Hospital Preparedness & Epi’s as partners in support of Public Health Preparedness Richard Bartlett, B.S., M.Ed. Emergency Preparedness & Trauma Coordinator Kentucky Hospital Association Kentucky Hospital Research & Education Foundations

ASPR HPP & CDC PHEP In response to the National Preparedness Goals ASPR (Assistant Secretary for Preparedness and Response) aligned the Hospital Preparedness Program (HPP) with CDC’s Public Health Emergency Preparedness (PHEP) program. Defined a set of Healthcare Preparedness Capabilities to assist healthcare systems, Healthcare Coalitions, and healthcare organizations with preparedness and response. 1. Healthcare System Preparedness 2. Healthcare System Recovery 3. Emergency Operations Coordination 5. Fatality Management 6. Information Sharing 10. Medical Surge 14. Responder Safety and Health 15. Volunteer Management

Interoperable Communications Systems Tracking Bed Availability (HAvBED) ESAR-VHP (KHELPS in KY) Medical Evacuation/Shelter in Place Alternate Care Sites (ACS) Mobile Medical Assets Pharmaceutical Caches Personal Protective Equipment Decontamination Medical Reserve Corps (MRC) Critical Infrastructure Protection (CIP) Sub-Capabilities

Healthcare Coalitions Collaborative network of HC organizations, and their respective public and private sector response partners, within a defined region. Coalitions serve as a multi-agency coordinating group – Participating agencies include, but are not limited to:  Hospitals, Urgent Care Centers and FQHC  Local/district Health Departments  EMS, coroners, medical societies  Mental Health and crisis response groups  Long-Term Care  Red Cross & NGO’s – Assists with Emergency Management, ESF-6 and ESF-8 Partner specific and regional HVA development – Coordinates preparedness, response, recovery and mitigation related to HC disaster operations. – Jointly plan, exercise and train as a region – Regional information sharing & information development – Provides situational awareness

Severe Weather Lessons Learned

Example HVA SEVERITY = (MAGNITUDE - MITIGATION) EVENT PROBABILITY HUMAN IMPACT PROPERTY IMPACT BUSINESS IMPACT PREPARED- NESS INTERNAL RESPONSE EXTERNAL RESPONSE RISK Likelihood this will occur Possibility of death or injury Physical losses and damages Interuption of services Preplanning Time, effectivness, resouces Community/ Mutual Aid staff and supplies Relative threat* SCORE 0 = N/A 1 = Low 2 = Moderate 3 = High 0 = N/A 1 = Low 2 = Moderate 3 = High 0 = N/A 1 = Low 2 = Moderate 3 = High 0 = N/A 1 = Low 2 = Moderate 3 = High 0 = N/A 1 = High 2 = Moderate 3 = Low or none 0 = N/A 1 = High 2 = Moderate 3 = Low or none 0 = N/A 1 = High 2 = Moderate 3 = Low or none % Mass Casualty Hazmat Incident (From historic events at your MC with >= 5 victims) % Small Casualty Hazmat Incident (From historic events at your MC with < 5 victims) % Chemical Exposure, External % Small-Medium Sized Internal Spill % Large Internal Spill % Terrorism, Chemical % Radiologic Exposure, Internal % Radiologic Exposure, External % Terrorism, Radiologic % AVERAGE % 8

Joint Commission requires a hospital to have an alternate site outside the hospital setting in case of evacuation Very few facilities have actually had to implement these types of plans.

Statewide Mobile Treatment Center

Medical Evacuation

Trust for America’s Health Ready or Not

Cumberland Valley Outbreak Started with reports of some unusual deaths, some involving people who had been in jail Regional EPIs worked with local hospital ICP and ED staff to build/refine case definition Coordinate access and review of current and past medical records Worked with MDs in private practice and local coroners Worked with state PH in adjoining states Confluence of circumstances, but not necessarily a new disease.

BECKY Long range effort to collaboratively build EPI capacity throughout the state Encourage academic programs, and internships Recent question: Can BECKY help create the next generation of Hospital ICP’s? – Discussions about create working sub-committee of the regional HCC of local and regional EPIs and ICPs from regional HCO – Networking, education, partnerships for outbreak investigations

What can you do? Become engaged with the regional coalitions Find and get to know the key hospital POCs – Emergency preparedness coordinator – Hospital ICP & ED managers Work within the regional JIS to coordinate messaging and information sharing – HD, hospital, EMS, coroner and other PIOs – Consistency with State PH and CDC

Richard Bartlett, B.S., M.Ed. Emergency Preparedness & Trauma Coordinator Kentucky Hospital Association