building back better after superstorm sandy · superstorm sandy • to demonstrate an understanding...
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Marg Verbeek, MA (DEM), CEM, MEPDirector, Emergency PreparednessNYU Langone Medical Center
Kimberly Glassman, PhD, RN, NEA-BCSenior Vice President, Patient Care Services/CNONYU Langone Medical Center
Building Back Better After Superstorm Sandy
• To demonstrate an understanding of the planning required for current and future complex disasters.
• To develop strategic tools for enhancing organizational readiness for leadership and management.
• To design a resilient hospital culture through protective infrastructure measures, people, plans and preparation.
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Presentation Objectives
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• Academic Medical Center• Biomedical Research• School of Medicine• Four Hospitals
– Tisch– Rusk Rehabilitation– Hospital for Joint Diseases– Hassenfeld Children’s Hospital
• Article 28s• Faculty Group Practices• Across 250 locations• Approx. 20,000 staff, faculty and students
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About NYULMC
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Then Along Came Sandy…
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Superstorm Sandy Video
https://www.youtube.com/watch?v=3z078ak7_sc
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A Call from the President
EOC Coordination
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Presentation Title Goes Here 13
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Seminar Room
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What is e-FINDS
Evacuation of Facilities in Disasters System
A patient tracking system developed afterSandy
e-FINDS Lower Manhattan Exercise May 2015
NYU Hospitals Center – Tisch
NYU Hospital for Joint Diseases
Mount Sinai Beth Israel
Bellevue
NYP – Lower Manhattan
Gouverneur Health16
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e-FINDS: Areas for Improvement
Coordination with New
York State Department
of Health
Access for Networks
Integration of e-FINDS and EMR
Unable to track some
patients
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Post-Sandy Flood Mitigation Strategy
• Created a protective barrier around campus
• Secured all points of entry
• Provided containment for vital hospital systems
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NYU Langone Medical CenterDecember 2013
Facilities Changes Post-Sandy
• Infrastructure relocations to higher elevation
• Flood protection at critical areas within and between buildings
• Hardening of the building perimeters
• Deployable systems at campus perimeter to the Sandy flood level
• New Tisch elevators without cellar level stop
EMERGENCY POWER
CIRCUITRY
FDR
First Ave.
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3
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NORMAL POWER
SYSTEMS
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5
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Facilities Mitigation Measures
• Infrastructure relocations to higher elevation
• New emergency generators
• New fuel oil system
• All automatic transfer switches elevated
New automatic transfer switch in Tisch Hospital, 7th
floor
New energy building with 7,500 kW generator capacity on 3rd floor
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Facilities Mitigation Measures (cont.)
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New permanent flood doors protecting Skirball Ground Floor
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Facilities Mitigation Measures (cont.)
Hardening of the Building Perimeter
Pipe penetrations sealed
Area ways closed
Walls structurally reinforced
Barriers between interconnected buildings
TISCH HOSPITAL
RUSK
Tiger Dam along FDR Service Road
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Tiger Dams — Flood Wall System
Facilities Mitigation Measures (cont.)• Elevator Service
– Operational plan to lock-out lower level access
– New elevator tower that serves the Tisch Hospital
– Temporary protection plan for pits and equipment
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Facilities Mitigation Measures (cont.)
• Increase on-site power generation, electrical distribution and fuel oil storage
• Enhance system redundancy
CON EDISON
GENERATOR
STAND-BY LOADS100%
Building
NORMAL (Primary) LOADS
Typical Installation:• Normal power fed by ConEdison and CoGen in parallel
(Primary)• Standby power backed up by generator (Emergency)
STANDBY (Emergency)
LOADS
UTILITY GAS
COGENFuel Oil
Power and Fuel Sources
UTILITY ELECTRICITY
Fuel Oil
Campus Perimeter Protection Flood Wall
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Energy Building Loading Dock—New Permanent Flood Barrier
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Elevate and Protect Key Infrastructure
Emergency generators and ConEd normal power switchgear in the energy building
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Developed 2014 Hurricane Season Emergency Plan
• Identified NYULMC facilities within evacuation zones
• Planning assumptions• Strategic decision
support matrix• Five-day hurricane
countdown matrix• Inter-agency
coordination• Damage assessments
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NYULMC Properties & Hurricane Evacuation Zones
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Redesigned NICS Organizational Structure
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Strategic Decision Support Tool Matrix
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Five-Day Countdown
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Action Plan Notification Period
NOAA/NWSannounce
that a damaging storm is
predicted to impact the NYC Area
72-Hour 48-Hour 24-Hour 0-Hour
Tiger DamsFill Port Plumbing
ElevatorsPlywoodBitutheneSandbags
Temporary structural Barricades
Exterior pumps within Tiger Dam perimeter
Interior PumpsAll mitigation measures to
be in place
Final Field Verification
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• Pre-storm strategic decision-making scenario
• Validated the Hurricane Plan and functional annexes
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Exercise Improvement Plan Tracker
Building a Resilient
Health Care Center
Building a Resilient
Health Care Center
Human Capital
(including trained staff)
Human Capital
(including trained staff)
Emergency and
Business Continuity
Plans
Emergency and
Business Continuity
Plans
Processes and Sub Systems
Processes and Sub Systems
Physical Protection of Assets
Physical Protection of Assets
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Departmental Goals for Achieving Organizational Resilience
Established NYULMC as
national/international leader
Built a comprehensive EM and Resilience
Program
Developed EM and Resilience strategies,
plans, tools & resources
Fully integrated EM and Resilience
policies across the enterprise
Promoted an enterprise-wide
culture of resilience and a highly prepared
workforce
Launched Enterprise-Wide Business Continuity Management
• Obtained executive-level support
• Determined how and where to initiate Program
Pilot Study
Policy
HVA
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RATING STANDARD DESCRIPTION
Needs Basic Resilience
Has a general awareness of resilience and participates in some emergency preparedness activities.
Meets Minimum Resilience Requirements
Has at least some informal procedures in place to deal with emergencies and/or business interruptions or has emergency plans that need significant update or revision.
Maintains Appropriate Baseline Resilience
Has optimized resilience for the types of services provided. No outstanding critical resilience recommendations related to core business processes.
Exceeds Baseline Resilience Requirements
Has a formal written business continuity or resilience strategy or similar document(s), has implemented all high priority resilience recommendations, and conducts periodic contingency training and drills.
Achieves Maximum Resilience
Has implemented exceptional resilience measures necessary to avoid business interruptions for all types and magnitudes of potential hazards.
Rating System Description by Department Classification
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Emergency Operations Plan
April 2012 • Scope is hospital/inpatient &
ambulatory care facilities centric• NICS is a hierarchical structure• NICS is only activated during
emergencies• EOP does not have a strategic
component • EOP was updated post-Hurricane
Sandy but not submitted for approval – many lessons learned were not integrated
• Annexes A-Z
July 2015• Enterprise-wide scope• NICS is a network structure which
mirrors how the Medical Center operates
• NICS is always activated and used for incidents of all types and sizes
• Established CENTCOM and executive-level strategic decision-making
• Redesigned the relationship between the EOP, Appendices, Annexes
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Questions?
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Thank you
Kimberly Glassman, PhD, RN, [email protected]
Marg Verbeek, MA(DEM), CEM®, [email protected]