SC’s Critical Access & Rural Hospitals; Assessing Their Capability to Handle a Surge in Ventilator Patients Rich Branson MSc RRT FAARC Professor of Surgery.

Slides:



Advertisements
Similar presentations
Hospital Pandemic Influenza Planning by Ed Lydon, CVPH.
Advertisements

Appendix L, Ambulatory Surgical Centers Comprehensive Revision
Professor Stephen Smith Principal, Faculty of Medicine, Imperial College London and CEO of Imperial College Healthcare NHS Trust London’s 4th Major Trauma.
Hospital Emergency Management
Revised: March 21, 2011 Click anywhere on the screen to advance.
Karen M. Fuller Centers for Medicare & Medicaid Services
Hospital Surge Capability Program Neighborhood Emergency Acute Care Center Ned Wright Lisa Gibney Linn County, Iowa Medical Reserve Corps Coordinators.
The effect of ED crowding on outcomes Jesse M. Pines, MD, MBA, MSCE Associate Professor of Emergency Medicine and Health Policy George Washington University.
New Staff Orientation1 SURVEY AND CERTIFICATION 101 Tracey B. Mummert, MT (ASCP) Special Assistant CMSO, Survey and Certification Group.
June 2014 ILLINOIS SMALL & RURAL HOSPITALS : Anchors of Their Communities.
Homeless Respite. Committee Members and Contributors Alachua County Health Dept. Shands St. Francis House Alachua County Poverty Reduction Program North.
(FOR USERS OF EMRESOURCE© IN CA INLAND REGION) REVISED: MAY 28, 2013 CLICK ANYWHERE ON THE SCREEN TO CONTINUE Welcome to the HAvBED Training Module
Topics covered today:  Observation Beds  Initial Surveys  Deaths Related to Restraint/Seclusion  Other.
Results of the 2002 Emergency Pediatric Services and Equipment Supplement (EPSES) to the National Hospital Medical Care Survey (NHAMCS) Centers for Disease.
Hull and East Yorkshire Hospitals NHS Trust Membership Event: 7 October 2014 Emergency Preparedness: How would HEY respond to a major incident?
Hospital Patient Safety Initiatives: Discharge Planning
MEDICALLY CLEARED NOW WHAT? From hospital to rehab where do the children go?
Adapted from CMS guidelines Aug 2013 for Ambercare Corporation Education Department 2014.
© 2011 Smith Moore Leatherwood LLP. ALL RIGHTS RESERVED. The ER, Physicians, and EMTALA September 22, 2011 Presented by: Toby WattErin Shaughnessy ZuikerSmith.
EMERGENCY MEDICAL SERVICES (EMS). Emergency Medical Services (EMS) Responsibilities Include Providing emergency medical aid, triage, and decontamination.
EMTALA Rules of the Road The History of EMTALA The Emergency Medical Treatment and Labor Act (EMTALA) was enacted by Congress in 1986 as part.
Surge Capacity Plan EMERGENCY DEPARTMENT.  Surge capacity strategies will be implemented when volume exceeds staffing and/or treatment space POLICY:
PREECHA SIRITONGTAWORN,MD,FRCST,FAC S. DEPARTMENT OF SURGERY FACULTY OF MEDICINE SIRIRAJ HOSPITAL.
Copyright © 2008 Delmar Learning. All rights reserved. Unit 1 Community Health Care.
U.S. Hospital Support for Major Emergencies Megan R. Angelini Senior Fellow American College of Healthcare Executives.
Rural Wisconsin Health Cooperative Critical Access Hospitals Better Medicare Financing For Smaller Hospitals Serving Rural Communities.
The State of America’s Hospitals— Taking the Pulse Results of AHA Survey of Hospital Leaders, March/April 2010 May 24, 2010.
What is a Critical Access Hospital ? Robert David, President UH Regional Hospitals – Richmond and Bedford Medical Centers.
HRSA SURGE CAPACITY DATA SURVEY TECHNICAL ASSISTANCE California Department of Health Services Emergency Preparedness Office.
Hospital Categorization: Role in Advancing Emergency Medicine Track D September 15, 2003 Barcelona Lewis R. Goldfrank, MD Professor and Chairman of Emergency.
Question Are Medical Emergency Team calls effective in reducing cardiopulmonary arrest rates in the general medical surgical setting? Problem The degree.
The State of America’s Hospitals – Taking the Pulse A CHART PACK Findings from the 2006 AHA Survey of Hospital Leaders.
Winter planning in Dumfries and Galloway. Surge in demand outstrips capacity Multi agency escalation policy signed off by CHP in Fully worked up.
Revised: March 23, 2010 Click anywhere on the screen to advance.
Homeless Respite Presented by: Diane Dimperio. Committee Members and Contributors Alachua County Health Dept. Shands St. Francis House Alachua County.
Assessing Hospital and Health System Preparedness and Response Helen Burstin, M.D., M.P.H. Director Center for Primary Care Research Agency for Healthcare.
ACUTE-CRISIS PSYCHIATRIC SERVICES DEVELOPMENT INITIATIVE DC Hospital Association Department of Mental Health June 30, 2004.
Home Care Standards for Respiratory Therapists Tim Buckley, RRT FAARC Director Respiratory Services Walgreens Home Care.
Prepared to Care: The 24/7 Role of America’s Full- service Hospitals.
HIT FINAL EXAM REVIEW HI120.
The Need to Re-Engineer the Way Hospitals Work and Respond National CME Emergency Management Audioconference July 22 nd, 2008 Brent Asplin, MD, MPH Head,
Transfer Center & Emergency Medical Treatment and Labor Act (EMTALA)
TIME CRITICAL DIAGNOSIS
Nursing Assistant Unit 1 Chapter 1: The Health Care System Unit 1 Chapter 1: The Health Care System.
Liaison Psychiatry Service Models ‘Core 24’ and more
Proposals by Paramedical Staff to Initiate Rehabilitation in Patients with Critical Illness on Mechanical Ventilation Acknowledgements This study was approved.
Question Are Medical Emergency Team calls effective in reducing cardiopulmonary arrest rates in the general medical surgical setting? Problem The degree.
West Gables Rehabilitation Hospital 2015 Stakeholder Report: Brain Injury Program For more than 25 years, West Gables Rehabilitation Hospital has made.
By: Alisa and Courtney Fourth Intro.  A respiratory therapist treats people with disorders affecting the cardiopulmonary system.  The RRT will diagnose.
Dr. Andrew Foulkes Medical Director Surrey and Sussex Area Team Clinical Senate Summit A&E, Acute Medicine and the Medical Specialties.
The Status of the Nation’s Emergency Management System Gail L. Warden Chair, Committee on The Future of Emergency Care in the United States Health System.
Carolinas Healthcare System Blue Ridge. Blue Ridge Together, Morganton (Grace) and Valdese Hospitals have been serving people throughout our area for.
CRITICAL ACCESS HOSPITALS. Balanced Budget Act of 1997 The BBA had a severe financial impact on hospitals around the country. To help alleviate the impact.
Survey of acute hospital resources for patients with COPD T McCarthy, M O’Connor, on behalf of the National COPD (Respiratory) Strategy Group Population.
EMS Workforce in the Hospital
Community Health Centers of Arkansas Hazard Vulnerability Assessment Workshop August 11, 2017 Mark Fuller.
Understanding the Centers for Medicare & Medicaid Services (CMS) Rule
Governing Body QAPI 2013 Update for ASC
[Exercise Name] [Date]
Health Facility Services
CMS Emergency Preparedness Rule
Trauma and Stroke Improved Outcomes in Utah Hospitals
Skills Station: Surge.
What is Critical Care.
Understanding the Centers for Medicare & Medicaid Services (CMS) Rule
OHA update Ohio Hospital transparency
OHA update Ohio Hospital transparency
LEVERAGING PURCHASED/REFERRED CARE (PRC) RATES
SCDMH Telepsychiatry :
Presentation transcript:

SC’s Critical Access & Rural Hospitals; Assessing Their Capability to Handle a Surge in Ventilator Patients Rich Branson MSc RRT FAARC Professor of Surgery University of Cincinnati Scott M. Lane, RRT, RCP Chairman, SCSRC Disaster Preparedness Committee Brooke Yeager, MSc, RRT, RCP President-Elect SCSRC

Chest Aug 21. doi: /chest [Epub ahead of print]

Critical Access Hospitals A Medicare participating hospital must meet the following criteria to be designated as a CAH: Be located in a State that established a State rural health plan for the State Flex Program Be located in a rural area or be treated as rural under a special provision that allows qualified hospital providers in urban areas to be treated as rural for purposes of becoming a CAH; Demonstrate compliance with 42 CFR Part 485 subpart F at the time of application for CAH certification; Furnish 24-hour emergency care services 7 days a week, using either on-site or on-call staff, with specific on-site response timeframes for on-call staff Maintain no more than 25 inpatient beds that may also be used for swing bed services; however, it may also operate a distinct part rehabilitation or psychiatric unit, up to 10 beds; Have an average annual length of stay of 96 hours or less per patient for acute care

Participants The five critical access hospitals surveyed were: – Abbeville – Allendale – Edgefield – Fairfield – Williamsburg The rural hospitals surveyed were: – Cannon Memorial – Chesterfield – Coastal Carolina- No response – Lake City- - No response – Southern Palmetto Hospital- No response

The Survey Does your facility have a disaster plan?

The Survey Does your facility have a disaster plan? All CAH and Rural hospitals who responded had a disaster plan. This finding was suspected as this is a JCAHO requirement

The Survey The Space How many ICU beds are in your facility? How many recovery rooms or PACU beds are in your facility? How many emergency room beds are in your facility? The Staff Is there 24 hour day, in-house physician coverage? Is there 24 hour day, in-house respiratory therapy coverage? If not, how many hours? The Stuff How many ventilators does your facility own?

The Survey The Space How many ICU beds are in your facility? CAH – 3 none2 4-6 beds Rural – 4-6 beds How many recovery rooms or PACU beds are in your facility? CAH – four hospitals– none1– 4 beds, Rural – 2-4 beds How many emergency room beds are in your facility? CAH – 5-9, Rural 8-9

The Survey The Staff Is there 24 hour day, in-house physician coverage?Yes all_____ Is there 24 hour day, in-house respiratory therapy coverage CAH 3 Y Rural Y If not, how many hours?CAH 8 or 16 H The Stuff How many ventilators does your facility own? – CAH 1-4 (2), Rural 3-4

Bed Space

Total Additional Ventilators

The Survey Is your facility affiliated with a health system ? If yes, does this affiliation include transfer of patients during a disaster? If yes, does this affiliation include staff sharing? Could your facility accept patients from other areas in the event of a MCRF event? How many additional mechanically ventilated patients could your facility care for over an 8-12 week cycle?

The Survey Is your facility affiliated with a health system ? CAH – 4 N 1 Y, Rural – 2 Y If yes, does this affiliation include transfer of patients during a disaster? 1 Y If yes, does this affiliation include staff sharing?_No_ Could your facility accept patients from other areas in the event of a MCRF event?CAH 2- Y, 2 N, 1 Maybe____ How many additional mechanically ventilated patients could your facility care for over an 8-12 week cycle?_2-4 (two CAH 0)

The Survey Do you have an written agreement or contract with a medical equipment supplier to supply extra ventilators during a surge? __________

The Survey Do you have an written agreement or contract with a medical equipment supplier to supply extra ventilators during a surge? All No____

Increasing Capacity Neither the rural or CAH hospitals could contribute significantly to the Critical Care Capacity in the State. Additional patients at the CAH would require sending staff and stuff (ventilators) Critical care is best accomplished in centers with capacity and expertise Movement of less severely ill patients to CAH or rural hospitals seems prudent to clear space in larger centers

Conclusions CAH and rural hospitals should consider developing patient transfer agreements with larger health systems for diversion of patients in a mass casualty situation. Health systems should develop systems to direct patients requiring the highest levels of care to tertiary centers avoiding crowding of CAH and rural emergency departments. Transport teams with experience and equipment capable of caring for critically ill mechanically ventilated patients with respiratory failure should be developed for safe patient transfer. These teams should include a respiratory therapist.