1. Rural Nebraska Medical Response System Partnership Ginger Bailey, R.N., B.S.N. Dave Glover***** Justin Watson, B.A.

2. Partners 51 Hospitals 51 Hospitals 44 Critical Access (25 or fewer beds) 44 Critical Access (25 or fewer beds) 4 Acute Care Hospital (larger than 25 beds) 4 Acute Care Hospital (larger than 25 beds) 3 Designated Trauma Centers 3 Designated Trauma Centers 13 Health Departments 13 Health Departments 2 Federally Qualified Health Center 2 Federally Qualified Health Center 1 Emergency Manager 1 Emergency Manager 72 County area (93 counties in Nebraska) 72 County area (93 counties in Nebraska) Built on the foundation established by the Nebraska Medical Response System Built on the foundation established by the Nebraska Medical Response System

3. Nebraska MRS Regions

4. Rural Nebraska Medical Response System Partnership Rural Region One Medical Response System Rural Region One Medical Response System Panhandle Region Medical Response System Panhandle Region Medical Response System Tri-Cities Medical Response System Tri-Cities Medical Response System West Central Region Medical Response System West Central Region Medical Response System

5. Rural Nebraska Medical Response System Partnership: Goals

6. Assist hospitals in adopting NIMS at the organizational level for all appropriate departments and business units Help hospitals that are short staffed more efficiently adopt NIMS. Providing a Monthly Newsletter

7. Volunteer Medical Professionals Working ESAR-VHP and Medical Reserve Corp Using a Regional Approach Large geographic area/sparse population Large geographic area/sparse population Similar needs Similar needs Limited number of medical professionals Limited number of medical professionals Ability to draw from other areas in disaster situations Ability to draw from other areas in disaster situations Sharing of expertise and resources Sharing of expertise and resources

8. Develop a model for establishing alternative care sites in rural communities Also purchasing Mobile Medical Assets which are “Hospital Pods or Hospital-In-A-Box” for each Medical Response System Influenza Outbreak 1918

9. Integrate emergency preparedness with hospital and region specific trauma care capabilities Limited number of Level II and III trauma centers Limited number of Level II and III trauma centers Most disasters involve trauma Most disasters involve trauma Integrate preparedness planning with trauma planning Integrate preparedness planning with trauma planning Provide more education Provide more education Provide rural sites additional assistance in caring for trauma patients Provide rural sites additional assistance in caring for trauma patients

10. Integrate emergency preparedness with hospital and region specific trauma care capabilities Activities Expand teletrauma capabilities to additional facilities Expand teletrauma capabilities to additional facilities Over 100 sites in Nebraska connected via telehealth (hospitals and public health departments) Telehealth is used for patient care, education and administrative meetings Teletrauma: videoconferencing placed in emergency departments allowing connection between rural hospitals and large centers, including trauma centers and burn centers

11. Integrate emergency preparedness with hospital and region specific trauma care capabilities Activities Provide telehealth equipment to hospital partners interested in teletrauma capabilities Provide telehealth equipment to hospital partners interested in teletrauma capabilities Establish specific protocols for use of telehealth in emergency situations (such as in the identification of unknown exposures, treatment of trauma patients with burns, etc…) Establish specific protocols for use of telehealth in emergency situations (such as in the identification of unknown exposures, treatment of trauma patients with burns, etc…) Train practitioners in the appropriate use of telehealth in emergency situations Train practitioners in the appropriate use of telehealth in emergency situations Assess the success of teletrauma adoption Assess the success of teletrauma adoption Develop and implement specific training and educational uses for telehealth in supporting emergency preparedness in multiple entities Develop and implement specific training and educational uses for telehealth in supporting emergency preparedness in multiple entities Help partners incorporate the use of telehealth as a source of communication, surveillance, consultation, education and training Help partners incorporate the use of telehealth as a source of communication, surveillance, consultation, education and training Research the potential for two way interactive video conferencing for sharing human resources in surge capacity situations Research the potential for two way interactive video conferencing for sharing human resources in surge capacity situations Work Team includes Statewide Trauma System Medical Director, Burn Center Medical Director and trauma nurse coordinators from all regions Work Team includes Statewide Trauma System Medical Director, Burn Center Medical Director and trauma nurse coordinators from all regions Could future grants be used to study the feasibility and effectiveness of placing mobile telehealth units at alternative care sites? We don’t know, but we want to find out!

12. Identification and establishment of MOUs and Medical Mutual Aid Agreements between entities Hospitals will have a toolbox that will guide them through the establishment and maintenance of appropriate MOUs and Medical Mutual Aid Agreements. Hospitals will have a toolbox that will guide them through the establishment and maintenance of appropriate MOUs and Medical Mutual Aid Agreements.

13. Partnership Strengths Number of Partners Number of Partners 65,000 + square miles 65,000 + square miles Strong system of accountability Strong system of accountability Use of the Nebraska Statewide Telehealth Network Use of the Nebraska Statewide Telehealth Network A strong history of successful regional and statewide collaborations A strong history of successful regional and statewide collaborations

14. Questions?

15. Contact Information Ginger Bailey rromrs@elvphd.org Justin Watson watsonj@mail.gprmc.com Kathy Nordby director@elvphd.org Dave Glover dkglover@charter.net Kim Engel engelk@bbc.net Melody Leisy mleisy@pphd.org Mark Graf mark@swhealthdept.com Laura Meyers, Coordinator laurameyers@charter.net