november 12, 2012 meeting objectives ensure everyone is warm and fuzzy on statewide exercise...
TRANSCRIPT
November 12, 2012
Meeting Objectives
• Ensure Everyone is Warm and Fuzzy on Statewide Exercise Processes and Activities
• Answer Any Outstanding Questions
Disaster Preparedness Workgroup
Statewide Health& Medical Exercise
2012
Capability Observation Recommendation
Intelligence/ Information Sharing & Dissemination
County only collected status reports via ReddiNet; CCALAC had to translate into email and send/receive
Assessment Polls from the EMS Agency should have an easily transportable form
Intelligence/ Information Sharing & Dissemination
Limited notification of CCALAC and MAC when clinics activated response procedures
Increase awareness training to clinics on best practice response notification procedures
Emergency Operations Center Management
Many clinic staff not regularly involved in disaster plans were unfamiliar with their response roles
Incorporate HICS Forms and Job Action Sheets into drills and exercise.
2011 Exercise Lessons Learned
• 2011 Lessons Learned
• MOA Contracts with “Site Summary” forms
• Site-Specific Incident Management Team Designations
• Incident Command System / Incident Action Planning
Training
• Quarterly Communications Drills
• 2012 Statewide Medical and Health Exercise
Participation
Putting It All Together
Our Clinic will be…
..here to help!
Exercise Overview
OBJECTIVE: To discuss the planning and response to a loss of power to the healthcare delivery system and the community. SCENARIO: Earthquake results in power loss. Earthquakes can cause a variety of problems and disruptions to infrastructure. Due to the limited time, this exercise will focus on power loss. Participants can customize the exercise and objectives to address other issues.
2008 Sayre Wild Land FireOlive View-UCLA Medical Center
lost power and emergency
generators failed
- 27 patients evacuated: 15 infants
from Neonatal ICU, 4 critical care
patients and 5 adult patients on
ventilators
- Patients evacuated down stairs
with assistance of local fire
departmentSource: ABC news: http://ABC.local.archives/SayreFire
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Historical Impact of Power Loss
2010 Palo Alto Plane Crash Power outage caused by the crash
of a twin-engine Cessna in East Palo Alto, which toppled several major power transmission lines
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Historical Impact of Power Loss
Stanford Hospital & Clinics and Lucile Packard Children’s Hospital in Palo Alto, CA were without power; the hospitals functioned on emergency power, and all non-emergency cases were postponed for the day
Source: www.mercurynews.com/peninsula/ci_14422658
September 2012: San Diego Power Failure5 million people without power in California, Arizona and Mexico
Roads gridlocked due to outage of traffic lights
Gas stations without power and unable to dispense fuel
Eisenhower Medical Center in Palm Springs served as a respite for the community
Source: www.nbcsandiego.com
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Historical Impact of Power Loss
Communications
Intelligence/Information Sharing and Dissemination
Medical Surge
Emergency Operations Center Management
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2012 Statewide Medical and Health Exercise Target Capabilities
Determine/Evaluate clinic’s ability to communicate with response partners
Discuss/Test ability to communicate needs with outside sources for essential supplies, services, and equipment• Focus on resource supply chains
Target Capability: Communications
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Communication with the MAC
…from the 2012 LAC EMS Agency Communications Directory
Review/test adequacy of information management plans and technology
• internal and externalReview/test risk communication and public information message dissemination
Discuss/exercise ability to provide situational status and projected impact updates to: CCALAC/EMSA/DRC/Local EMD
Target Capability: Intelligence/Information Sharing and Dissemination
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COMMUNICATIONS DIRECTORY
Target Capability: Medical Surge
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Determine/evaluate ability to expand patient capacity using non-traditional care areas for triage and treatment
Determine/evaluate ability to prioritize, manage, and allocate resources
Discuss/test capacity to provide care with out the use of power
Test EOP and hazard specific plans
Discuss/exercise activation of Incident Management Team
Exercise ability to initiate incident action plan
Work through Incident Action Planning Process using HICS Forms
Target Capability: Emergency Operations Center Management
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MASTER SCENARIO EVENTS LIST (MSEL)
Time Incident
0645 7.8 Earthquake : Official Activation of the EMS Operations Center
0700 Reddinet / Email Damage Assessment Request:- Clinics with Reddinet complete Assessment Poll- Clinics without Reddinet complete fill-able PDF and email or fax to the Medical Alert Center @ (562) 944-5248
0830 Clinics Respond to Scenario:- Patient Profiles: overwhelmed with worried well, ect.
0930 Clinic _____ Reports Downed Power lines trapping staff.
1010 Clinics testing Mass Fatality Plans activate plan, request coroner, and initial PsySTART triage of staff
1058 Clinics testing MFI request MAC support
1300 Official End of Exercise: Clinics conduct Hotwash Debrief with Staff and collect Evaluator/Controller Feedback Forms
Key Injects
Communicate, Communicate, Communicate!!!!• Respond to Everbridge Messages
• Complete and send in Situation Report Assessments
• Send in Resource Requests to EMS Agency
Take Action• Activate your Incident Management Team
• Work through the Incident Action Planning Process and MSEL Injects
• Complete HICS Forms 201, 202, 203, 204, 214 http://dp.ccalac.org/Policies/Incident%20Action%20Planning/Pages/default.aspx
• Complete Hotwash Debrief
• Create After Action Report
Key Actions
• Logistical issues
• Technological issues
• People issues
• Time issues
Addressing Past Concerns
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http://dp.ccalac.org/PREPAREDNESS/drills/SMHE http://ems.dhs.lacounty.gov/Disaster/Announcement.htm
http://dp.ccalac.org/PREPAREDNESS/drills/SMHE http://ems.dhs.lacounty.gov/Disaster/Announcement.htm http://www.californiamedicalhealthexercise.com/exercises/phase3.php
Identify overarching goals
Establish purpose
Define extent of play
Choose objectives
Define exercise assumptions, artificialities
Develop security plan (exercise safety)
Define resource requirements and logistics plan
Develop briefing materials (exercise handbooks and forms):• Controller/facilitator
• Evaluator/data collector
• Note taker/scribe
• Player
Create Exercise roster
EXERCISE DESIGN/PLANNING
Convene IMT
Announce Narrative
Provide Position Specific IRGs
Work through Injects• IMT Staff practice Emergency Management Mentality, not day-to-
day decision-making.
Conclude Exercise
Conduct Hotwash
Draft After Action Report
Tabletop Exercise - Basic
Convene IMT
Announce Narrative
Provide Position Specific IRGs
Work through Injects• Work through “Planning P” ;
• Incident Action Plan Establishment
• Ensure Staff Create Plan A and Plan B for key response strategies and tactics;
• Consider Having a “What-if” officer
Conclude Exercise
Conduct Hotwash
Draft After Action Report
Tabletop Exercise - Advanced
All that other stuff + actually “doing” something.
Functional Exercise
Immediate Operational PeriodPosition Actions-Operational Period
Incident Commander
1. Receive notification about the incident from local officials
2. Activate the Command Staff and Section Chiefs3. Activate the EOP4. Establish operational periods5. Establish operational objectives
Immediate Operational Period
Position Actions-Operational Period
Public Information Officer
1. Monitor media outlets for updates on the incident and possible impacts on the hospital
2. Establish a patient information center; coordinate with the Liaison Officer
3. Establish a media staging/briefing area initiate media/
communications plan
Position Actions-Operational Period
Liaison Officer 1. Establish communication with local EOC, DRC
2. Communicate with other health care facilities (situation status, surge capacity, supply/personnel lending capacity, etc.)
Immediate Operational Period
Position Operational Period-Action
Safety Officer 1. Monitor safety practices of staff, patients, facility and implement corrective actions, as needed
Medical/Technical Specialist-Medical
Assist Op Chief in identifying specific medical care management needs
Medical/Technical Specialist-Mental Health
Assist Op Chief in identifying specific mental health needs/Manage PsyStart
Immediate Operational Period
Position Actions-Operational Period
Operations 1. Conduct clinic census/determine patients to send home/reschedule
2. Provide facility security, traffic and crowd control
3. Activate surge capacity plan and patient emergency procedures
4. Rapidly triage/prioritize patient care and resources
Immediate Operational Period
Position Actions-Operational Period
Planning 1. Prepare and implement patient, room, material and personnel tracking
2. Establish operational periods and Incident Action Plan with IC
Logistics 1. Initiate staff call procedures2. Conduct inventory of supplies, equipment,
medication3. Ensure IT functionality
Immediate Operational Period
Position Actions-Recovery
Incident Commander
1. Oversee and direct demobilization and system recovery operations
Public Information Officer
1. Provide final briefings as needed to patients/visitors/staff/media
Liaison Officer 1. Prepare summary of the status of the Clinic and disseminate to Command Staff, as appropriate
Safety Officer 1. Oversee safe restoration to normal operations
Operations 1. Return patient care and services to normal
Planning 1. Finalize IAP2. Complete AAR3. Ensure file of incident documentation
Logistics 1. Provide for mental health services for staff and patients
Finance/ Administration
1. Submit final response expenses to IC for approval2. Submit for reimbursement
Recovery
Conduct participant hot wash
Conduct controller, data collector/evaluator critique
Collect observation/data collection forms (notes)
Develop initial after action report (AAR)
Coordinate and evaluate findings
Conduct senior management post-exercise briefing
Prepare final AAR
POST EXERCISE
Develop improvement plan
Track corrective actions
Share lessons learned
EVALUATE THE EXERCISE