1. Regional Resource Center Stony Brook University Medical Center Special Project Presentation December 2007

2. Our project Hospital Internal Surge Capacity/Capability Hospital Internal Surge Capacity/Capability

3. Our Task  Develop a model and system to evaluate and report on the potential internal surge capacity and capability for each hospital in its region.  Designated site evaluation factors to describe at a minimum the top three surge locations in each facility.

4. Purpose To allow the healthcare infrastructure in all regions of New York State to engage in meaningful planning based on credible estimates of its ability to surge by providing this method and data. To allow the healthcare infrastructure in all regions of New York State to engage in meaningful planning based on credible estimates of its ability to surge by providing this method and data.

5. Keep in Mind The internal sites being considered and evaluated related to this project are spaces not typically used for patient care, and are above and beyond the hospitals’ currently designated surge beds. So, the questions is “……..now what do we do?” The internal sites being considered and evaluated related to this project are spaces not typically used for patient care, and are above and beyond the hospitals’ currently designated surge beds. So, the questions is “……..now what do we do?”

6. The Plan  Provide a presentation for the Suffolk RPC members detailing the scope and purpose of the special project.  Hospitals will identify three non-patient care areas within each hospital which may be converted to a patient care area in response to surge.  Classify these areas by color: Red – critical patients Red – critical patients Yellow – intermediate patients Yellow – intermediate patients Green – minimal care patients Green – minimal care patients

7. The Process  Develop an evaluation/scoring tool based on specific criteria to rate the capacity and capability of each area.  Define the criteria used in the evaluation tool.  Document with photographs, floor plans and scores of each area.  Perform site visits at each hospital to determine suitability.

8.  Work with the support RRCs and RPC members to gain insight, creative thinking and feedback throughout the process.  Provide routine progress reports via conference calling to our support RRCs, field representative and liaison.  Design and create a hard copy report as well an audio/visual presentation of the project.

9. Site Identification  Choose non-patient care areas.

10. Scoring Tool  Based on the Rocky Mountain Assessment Tool for Alternate Care Sites.  Assessment Criteria - Infrastructure - Infrastructure - Total Space and Layout - Total Space and Layout - Utilities - Utilities - Communications - Communications - Other Services - Other Services

11. Evaluation Criteria For example:  Telephone The area has existing telephone lines and equipment. The phone lines have a back up system in case of power failure. If no existing telephone, portable phones (wireless) are available and can be brought to the area for use. The area has existing telephone lines and equipment. The phone lines have a back up system in case of power failure. If no existing telephone, portable phones (wireless) are available and can be brought to the area for use.

12. Rating  3 = Equal to or same as  2 = Similar but has some limitations (quantity/condition) (quantity/condition)  1 = Not similar (will take major modifications) modifications)  0 = Does not exist at this site

13. INTERNAL SURGE CAPACITY SITE SCORING TOOL INTERNAL SURGE CAPACITY SITES INTENSIVE CARE INTERMEDIATECAREMINIMALCARE INFRASTUCTURE DOOR SIZES ADEQUATE FOR BEDS 3 FLOORS (CLEANABLE SURFACES) TOILETS FACILITIES AND SHOWERS FOR PATIENTS 2 VENTILATION EMRGENCY EXIT FIRE SUPPRESSION EQUIPMENT (SPRINKLERS, EXTINGUISHERS,ALARMS) 0

14. Site Visits  On site walk through at each facility.  Discuss the features of the site.  Acquire floor plans and photos.

15. Collaboration  Routine conference calls with the support RRCs: *Pati-Anne Guzinski - ECMC *Pati-Anne Guzinski - ECMC *Kathy Same - SUNY Upstate *Kathy Same - SUNY Upstate  Support RRCs contribute to the process and provide feedback  Routine updates with DOH and the RPC members

16. Barriers to Progress  Coordination of site visits.  Reinforcing the difference between pre- designated surge areas and non-patient care areas.  Construction issues and changing environments.  They won’t give up the plans!

17. Final Product  A journal to provide an overview of the project.  A power point presentation to explain project.  Written report for HEPP.

18. How Did We Do?  All 11 hospitals in Suffolk County participated in the project.  Previously reported hospital surge beds for the region in 2007 = 684.  Potential hospital non-patient care area surge beds for the region captured in this project = 552.

19. What Does it Mean?  The number of potential surge beds assessed reflects physical space.  Effective operation of the surge sites is contingent on a number of variables.  The nature, scope and duration of the incident.  Is the facility affected by the incident?  Are the needed resources available?  Adequate staffing.

20. Lessons Learned  Hospitals have the ability to identify and convert non- patient care areas into patient care areas.  Keep green patients away from the “action.”  Keep yellow and red patients near areas of equal acuity.  Identified surge sites may not continue to exist over time.  All necessary resources may not be available.  Plans for staffing need regional elements.  Systems to manage internal surge data need further evaluation.

21. Next Steps  Exercise the activation and operation of a surge site for each facility.  Identify the sources and methods to acquire needed resources.  Identify staffing resources in the region (notification, mobilization, credentialing).  Continue to assess non-patient care areas as a regular component of hospital emergency planning.  Include regional partners in planning and exercises.

22. Any Questions? Thank you! Thank you!