mutual assistance agreement - philhospitalassn.org · mutual assistance agreement dr. jaime a....

Among Hospitals and Health Care Institutions as Enabler for Surge

Capacity Management – Enhancing Service Delivery Network

Vice President for Luzon, Philippine Hospital AssociationDr. Jaime A. Almora

MUTUAL ASSISTANCE AGREEMENT

Dr. Jaime A. Almora, Vice President for Luzon, Philippine Hospital AssociationMutual Assistance Agreement

PHA Mission:

L – lead

E - Enable

A – Assist

P – Protect

Enabling Hospitals to “continue serving

patients” in times of disaster through

MUTUAL ASSISTANCE AGGREEMENT


PHA

L.E.A.P

LEGISLATIVE/POLITICAL/

REGULATORY COMMITTEE

Lead - Protect

DISASTER

COMMITTEE

Enable

PATIENT SAFETY AND

QUALITY CARE

Assist

COMMAND

AND CONTROL

MUTUAL ASSISTANCE

AGREEMENT (MAA)HEALTH CARE CONTINUITY

RESERVE CORPS (HCRC)

INFECTION

PREVENTION &

CONTROL

MAA

HCRC

Present Situation of

Disaster Preparedness and Response


Not a question of “IF”, but a question of “WHEN”

http://assets.rappler.com/612F469A6EA84F6BAE882D2B94A4B421/img/7BF204D75AFD46418B2589BFE0023073/west-valley-fault-20150520.png

http://manila.coconuts.co/sites/manila.coconuts.co/files/styles/article_header/public/field/image/west-valley-fault.jpg

PRESENT SITUTATION OF DISASTER PREPAREDNESS AND RESPONSE


NDRRMC

LGUs RED

CROSS

BFP

DOHNGOs &

Industry

Leaders

RESCUE

AND

RECOVERY


Current

Focus

Bring

Victims

To

Hospital

Department of Health (DOH)



Organized the

Health Emergency Management System

(HEMS) - For Government Hospitals only

Disaster Risk Reduction, Recovery, Response

and Resiliency Management Council

(DRRRMC)

Capable of setting up field hospitals

Ability to come up with adequate services and access

to complete compliment of profession resource is yet to

be tested

Red Cross



Rescue volunteers (REACT, Rotary, Red Cross,

NGOs, LGU’s, citizens, and communications

groups) expect the hospitals in a disaster area to

receive and deliver adequate services.

Some hospitals have given serious thought to

preparing for a sudden patient surge in times of

disaster and have done some preparation

DOH hospitals are mandated to have their own

Health Emergency Management System (HEMS)

Hospitals



But majority of hospitals have not embarked on

serious preparation or their preparation is yet to

be tested. They are yet to organize themselves

into a common action plan that would pool their

strength and identify solutions for their weakness.

Because of spirit of competition, there is no

assurance yet that hospitals will assist each other

in a disaster situation in order to shorten response

time and deliver services quickly, efficiently, and

effectively in any form of disaster

Hospitals



Reality of Disaster Preparedness

and Response


Everything about disaster is a supposition and nobody can claim full

preparation or expertise. Anybody who would go into full preparation

would appear as ridiculous as Noah was in his time.


REALITY OF DISASTER PREPAREDNESS AND RESPONSE

From the disaster

preparedness point of view,

Noah could have saved

more people if the people

believed him and heeded

his warning.

He could have done better if

he people agreed to assist

him.

He was considered crazy

but eventually he was

proven right.




In times of disasters

Incapacitated when

power and water supply

is damaged

Same Structural Damage

proportionate to the natural force Structural Damage

proportionate to the

natural force Equally incapacitated when power and

water supply is damaged

Isolated when roads, bridges or

transportation are cut off

HOSPITALSINFRASTRUCTURE


Hospital Scenario

Hospital personnel are likely to have problems

of their own and inclined to help themselves

first and will not report to work

Hospitals who are lucky to have sustained

partial damage will be forced to work in a

chaotic and helpless situation

Trauma victims will surge to hospitals (as most

responders will concentrate in rescue and

provision of food and shelter to victims)


No known major occasion

where hospitals met and

organized themselves to

execute a common plan of

action to address anticipated

problems in a disaster.


HOSPITALS ALSO

NEED TO BE RESCUED


DELAY

UNCERTAINTY

NO PRIOR COMMITMENT

LACK OF ANTICIPATION

NO COMMUNICATION

LACK OF KNOWLEDGE ON

SERVICE CAPABILITY

NO SITUATIONAL REPORT


What can

hospitals do to

insure continuity

and resiliency?

Proposal



Proposal

Hospitals will need to

organize themselves and

draft a plan to enable

themselves through a

“Mutual Assistance

Agreement”;

Better operation by

enhancing the existing

DOH program on

“Service Delivery

Network”, and by linking

with DOH HEMS

Facilitated by an

Information Technology

platform and;


Hospitals will need to organize themselves and draft a plan to enable

themselves through a “Mutual Assistance Agreement”.

Proposal


Proposal

Mutual Assistance Agreement

was the “MISSING LINK”

creates a pre-event formal

understanding

sets expectations

develop commitment, and

facilitate speedy response

for resource sharing


Provisions of

the MAA MUTUAL ASSISTANCE AGREEMENT

1. Hospitals are the best source of assistance to other hospitals

damaged by disaster because they have the manpower, supplies,

medicines, equipment, and other resource necessary to continue

hospital operation

PREMISE:

4. There is a need to have reliable and committed

partners with common understanding and expectations

3. “Time is of the essence” in disaster conditions which

necessitate connectivity on a real time basis.

2. There is a need to link Hospitals for speedy identification

of services and capabilities available for resource sharing

during disaster

5. There is a need to agree on mode and manner of

financial recoupment.


Provisions of


Hospitals agree to bind themselves and commit to:UNDERTAKING:

4. Provide on deferred payment to MAAG hospitals the

following services:

a. Medicines

b. Laboratory equipment

c. Diagnostic equipment

d. Other needs that a situation demands

3. Share manpower, equipment, technical, logistical assistance

when asked

2. Receive assistance

1. Volunteer assistance to members of Mutual

Assistance Agreement Group (MAAG) during disasters


Provisions of


5. Lend for free such items as:

a. Non consumable items like instruments, generator,

tools, operating lights, operating table, etc.

b. Transport vehicles/ambulance except fuel

c. Professional Services

d. Other items that the situation demands

7. Pay promptly obligations as soon as able

6. Install a common incident management system to

facilitate communication and connectivity

Introducing AMSAdvance Incident

Management System (

AMS )

AMS is a comprehensive software

system for urgent tracking of

medical resources within a region in

near-real-time.

AMS was built on the positive

attributes of the Alabama Incident

Management System (AIMS) which

was developed within the University

of South Alabama Center for

Strategic Health Innovation (CSHI)

in Mobile, under the leadership of

Carl Taylor, Director for CSHI. This

was originally a research effort

which rapidly became the backbone

of the Alabama response to

Hurricane Katrina.

According to Federal and State

Officials, it is the best of those they

saw on a survey of tools available

for medical incident management

that they selected.


http://amsph.xchlive.org

Enhanced Connectivity thru AMS


Asian Medical Management

System ( AMS )

Two-way Referral System

BHS/Clinics-

Birthing Homes

Service Delivery

Network (SDN)


BHSCommunity Health

Teams (CHTs)

Community/

District Hospital

Higher Level

HospitalS

hort

est

Tra

vel T

ime

Enhancement of SDNService Delivery

Network (SDN)


Patient Referral (SDN) Resource Sharing

Enhancement

Connect with HEMS

Health Emergency

Management System

(HEMS)


Health Emergency Management System

(HEMS)

Hospital based disaster response

Have the resource, manpower, training

Government network only

HEMS HEMS HEMS

HEMS HEMS

MAA

MAA

MAA

MAAMAA

MAAMAA

Mechanics of the




being the organization of government and private

hospitals will do the organizational efforts, utilizing its

regular monthly Regional Conferences and Hospital

leaders Dialogue to forge a Mutual Assistance

Agreement among hospitals

will provide logistic support and

allow modification and

enhancement of its existing

program on Service Delivery

Network (SDN) and HEMS

AMS

PHA DOH

RESCUE

GROUP

SAsian Medical Management

System (AMS)

Philippine Hospital Association (PHA)

will be the nerve center to

provide real time situationers,

facilitate communication, and

resource sharing


will network with other MAAGs

and with foreign hospitals and

health care institutions

Mutual Assistance

Agreement Group (MAAG)

MECHANICS

will augment sharing of

resources

Rescue Groups and

VolunteersMAAG


HEMS HEMS HEMS

HEMS HEMS

MAA

MAA

MAA

MAAMAA

MAAMAA

MECHANICS

INTERCONNECTIVITY


RESOURCE IDENTIFICATION,

BUILD UP, AND SHARING

1. VOLUNTEER MANPOWER

(HCRC)

2. MOBILITY

3. SUPPLIES

4. MEDICINES

5. EQUIPMENT


HCRC Initiatives

Pool of healthcare provider volunteers


HCRC Initiatives

EXPECTED RESULTS



Mutual Assistance

Agreement ( MAA) Expected Results

1. FASTER and ANTICIPATED RESPONSE to a

HOSPITAL faced with capability, logistics, and

manpower crisis

3. COST RECOUPMENT ASSURANCE because the

process of reimbursement will be provided for

in the Mutual Assistance Agreement. PHIC,

DSWD, NDRRMC and DOH is expected to help

insure cost recoupment

2. FREEDOM FROM UNCERTAINTY OR DOUBT in

requesting for assistance without worrying for

payment


Mutual Assistance

Agreement ( MAA) Expected Results

4. REAL TIME INFORMATION because of

CONNECTIVITY by using an IT Software usable

during normal times and during disaster

situations (AMS)

6. High SUCCESS OF IMPLEMENTATION if it will

network with existing DOH disaster program

(HEMS) and two-way referral system (SERVICE

DELIVERY NETWORK)

5. ENHANCEMENT of SERVICE DELIVERY

NETWORK program and HEMS of DOH

THANK YOU.


Sources

• Taylor, Carl. ND. Principles of Health Risk Preparedness-AMS as a Key to Surge Capacity Management, Situational

Awareness and Connected Response-Ability- Anywhere.

• DOH-AO 2014-0313: Guideline on Establishing SDN

• DOH AO 2014-0046: Defining SDN

• http://xchlive.org

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valley-fault-20150520.png

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References


http://xchlive.org/

http://assets.rappler.com/612F469A6EA84F6BAE882D2B94A4B421/img/7BF204D75AFD46418B2589BFE0023073/west-valley-fault-20150520.png

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https://earthquake.usgs.gov/monitoring/buildings/img/schematic-sdva-2x.png

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http://papyrus.greenville.edu/wp-content/uploads/2014/04/noah-3.jpg

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OSpzsrPAhVGpZQKHVETBp8Q_AUIBigB#tbm=isch&q=hospital+png

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hive.com%25252Ftag%25252Fearthquake&source=iu&pf=m&fir=cK9Nbk8iaFMbsM%253A%252CFz_1wfwDIe4EM%252C_&u

sg=__ASNUB8W5aRckx5R8SNSfCsXmWkA%3D#tbm=isch&q=earthquake+icon+png

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formation_27825&docid=G1xRft7azGNZmM&tbnid=k-

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http://www.pngall.com/success-png

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http://www.rfedistribution.com/wp-content/uploads/2011/05/backhoe-parts-300x150.png

http://www.pngall.com/wp-content/uploads/2016/06/Ambulance.png

http://bencohospitex.com/image/thumbnails/18/80/tables_hospitex_lucerne_png-100366-380x380.png

http://www.omnicell.com/~/media/Images/Product Images/2014 Redesign/Supply Management/Supply Management System/1-0-Supply-Management-Module.png?mh=320&mw=470&thn=0

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References


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SUPPLEMENTARY SLIDES



Major Advocacies of PHA

1. Legislative and political = Lead,---- Protect

2. Disaster preparedness and response =

Enable

3. Infection prevention and control = Assist

Overview Present Situation of Disaster

Preparedness and Response

Reality of Disaster Preparedness

and Response

Proposal for Mutual Assistance Agreement

Mechanics of


Expected Results





Not yet required all hospitals to provide isolation

facilities to handle new and emerging disease

epidemics

Advised builders of new hospital to incorporate

earthquake-proof structures -HSI

Embarked on logistics preparations for:

Vaccines

Medicines, and

Hospital supplies

Identified and assigned

Selected government trauma centers

Epidemic confinement centers

Organized the Health Emergency Management System

And the Disaster Risk Reduction, Recovery, Response and

Resiliency Management (DRRRM)

From the disaster

preparedness point of view,

Noah could have saved

more animals from the

worst disaster on earth if

only he had partners who

have known what he was

doing and willing to lend him

arks to save more animals.

If his ark capsized during

the flood because there

were no fallback options,

the earth would have been a

barren planet today. There

was nobody to assist him.

No Mutual Assistance

Agreement



Framing the Service Delivery Network

DOH-AO 2014-0313: Guideline on Establishing SDN

DOH AO 2014-0046: Defining SDN

Service Delivery

Network (SDN)

Recently, with the help of JICA,

DOH rolled out its “Service

Delivery Network” program

which is to link hospitals and

health institutions of different

capability level into an interlocal

network of referral system to

help patients access health

services in a Health Zone.

This is designed to facilitate

access of patients to other

centers in normal situation but

does not include resource

sharing, and rescue mode

assistance from other hospitals

in emergency surge situation.


Identification

of Priority

Population

Identification of

Service Providers

(Private and Public)

Set-Up Service

Delivery Network

and Forged

Partnership

Providers Facilities

Integration of Cultural Integrity and

Geographical Set-Up

Enhanced Connectivity thru AMSAsian Medical Management

System ( AMS )


DASHBOARDS



DASHBOARDS


System ( AMS )



MAILBOX


System ( AMS )



REQUESTS


System ( AMS )



DISPLACED PERSONS


System ( AMS )



VOLUNTEERS


System ( AMS )



MAP & DISEASE SURVEILLANCE


System ( AMS )




System ( AMS )

Neutrality



System ( AMS )

Freedom

Capability

Lightweight

User Friendly

Configurable


We recently added a displaced persons module

and can continue customization to meet your

needs.

- Carl Taylor, Director for CSHI



System ( AMS )

Scalable


There are two approaches-one full integration

with government efforts, much as AIMS does in

Alabama. The second, limited integration,

which is the goal of the Haitian Private Hospital

Association. They prefer AMS to be used to

support their members directly outside of the

government structure.


Effective but not Invasive

Budget Sensitive

“We are happy to support your hospitals with

AMS at no charge and certainly happy to be

embedded into a Mutual Aid agreement.”



Service Delivery

Network (SDN)

Mutual Assistance

Agreement Group

(MAAG)

HDEC/

HEMS

HDEC/

HEMSHDEC/

HEMS

HDEC/

HEMS

HDEC/

HEMS

HDEC/

HEMS


Mutual Assistance

Agreement Group (MAAG)

HOSPITAL DISASTER

EMERGENCY COMMITTEE (HDEC)

MAAG

(CHAPTERS)

COMMAND

& CONTROL

SEARCH FOR OUTSTANDING CHAPTER CRITERIA:

1.NO. OF MEMBER HOSPITALS IN THE CHAPTER WHO JOINED THE

MAA GROUP

2.PRESENCE OF HOSPITAL EMERGENCY AND DISASTER

MANAGEMENT COMMITTEE (HDEC) IN EACH MEMBER HOSPITAL

3. LIST OF HAZARDS AND RISK WITHIN THE GEOGRAPHICAL

LOCATION OF THE CHAPTER

4. PRESENCE OF DISASTER PREPAREDNESS AND RESPONSE

PLAN

5. PRESENCE OF VOLUNTEERS FOR HEALTHCARE CONTINUITY

RESERVE CORPS

6. NO. OF DISASTER PREPAREDNESS MEETINGS AND GROUP

TRAININGS


PHA NATIONAL CONVENTION

November 15 – 16 – 17 – 18, 2017

Nov. 17- Plenary Session on Disaster1. Healthcare Continuity and Connectivity in

Times of Disaster

- Carl W. Taylor, J.D.

2. Disaster Risk Reduction and Management

in Hospitals in the Philippines

-Renato U. Solidum, Jr.


PHA ANNUAL NATIONAL CONVENTION

Nov.18- DISASTER PREPAREDNESS & RESPONSE TRAINING AND

WORKSHOP

1. TIEMS Worldwide Efforts Towards More Resilient Societies-

-Dr. Harald Drager (TIEMS President)

2. USAR Capacity Buildings and Disaster Responses in Asia and

Pacific Area

–Dr. QU Guosheng

3. HOSPITAL CONNECTIVITY – Installation of Software and Training

of Communication Officers and Disaster Response Teams

- Carl W. Taylor, J.D.

4. OVERVIEW OF MUTUAL ASSISTANCE AGREEMENT

-Jaime A. Almora, MD

5. OVERVIEW OF HEALTHCARE CONTINUITY RESERVE CORPS

-Ms. Angeli Medina


YOU ARE CORDIALLY INVITED.

THANK YOU!!!


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