1. WUMC Medical Surge Plan FPP Clinical Practice Committee August 16, 2016

2. 2 Background The Medical Surge plan is designed to coordinate and manage medical staff, supplies and facilities on the WUMC campus in the event of a mass casualty event WUSM Emergency Management convened a group of BJH, SLCH, and WUSM faculty and staff to design a plan to coordinate and manage medical staff, supplies, and facilities. Group Leaders: Ryan Nicholls and Anna Taylor BJHSLCHWUSM Katie Henderson, MD Alexis Elward, MD Doug Char, MD Emma Hooks Dwynn Isringhausen Dee Hodge, MD Dan King Michelle Tanton David Tan, MD Kelley Mullen, RN

3. 3 Plan Scope Original mass casualty plan was co-developed by WUSM, BJH and SLCH and approved by the FPP CPC in April 2009 The plan was reviewed for potential vulnerabilities and gaps in 2012 following a tornado-related mass casualty event in Joplin, Missouri The plan has now been further refined and expanded to include sharing of:  Providers  Staff  Supplies  Equipment  Space

4. 4 Assumptions BJH, SLCH, and WUSM clinical departments will have more detailed plans for use of their internal resources When an event occurs requiring multi-institutional support, this plan will coordinate efforts across institutions

5. 5 Definitions Each hospital will define the following:  Conventional Capacity (Level 1): ED capable of managing volume  Contingency Capacity (Level 2): ED may need some assistance to manage increased volume  Crisis Capacity (Level 3): A full mass casualty implementation is needed to manage increased ED volume

6. 6 Notification Any institution declaring a level 2 (contingency capacity) or level 3 (crisis capacity) emergency, will notify the 24/7 contacts of the other institutions immediately 24/7 contacts are:  BJH Environmental Health and Safety  SLCH Emergency Management  WUSM Protective Services Dispatch From there, each institution will notify their internal departments WUSM Dispatch will notify Emergency Management and FPP Clinical Operations

7. 7 Command Centers Each institution will stand up their respective command centers  BJH and WUSM will co-locate their command centers once the new Mid-Campus Center opens in 2017 BJH and SLCH will use available on-call providers first Both hospitals have designees who will communicate medical surge needs to WUSM WUSM FPP will serve as primary coordination point for hospital requests

8. 8 Requests for Medical/Clinical Personnel Three groups defined: 1)Privileged Medical Practitioners (MD, NP, PA, etc) Hospitals will activate Anesthesiology, Radiology, Trauma Surgery, and Emergency Medicine Use of residents will be coordinated through their Program Directors Additional requests through WUSM Emergency Operations Center (EOC) and FPP 2)Non-Privileged and/or Non-Employed Medical Professionals Process established to grant temporary privileges 3)Non-Medical Personnel Requests made through WUSM EOC NOTE: The BJC Command Center and St. Louis Medical Operations Center will be contacted if staff and other resources are required beyond those available at WUMC

9. 9 Communication The FPP will coordinate communication of mass casualty events to WUSM departments using:  Phone calls  Direct e-mail  FPP Announce  Everbridge notification system Updates will be provided to the Department Chairs, Business Directors and Medical School Leadership regularly until the conclusion of the event

10. 10 Requests for Equipment & Supplies Requests will come from Hospital Command Centers WUSM EOC/FPP will coordinate requests to WUSM departments, as needed, and track quantity, length of use, and location where equipment/supplies are deployed

11. 11 Alternate Medical Space Alternate medical spaces may be required for major mass casualty incidents WUSM EOC will coordinate use of alternate space with BJH and SLCH Examples include:  Olin Hall  CAM  EPNEC

12. 12 Next Steps 1)Approval of plan by BJH Medical Executive Committee (Done – Aug 1) 2)Approval of plan by FPP Clinical Practice Committee (Aug 16) 3)Communication of plan to Clinical Management Council (Aug 18) 4)Communication of plan to Clinical Administrator’s Committee (Aug 23) 5)Approval of plan by SLCH Medical Executive Committee (Sep 12) 6)WUSM Emergency Management and FPP will work with departments to coordinate the WUMC Medical Surge Plan with exisiting department- based plans