1. COLORADO HOSPITAL MASS EVACUATION SUMMIT Developing a plan for evacuating your facility

2. Summit Process  Questions will be presented on ETACS and on the screens  Submit on ETACS as you finish each question  Give the consensus answer and any unique answers  Sharing and debriefing will occur periodically  ETACS answers will be compiled for distribution

3. Session One Mitigation and Preparedness  Sections I, II, and III of the plan  Time is allotted for each section but only as a guideline

4. Section I Questions  Why is Section I: Introduction of the plan important?  How are your facility’s plans organized? Do they use HICS/ICS or response procedures?  What format is most useful for your staff when the plan is activated? (Format examples include: quick checklists, detailed procedures, comprehensive explanation in paragraph form, etc.)  Has your facility determined if the evacuation plan will be a standalone plan, an annex, or an addition to another plan? What factors led to this decision?

5. Section I Review  Scope of the plan is important to determine  Plan organization varies  Integrate the Evacuation Plan with existing plans

6. Section II Questions  What definitions for evacuation does your facility currently use?  Why is it important to clearly define the type of evacuation?  How can we standardize definitions across facilities?  Brainstorm: name an example scenario for each type of evacuation.  Is there value in having a code for anything other than an immediate evacuation?

7. Section II Review  Definitions and terms should align with current plans and procedures  Clearly identifying evacuation types is crucial to a universal understanding of the evacuation goal  The communication process and terminology for the evacuation is vital for the success of the event

8. Section III Questions  What are types of resources the facilities should list as internal resources?  What community agencies do you regularly partner with for emergency planning?  For planning and preparedness, how do you coordinate with outside agencies?  With what agencies have you shared your evacuation plan? How?  Who are the appropriate agencies with which to have MOUs in place?

9. Section III Review  List the available resources.  Coordinate with community resources.  Establish and regularly review MOUs.

10. Please return in 15 minutes BREAK

11. Session Two Response  Section IV and V of the plan  Time is allotted for each section but only as a guideline.

12. Section IV Questions  How do you assess the situation in order to determine the need to evacuate? Is there a formal process and assigned staff to carry it out?  Of the hazards identified on the HVA, how would you analyze the hazards with the most potential for creating a need for partial or complete evacuation?  Why is it important to have a clearly delineated authority to evacuate?  How does the order of succession change in after hours situations? Questions continued

13. Section IV Questions continued  Does an evacuation order automatically trigger the activation of your command structure?  What are the methods of notification? Are there backup systems in place?  What are the factors that contribute to the order of evacuation?  How are the incident priorities determined and what staff are responsible for creating these priorities?

14. Please return at 1:00 LUNCH

15. Section IV Review  Determine the criteria that will be used to call an evacuation.  Everyone should understand who is in charge (of the facility and the department) when an evacuation is called.  Create a notifications template for internal and external notifications  Train staff about the order in which patients will be evacuated and how to prioritize patients for evacuation.

16. Section V Questions Part One  Does your facility have up-to-date evacuation routes defined? When was the last time the routes were reviewed?  Who has the authority to control elevator use? How would it happen?  How do you determine which areas require a unit-specific evacuation route plan?  What criteria are used to determine appropriate assembly areas?  How will floor staff/additional staff/external staff be educated about their roles in evacuation procedures?  How will additional staff and external staff be assigned to tasks required?

17. Section V Review Part One  Define evacuation routes.  Educate staff about challenges in the routes.  Assembly areas should be designated and coordinated with evacuation routes.  An elevator use policy should be developed and disseminated.  Educate staff and outside agencies about their roles and responsibilities to support the evacuation.

18. Section V Questions Part Two  What is the need for tracking resources including patients, equipment, records, etc.?  Who needs to understand resource tracking?  How is the resource tracking information communicated to all parties that need to know?  What are the special patient types for your facility? How would these affect the method of transportation?  What patient carries have you found to be successful or presented challenges in your experience?  What are possible methods of confirming the evacuation of areas?

19. Section V Review Part Two  Moving and tracking resources must be considered in advance.  Methods for moving patients must be determined and all staff trained on those methods.  A process to confirm evacuation should be instituted.

20. Please return in 5 minutes BREAK

21. Section VI and VII Questions  What possible complications arise from transferring patients to off-site locations?  What are the best practices for coordinating the relocation of patients to on-site or off-site locations?  Do current surge plans contain all the information necessary for a hospital evacuation receiving site?  How does the approach change if the disaster is widespread with a city or region?  Have you shared your plans with the most likely receiving sites?

22. Section VI and VII Review  Specific planning should take place for on-site and off-site relocation.  MOUs will be important to help avoid hindrances during response.  Surge plans may need to be adapted to account for evacuation specific issues.

23. Session Three Recovery  Section VIII and IX of the plan  Time is allotted for each section but only as a guideline.

24. Section VIII Questions  Who is responsible to coordinate determining the hospital status?  How do you determine priority for reinstating services?  What is the decision making process for determining when to repopulate?  How do you prioritize returning patients?  What methods are used for compiling and disseminating after action information?  How would stress management and mental health support services be administered?  When does the emergency end and day-to-day operations begin? How is this notification made?

25. Section VIII Review  Checklists will be useful for an orderly return to normal operations.  Determining the decision making process for repopulating the facility in advance offers the leadership a guideline to follow.  Mental health support cannot be overlooked.  Ensuring that everyone understands when the emergency is over facilitates a smooth transition back to normal operations.

26. Section IX Questions  After reviewing the plan template, what appendices would be most useful to include in your facility’s plan?  How do appendices support the plan?

27. Section IX Review  Plans, policies, procedures, and MOUs may be helpful as appendices.  Appendices allow the plan to contain detailed or contact information that can be updated without updating the entire plan.  Appendices allow the plan to contain in-depth information that can be quickly referenced and leave the plan brief and easy to navigate.

28. Please return in 15 minutes BREAK

29. Wrap Up  What are the major steps your facility needs to accomplish in order to complete your plan?  What steps need to be taken with other hospitals and community partners to make the plan operational?  What were the top three lessons learned during this Summit?  What three items are of the most concern going forward in the planning process?  How can the challenges be addressed?