1. ST210 Concorde Career college

2. Objectives List the types of healthcare facilities and the sources of funds for each Describe the organizational structure of a healthcare facility List the chain of command in the surgical setting

3. Where are surgeries performed? Surgical services Now provided in many different settings Traditional ORs Free-standing ambulatory surgical center Free-standing specialty centers Doctor’s offices Doctor’s clinics Labor and delivery units 3

4. Workplace Management Healthcare Facilities/Funding Nonprofit – not for profit Proprietary – for profit Tax Supported – not for profit

5. Types of Hospitals Not-for-profit Proprietary or investor-owned

6. Types of Hospitals Preferred provider organization (PPO) Collection of private-practice donors, labs, patient-care facilities, and hospitals Contract with insurance companies and receive an agreed set rate for services Health maintenance organization (HMO) Collection of hospitals, health professionals, and doctors Work for a set fee and may require patients to use a primary care physician for all referrals 6

7. Types of Surgical Facilities Hospitals Ambulatory Surgery Centers Physician Offices

8. Ambulatory Surgery Center

9. Hospital Organization Organizational Structure of the Healthcare Facility Figure 1-8 Page 20 of ST4ST

10. Hospital Organization Characteristics Philosophy and policies: typically established by a board of directors or trustees Administration: typically several layers Second division for medical affairs: medical and nursing services Surgical services department: may be divided into units 10

11. Hospital Organization (cont’d.) Hospital departments and interdepartmental communication Departments can be categorized as having direct or indirect patient care responsibilities Refer to Tables 1-8 and 1-9 11

13. Hospital Organization (cont’d.) Financial considerations and reimbursement Intervention may be provided free of charge or as a charitable mission Insurance: one party or entity agrees to pay another for a specified loss or condition Health care reimbursement Government financial assistance 13

14. Professional Management Chain of Command in the Surgical Setting Team members (according to the situation) Charge Nurse/Team Leader Director of Surgical Services Director of Nursing

17. Objectives Discuss nature-, human-, and nature/human-caused types of disasters Explain the various components of personal, health care facility, and national disaster planning Describe the initial response and steps taken when an all-hazards event occurs Discuss the various roles the surgical technologist can fulfill during an all-hazards event

18. All-Hazards Preparation All-encompassing term Refers to many different emergencies Emergencies Those that require the emergency response of outside assistance, which may be at the local, county, state, or federal levels Emergency preparedness Action taken by individuals, governments, and health care facilities and systems to be prepared for an emergency

19. Natural Disasters Most common occurring type of disasters that can affect large populations Avalanches Rock and land slides Winter storms Heat waves and wildfires Earthquakes and tsunamis Tropical storms and hurricanes Floods and tornados

20. Avalanche

21. Tsunami

22. Earthquake

23. Hurricane

24. Man-Made Disasters Disasters caused by people Transportation accidents Acts of terrorism and bioterrorism Industrial incidents Combination natural disaster—man-made disaster Chemical release accidents Infrastructure incidents Radiological injuries

25. Train Disaster

26. Terrorism

27. Personal Disaster Planning Personal and family preparation steps Research, identify, and familiarize yourself and your family with the local and regional emergencies that could occur Create a family emergency plan for each type of emergency Prepare emergency supplies: go-bag and in-home supplies

28. Individual Preparedness 72-Hour Kits http://www.ready.gov/b uild-a-kit http://www.ready.gov/b uild-a-kit FEMA recommends all families and individuals have a kit of food, water, and supplies sufficient to last 72 hours following a disaster

29. Local/Community/Regional Response Response to a disaster situation Divided into the local and federal responses Local response National Incident Management System Local Emergency Management Agencies Incident Command System

30. Local Emergency Response

31. Federal Emergency Response Federal assistance Must be requested through formal channels by the local and state governments Assistance will take up to three days or possibly longer Agencies and assistance forms Federal Emergency Management Agency National Response Framework National Disaster Medical System

32. Federal Emergency Response

33. Local & Government Preparedness FEMA: http://www.fema.gov/http://www.fema.gov/ American Red Cross: http://www.redcross.org/http://www.redcross.org/ Local Law Enforcement Agencies First Responders Local Military Units, National Guard

34. Health Care Facility Emergency Response Health care facilities Emergency action plan (EAP) follows state and federal emergency response guidelines EAP components Mitigation Preparedness Response Recovery

35. Health Care Facility Emergency Response

36. Medical Office EAP Should be developed based on the community EAPs Coordinated with the local and regional health care system Components Procedures for notifying employees of an emergency Procedures for evacuating the building Patient evacuation procedures

37. Immediate Response to an All- Hazards Event Important considerations Disaster scene must be safe before entering Standard Precautions and personal protective equipment Patient decontamination area Triage of victims Point of Distribution (POD) site Risk communication with the public

38. Immediate Response to an All- Hazards Event (cont’d.) Moral, ethical, and legal issues associated with providing care during a disaster Emergency System for the Advanced Registration of Volunteer Health Professionals (ESAR-VHP) and Community Emergency Response Team (CERT)