1. Introducing ASPR’s Coalition Surge Tool
An Exercise for Assessing and Improving Health Care Coalition Readiness
Regional Coordinators Retreat Charleston - June 9, 2017

2. Healthcare Preparedness Program (HPP): New Project Period 2017-2022
Building on where we’ve been
Regional Coordinators Retreat Charleston - June 9, 2017

3. The last grant period: 2012-2017
We were told to build “Coalitions”
INCLUDE EVERYONE
Regional Coordinators Retreat Charleston - June 9, 2017

4. Coalition Surge Tool (CST)
This Grant Period:
The Coalition’s exercise focus narrows in its application of the
Coalition Surge Tool (CST)
Regional Coordinators Retreat Charleston - June 9, 2017

5. Targeted Groups in the Coalition Exercise
Evac Hospital
Receiving Hospital
Mental Health
Nursing
Dialysis
Core Members
Hospitals
Public Health
EMS
Emergency Management
Evacuating and Receiving Hospitals
Healthcare Executives (in the After Action Review)
Other HCC members (non-hospital) EH RH N D M
Regional Coordinators Retreat Charleston - June 9, 2017

6. HPP Budget Period 1: 2017 - 2018 7 CST Exercises Coalition Surge Test
HSEEP compliant exercises – functional elements and a TTX (facilitated discussion)
ASPR confirmed it as a “functional exercise”
Data is collected using the provided tools; training will be provided (no EEGs)
AAR is developed and submitted by each HCC
7 CST Exercises
Conduct the Coalition Surge Test in each WV Healthcare Coalition Region each year
Collect and Report
baseline data
Regional Coordinators Retreat Charleston - June 9, 2017

7. CST Goal and Objectives
Goal: Determine how ready a Coalition is to evacuate patients and move/place them at other facilities within the Coalition
Objectives: Selected hospitals (typically 1 - 3) demonstrate plans to:
#1 – evacuate enough patients to total 20% of the Coalition’s acute care patients (inpatient, including ICU - based on average daily census, not including ED patients)
#2 – identify facilities (within the Coalition) willing and able to receive each evacuating patient
#3 – identify appropriate transportation to transfer each patient
Regional Coordinators Retreat Charleston - June 9, 2017

8. The Coalition Surge Test is really an Evacuation Planning Drill
NO ACTUAL MOVEMENT OF PATIENTS
Low to No Notice Exercise to transition quickly into “disaster mode”. Provides a more realistic picture of the level of readiness than a preplanned, announced exercise. NOTE: The “A-Team” might not be your players this time
2-week time window with one hour notice
Uses peer assessment methods with tools provided by ASPR
Functional component - patient movement and transport are arranged with assets available from that region’s Healthcare Coalition
Table Top Exercise (conference call discussion) - Coalition members discuss functional outcome and identify gaps in surge planning
After Action Review Must have senior management-level participation After Action Report developed and submitted
Regional Coordinators Retreat Charleston - June 9, 2017

9. Who Initiates and Controls the Exercise?
Regional Coordinator
“Trusted Insider” and “Lead Assessor”
Who Evaluates the Exercise?
The Hospital Representative
“Evacuation Assessor” (primary and backup)
Regional Coordinators Retreat Charleston - June 9, 2017

10. Terminology
Trusted Insider & Lead Assessor = Regional Coordinator (Initiates and controls the exercise, facilitates TTX discussion and after-action review conference calls, develops the AAR)
Evacuation Assessor = Hospital representative at the evacuating acute care facilities (assesses evacuation decisions and contributes to the AAR)
Players = Staff at evacuating facilities and receiving facilities; other Coalition members involved in transport anad/or the TTX
Regional Coordinators Retreat Charleston - June 9, 2017

11. Applying the CST is a Phased Process
DAY 1:
Functional Component (~90 minutes)
Who’s Invited?
All hospitals in the Coalition, EMS and transport companies, Emergency Managers, Public Health departments
What Happens?
Evac hospital(s) identify needs and coordinate to find beds for their patients
Receiving hospitals communicate ability to provide beds
Transportation resources identified
Gaps identified for patient movement and placement
Regional Coordinators Retreat Charleston - June 9, 2017

12. Next Step in the Phased Process
DAY 1:
Facilitated Discussion/Tabletop Component (~180 minutes)
Who’s Invited?
All Coalition members
What Happens?
Lead Assessor facilitates (conference call) discussion with all Coalition members
Begins shortly after the functional part of the exercise
Scripted question and answer period using data collected and gaps identified during the exercise, to address:
Transportation planning Capacity of receiving facilities
Patient Tracking Public Information
Needs of at risk patients Continuity of Operations
Regional Coordinators Retreat Charleston - June 9, 2017

13. The 3rd Step in the Phased Process
Within 7 days of exercise OR can occur same day:
After Action Review/ Debriefing (30-90 minutes)
Who’s Invited?
All Coalition members, with senior representation from evacuating hospitals
What Happens?
Facilitated by the Regional Coordinator
Assessment of strengths/weaknesses
Delineation of corrective actions and recommended actions
Must include executive level (decision-makers)
Documentation of discussion topics are part of the AAR
Regional Coordinators Retreat Charleston - June 9, 2017

14. The Final Step of the Process
Within 45 days following the Exercise:
Development of the After-Action Report (AAR)
Developed by the Regional Coordinator (with input from the evacuation assessors and hospital representatives)
Submitted to WVHA (and to CTP and ASPR)
Provided to all Coalition members
Regional Coordinators Retreat Charleston - June 9, 2017

15. Who’s involved in the Functional component of the exercise?
Command staff (involved in patient identification and movement) at each evacuating facility
At least one senior staff member at each receiving facility (communications link to evacuating facility)
EMS and/or transport staff at their facility to identify resources needed for patient movement (communications link to evacuating facility)
Regional Coordinators Retreat Charleston - June 9, 2017

16. If you are one of the evacuating facilities (acute care):
You can consider a patient “placed” when two things have happened…
You find an appropriate facility to receive the patient (does not have to be acute care)
AND
You find appropriate transportation to get the patient there
Regional Coordinators Retreat Charleston - June 9, 2017

17. Who’s invited to participate in the Tabletop part of the exercise?
All Healthcare Coalition members in that region:
Hospitals (evacuating, receiving, and others not involved in patient movement)
Public health departments
Emergency Management departments
EMS (including private ambulance companies with hospital contracts and Regional Medical Commands)
Non-hospital healthcare and medical facilities (including LTC, dialysis, primary care, mental health, etc.)
Regional Coordinators Retreat Charleston - June 9, 2017

18. The WV Approach Concepts and Objectives Meeting - June 22nd
Introduce CST to Regional Coordinators - June 9th
Concepts and Objectives Meeting - June 22nd
Overview at Task Force Meeting - August 25th
Training Sessions by Region – September to November 2017
Conference Calls with Coordinators - TBD
Coalition Surge Test (CST) Exercises – October 2017 to March 2018
AARs for all 7 CST exercises must be submitted to WVHA no later than May 31, 2018
Regional Coordinators Retreat Charleston - June 9, 2017

19. 9:00 am to 12:00 pm (for Regional Coordinator)
CST Training Schedule
Region
Date
Time 1
Wed., Sept 20
9:00 am to 12:00 pm (for Regional Coordinator)
12:00 to 4:00 pm (for the Regional Coordinator & 2 possible Evacuation Assessors for each acute care hospital & each acute care hospital’s taskforce representative)
Lunch beginning at 11:30 am 2
Wed., Oct. 4
3/4
Thurs., Oct. 5 5
Wed., Oct. 25
6/7
Wed., Nov. 8
8/9
Thurs., Nov. 9
10/11
Thurs., Oct 26

20. Any Questions? Regional Coordinators Retreat Charleston - June 9, 2017
This Photo by Unknown Author is licensed under CC BY
This Photo by Unknown Author is licensed under CC BY-SA