Introducing ASPR’s Coalition Surge Tool An Exercise for Assessing and Improving Health Care Coalition Readiness Regional Coordinators Retreat Charleston - June 9, 2017

Healthcare Preparedness Program (HPP): New Project Period 2017-2022 Building on where we’ve been Regional Coordinators Retreat Charleston - June 9, 2017

The last grant period: 2012-2017 We were told to build “Coalitions” INCLUDE EVERYONE Regional Coordinators Retreat Charleston - June 9, 2017

Coalition Surge Tool (CST) This Grant Period: 2017-2022 The Coalition’s exercise focus narrows in its application of the Coalition Surge Tool (CST) Regional Coordinators Retreat Charleston - June 9, 2017

Targeted Groups in the Coalition Exercise Evac Hospital Receiving Hospital Mental Health Nursing Dialysis Core Members Hospitals Public Health EMS Emergency Management Evacuating and Receiving Hospitals Healthcare Executives (in the After Action Review) Other HCC members (non-hospital) EH RH N D M Regional Coordinators Retreat Charleston - June 9, 2017

HPP Budget Period 1: 2017 - 2018 7 CST Exercises Coalition Surge Test HSEEP compliant exercises – functional elements and a TTX (facilitated discussion) ASPR confirmed it as a “functional exercise” Data is collected using the provided tools; training will be provided (no EEGs) AAR is developed and submitted by each HCC 7 CST Exercises Conduct the Coalition Surge Test in each WV Healthcare Coalition Region each year Collect and Report baseline data Regional Coordinators Retreat Charleston - June 9, 2017

CST Goal and Objectives Goal: Determine how ready a Coalition is to evacuate patients and move/place them at other facilities within the Coalition Objectives: Selected hospitals (typically 1 - 3) demonstrate plans to: #1 – evacuate enough patients to total 20% of the Coalition’s acute care patients (inpatient, including ICU - based on average daily census, not including ED patients) #2 – identify facilities (within the Coalition) willing and able to receive each evacuating patient #3 – identify appropriate transportation to transfer each patient Regional Coordinators Retreat Charleston - June 9, 2017

The Coalition Surge Test is really an Evacuation Planning Drill NO ACTUAL MOVEMENT OF PATIENTS Low to No Notice Exercise to transition quickly into “disaster mode”. Provides a more realistic picture of the level of readiness than a preplanned, announced exercise. NOTE: The “A-Team” might not be your players this time 2-week time window with one hour notice Uses peer assessment methods with tools provided by ASPR Functional component - patient movement and transport are arranged with assets available from that region’s Healthcare Coalition Table Top Exercise (conference call discussion) - Coalition members discuss functional outcome and identify gaps in surge planning After Action Review Must have senior management-level participation After Action Report developed and submitted Regional Coordinators Retreat Charleston - June 9, 2017

Who Initiates and Controls the Exercise? Regional Coordinator “Trusted Insider” and “Lead Assessor” Who Evaluates the Exercise? The Hospital Representative “Evacuation Assessor” (primary and backup) Regional Coordinators Retreat Charleston - June 9, 2017

Terminology Trusted Insider & Lead Assessor = Regional Coordinator (Initiates and controls the exercise, facilitates TTX discussion and after-action review conference calls, develops the AAR) Evacuation Assessor = Hospital representative at the evacuating acute care facilities (assesses evacuation decisions and contributes to the AAR) Players = Staff at evacuating facilities and receiving facilities; other Coalition members involved in transport anad/or the TTX Regional Coordinators Retreat Charleston - June 9, 2017

Applying the CST is a Phased Process DAY 1: Functional Component (~90 minutes) Who’s Invited? All hospitals in the Coalition, EMS and transport companies, Emergency Managers, Public Health departments What Happens? Evac hospital(s) identify needs and coordinate to find beds for their patients Receiving hospitals communicate ability to provide beds Transportation resources identified Gaps identified for patient movement and placement Regional Coordinators Retreat Charleston - June 9, 2017

Next Step in the Phased Process DAY 1: Facilitated Discussion/Tabletop Component (~180 minutes) Who’s Invited? All Coalition members What Happens? Lead Assessor facilitates (conference call) discussion with all Coalition members Begins shortly after the functional part of the exercise Scripted question and answer period using data collected and gaps identified during the exercise, to address: Transportation planning Capacity of receiving facilities Patient Tracking Public Information Needs of at risk patients Continuity of Operations Regional Coordinators Retreat Charleston - June 9, 2017

The 3rd Step in the Phased Process Within 7 days of exercise OR can occur same day: After Action Review/ Debriefing (30-90 minutes) Who’s Invited? All Coalition members, with senior representation from evacuating hospitals What Happens? Facilitated by the Regional Coordinator Assessment of strengths/weaknesses Delineation of corrective actions and recommended actions Must include executive level (decision-makers) Documentation of discussion topics are part of the AAR Regional Coordinators Retreat Charleston - June 9, 2017

The Final Step of the Process Within 45 days following the Exercise: Development of the After-Action Report (AAR) Developed by the Regional Coordinator (with input from the evacuation assessors and hospital representatives) Submitted to WVHA (and to CTP and ASPR) Provided to all Coalition members Regional Coordinators Retreat Charleston - June 9, 2017

Who’s involved in the Functional component of the exercise? Command staff (involved in patient identification and movement) at each evacuating facility At least one senior staff member at each receiving facility (communications link to evacuating facility) EMS and/or transport staff at their facility to identify resources needed for patient movement (communications link to evacuating facility) Regional Coordinators Retreat Charleston - June 9, 2017

If you are one of the evacuating facilities (acute care): You can consider a patient “placed” when two things have happened… You find an appropriate facility to receive the patient (does not have to be acute care) AND You find appropriate transportation to get the patient there Regional Coordinators Retreat Charleston - June 9, 2017

Who’s invited to participate in the Tabletop part of the exercise? All Healthcare Coalition members in that region: Hospitals (evacuating, receiving, and others not involved in patient movement) Public health departments Emergency Management departments EMS (including private ambulance companies with hospital contracts and Regional Medical Commands) Non-hospital healthcare and medical facilities (including LTC, dialysis, primary care, mental health, etc.) Regional Coordinators Retreat Charleston - June 9, 2017

The WV Approach Concepts and Objectives Meeting - June 22nd Introduce CST to Regional Coordinators - June 9th Concepts and Objectives Meeting - June 22nd Overview at Task Force Meeting - August 25th Training Sessions by Region – September to November 2017 Conference Calls with Coordinators - TBD Coalition Surge Test (CST) Exercises – October 2017 to March 2018 AARs for all 7 CST exercises must be submitted to WVHA no later than May 31, 2018 Regional Coordinators Retreat Charleston - June 9, 2017

9:00 am to 12:00 pm (for Regional Coordinator) CST Training Schedule Region Date Time 1 Wed., Sept 20 9:00 am to 12:00 pm (for Regional Coordinator)   12:00 to 4:00 pm (for the Regional Coordinator & 2 possible Evacuation Assessors for each acute care hospital & each acute care hospital’s taskforce representative) Lunch beginning at 11:30 am 2 Wed., Oct. 4 3/4 Thurs., Oct. 5 5 Wed., Oct. 25 6/7 Wed., Nov. 8 8/9 Thurs., Nov. 9 10/11 Thurs., Oct 26

Any Questions? Regional Coordinators Retreat Charleston - June 9, 2017 This Photo by Unknown Author is licensed under CC BY This Photo by Unknown Author is licensed under CC BY-SA