1. Certified Hospital Emergency Coordinator (CHEC) Training Program
Emergency Communications and
the Media

2. Objectives After completing this lesson, you should be able to:
Describe the alert and notification methodologies and emergency communication equipment commonly used in hospitals.
Recognize the difference between internal and external alert and notifications.
Discuss Media management strategies.

3. Alerts and Notifications-ASPR
“Recipients shall build or complete development of an operational redundant communication system that is capable of communicating both horizontally between healthcare providers and vertically with the jurisdiction incident command structure”
—(ASPR Cooperative Agreement, 2007)
This slide is for comparison from 10 years ago, from where we’ve come from to what is expected now.
Under the requirement for the Hospital Preparedness Program, interoperable communications, which included methods and technologies for alerts and notifications is a critical component of emergency response. Not only should these systems work within the hospital, but they should also be able to communicate with community partners outside of the hospital.

4. Hospital Preparedness Program Measure Manual, Implementation Guidance for the HPP Program Measures
Indicator #4: The HCC has demonstrated the capability of a redundant means of communication for achieving and sustaining situational awareness.
Interpretation:
As IT becomes central practice, healthcare organizations must become increasingly vigilant about preparations for continuity of operations when normal IT and communication functions are disrupted.
The HCC should help members develop plans and checklists to recover and restore IT and communication delivery systems, voice/data networks, and clinical and business applications/data before unacceptable loss occurs.
This includes the implementation risk mitigation and recovery strategies, and the development of technology recovery plans and the creation of redundant communication systems.
From the 2015 measures manual. HCC=healthcare coalition (in the HPP document referenced above)

5. Communications-Joint Commission
Standard EM
“As part of its Emergency Operations Plan, the hospital prepares for how it will communicate during emergencies”
The Joint Commission Emergency Management Standards also addresses communications, and requires that those plans and processes are included in the hospital’s Emergency Operations Plan.

6. Communications-CMS CMS 2017 EM Standard
“We are requiring facilities to develop and maintain an emergency preparedness communication plan that complies with both federal and state law. Patient care must be well-coordinated within the facility, across healthcare providers, and with state and local public health and emergency management agencies and systems to protect patient health and safety in the event of a disaster.”

7. Alerts and Notifications
Who needs to be notified?
What technology will you use for notification?
When should they be notified?
Where are alert and notification procedures and equipment located?
Why do they need to be notified?
How are alert and notification procedures and equipment tested?
Click for each bullet and ask for a response from the students.
When creating or revising alert and notification procedures, think of the who, what, when, where, why, and how in various emergency response situations. Creating an all-hazards approach can help in keeping contact lists manageable and easier to maintain, although there may be examples of agencies that will only be alerted in certain situations. In this unit, each of these questions will be addressed.

8. Who needs to be notified?
Internal
Hospital Incident Command Staff
CEO or Administrator on-call
Members of the Hospital Emergency Management Committee
Security Staff
Switchboard/Dispatch Staff
Patients (in and outpatients) visitors, and families
Others?
In an emergency response situation, there are people within the hospital to alert and notify. These people may include the Hospital Incident Command Staff, the CEO or Administrator on-call, members of the Hospital Emergency Management Committee, security personnel, and dispatch/switchboard personnel.
It is especially critical to plan on how to alert and notify patients and families in case of an emergency. Consider any differences in how inpatients and outpatients may need to be alerted. Also plan on how to alert and notify visitors in the hospital, as well as how family members outside the hospital.
What other notifications and alerts internal to the hospital should be included?

9. Who needs to be notified?
External
Law Enforcement
Public Works
Emergency Medical Services
Public Health
Vendors
Media
Emergency Management Agency
Fire
Coordinating Hospitals
Hospital Association
Other Hospitals
911
There are multiple external agencies that many need to be notified due to a hospital emergency. These are just a few examples of common emergency response partners within the community that often assist in emergency response. There may be others specific to your hospital, including corporate offices if your hospital is part of a system, volunteer agencies, and other community organizations.

10. What technologies are used for notification?
Internal
Hospital Alert Systems
Call Down Lists
External
911 Emergency /Fax
800 MHz Radios
HAM/Amateur Radio
REDUNDANCY, REDUNDANCY, REDUNDANCY!!!
Next, we will talk about some of the technologies used to alert and notify hospital staff and internal partners. Many of these technologies may already be incorporated into your Emergency Operations Plan. Knowing what technologies are available, how to utilize them, and what their purpose is can help determine the best systems for the particular emergency. However, not all technologies may work in all emergency responses. That is why having redundant communications systems is absolutely critical to an effective response.

11. Internal Systems Hospital Alert Systems Pager Email Call trees
Overhead page
Bulletin board
Intranet
Switchboard
Push To Talk/Radios
Others?
Many hospitals have internals systems for internal communications. Depending on the hospital, these systems vary widely in their scope, use, and purpose. Some hospitals use pager systems, alerts, and intranet to alert and notify staff. Others incorporate cell phones and overhead pages. Knowing your hospital’s organizational culture can help identify those systems that may work best within your hospital.

12. HAM Radios
Amateur Radios, or “HAM” radios often work when everything else has failed
Some hospitals have HAM radio capability
HAM requires licensed operators
HAM radio groups have agreed to assist the states in emergencies
Regular means of communications can sometimes fail in disaster situations. Amateur radio, or “HAM” radios are utilized by some hospitals to communicate with outside agencies. HAM radios must have licensed operators. Some hospitals have incorporated HAM radios and HAM operators into their Hospital Command Centers. The HAM radio group has agreed to come to Georgia’s aid in case of an emergency.

13. Other External Alert and Notification Systems
In addition to external alert and notification systems provided by ASPR funding, hospital may also have access to additional technologies that may include:
Reverse 911 systems
Satellite Phones
Communications GO-Kits
Others?
Some hospitals have 800 MHz radios incorporated within their communications plans. These radios may be used to communicate with various first responder agencies. Check with your hospital to see if your facility utilizes 800 MHz radios.
Reverse 911 systems are utilized by several communities in Georgia as a notification system.
Communication GO-Kits are located at public health districts and can be deployed to access several of the communications tools already mentioned (LiveProcess, etc). These GO-kits also contain satellite phones.

14. When should they be notified?
Develop “trigger points” to include in Emergency Operations Plan
For example, “If a tornado/severe weather warning is issued, incident command system will be activated”
Talk to external partners (EMA, public health, etc) to find out when in an event they would need to be notified
It is important to notify and alert as soon as possible. Debating over whether or not it is “too soon” to notify can use valuable time. “Trigger points” can be especially useful for staff that may not be as familiar with emergency alert protocols. Sharing these procedures with community partners can be mutually beneficial.

15. Where are alert and notification procedures and equipment located?
Emergency Operations Plan
Consider posting relevant contact information near alert and notification technologies
Many technologies are located in the Emergency Department, others are in the Hospital Command Center or other Administrative Areas.
Alert and notification procedures should be in several places throughout the hospital, to make alert and notification go as quickly as possible. Technologies may be located in different places throughout the hospital.

16. Why alerts and notifications?
Required by regulatory standards
Communications are always problematic
Allows internal and external staff to support the response efforts

17. How are alert and notification procedures and equipment tested?
Exercise, Exercise, Exercise!
Test alert and notification in every exercise and drill
Think about testing alert and notification during evening or weekend hours
Use exercises as opportunities to train staff on equipment, check accuracy of contact information, and time it takes to notify and alert external partners

18. More Problems with Communications
Desire to know
Media
Public
Need to know
Healthcare providers and other responders
Local, State, and Federal Agencies

19. Media Use Public Warning and Information Support Role
Instructions for evacuation
Shelter in place instructions
Locations where to seek assistance
Secondary Treatment Facilities
Neighborhood Emergency Health Centers
Calming and reassurance
Support Role
Supplies that are needed
Blood donations, etc

20. Media Use Must use caution to control message
May result in unwanted or unneeded donations
Require resources to manage donations
Think about the source before you issue a statement
Print media vs. broadcast media

21. The public must receive a single, clear message
A redundancy of persons authorized to talk to the media must be created, preferably well in advance of any disaster. In addition, they should work closely with one another

22. Persons involved in any portion of the incident must be responsive and helpful to the media
During communication, the nature of the content that is released must be carefully controlled. The individual communicating with the media must always tell the truth but should resist giving every detail
The face that is shown to the media must be one of concern.

23. The authorized individual communicating with the media (generally a Public Information Officer-PIO) must remember not to panic, especially under media pressure
Get formal training to handle and speak to the Media (EMA PIO Course)

24. Avoid the phrase “no comment”, recalling that “when facts are scarce, words soon take their place”; remember to give only facts you can verify or have first hand knowledge of

25. Listen to the question carefully
Establish a prior relationship with local media
Treat local and national media equally
Don’t be afraid to ask to start the interview over
Use the time you have after a disaster when the public is attentive to put out public service announcements and informative campaigns

26. Summary
Know what procedures and equipment are available in the hospital, and the community
Ensure redundancy by utilizing several different notification procedures
Maintain accuracy and utility of alert and notification system through frequent exercises
Ensure proper planning for handling the Media during a disaster or emergency situation

27. Certified Hospital Emergency Coordinator (CHEC) Training Program
Emergency Communications and
the Media
Questions?