state and regional concepts of operations (conops) · state and regional conops planning 2. ......
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Objectives
• Reviewtherequirementsandrolesoffrontlinefacilities,assessmenthospitals,State-designatedEbolaTreatmentCenters,RegionalEbolaandSpecialPathogenTreatmentCenters(RESPTC)andhealthcarecoalitionsinStateandregionalconceptsofoperations(CONOPs) forapatientwithasuspectedorconfirmedhighlyinfectiousdisease
• DiscussstrategiesforengagingkeystakeholdersinStateandregionalCONOPsplanning
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NYCHealth+Hospitals’TieredSystem
FrontlineHealthcareFacilityQuicklyidentifiesandisolatespatientswithpossibleEbola
Notifiesfacilityinfectioncontrolandstateandcitypublichealthofficials
HasenoughPPEequipmentfor12-24hoursofcare
TransferspatienttoRegion2EbolaTreatmentCenter
QuicklyidentifiesandisolatespatientswithpossibleEbola
Notifiesfacilityinfectioncontrolandstateandcitypublichealthofficials
HasenoughPPEequipmentfor<8hoursofcare
TransferspatienttoRegion2EbolaTreatmentCenter
Region2EbolaTreatmentCenter
SafelyreceivesandisolatespatientswithconfirmedorsuspectedEbola
CaresforpatientswithEbolafordurationofillness
HasenoughEbolaPPEforatleast7daysofcare(willrestockasneeded)
Hassustainablestaffingplantomanageseveralweeksofcare
Ambulatory/OutpatientFacility
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WhatareConceptsofOperations?
• Outlineplansfortransportofhighlyinfectiouspatientsinstatesorregions.– Stateplansshoulddetailpatienttransportationlogisticsandcommunications.
– Regionalplansshouldfocusoncollaborationandcommunicationamongststatesinaparticularregion.
– CONOPsleadsshouldcommunicate,coordinateandcollaboratewithkeystakeholdersthroughouttheCONOPsprocess.
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NYCHealth+Hospitals’CONOPsEssentialElementsofInformation
Agency/Organization TypeofInformation
Sentto AgencybyNYCHealth+Hospitals
ReceivedbyNYCHealth+Hospitals
Within NYCHealth+Hospitals
AllofNYCHealth+Hospitalsintegratedhealthcarefacilities
NotificationofsuspectedorconfirmedEVDcase X
NewYorkCityFireDepartment(FDNY) TransportationofPUI(s)fromexternalhealthcarefacilitytooneofNYCHealth+Hospitalsfacilities ORintra-systemtransportation
X
NewYorkCityDepartmentofHealthandMentalHygiene(NYCDOHMH)– Laboratory
ClinicallaboratoryspecimentoruleoutorconfirmEVD X X
DepartmentofHealthandMentalHygiene(DOHMH) SituationalUpdateX
CentersforDiseaseControlandPrevention(CDC) SituationalUpdateX
FederalEmergencyManagementAgencyRegion (FEMA) SituationalUpdateX
NewYorkCityEmergencyManagement(NYCEM) SituationalUpdateX
NewYorkStateDepartmentofHealth(NYSDOH) SituationalUpdateX
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① Patient transfer determined by NYCDOHMH:• FDNYEMS notified • CMO at Bellevue Hospital Center notified• NYC Health + Hospital Leadership notified
② Transfer Hospital Facility will follow facility-specific Bio Isolation Transfer Card (BIT):• Transfer Team Dons PPE • Control of Transfer Area via
Hospital Police/Security• Hospital Liaison reports to the
Command Post • Identify Transfer Location
(based on BIT)• Await HazTac Personnel to
hand-off Patient • HazTac Personnel Accepts
Patient • HazTac Transport Patient to
Treatment Facility (Bellevue)
Transfer Hospital Facility
③ FDNYEMS arrival at Transfer Hospital Facility:• HazTac Officer meets
Hospital Liaison• Transfer Point Confirmed with
Liaison • HazTac Personnel Don PPE • HazTac Officer supervises
transfer • Ensure response of Clean
Ambulance • Both Ambulances driven by
clean personnel ONLY • HazTac Doffing and Decon
per FDNY EMS protocols
Note 1: Any patient assessment and treatment shall be initiated according to FDNY EMS policies, procedures and protocols.
Note 2: DOHMH shall notify the OLMC Physician of patient results determined by treatment hospital facility.
FDNY EMS
② Activation of the Special Pathogens Unit via DOHMH/FDNY Transfer to Bellevue: • Assemble SPP Receiving
Team • Prepare 55 Gallon Bio-Waste
Drums • SPP Liaison Report to the
Command Post • SPP Team Don PPE to
Receive Patient from FDNY • Standby at the Transfer Point
Receiving Hospital Facility (Bellevue)
② After receiving notification from NYCDOHMH for transport from transfer facility to treatment facility, FDNY EMS dispatch initiates:• Briefing with Hospital Liaison
prior to Patient Transfer • Confirm Transfer Point • Decontamination Corridor
Prepared • Deployment of Haz-Tac Units
and Resources to Transfer Hospital Facility
③ Transfer Facility Decontamination as per NYC
Health + Hospital protocol
④ Haz-Tac Team Doff and Decon per FDNY EMS protocols and procedures.
Note; All disposable materials will be bagged in prepared 55 Gallon Bio-Waste Drums and disposed according to NYC Health + Hospital Regulated Waste Protocol.
Note: See “Ebola Treatment Facility (Bellevue)
Transportation Protocol” for continuation of receiving facility
transport procedures.
Intra-System Transportation Protocol
Note: See Appendix H: NYC Health + Hospitals Facility-Specific Bio
Isolation Transfer Cards
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RegionIVCONOPS
• Builtuponestablishedrelationships.• Sharedmorematureplanstojumpstartplanninginlessadvancedstatesandfacilities.
• Ledpartnerstoresources,butdidnotforcethemtofollow.
• Understoodthatplanningisanongoingprocess.
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RegionIVLessonsLearned
• Needforsoundandexercisedcommunicationpathways.
• Essentialtohave“PlanB”fortransport.
• Justbecausesomethingworkeddoesnotmeanitisfinished.
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RegionIV“A-ha”MomentsandPromisingPractices
• Don’tforgetaboutyourFieldProjectOfficer.
• Importanttoaccountfordifferinglevelsofexperience.
• Activesupportfromleadershipmakestheprocesseasier.
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RegionVIICONOPSContentExample
• PromulgationStatementandSignatures
• Purpose,Scope,Situation,andAssumptions
• OrganizationandAssignmentofResponsibilities
• Direction,Control,andCoordination
• AirTransportationPlantoRegionalTreatmentCenter
• GroundTransportationPlantoRegionalTreatmentCenter
• WasteManagement
• MortuaryAffairs
• AdministrationandFinance
• TrainingandExercise
• PlanDevelopmentandMaintenance
• AuthoritiesandReferences
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Easyplacetofind24hourcontactinformation
RegionVIICONOPSDevelopment
• EmbarkedonprocesswithanumberofconferencecallswithASPRFPO,ASPRREC,andstateofficialsrepresentingentireregion.
• Anin-personmeetingwasheldtoshareaboutstateplansandbeginasection-by-sectionrevisionofaRegionalCONOPSPlanthatallparticipantscouldagreeupon.Thistookseveralfollowupphoneconferencemeetingstocomplete.
• Detailsthatwerestate-specificwereoftenremovedtobedescribedindetailinthestateCONOPSplans.
• Goal:AnewstateofficialcouldutilizethedocumentintheeventofaEbolaorotherdangerous,highlyinfectiousdiseaseevent.
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Resources
• NETEC– www.netec.org
• RegionalETC– 10RegionalCenters
• CDC• LocalPublicHealth• LocalMedicalResponseSystem– i.e:OMMRS
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PollQuestion2
WhatisthecurrentstatusofyourRegional CONOPs?a) Noplanb) Inprogressc) Completed) Unsure
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CONOPSWorkshop
• Divideparticipantsintogroupsbasedontheirrespectiveregions.– CONOPsPlanningTemplatewillserveascatalyst
• Groupstodiscuss:– What’sonekeysuccessoftheCONOPSplanning/developmentprocess?
– What’sonekeychallengeoftheCONOPsplanning/developmentprocess?
– ForthosewithoutaRegionalorStateCONOPs:• Why?What’syournextstep?
• Reconveneallparticipantsforhotwash.19
DevelopmentStrategies
• In-personmeetings,withafacilitatororpolicydevelopmentteamifpossible.
• Periodicweb-conferencingwithrevisionstothedocumentsegmentbysegment.
• CONOPsmeetingsmightbeplannedtocoordinatewithexistingtrainingorplanningdatestoreducetravelexpenses.
• Setgroundrules.Bringupissuesastheyarise,don'tletthemfester.
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HospitalStrategies
• Thinkaboutwhatdetailsareimportantinthedifferentdocuments.TheStateCONOPsmaybemuchmoredetailedthantheregionalCONOPs.
• CONOPsplanningisanexerciseinplanning,documentation,andrelationshipbuildingwithpeerinstitutionsandcommunitypartners.
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Engagement
• Celebratethecompletionoftheplan.• PlantomeetatleastannuallytoshareyourkeylearningsfromthepastyearandtoupdateanynecessaryitemsintheCONOPSaccordingly.
• Knowyourpartnersattheregional,state,andlocallevel.
• SharethecontentsofyourCONOPSdocumentsandconstantlyseekfeedbackandsuggestions.
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