chapter 7 coordination with hmdos [enter facilitators name and contact information] developed by...
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Ch
apte
r 7
COORDINATION WITH HMDOs
[ENTER FACILITATOR’S NAME AND CONTACT INFORMATION]
Developed by Troutman Sanders LLPDeveloped for the Virginia Department of Health
Funded by Centers for Disease Control and Prevention
2Coordination with HMDOs
3Coordination with HMDOs
Toolkit Presentations Instructions for Use
Toolkit Presentations are intended to be a companion to the Hospital Implementation Guide and should not be used in isolation.
The Presentations are intended to serve as a starting point for the facilitator. The facilitator should thoroughly review the Presentation prior to use in Implementation Team, CRAG or Subcommittee meetings and customize the Presentation to meet the unique needs of the meeting participants.
Pay particular to attention to the information provided in brackets ([ ]), which must be completed by the facilitator prior to use.
Included in the “Notes” section of each slide are the following types of information:
• Slide Type, which indicates whether the slide is for information or discussion, serves as a placeholder, or is some combination thereof
• Planning Guide Section(s), which will direct the facilitator to the corresponding sections of the Planning Guide and Hospital Implementation Guide for further information
• Special Instructions, which provides directions for the facilitator to customize the slide for the intended audience
• Speaker’s Notes, which provides more detailed information to supplement the material on the slide
Refer to the Hospital Implementation Guide for further guidance and helpful hints on effectively completing the process described in the Planning Guide.
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CRAG Members
[Enter names and departments of each CRAG member]
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Add slides from Altered Standards Overview and/or Chapter 1 presentation, as needed, to re-introduce the CRAG to the concept of altered standards and critical resource shortage response planning, especially if new members are involved.
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Introduction
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Chapter Overview
Identify HMDOs for coordination Create a communication strategy with other HMDOs Understand how HMDOs’ responses to the CRSE will
impact other HMDOs Engage in discussions regarding changes to scope of
services• Expansion of scope• Reduction of scope
Discuss cooperative initiatives with other HMDOs Establish parameters regarding “essential
documentation”
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Other HMDOs
Hospital(s) in Planning Unit
Coordination During “Normal” Times
9Coordination with HMDOs
Other HMDOs
Hospital(s) inPlanning Unit
Patient Care in CRSE Without Coordinated Planning
Smaller degree of overlap
Each will retreat into its own silo and implement its own “disaster plan”
““Non-Productive Interaction”Non-Productive Interaction”
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Other HMDOs
Hospital(s) in
PlanningUnit
Patient Care in CRSE With Coordinated Planning
Higher degree of overlap
Both entities will rely on each other to do more
““Productive Interaction”Productive Interaction”
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OtherHMDOs
Hospital(s) in
PlanningUnit
Patient Care in CRSE With Coordinated Planning
What exactly does this coordination What exactly does this coordination look like during a CRSE?look like during a CRSE?
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Decisions for the Planning Unit
With which HMDOs are we going to coordinate?How are we going to coordinate with the
selected HMDOs?Will we expect these HMDOs to change their
scope of services to support our response to the CRSE? If so, how?
Are there any cooperative initiatives that we want to pursue with other HMDOs?
What problems, if any, do we see with “essential documentation” between the hospital(s) in the Planning Unit and HMDOs?
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Selecting HMDOs for
Coordination
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Selecting HMDOs for Coordination
There are a vast number of other HMDOs in the [Planning Unit]
It will be difficult to coordinate with each type of HMDO
It will be almost impossible to coordinate with individual HMDOs (e.g., each EMS provider)
The CRAG will have to prioritize types of HMDOs for coordination efforts
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Brainstorm a List of Other HMDOs
EMS Providers Community Physicians Ambulatory Surgery Centers Home Health Assisted Living Long Term Care Dialysis Facilities Community Health Centers FQHCs
Hospice Outpatient Lab Infusion Centers Outpatient Imaging Rehabilitation Hospitals Alternate Care Facilities Other Acute Care
Facilities Pharmacy
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Prioritize the HMDOs for Coordination
Which HMDOs may be able to help protect the hospital(s) in the Planning Unit from being overwhelmed during a CRSE by providing certain types of care or early triage?
Which HMDOs may pose a risk to hospital(s) in the Planning Unit during a CRSE because they have the potential to transfer large numbers of patients to the hospital(s)?
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Prioritizing HMDOs for Coordination
High Priority Medium Priority Low Priority
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Coordination Strategy
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Coordination Considerations
HMDO representative bodies v. each individual HMDO
CRAG v. selected representative(s) of the CRAG
Methods of communication with the HMDOs
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Representative Body v. Individual HMDOs
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CRAG v. Representative(s) of the CRAG
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Communication Methods
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Scope of Services
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Changes to Scope of Services
HMDOs may be planning to change their scope of services as part of their critical resource shortage response plans
The Planning Unit’s CRSRP and associated Protocols may be more effective if other HMDOs change their scope of services • Expansion• Reduction
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CRSRP and Associated Protocols
Ethical frameworkOperational infrastructureProtocols
• [LIST ALL RESOURCE-SPECIFIC PROTOCOLS]
Ad Hoc Protocol Development InfrastructureEvaluation and MaintenanceApproval and IntegrationCommunication
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EXPANSION[Can any care be performed by other
HMDOs to provide relief to the hospital(s) in the Planning Unit?]
[Can any additional testing or services be performed at other HMDOs to facilitate the hospital’s implementation of Protocols?]
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[Is there any care that may be provided by other HMDOs that will negatively impact a hospital’s ability to implement a Protocol?]
[If so, does it make sense to ask these other HMDOs to limit this type of care?]
REDUCTION
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Other Collaboration
Issues
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Are there any cooperative initiatives that we want to pursue with other HMDOs?
Cooperative stockpiling
Ambulance re-stocking
SNS distribution
Alternate care facility
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What problems, if any, do we see with “essential documentation” between the
hospital(s) in the Planning Unit and HMDOs?
[INSERT DEFINITION OF “ESSENTIAL DOCUMENTATION” FROM SECTION 4.5]
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EssentialDocumentation
What documentation is used today?
Is all of today’s documentation necessary during a CRSE?
What is the minimum amount of information needed?
What information is needed for reimbursement purposes?
“Essential Documentation” between the Hospital(s) in the Planning Unit and HMDOs
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BREAK
33Coordination with HMDOs
HMDO Coordination
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Summary of Discussions with HMDOs
[WHICH HMDOs WERE CONTACTED][NUMBER AND TYPES OF
COMMUNICATIONS/MEETINGS][PARTICIPANTS IN DISCUSSIONS][GENERAL TOPICS OF
COMMUNICATIONS/MEETINGS]
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HMDO Response to a CRSE
HMDO’s response is designed to support its continuity of operations
[DETAILS REGARDING HMDO’S CRITICAL RESOURCE SHORTAGE RESPONSE PLAN, IF ANY]• [CHANGES TO SCOPE OF SERVICES]• [ASSUMPTIONS THAT HMDO IS MAKING
ABOUT THE HOSPITAL(S) IN THE PLANNING UNIT]
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HMDO Response to a CRSE
[PRELIMINARY CONCLUSIONS ABOUT IMPACT THAT HMDO RESPONSE TO A CRSE WILL HAVE ON THE HOSPITAL(S) IN THE PLANNING UNIT]
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HMDO’s Willingness to Change its Scope of Services
[SUMMARY OF THE “ASK” – HOW DID THE CRAG WANT THE HMDO TO CHANGE ITS SCOPE OF SERVICES TO SUPPORT THE PLANNING UNIT’S CRSRP AND ASSOCIATED PROTOCOLS?]
[SUMMARY OF THE HMDO’S RESPONSE]
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[PRELIMINARY CONCLUSIONS ABOUT IMPACT THAT HMDO’S RESPONSE TO REQUEST TO CHANGE ITS SCOPE OF SERVICES WILL HAVE ON THE HOSPITAL(S) IN THE PLANNING UNIT]
HMDO’s Willingness to Change its Scope of Services
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HMDO’S Interest in Pursuing Cooperative Initiatives
[SUMMARY OF PROPOSED INITIATIVES]
[SUMMARY OF HMDO’S INTEREST IN PURSUING SUGGESTED COOPERATIVE INITIATIVES]
[HMDO’S CONCERNS ABOUT COOPERATIVE INITIATIVES]
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HMDO’s Ability to Provide “Essential Documentation”
[CHANGES THAT THE HMDOs ARE PLANNING TO MAKE TO THEIR DOCUMENTATION DURING A CRSE]
[SUMMARY OF COMPONENTS OF “ESSENTIAL DOCUMENTATION” FOR HMDO THAT CRAG IDENTIFIED]
[ABILITY TO SUPPORT THE SUGGESTED COMPONENTS OF “ESSENTIAL DOCUMENTATION” AS IDENTIFIED BY THE CRAG]
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HMDO’s Ability to Provide “Essential Documentation”
[PRELIMINARY CONCLUSIONS ABOUT THE IMPACT THAT HMDO’S ABILITY TO SUPPORT COMPONENTS OF “ESSENTIAL DOCUMENTATION” WILL HAVE ON THE HOSPITAL(S) IN THE PLANNING UNIT]
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Next Steps in Coordination with HMDOs
[Preliminary suggestions for next steps in the coordination effort with other HMDOs]
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Modifications to CRSRP or Associated Protocols
[Preliminary suggestions for modifying the CRSRP or associated Protocols as a result of the coordination among the hospital(s) in the Planning Unit and HMDOs]
44Coordination with HMDOs
Questions?Questions?
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