1. REGION 5/6: DISASTER CLINICAL ADVISORY COMMITTEE Vicki L. Sakata, MD, FAAEM, FAAP Senior Medical Advisor NWHRN

2. Disclosure Statement of Financial Interest I, Vicki Sakata, I, Vicki Sakata, DO NOT have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this presentation. DO NOT have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this presentation.

3. DISASTER CLINICAL ADVISORY COMMITTEE  IOM Letter Report 2009  “Establish a Medical Disaster Advisory Committee”  Responsible for developing CSC  Provide input on a wider range of medical care issues during a disaster for which consistent policies are required  Ethical Framework  Fairness  Duty to Care  Duty to Steward Resources  Transparency  Consistency  Proportionality  Accountability

4. DISASTER CLINICAL ADVISORY COMMITTEE  IOM Recommendations for Membership:  Technical medical expertise from a variety of medical specialties  Individuals informed by real life experience  Personal responsibility for coordinating healthcare system response and mitigation efforts  Practical know-how

5. CSC WORKSHOP 2011

6. REGION 5/6 DISASTER CLINICAL ADVISORY COMMITTEE CORE COMMITTEE  Ambulatory primary care clinician (Adult and Pediatric)* (2)  Blood specialist (2)  Clinical operations nurse (2)  Critical care nursing supervisor  Critical Care Physician (Adult (5)and Pediatric(2))  Emergency medicine physician (6)  Emergency Medical Services (EMS)  Ethicist (4)  Home health clinician*  Hospitalist (Adult and Pediatric) (1)  Infection control professional/Infectious Disease Specialist* (4)  Long term care clinician*  Mental health clinician* (1)  Palliative care clinician*  Patient advisory committee representative  Pharmacist (1)  Surgeon (1)

7. REGION 5/6 DISASTER CLINICAL ADVISORY COMMITTEE Subject Matter Experts:  Gerontologist  Laboratory/Pathology Specialist  Legal counsel  Local Public Health  Medical Examiner’s Office  Nephrologist  Obstetrician  Perinatologist/neonatologists  Radiologist  Surgical Subspecialists  Toxicologist

8. REGION 5/6 DISASTER CLINICAL ADVISORY COMMITTEE Feb 1, 2012 Preparedness role  Provide clinical guidance and expertise in:  Identifying indicators and triggers  Developing resource conservation strategies for medical surge  Input on regional preparedness plans  Build relationships

9. REGION 5/6 DISASTER CLINICAL ADVISORY COMMITTEE  RESPONSE ROLE  Information Only: Situational awareness  Action required  Provide a clinical forum for discussion  Provide recommendations and/or guidance during medical surge  Stuff, staff, space, standards of care  Develop or modify regional clinical protocols and triage algorithms  Provide guidance and interpretation of State and/or Federal guidelines.

10. REGION 5/6 DISASTER CLINICAL ADVISORY COMMITTEE 2012-2013

12. REGION 5/6 DISASTER CLINICAL ADVISORY COMMITTEE 2012-2013 – Education: IOM 3C’s (Conventional, Contingency, Crisis 4S’s Surge (Space, Stuff, Staff, Standards of Care) Surge Strategies (Prepare, Conserve, Adapt, Re-use, Re-allocate Scarce Resource Cards 2014-2015 – Scarce Resource Cards – Subspecialty Workgroups

13. REGION 5/6 DISASTER CLINICAL ADVISORY COMMITTEE  Pediatric Critical Care Workgroup (15)  Neonatologists (2)  Critical Care MD (4)  Peds EM MD (2)  General Peds/Hospitalists (2)  Critical Care/General Pediatric Nurse Managers and ANM (4)  Peds Ethicist (1)  Adult Critical Care Workgroup (12)  Critical Care MD (4)  Adult EM MD (3)  Adult Hospitalists (2)  Ethicist (1)  Hospital Nurse Managers (2)

14. REGION 5/6 DISASTER CLINICAL ADVISORY COMMITTEE  Nephrology Workgoup (10)  Nephrologist (Adult) (4)  Clinical Nurse Specialists (Adult/Peds) (3)  Hospital Nursing Director (1)  Dialysis Centers (1)  Northwest Renal Network (1)  Liability Workgroup (9)  Physicians  State  Public Health

15. REGION 5/6 DISASTER CLINICAL ADVISORY COMMITTEE 2012-2013 – Education: IOM 3C’s (Conventional, Contingency, Crisis 4S’s Surge (Space, Stuff, Staff, Standards of Care) Surge Strategies (Prepare, Conserve, Adapt, Re-use, Re-allocate Scarce Resource Cards 2014-2015 – Scarce Resource Cards – Subspecialty Workgroups – EVD68 – Ebola – State DMAC

16. REGION 5/6 DISASTER CLINICAL ADVISORY COMMITTEE Benefits

17. REGION 5/6 DISASTER CLINICAL ADVISORY COMMITTEE Video

18. REGION 9 DISASTER CLINICAL ADVISORY COMMITTEE Find the right people – ER, Critical Care, Primary Care, Peds, Surgery, Mental Health Education Understand Resources Define goals – Medical Surge Continuum: – Identify players and how they would integrate (PH, Healthcare, EMS, Coalitions, DMCC) – Gap Analysis: What does your region need? – Crisis Standards of Care Scarce Resource Cards Consider: Healthcare Executive Response Committee (HERC) – Clinical vs “business” of Healthcare Keep the “Clinical” in DCAC

19. Questions? Thank you. CONTACT: vicki.sakata@nwhrn.org 425-988-2898

20. Vicki Sakata 425-988-2898 vicki.sakata@nwhrn.org