1. COULEE MEDICAL CENTER NORTH STAR FIRE 2015

3. INITIAL CALL: AUGUST 19 TH, 2015 Our Charge nurse was contacted by Mid Valley hospital at approximately 2000 to see if we could take in evacuated patients in the event that they would have to evacuate. –Disaster Coordinator and Disaster Medical Coordinator initiated IC at this time to determine bed availability in the event we needed to take in patients. –It was confirmed later that night that evacuation was not going to be ordered at that time.

4. AUGUST 20 TH, 2015 Call received from Colville Tribal Convalescents Center (CTCC) as well as Ferry County Hospital on possibly taking in patients from them in the event that they needed to evacuate. Both facilities were on a level 2 evacuation at that time and the fire had jumped numerous fire lines the previous night and was at 0% containment and growing rapidly. CTCC was advised by their IC that they should evacuate due to the rapidly growing fire and the acuity of their patients and time required to move them. They asked us to take in 11 of their higher acuity patients and the remaining patients would be taken to a Red Cross shelter that had been set up at the LR High School. The outter edges of Nespelem were moved to a level 3 evacuation affecting some of our staff. Air quality at this time was very poor.

5. PREP WORK We agreed to accept the 11 CTCC patients and began prep work. They were set to arrive at 1300 on the 20 th. We reorganized our patients to open up rooms in the same location to put the CTCC patients together. Additional gurneys were brought in and single rooms were rearranged to hold 2 residents. Staffing was looked at to care for the additional patient load. –At this time CTCC was not able to guarantee any amount of staff and we agreed to help care for the residents with our staff until the following day.

6. ARRIVAL OF PATIENTS The 11 evacuated patients were received at CMC at 1600 on August 20 th. Med carts and charts were brought with the patients and CTCC Staff assisted nursing management in making “quick” reference cards for each resident to assist our staff with caring for them. The residents were moved to their rooms and report given to staff. Throughout the afternoon and night, very limited issues arose. CTCC supplied us with 1 NAC to assist with caring for the residents. 1 patient was having wandering issues which posed some challenges for us.

7. AUGUST 21 ST, 2105 Morning of the 21 st our IC team met to update: –Care of the 11 evacuated residents was going well –no new concerns Cliff Russel & Kathy Moses with Southwest Incident Management team 5 came in and briefed our team of the current status of the North Star Fire.

8. AUGUST 22 ND & 23 RD IC met over phone conferences, no new issues arose. The 11 residents continued to be cared for at CMC. Air Quality remained poor in our area.

9. AUGUST 24 TH & 25 TH Staffing concerns began to arise. –CMC was calling in agency staff to try and staff for the 11 additional residents –Some of our staff were unable to work due to their own evacuations –Staffing from CTCC was very limited IC discussed developing a plan in the event that we needed to take in evacuated patients. –MOU’s, Concise expectations, concerns, credentialing forms 1200- CMC was informed that CTCC would be removing their residents and relocating them to the Red Cross Shelter set up at Lake Roosevelt High School. –Nespelem IC was contacted by CMC IC and they were unaware that the decision had been made to relocate the residents. –1630: CTCC Residents left CMC

10. DEBRIEF Lessons Learned:

11. DEBRIEF- AUGUST 25 TH LESSONS LEARNED: “Too many hands in the pot” –IC was not the soul source communicating with CTCC Credentialing was not a priority as it should have been. –Region 7 MOU Annex B No discussion regarding expectations, or needs with CTCC –Staffing –Resident behaviors TO COME: Policy and procedure/ Guideline on accepting evacuated patients Improved communication amongst ourselves –Admin, Disaster Team, IC, Nursing Staff, etc.