2. Emergency Management Planning Louis Stokes Cleveland, Department of Veterans Affairs Medical Center JCAHO Environment of Care Series Fiscal Year 2009

3. A disaster is an emergency that results in large scale, severe injuries and deaths or a major disruption to patient care. An important factor in deciding whether any event is a disaster is whether the event can be handled by routine procedures. What is disaster? Emergency Management Planning

4. Emergency Management has four phases: uMitigation uPreparedness uResponse uRecovery

5. Mitigation –  Building codes and retrofitting  Non-structural improvements (i.e., protecting building contents)  Land-use controls  Levees and stream channel modifications  Slope stabilization  Improving chemical storage facilities or reducing hazardous inventory  Public education and other prevention programs Mitigation efforts include: Those activities an organization undertakes in attempting to lessen the severity and impact of a potential emergency.

6. Those activities an organization undertakes to build capacity and identify resources that may be used should an emergency occur. Preparedness -  Disaster and contingency plans  Government and business continuity of operations plans  Warning and emergency communications systems  Evacuation plans with pre-designated routes  Equipment upgrades  Mutual aid agreements  Training and exercises  Public information and education Preparedness includes:

7. Response - Response to disaster is the function of first responders: Fire- rescue, police, hospitals and other trained emergency personnel.  Warning system activation (Cascade calls, sirens, TV/radio broadcasts)  Emergency medical, fire, police  Activation of emergency operations centers (EOCs)  Mutual aid  Disaster declarations  Chemical release containment Response includes: When a large scale event has occurred such as a flood or hurricane, that response needs to be coordinated.

8. Recovery is the hardest phase of a disaster and requires personal and community motivation. It also requires advance planning for how we're going to recover. Recovery -  Longer-term temporary housing  Debris removal, including demolition of unsafe structures  Continuity of government, business  Economic aid to offset business losses  New land-use controls (e.g., floodplain easements, reforestation)  Re-establishment of essential services  Health and safety education Recovering includes:

10. Hazard Vulnerability Analysis- Identifies potential emergencies and the direct and indirect effects these emergencies may have on the healthcare organization’s operations and the demand for its services. Windstorm Tornado Flood Earthquake Terrorism Assign probability and severity ratings Very Low Low Moderate High Extreme Consider Possible Hazards

11. Look at historical records.

12. Tornadoes Windstorms

13. Earthquakes

14. Flood Maps

18. The Medical Center uses the Incident Command System (ICS) which is based on the principal activities of command, operations, medical, logistics, and planning. Incident Command System At the Louis Stokes VAMC, the Commander is either the Medical Center Director, the Associate Director, Chief of Staff or the Medical Officer of the Day.

19. There are several ways to notify people that the Plan has been activated. The notification can be by telephone (either individually or using the Cascade System), the overhead page, activation of beepers, or notes carried by runner. Timely and accurate communication is one of the most important parts of the management of a disaster. Emergency Response

20. An activation of the Disaster Plan calls for many people to change their routine. Many service chiefs and patient care staff have to alter their schedules to fit an emergency. The staffs of Engineering Service, EMS, and Dietetics frequently are used to help respond to disasters. (MANPOWER POOL) Emergency Response

21. Bomb Threat Procedures u Remain calm. u Listen carefully to the caller. u Write down information  Background noises  Ask, “Where is the bomb?”  Ask, “When is set to go off?”  Ask, “What does it look like?” u Notify your supervisor, who will report the matter. u Notify police if you cannot locate your supervisor immediately. If you receive a bomb threat:

22. Joint Commission on the Accreditation of Health Care Organizations (JCAHO) is the licensing authority for most hospitals. Every JCAHO hospital is required to activate their Emergency Preparedness Plan at least twice a year. EMERGENCY DRILLS One of the drills must use simulated casualties.

23. Emergency Drills At least twice per year Drills at least 4 months apart Drills no more than 8 months apart Drill Less than 4-month window 4 to 8-month “OK” window to conduct drill More than 8-month window JanFebMarAprMayJunJulAugSeptOctNovDec

24. Emergency management plan must consider: –Patient Activities Scheduling, modifying or discontinuing services Control of patient information Patient transportation –Staff Activities Change schedules and roles to meet needs Incident Stress Debriefing –Staff/family-support Activities Housing, Transportation

25. –Hospital Patient Treatment Capabilities Trauma Victims Burn Victims Contaminated Victims Psychiatric Victims Infants and Children –Logistics of Critical Supplies Water Supplies Linen Supplies –Security Access Crowd & Traffic Control –News Media Interaction Emergency management plan must consider:

26. Congratulations, you have Completed Emergency Preparedness Training. Follow the prompts to complete the associated test.