospitalprepare.org/hics Hurricane Katrina Statistics Fast Facts. (2017). Retrieved February 21, 2018, from https://www.cnn.com/2013/08/23/us/hurricane-katrina-statistics-fastfacts/index.html Plan and Prepare for Disasters. (2017). Retrieved February 21, 2018, from https://www.dhs.gov/topic/plan-and-prepare-disasters Post-Katrina Emergency Management Reform Act. (n.d.). Retrieved February 21, 2018, from https://emilms.fema.gov/is230c/fem0101200.htm Share and discover research. (n.d.). Retrieved February 21, 2018, from https://www.researchgate.net/ T. (2016). The world is unprepared for impending natural disasters. Retrieved February 21, 2018, from https://watchers.news/2016/04/26/the-world-is-unpreparedfor-impending-natural-disasters/ "UK Government Advice on Definition of an Emergency" (PDF). Archived from the original (PDF) on 2007-06-06. Retrieved 2007-05-30. Welcome to National Preparedness. (n.d.). Retrieved February 21, 2018, from http://training.fema.gov/ https://www.youtube.com/watch?v=zhmk8iedsrs&t=20s https://www.youtube.com/watch?v=ggzk32m47fk https://www.youtube.com/watch?v=iwvevsbhlbo 52 18