1. Introducing ASPR’s Coalition Surge Tool
An Exercise for Assessing and Improving Health Care Coalition Readiness
Presented to:
EMS Agency Official Representative Meeting
Regional Coordinators Retreat Charleston - June 9, 2017

2. Healthcare Preparedness Program (HPP) New Project Period 2017-2022
Building on where we’ve been – Who we are
We were told to build “Coalitions”
INCLUDE EVERYONE
The Coalition’s exercise focus narrows in its application of the
Coalition Surge Tool (CST)
Regional Coordinators Retreat Charleston - June 9, 2017

3. What is the CST? EMS is crucial to the success of this exercise
It’s a tool designed by ASPR
(Assistant Secretary for Preparedness and Response)
To test a healthcare coalition’s ability to simulate an evacuation of 1-3 hospitals and find appropriate placement within the coalition to receive those patients and to find appropriate transportation to get them there.
EMS is crucial to the success of this exercise

4. EMS must participate in these exercises
Regional Coordinators Retreat Charleston - June 9, 2017

5. 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: Hospitals demonstrate plans to: 1. Simulate evacuation of enough patients to total % of the Coalition’s 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

6. The Coalition Surge Test is really an Evacuation Planning Drill with 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.
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

7. 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

8. HPP Budget Period 1:
Conduct the Coalition Surge Test in each of the seven regions
Collect and Report Baseline Data
HSEEP compliant exercises – Functional Evacuation, Facilitated Discussion and After Action Review
Data is collected using the provided tools; Training is being provided to Hospital Evaluators
After Action Report is developed and submitted by each HCC
Regional Coordinators Retreat Charleston - June 9, 2017

9. Applying the CST is a Two-Phase Process
Part 1
Functional Component (90 minutes)
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
Part 2
Facilitated Discussion/Tabletop Exercise (90 minutes)
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:
Applying the CST is a Two-Phase Process
Regional Coordinators Retreat Charleston - June 9, 2017

10. After Action Review/ Debriefing (60 minutes)
Phase 2
After Action Review/ Debriefing (60 minutes)
Facilitated by each facility’s designated Evac Assessor
Assessment of strengths/weaknesses
Delineation of corrective actions and recommended actions
Must occur within 30 days of exercise; Can occur same day
Must include executive level (decision-makers)
Documentation of discussion topics are part of the AAR
Development of the After-Action Report (AAR)
Developed by the Regional Coordinator (with input from the evacuation assessors and hospital representatives)
Reviewed by all Coalition members
Submitted to WVHA (and to CTP and ASPR)
Regional Coordinators Retreat Charleston - June 9, 2017

11. Who’s involved in the Functional component of the exercise?
Command staff (involved in patient identification and movement) at each evacuating facility
Cabell Huntington Hospital Example
At least one senior staff member at each receiving facility (communications link to evacuating facility)
For Hospitals and/or nursing, rehab or psych facility
EMS and/or transport staff at their facility to identify resources needed for patient movement (Communications link to evacuating facility)
This can be a minimal number of staff
Regional Coordinators Retreat Charleston - June 9, 2017

12. Evacuating facilities:
Will consider a patient “placed” when two things have happened…
They find an appropriate facility to receive the patient
AND
They find appropriate transportation to move the patient
Regional Coordinators Retreat Charleston - June 9, 2017

13. All Healthcare Coalition members in that region:
Who’s invited to participate in the Facilitated Discussion portion 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

14. The WV Approach Introduce CST to Regional Coordinators - June 9th
Concepts and Objectives Meeting - June 22nd
Overview at Emergency Preparedness Task Force Meeting - August 25th
Training Sessions for Coordinators – September to November 2017
Training Sessions for Regions – September to November 2017
Presentation to Emergency Medical Services – November 2017
Conference Calls with Coordinators - TBD
Coalition Surge Test (CST) Exercises – October 2017 to March 2018
Regional Coordinators Retreat Charleston - June 9, 2017

15. Whoooooooooo has 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