WALES CRITICAL CARE & TRAUMA NETWORK (North) EMERGENCY PLANNING GROUP Thursday 1 st February 2018 14:30-16:30hrs Venue: Room 3, Residents Block, Abergele Hospital Minutes Present: Chris Littler, Consultant Intensivist, ICU, WM Chairperson Ian Johnson, Consultant Intensivist, YG George Bugelli, Consultant Intensivist, YGC Sue O Keeffe, Wales Critical Care & Trauma Network Manager Emma Bins, Business Continuity Manager, BCUHB Nicola Vaughan-Jones, PDN, YG In Attendance: Rachael Thistleton, Wales Critical Care and Trauma Network Administrator, Minute Taker 1. Welcome and Apologies Judith Rees, John Glen and Joanne White 2. Minutes of the last meeting The minutes of the last meeting held on the 15 th November 2017 were accepted as a true and accurate record. 3. Matters Arising Agenda Actions from the Minutes of 15 th Item November 2017 3.1 to contact Rachael Barber to ask her to review Paediatric Guidelines SS,RP/JG,EFH to draft guidance. to include as 3.2 appendix in Emergency Planning Guidelines 4.1 to circulate JG emails to CL/IJ re: action cards for precis 4.2 to update page 48 with new website address 4.3 JW send phone numbers to for to correct if necessary 5.1 / to amend the figures pertaining to bed numbers 5.2 to ensure all three Emergency Planning, Escalation Plan and Escalation Plan & Triage Tool for Pandemic Flu align accordingly. 6.1 to find out next Q&S meeting date and feedback to CL 6.2 CL to present The Escalation Plan & Triage Tool for Pandemic Flu at the next QSE meeting 9.1 JG and MW-J to meet with theatre managers re: decant area By Whom SS,RP/JG, EFH/ JW / Update Rachael Barber has tasked a registrar with returning comments. See agenda item 5 for YG and YGC (WM still being drafted) however it was commented that the paediatric appendix is not yet through approval stage. CL to attend via VC 14 th February 2018 CL CL to attend via VC 14 th February 2018 JG/MW-J GB will follow up to see if there has been a meeting at YGC regarding the decant areas. EB noted mainly a YGC issue Action 3.1: GB to ensure theatre managers are aware re: decant areas 1
9.2 to add Critical Care Business Continuity Plan approval to next agenda 10.1 EB to send CL information on Health Prepared on the 27th November 11.1 The group to promote the use of the CitizenAid app 12.1 to send the document relating to Madagascan plague to ICU leads 13.1 to circulate VC numbers for next meeting : 01.02.18 2 EB All ; CL commented that he was unable to attend. email sent 15.11.17 4. Emergency Planning Guidelines discussed the Emergency Planning guidelines with the group. To avoid the Guidelines becoming too bulky it was agreed to amend the Guidelines to include a précis of the Critical Care requirements. advised that this has now been completed, with précis included from each site. The group discussed amendments and agreed the following: On page 2 (contents) there is an incorrect page number To remove information on ICBIS and include DOS on page 11 (and other pages as necessary) Embed pandemic flu guidelines and update hyperlinks when approved CL to check the WM Hospital Control Centre telephone number for appendix 1 Heather Piggott to be removed as WM site lead EMS Telephone number to be added to Appendix 1 (useful telephone numbers) Action 4.1: / to make amendments to the Emergency Planning Guidelines Action 4.2: CL to contact with the WM HCC telephone number updated the group with regards to the Directory of Services (DOS) IT system. ICBIS were previously collating bed status information online however are experiencing staff shortages. has spoken with Graham Brant who has sent the link and given permissions to. There had been issues having it installed previously due to antiquated PCs across BCU. This has now been resolved and the PCs require Google Chrome to be installed to run the DOS system, which commented should be completed in the next month. It was noted that DOS must be kept live for the system to be useful and fit for purpose. Action 4.3: HW/JW/NV-J to review Unit PCs to ensure Google Chrome installed in readiness for DOS training 5. Draft Paediatric Appendix The group discussed the paediatric appendix for children age 10yrs or over. This was initially written several years ago and has been sent to Rachael Barber, Paediatric Consultant in Manchester Children s Hospital for comments. It was agreed that GB would contact the Clinical Fellows (from AlderHey Hospital), who are working in YGC, for comments Action 5.1: GB to contact AlderHey clinical fellows re: paed appendix The following amendments were agreed: The wording is to be amended on page 2 i.e. change discussed to re-discussed with PICU 0.9% saline in 5% dextrose is to be re-worded Noradrenaline sentence is to be amended to incorporate less commonly used Be sure to check drug is to be moved up to ensure more prominent and nearer the drugs section Volume packed cells equation to be amended Action 5.2: GB to liaise with AlderHey clinical fellows re: Volume packed cells equation Action 5.3: CL to make amendments agreed to the paediatric appendix 6. Escalations advised the group that as amendments were made to the Escalation guidelines re: bed numbers at the last meeting so approval is now required. Overall the group agreed that the bed numbers were correct; however CL commented that he will confirm with HW and feedback to re: WM figures. Action 6.1: CL to confirm L2/L3 bed numbers and feedback to Action 6.2: to amend WM bed numbers if necessary
The following amendments were agreed: Amend discharge to past tense (i.e. to read discharged ) Add or use Critical Care area Action 6.3: to make amendments to Escalation guidelines 7. Escalation Plan & Triage Tool for Pandemic Flu CL presented the Escalation Plan & Triage Tool for Pandemic Flu at the September QSE meeting however they wished for further narrative regarding the provision for level 2 patients where there has been escalation of level 3 in level 2 bed spaces and therefore the Plan has been amended. CL commented that the Triage Tool is the best on offer for critical care and that currently there is no alternative. The following amendments were agreed To remove the paediatric appendix as it is duplicated in the overall Emergency Planning Guidelines To add the word Planning to the front page Action 7.1: to make amendments to Escalation Plan 8. Winter Pressures Planning No issues were reported however it was agreed to keep the item as a standing agenda item for future meetings. 9. Critical Care Business Continuity Plan approval EB discussed the Business Continuity Plan with regards to business impact and analysis and enquired whether the group had any amendments to the draft. She explained that the action plans are for use when there is an incident. EB advised that the plan has been compiled from information she has previously received. EB further noted that the document can be populated beforehand with specific information however it will depend on the issue. requested page numbers to be added. Action 9.1: EB to add page numbers to the CC Business Continuity Plan CL commented on the circulated WM business continuity assessment originally compiled in 2006, which he has updated as a new plan for use. It was agreed that each site would adopt CLs business continuity assessment relevant to their areas and return to EB for inclusion into the overarching continuity plan. Action 9.2: to circulate CLs business continuity document for localisation Action 9.3: JW/GB and NV-J/IJ to send localised business continuity to EB for inclusion on the Business Continuity Plan by 23 rd February 2018 Action 9.4: EB to send business continuity plan to by 2 nd March 2018 for inclusion onto the agenda for the next meeting IJ noted issues locally if the internet goes down. EB advised that she has had difficulties obtaining contingency plans from IT/operational estates. EB requested a list regarding any issues from each site. Action 9.5: CL, JW/GB and NV-J/IJ to send IT issues and/or concerns to EB requested that the titles be amended to reflect the title of the individual guidelines. commented that she will amend the document and return to EB. Action 9.6: to amend titles (track changes) and return to EB 10. AOB noted a document re: mask cleaning sent to the group by Jo White, PDN at YGC for information. CL commented on the upcoming IT overhaul to switch over servers. It is anticipated that there will be a 12 hour period with no network on computers (i.e. Synapse, Myrddin, portal etc). CL expressed concern about the clinical impact and requested feedback re: business continuity planning. YGC switchover is to be in March, WM in early May. It was noted that a Task & Finish group has been set up to discuss a possible divert of critically ill patients. Action 10.1: EB will speak to Geoff Laing re: business continuity for IT downtime Action 10.2: CL will confirm dates of IT downtime to so that she can inform RSUH of IEP downtime 3
IJ fed back on recent attendance at a conference on the Manchester attack; however only a small amount of learning has been fed back. He noted the use of MI numbering of individual patients from scene which should continue with them through the hospital and the use of Cruciform triage documentation. EB advised Graham Mayers went to a lessons learned from Manchester meeting and fed back to the recent Civil Contingency Group. Action 10.3: EB to circulate Graham Mayers feedback 11. Date & Venue of Next Meeting : The group agreed on Monday 12 th March 2018 at 9.30am. Action 11.1: to circulate date and room details 4
Action Card Emergency Planning Minutes of the 1 st February 2018 Agenda Item By Whom 3.1 GB to ensure theatre managers are aware re: decant areas GB 4.1 / to make amendments to the Emergency Planning Guidelines / 4.2 CL to contact with the WM HCC telephone number CL 4.3 HW/JW/NV-J to review Unit PCs to ensure Google Chrome installed in readiness for DOS training HW/JW/NV-J 5.1 GB to contact AlderHey clinical fellows re: paed appendix GB 5.2 GB to liaise with AlderHey clinical fellows re: Volume packed cells equation GB 5.3 CL to make amendments agreed to the paediatric appendix CL 6.1 CL to confirm L2/L3 bed numbers and feedback to CL 6.2 to amend WM bed numbers if necessary 6.3 to make amendments to Escalation guidelines 7.1 to make amendments to Escalation Plan 9.1 EB to add page numbers to the CC Business Continuity Plan EB 9.2 to circulate CLs business continuity document for localisation 9.3 JW/GB and NV-J/IJ to send localised business continuity to EB for inclusion on the Business Continuity Plan by 23 rd February 2018 JW/GB and NV-J/IJ 9.4 EB to send business continuity plan to by 2 nd March 2018 for inclusion onto the agenda for the next meeting EB 9.5 CL, JW/GB and NV-J/IJ to send IT issues and/or concerns to EB CL, JW/GB and NV-J/IJ 9.6 to amend titles (track changes) and return to EB 10.1 EB will speak to Geoff Laing re: business continuity for IT downtime EB 10.2 CL will confirm dates of IT downtime to so that she can inform RSUH of IEP downtime CL 10.3 EB to circulate Graham Mayers feedback EB 11.1 to circulate date and room details 5