PRESENTED BY NOVEMBER 9, 2017 Stanford University Medical Center Palo Alto, CA
Brandon Bond, MS, NHDP-BC, CBCP
A little bit about us Stanford Hospital Level 1 Adult & Pediatric Trauma Center Hospital Life Flight 613 Licensed Beds 21 Operating Rooms Lucile Packard Children s Hospital Stanford 311 Licensed Beds (40 NICU & 20 IICU Nursery's) 11 Operating Rooms Expanding Network of Specialty & Primary Care Clinics (198 facilities across 21 cities) Office of Emergency Management 4 Full Time Staff, 1 Part Time 2 Part Time Medical Directors A full evacuation at peak census mid day could be 960 patients
Complex Environment
False Assumptions The Fire Department will evacuate our patients County Emergency Medical Services has plenty of ambulances to transport our patients Evacuation Equipment is strategically located on the units Everyone will react in a calm and controlled manner Smoke, creates fear.. Fear creates PANIC PANIC leads to CHAOS 5
What leads to evacuation? Smell of Smoke Sight of Smoke Hear the Fire See the Fire Hazardous Material Release Utility disruption Imminent threat of any kind Kaiser Santa Rosa: wildfire prompts hospital evacuation 6
What s the plan? Move away from the threat Move out of the building Brotman Medical Center: smoke prompts hospital evacuation 7
Food For Thought How will the staff respond? Do evacuations happen spontaneously? How will you gain control of the reaction? 8
Spontaneous Evacatution Courtesy of Pioneers Memorial Healthcare District, Brawley, CA 9
Controlling the Chaos 10
HICS Structure Incident Commander Public Information Officer Liaison Officer Safety Officer Command Staff Operations Section Chief Planning Section Chief Logistics Section Chief Finance/Admin Section Chief General Staff
Unit Assignments B3 IICU 26 C3 26 D3 IICU 26 E3 Gen Surg 26 F3 Gen Surg 25 OB (PDC) 3West 16 3East 10 3South 10 B2 IICU 26 C2 G2S G2P Trauma IICU 14 25 8 H2 Locked Psyh 16 MOR 21 PACU 18 D2 IICU 14 E2 ICU 33 E29 ICU 25 F2 OB 20 PICN 32 NICU 40 2West CVICU 20 2South OB 3 ORs 10 LDRs B1 17 C1 14 G1 Neuro 27 H1/CDA 11 Emerg D1 Radiolo Dept. CCU gy 70 14 D1 CSU 14 E1 BMT 22 F1 Perinata l 20 IICU Level 2 20 Heart Ctr/ Neuro Diag/ Pulmonary ITA Day Hospital 9 1North Onc/BMT 27 Edoscopy 21 CAPR 22 Cath Angio 10 DGR Ortho 37 FGR ONC 38 Peds MOR 7 Pre-Post Op Imaging
Stairwell Assignments 14
Assembly Area Assignments 15
Pre-planning Disaster Triage for Hospital Evacuation Triaging Resource Allocation for In-Patient Movement TRAIN 16
HavBed Polling Adult ICU Burn Medical Surgical Neg Flow Isolation Operating Room Pediatric ICU Pediatrics Psychiatric What s Missing?
HavBed Vs. Hospital Operations -25 bed availability
Back To The Complex Environment
Starting Data Triage 120 patients and determine the needed ambulance transport type. Computer 48 second Manual- 57 minutes Hospital Command Center request - over 2 hours
TRAIN
TRAIN Report Last Unit Name, First Name Level Report CSN MRN Room # Parent Name Phone # Last Name, First Name Last Name, First Name Last Name, First Name Last Name, First Name Last Name, First Name
TRAIN Report Summary
11/2/2017 4:00 AM: 855 PATIENTS STANFORD UNIVERSITY MEDICAL CENTER Red - SPC, 133, 15% Blue - Car, 235, 27% Orange - CCT, 176, 21% Yellow - ALS, 108, 13% Green - BLS, 203, 24%
Evacuation Tags Transfer Report
Evacuation Tracking Board
Escalation of Request for Assistance with Patient Movement MHOAC Program Regional (RDMHS) Cal OES FEMA HHS HCF submits Patient Movement Request to MHOAC If the MHOAC needs resources submit to Regional Patient Movement Function If the State does not have sufficient resources and suitable hospital beds Cal OES submits a RRF to FEMA National Disaster Medical System - HHS - DOD - VA - FEMA Medical Health Operational Area Coordinator (MHOAC) Regional Disaster Medical Health Specialist (RDMHS) Resource Request Form (RRF) 27
Nearby HCF (if available) Patient Movement Into NDMS Closest HCFs (if available) Transported by CA EMS resources or own vehicle FTS/CCP/ACS (if HCFs initially available) Transported by CA EMS resources or FEMA Ambulance Contract APOE FCC (NDMS) Transported CNG or NDMS Repatriation Home Field Treatment Site (FTS) Casualty Collection Point (CCP) Alternate Care Site (ACS) Aerial Port of Embarkation (APOE) Federal Coordination Center (FCC) California National Guard (CNG)
NDMS Patient Movement: Hurricane s Irma & Maria
Aerial Port of Embarkation St. Thomas
Patient Reception -Puerto Rico 32
NDMS Patient Movement: Puerto Rico to Miami 33
Thank You! Brandon Bond Administrative Director, OEM bbond@stanfordhealthcare.org 650-723-0592