The Emergency Operations Plan Checklist Surveillance and epidemiological processes Identified command structure with leaders Notification/activation processes Department level response plans Hospital Command Center (HCC) and alternate site set-up Redundant communication Community response integration Access and traffic control Media management The Emergency Operations Plan Checklist (cont.) Patient management (e.g. triage, registration, admit) Needs of various populations (e.g. elderly, peds, language) Volunteer management Information management Evacuation relocation Hazmat isolation Supply management Pharmaceutical management
Testing and Evaluating 1. Organization tests plans twice per year 2. Must include influx of real or simulated patients 3. At least one exercise per year is escalated to evaluate how effectively the organization performs when it can t be supported by the community. 4. Organizations that have a defined role in the community s emergency plan participate in at least one community-wide exercise per year 5. Planned exercises are realistic and consistent with the organization s HVA Testing and Evaluating (cont.) 6. Must include a designated formal observer *Organization must monitor the six critical functions Communication Resources & Assets Safety & Security Staff Responsibilities Utilities Management Patient Clinical & Support Activities 7. Monitor safety & security 8. Monitor staff roles & responsibilities 9. Monitor utilities
Testing and Evaluating (cont.) 10. Exercises are critiqued through a multidisciplinary process which includes administration, clinical (including physicians) & support staff 11. Organization modifies it s plans based on critiques 12. Planned exercises evaluate the effectiveness of improvements that were made in previous critiques 13. Strengths and weakness of the plans are communicated to the multi-disciplinary improvement team responsible for monitoring Environment of Care Issues Exercise Planning Components (HSEEP) Project Management 1. Determine exercise type 2. Create a timeline 3. Identify a planning team 4. Conduct planning conferences (meetings)
Exercise Planning Components (HSEEP) Exercise Design and Development 1. Assess needs 2. Define scope 3. Prepare statement of purpose 4. Define objectives 5. Create a scenario 6. Prepare all documents Exercise Plan Controller Evaluator Handbook Master Scenario Events List (MSEL) Exercise Evaluation Guides (EEG) Exercise Planning Components (HSEEP) Exercise Conduct and Evaluation 1. Arrange for logistics Site setup Briefings Feedback 2. Coordinate participants Rules for play Controller and evaluator training 3. Evaluate After Action Report (AAR) Corrective Action Plan (CAP)
Emergency Management Exercises Design for Compliance Design to Survey External Planning Designed Drill with local agencies Local Health Department Local Hospitals Fire Department Law Enforcement Military Base Red Cross
Internal Planning Advise Executive Administration Ensure they are part of planning process Ensure there is physician involvement and it is documented Ensure all planning activities are documented throughout hospital based committee Document all interactions Drill Design Use Hazard Vulnerability Analysis to determine type of drill Emergency Management Policies When drilled last What needs to be drilled Create Objectives Enough to test response Test areas that were a concern from the last drill Communications Patient Tracking Specific Response Plans
Hazard and Vulnerability Analysis (HVA) Hazard Vulnerability Analysis Results A score or hazard rating above 15 shall require RCRMC to focus resources and efforts to prepare for those emergency events. The following are events that have a hazard rating greater than 15: Ranking 1 2 Earthquake Emergency Event Small Casualty Haz-Mat Incident (less than 5 victims) Score 30 20 2 3 Failure of Medical Gases Water Failure 20 16 Master Scenario Event List (MSEL) Developed master scenario event list with local agencies Earthquake Partial structural collapse of patient care area Patient Surge Water leak within hospital Liquid oxygen tank compromised Loss of utilities
Master Scenario Event List (MSEL) Structural Collapse Simulated structural collapse on 4 th floor of the Medical Center Used volunteers (EMT students) as patients that needed to be evacuated Evacuated 10 patients from 4 th of the building using the stairs
Drill Design Utilities Oxygen\ Vacuum \ Medical Air Failure Electricity Disruption Sentinel Alert 37 Water Failure Potable water Waste removal Boilers Sterilization HVAC Failure Patient Isolation OR procedures Structural Collapse Evacuated mock patients from the Medical Center to local military base.
Patient Surge Erected mass casualty tents Deployed resources to Emergency Department to assist with patient surge Established communications with the Operating Room and Patient Care Units Cancel elective surgeries Free up beds through early discharges, if possible Surge Capacity
Water Leak Locate shut-offs in a timely manner Test response plan External Communications Test the use of alternative communication 800 MHz Radio RACES Radio (Ham) Satellite Phone
Internal Communications Test the use of alternate forms of internal communications devices Nextel Radio Personal Pagers Overhead Paging System Hand Held Radios Runners Completion of Drill Hot Wash Document the good, the bad, and the ugly Sign in sheet Create a critique of the drill Prepare an After Action Report Track corrective action with the appropriate committee
Documentation All drill documentation is placed in a well organized binder Critique After Action Plan Keep Updated MSEL Details Meeting minutes from planning sessions (both internal & external) Completed Disaster Inventory forms Completed HICS forms Communications (message forms, radio, live process) Victim Information Photos of drill / Press Coverage Newspaper Article Attempt to involve local press for a third- party validation of your drill. Be cautious and ensure there is a favorable perspective on their coverage.
Surviving the Joint Commission Survey Just Completed: January 2009 Talking points with surveyor Well organized paperwork Prepare power presentation for survey Emergency Operations Plan (Manual) updated and available for reference Annual review of Emergency Management Program has been completed Be prepared to conduct a table top drill Training documentation available Surviving the Joint Commission Survey
Contact Information Michael Bowers Director of Facilities & Engineering Riverside County Regional Medical Center mbowers@co.riverside.ca.us (909) 486-4066 Mitch Saruwatari Vice President, Quality and Compliance LiveProcess msaruwatari@liveprocess.com (818) 312-0131 Emergency Preparedness. Peace of Mind.