Certified Hospital Emergency Coordinator (CHEC) Training Program Plan Development

Objectives Review hospital emergency planning, including: Creation of a Hospital Emergency Management Committee (HEMC) Formation of a Hospital Emergency Management Program (HEMP) Perform a Hazard Vulnerability Analysis (HVA)

Objectives, cont.. Creation of an Emergency Operations Plan (EOP) Discuss the importance of training, education, and exercises Discuss the necessity and value of frequent reassessment and revisions of the plans

Objectives, continued Define the current Emergency Management Standards from regulating bodies Understand the necessity of complying with standards

A Review of Hospital Emergency Planning Creation of a HEMC Formation of a Hospital Emergency Management Program (HEMP) Conduction of an HVA Creation of an EOP Training, education, and exercising Reviews and revisions The Hospital Emergency Management Committee should consist of key internal and external partners (can be ad hock members) Hospital Administrators Department Leaders Hospital Safety and Operations Leaders Representatives from Fire/EMS/Law Enforcement/Public Health/Business Community/Community Healthcare Providers (ad hock-most likely) The Hospital Emergency Coordinator (HEC) should be the leader of the HEMC (or an advisor to the committee) The Hospital Emergency Management Program (HEMP) addresses the four phases of emergency management: Mitigation Preparedness Response Recovery The HEMP governs disaster preparedness from day to day It’s the framework in which all elements of disaster planning exist It dictates that the hospital needs a HEMC, which must: Prepare, review, and revise an HVA, EOP, and COOP Ensure staff education & training Plan & execute drills in accordance with Joint Commission Standards The HVA should be prepared by the HEMC It should include a survey of hazards that not only might affect the hospital, but also those that might affect the broader community Resources, and historical data should be used to ease and streamline the process Using the HVA, the HEMC must author an EOP The EOP must contain key components, and it must provide a Continuity of Operations Plan (COOP) The EOP must also describe ways to mitigate the negative effects of an emergency or disaster, and it should suggest a route to recovery This needs to be done within the framework of the regulatory Guidelines

Compliance with Standards CMS, DNV, and TJC Standards in Emergency Management The organization develops and maintains an Emergency Operations Plan The Scope of the EOP is evaluated and updated annually (TJC). These are the guidelines…

Compliance with Standards Must maintain a written EOP that: Describes an all-hazards command structure Establishes an incident command structure that is integrated into and consistent with the community’s command structure Identifies to whom staff report within the Incident Command structure

Compliance with Standards, cont. Describes processes for initiating & terminating response & recovery phases, including: Who has the authority to activate the phases How the phases are to be activated Identifies the organization’s capabilities & establishes response efforts for at least 96 hours Identifies alternative sites for care, treatment, or services for patients during emergencies How many sites? Secondary? Of Course! Tertiary? We should! Termination of plans and phases is often overlooked and should warrant more thoughtful planning. Initiating is also an issue who has authority? Do employees have to notify that person to pull a fire alarm? Of course not! So why is it that way in other types of Disasters???

Compliance with Standards The guidelines, from TJC, CMS, and DNV can assist hospital emergency coordinators and their teams in developing plans which will mitigate many adverse impacts on patient safety and the hospital staff’s ability to provide care, treatment, and services for an extended time This is especially true in situations where the community cannot adequately support the [organization]. Power failures, water and fuel shortages, flooding, and communication breakdowns are just a few of the hazards that can disrupt patient care, and pose risks to staff and the [organization]. Though it’s not possible to predict future emergencies, hospitals can plan for managing critical areas of emergency response in order to assess their needs and prepare staff to respond to events most likely to occur

Compliance with Standards Areas of Emergency Response 1.Communication (EM.02.02.01) 2.Resources and Assets (EM.02.02.03) 3.Safety and Security (EM.02.02.05) 4.Staff Responsibilities (EM.02.02.07) 5.Utilities Management (EM.02.02.09) 6.Patient Clinical and Support Activities (EM.02.02.11) INSTRUCTOR: Spend a few minutes on this slide, fleshing out each bullet with the information below (Mention that the current standards provide reference materials and are available from their regulating bodies): Communication (see EM.02.02.01). In the event that community infrastructure is damaged and/or an [organization]’s power or facilities experience debilitation, communication pathways, whether dependent on fiber optic cables, electricity, satellite, or other conduits, are likely to fail. [Organization]s must develop a plan to maintain communication pathways both within the [organization] and to critical community resources. During an emergency, the campus or immediate environment around the [organization] may be under the authority of the local police or sheriff serving the larger community. Access to and from the [organization] on local roads and interstates could be subject to local, state or even federal control. As an incident evolves, this responsibility and authority may shift from one agency to another. For this reason, it is important that the Emergency Operations Plan includes reference to any existing community command structure to provide for on-going communication and coordination with this structure. In the absence of such a command structure, the [organization] maintains direct contact with the agencies charged with community security. 2. Resources and assets (EM.02.02.03). A solid understanding of the scope and availability of an [organization]’s resources and assets is as important, and perhaps more important, during an emergency than during times of normal operation. Materials and supplies, vendor and community services, as well as state and federal programs, are some of the essential resources that [organizations] must know how to access in times of crisis in order to ensure patient safety and sustain care, treatment, and services. 3. Safety and security (EM.02.02.05). The safety and security of [patient]s is the prime responsibility of the [organization] during an emergency. As emergency situations develop and parameters of operability shift, [organization]s must provide a safe and secure environment for their [patients] and staff. 4. Staff responsibilities (EM.02.02.07). During an emergency, the probability that staff responsibilities will change is high. As new risks develop along with changing conditions, staff will need to adapt their roles to meet new demands on their ability to care for patients. If staff cannot anticipate how they may be called to perform during an emergency, the likelihood that the [organization] will not sustain itself during an emergency increases. To provide safe and effective [patient] care during an emergency, staff roles are well defined; staff are oriented and trained in their assigned responsibilities; and staff maintains their competencies over time. 5. Utilities management (EM.02.02.09). An [organization] depends on the uninterrupted function of its utilities during an emergency. The supply of key utilities, such as power or potable water, ventilation, and fuel must not be disrupted or adverse events may occur as a result. 6. Patient clinical and support activities (EM.02.02.11). The clinical needs of patients during an emergency are of prime importance. The [organization] must have clear, reasonable plans in place to address the needs of patients during extreme conditions when the [organization]’s infrastructure and resources are taxed.

Training, Educating, and Exercising It is important that the plan is shared with all members of the hospital staff They must be educated on its contents and their roles in the execution of the plan Team work is required to succeed in an emergency, and in order to win the game, all players must understand the game and its rules CMS Guidelines “The organization tests its emergency operations plan twice a year.” One must be a community full-scale exercise Emphasize the importance of not allowing disaster response to be out of site, out of mind. Staff can not know what to do unless they are educated. They won’t remember what to do unless they train routinely. And, they won’t function well as a team unless they practice as a team, fairly often…and, at least as often as TJC says that they have to… Instructor should note that the last unit of this course is devoted to exercises and exercising: It will cover the number and types of exercises and the scope of exercises

Review and Revisions The EOP is a “living document” After action reports (AARs) should be completed and discussed by the HEMC after all exercises and real-life responses Routine assessments of staff training should also be done Information gained by such AARs and reviews should be used to revise and improve the EOP, and if necessary, the Emergency Management Program itself When [organizations have a sound understanding of their response to these six critical areas of emergency management, they have developed an “all hazards” approach that supports a level of preparedness sufficient to address a range of emergencies, regardless of the cause. [Organization]s should also identify potential hazards, threats, and adverse events, and assess their impact on the care, treatment, and services they must sustain during an emergency. This assessment is known as a Hazard Vulnerability Analysis (HVA) and is designed to assist [organization]s in gaining a realistic understanding of their vulnerabilities, and to help focus their resources and planning efforts. Finally, [organization]s should use the information from their assessments to develop Emergency Operations Plans, which should be tested regularly, and use the lessons learned to improve. This is the last slide, so if needed, the instructor may verbalize a quick summary of this lesson, and then ask for any questions before moving on to the PE.

Certified Hospital Emergency Coordinator (CHEC) Training Program Plan Development Questions?