Transcript HOSPITAL EVACUATION EXERCISE

MUTAL AID AGREEEMENTS FOR
HOSPITAL EVACUATION
Presented By: Emergency Management Professionals
Dee Grimm RN, JD
Presentation Objectives
Examine the need for mutual cooperative
efforts between healthcare agencies
Review different approaches to developing
mutual aid agreements
Examine components of a mutual aid
agreements between facilities
Discuss potential issues that can arise
during hospital to hospital evacuations
Need For Cooperative Efforts
We can no longer operate in a silo
Best care for patients
Federal trend for grant funding
NIMS/NRF
Streamlines evacuation process
Mutual Aid Evacuation Agreement
Purpose
“To coordinate transportation and care of
patients who have been evacuated from a
member hospital in a qualified disaster,
with minimal disruption to the provision of
acute emergency care to the community”
Elements of the Plan
Assumptions and definitions
Evacuation criteria/Disaster declaration process
Patients distribution/transportation
Pre determined distribution charts
Hospital responsibilities
Cross Privileges
Supplies, personnel, equipment, records
Basic Assumptions
Only one hospital evacuating at a time
No other emergency occurring in community
Emergency Departments will not be receiving sites
Evacuating hospital is at high average census
minus a 10% reduction by discharge
Emergency Manager of the jurisdiction will seek
an emergency declaration
Transfer will be to a facility with “similar services”
Non-ambulance transport may need to be used
Special care patients will be sent directly to
receiving hospitals, not to external holding areas
(may be the last patients sent)
Definitions
Immediate evacuation – requires
immediate, prompt departure due to
life threatening conditions. Rapid
movement of patients to external
holding areas
Urgent evacuation – quick, but
orderly hospital departure. May
allow for period of internal holding
Notification and Transfer Decisions
Accepting numbers have
been pre-determined
Decision about where
patients go made by EMS
authority
Disbursement based on type
of patients – not red, yellow,
green
Types – Not Color Codes
Disbursement of patients based on
“types”, not standard MCI color codes
Why won’t red/yellow/green categories
work?
Based on transportation needs and special
needs
ROLE OF MEDICAL DISPATCH
and TRANSPORTING AGENCY
Make notifications to hospitals and others
Notify receiving facilities of patient
information and ETA
Receive updated acceptance information
from receiving facilities
Provide updated acceptance information
to field personnel
Final record to go to evacuating facility for
patient tracking
Evacuating Facility Responsibilities
Evacuating Facility will:
– Reduce patient census
– Track patients and document
– Send records with patient
– Send equipment, medications and staff
– Maintain list of supplies, equipment transferred
– Maintain SNF transfer agreement if applicable
– Notify family, doctors of patient transfers
Receiving Facility Responsibilities
Receiving Facility will:
– Reduce patient census
– Obtain additional equipment and staff
– Update Medical Dispatch of acceptance numbers if
needed
– Set up non-ER reception sites to receive patients
– Maintain patient tracking
– Notify family, doctors of patients received
– Be responsible for safety of staff received and
maintenance of equipment
– Return patients, equipment, and staff when appropriate
LINKAGE OF HOSPITAL
POSITIONS TO FIELD ICS
INCIDENT
COMMANDER
HOSPITAL AGENCY
REPRESENTATIVE
OPERATIONS
CHIEF
MEDICAL BRANCH
DIRECTOR
MEDICAL
GROUP
SUPERVISOR
PATIENT
TRANSPORTATION
GROUP
SUPERVISOR
MEDICAL
COMMUNICATIONS
COORD
AIR AMBULANCE
STAGING MGR
GROUND
AMBULANCE
STAGING MGR
HOSPITAL
PLANNING
TECHNICAL
SPECIALIST
Hospital Agency Representative
Assigned by evacuating hospital
Reports to field IC or Liaison Officer and requests to
participate in Unified Command
Speaks for hospital with full authority
Makes decisions in all matters affecting hospital
Provides information for media release
Participates in development of Incident Action Plan
Shares incident management information with
Hospital Incident Commander
Hospital Planning Technical Specialist
Assigned by evacuating hospital
Reports to IC or Liaison to participate in Medical
Branch Operations as technical specialist to Patient
Transportation Group Supervisor
Obtains information from hospital on patients’
medical acuity, transportation requirements,
equipment, and staffing needs
Acts as liaison with evacuating hospital to share
patient tracking information from the field and to
obtain updated hospital information for the medical
branch
Special Issues
Liability (declared emergency to initiate
limited liability)
Confidentiality/HIPAA
Cross privileges of staff/credentialing
Worker Compensation and staff payment
Notification to Bureau of Health Facilities,
Licensure, and Certification
Transfer of medications (scheduled
drugs)
Guidelines for Hospital Participants
Become familiar with your hospital’s own plan
Become familiar with the evacuation annex
and your field ICS roles/responsibilities
Review the pre-planned patient distribution
scheme your agency agreed to
Your hospital agreed to make “best efforts” to
accommodate evacuated patients
Overall Responsibilities
Develop facility’s own internal plan
Use same Patient Evacuation Tracking
Sheets
Inform Health Department of changes of
hospital’s information in the annex
Maintain adequate business interruption
insurance
Attend training, drills and participate in
debriefing processes