Introducing ASPR’s Coalition Surge Tool An Exercise for Assessing and Improving Health Care Coalition Readiness Presented to: EMS Agency Official Representative Meeting Regional Coordinators Retreat Charleston - June 9, 2017

Healthcare Preparedness Program (HPP) New Project Period 2017-2022 Building on where we’ve been – Who we are We were told to build “Coalitions” INCLUDE EVERYONE The Coalition’s exercise focus narrows in its application of the Coalition Surge Tool (CST) Regional Coordinators Retreat Charleston - June 9, 2017

What is the CST? EMS is crucial to the success of this exercise It’s a tool designed by ASPR (Assistant Secretary for Preparedness and Response) To test a healthcare coalition’s ability to simulate an evacuation of 1-3 hospitals and find appropriate placement within the coalition to receive those patients and to find appropriate transportation to get them there. EMS is crucial to the success of this exercise

EMS must participate in these exercises 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: Hospitals demonstrate plans to: 1. Simulate evacuation of enough patients to total 20% of the Coalition’s 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 with 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. 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

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 Conduct the Coalition Surge Test in each of the seven regions Collect and Report Baseline Data HSEEP compliant exercises – Functional Evacuation, Facilitated Discussion and After Action Review Data is collected using the provided tools; Training is being provided to Hospital Evaluators After Action Report is developed and submitted by each HCC Regional Coordinators Retreat Charleston - June 9, 2017

Applying the CST is a Two-Phase Process Part 1 Functional Component (90 minutes) 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 Part 2 Facilitated Discussion/Tabletop Exercise (90 minutes) 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: Applying the CST is a Two-Phase Process Regional Coordinators Retreat Charleston - June 9, 2017

After Action Review/ Debriefing (60 minutes) Phase 2 After Action Review/ Debriefing (60 minutes) Facilitated by each facility’s designated Evac Assessor Assessment of strengths/weaknesses Delineation of corrective actions and recommended actions Must occur within 30 days of exercise; Can occur same day Must include executive level (decision-makers) Documentation of discussion topics are part of the AAR Development of the After-Action Report (AAR) Developed by the Regional Coordinator (with input from the evacuation assessors and hospital representatives) Reviewed by all Coalition members Submitted to WVHA (and to CTP and ASPR) 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 Cabell Huntington Hospital Example At least one senior staff member at each receiving facility (communications link to evacuating facility) For Hospitals and/or nursing, rehab or psych facility EMS and/or transport staff at their facility to identify resources needed for patient movement (Communications link to evacuating facility) This can be a minimal number of staff Regional Coordinators Retreat Charleston - June 9, 2017

Evacuating facilities: Will consider a patient “placed” when two things have happened… They find an appropriate facility to receive the patient AND They find appropriate transportation to move the patient Regional Coordinators Retreat Charleston - June 9, 2017

All Healthcare Coalition members in that region: Who’s invited to participate in the Facilitated Discussion portion 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 Introduce CST to Regional Coordinators - June 9th Concepts and Objectives Meeting - June 22nd Overview at Emergency Preparedness Task Force Meeting - August 25th Training Sessions for Coordinators – September to November 2017 Training Sessions for Regions – September to November 2017 Presentation to Emergency Medical Services – November 2017 Conference Calls with Coordinators - TBD Coalition Surge Test (CST) Exercises – October 2017 to March 2018 Regional Coordinators Retreat Charleston - June 9, 2017

Whoooooooooo has 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