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November 12, 2012 Meeting Objectives Ensure Everyone is Warm and Fuzzy on Statewide Exercise Processes and Activities Answer Any Outstanding Questions Disaster Preparedness Workgroup

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Disaster Preparedness Workgroup . November 12, 2012 Meeting Objectives Ensure Everyone is Warm and Fuzzy on Statewide Exercise Processes and Activities Answer Any Outstanding Questions. 2012. Statewide Health & Medical Exercise. 2011 Exercise Lessons Learned. Putting It All Together. - PowerPoint PPT Presentation

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Page 1: Disaster Preparedness Workgroup

November 12, 2012

Meeting Objectives• Ensure Everyone is Warm and Fuzzy

on Statewide Exercise Processes and Activities

• Answer Any Outstanding Questions

Disaster Preparedness Workgroup

Page 2: Disaster Preparedness Workgroup

 Statewide Health& Medical Exercise

2012

Page 3: Disaster Preparedness Workgroup

Capability Observation Recommendation

Intelligence/ Information Sharing & Dissemination

County only collected status reports via ReddiNet; CCALAC had to translate into email and send/receive

Assessment Polls from the EMS Agency should have an easily transportable form

Intelligence/ Information Sharing & Dissemination

Limited notification of CCALAC and MAC when clinics activated response procedures

Increase awareness training to clinics on best practice response notification procedures

Emergency Operations Center Management

Many clinic staff not regularly involved in disaster plans were unfamiliar with their response roles

Incorporate HICS Forms and Job Action Sheets into drills and exercise.

2011 Exercise Lessons Learned

Page 4: Disaster Preparedness Workgroup

• 2011 Lessons Learned

• MOA Contracts with “Site Summary” forms

• Site-Specific Incident Management Team Designations

• Incident Command System / Incident Action Planning Training

• Quarterly Communications Drills

• 2012 Statewide Medical and Health Exercise Participation

Putting It All Together

Page 5: Disaster Preparedness Workgroup

Our Clinic will be…

..here to help!

Page 6: Disaster Preparedness Workgroup

Exercise OverviewOBJECTIVE:  To discuss the planning and response to a loss of power to the healthcare delivery system and the community.   SCENARIO:  Earthquake results in power loss. Earthquakes can cause a variety of problems and disruptions to infrastructure.  Due to the limited time, this exercise will focus on power loss.  Participants can customize the exercise and  objectives to address other issues.

Page 7: Disaster Preparedness Workgroup

2008 Sayre Wild Land FireOlive View-UCLA Medical Center lost

power and emergency generators failed

- 27 patients evacuated: 15 infants from Neonatal ICU, 4 critical care patients and 5 adult patients on ventilators

- Patients evacuated down stairs with assistance of local fire department

Source: ABC news: http://ABC.local.archives/SayreFire

7

Historical Impact of Power Loss

Page 8: Disaster Preparedness Workgroup

2010 Palo Alto Plane Crash Power outage caused by the crash

of a twin-engine Cessna in East Palo Alto, which toppled several major power transmission lines

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Historical Impact of Power Loss

Stanford Hospital & Clinics and Lucile Packard Children’s Hospital in Palo Alto, CA were without power; the hospitals functioned on emergency power, and all non-emergency cases were postponed for the day

Source: www.mercurynews.com/peninsula/ci_14422658

Page 9: Disaster Preparedness Workgroup

September 2012: San Diego Power Failure5 million people without power in California, Arizona and MexicoRoads gridlocked due to outage of traffic lightsGas stations without power and unable to dispense fuelEisenhower Medical Center in Palm Springs served as a

respite for the communitySource: www.nbcsandiego.com

9

Historical Impact of Power Loss

Page 10: Disaster Preparedness Workgroup

CommunicationsIntelligence/Information Sharing and

DisseminationMedical SurgeEmergency Operations Center Management

10

2012 Statewide Medical and Health Exercise Target Capabilities

Page 11: Disaster Preparedness Workgroup

Determine/Evaluate clinic’s ability to communicate with response partners

Discuss/Test ability to communicate needs with outside sources for essential supplies, services, and equipment• Focus on resource supply chains

Target Capability: Communications

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Page 12: Disaster Preparedness Workgroup

Communication with the MAC

…from the 2012 LAC EMS Agency Communications Directory

Page 13: Disaster Preparedness Workgroup

Review/test adequacy of information management plans and technology • internal and externalReview/test risk communication and public information message disseminationDiscuss/exercise ability to provide situational status and projected impact updates to: CCALAC/EMSA/DRC/Local EMD

Target Capability: Intelligence/Information Sharing and Dissemination

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Page 14: Disaster Preparedness Workgroup

COMMUNICATIONS DIRECTORY

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Target Capability: Medical Surge

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Determine/evaluate ability to expand patient capacity using non-traditional care areas for triage and treatment

Determine/evaluate ability to prioritize, manage, and allocate resources

Discuss/test capacity to provide care with out the use of power

Page 16: Disaster Preparedness Workgroup

Test EOP and hazard specific plans

Discuss/exercise activation of Incident Management Team

Exercise ability to initiate incident action plan

Work through Incident Action Planning Process using HICS Forms

Target Capability: Emergency Operations Center Management

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Page 17: Disaster Preparedness Workgroup

MASTER SCENARIO EVENTS LIST (MSEL)

Page 18: Disaster Preparedness Workgroup

Time Incident0645 7.8 Earthquake : Official Activation of the EMS

Operations Center0700 Reddinet / Email Damage Assessment Request:

- Clinics with Reddinet complete Assessment Poll- Clinics without Reddinet complete fill-able PDF and email or fax to the Medical Alert Center @ (562) 944-5248

0830 Clinics Respond to Scenario:- Patient Profiles: overwhelmed with worried well, ect.

0930 Clinic _____ Reports Downed Power lines trapping staff.

1010 Clinics testing Mass Fatality Plans activate plan, request coroner, and initial PsySTART triage of staff

1058 Clinics testing MFI request MAC support

1300 Official End of Exercise: Clinics conduct Hotwash Debrief with Staff and collect Evaluator/Controller Feedback Forms

Key Injects

Page 19: Disaster Preparedness Workgroup

Communicate, Communicate, Communicate!!!!• Respond to Everbridge Messages• Complete and send in Situation Report Assessments• Send in Resource Requests to EMS Agency

Take Action• Activate your Incident Management Team• Work through the Incident Action Planning Process and MSEL Injects• Complete HICS Forms 201, 202, 203, 204, 214

http://dp.ccalac.org/Policies/Incident%20Action%20Planning/Pages/default.aspx

• Complete Hotwash Debrief• Create After Action Report

Key Actions

Page 20: Disaster Preparedness Workgroup

• Logistical issues

• Technological issues

• People issues

• Time issues

Addressing Past Concerns

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Page 21: Disaster Preparedness Workgroup

  http://dp.ccalac.org/PREPAREDNESS/drills/SMHE http://ems.dhs.lacounty.gov/Disaster/Announcement.htm

 

http://dp.ccalac.org/PREPAREDNESS/drills/SMHE http://ems.dhs.lacounty.gov/Disaster/Announcement.htm http://www.californiamedicalhealthexercise.com/exercises/phase3.php

Page 22: Disaster Preparedness Workgroup

Identify overarching goalsEstablish purposeDefine extent of playChoose objectivesDefine exercise assumptions, artificialitiesDevelop security plan (exercise safety)Define resource requirements and logistics planDevelop briefing materials (exercise handbooks and forms):• Controller/facilitator• Evaluator/data collector• Note taker/scribe• Player

Create Exercise roster 

EXERCISE DESIGN/PLANNING

Page 23: Disaster Preparedness Workgroup

Convene IMTAnnounce NarrativeProvide Position Specific IRGsWork through Injects• IMT Staff practice Emergency Management Mentality, not day-to-

day decision-making.

Conclude ExerciseConduct HotwashDraft After Action Report

Tabletop Exercise - Basic

Page 24: Disaster Preparedness Workgroup

Convene IMTAnnounce NarrativeProvide Position Specific IRGsWork through Injects• Work through “Planning P” ;

• Incident Action Plan Establishment• Ensure Staff Create Plan A and Plan B for key

response strategies and tactics;• Consider Having a “What-if” officer

Conclude ExerciseConduct HotwashDraft After Action Report

Tabletop Exercise - Advanced

Page 25: Disaster Preparedness Workgroup

All that other stuff + actually “doing” something.

Functional Exercise

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Immediate Operational PeriodPosition Actions-Operational PeriodIncident Commander

1. Receive notification about the incident from local officials

2. Activate the Command Staff and Section Chiefs3. Activate the EOP4. Establish operational periods5. Establish operational objectives

Page 27: Disaster Preparedness Workgroup

Immediate Operational Period

Position Actions-Operational PeriodPublic Information Officer

1. Monitor media outlets for updates on the incident and possible impacts on the hospital

2. Establish a patient information center; coordinate with the Liaison Officer

3. Establish a media staging/briefing area initiate media/

communications plan

Page 28: Disaster Preparedness Workgroup

Position Actions-Operational PeriodLiaison Officer 1. Establish communication with local EOC,

DRC

2. Communicate with other health care facilities (situation status, surge capacity, supply/personnel lending capacity, etc.)

Immediate Operational Period

Page 29: Disaster Preparedness Workgroup

Position Operational Period-Action

Safety Officer 1. Monitor safety practices of staff, patients, facility and implement corrective actions, as needed

Medical/Technical Specialist-Medical

Assist Op Chief in identifying specific medical care management needs

Medical/Technical Specialist-Mental Health

Assist Op Chief in identifying specific mental health needs/Manage PsyStart

Immediate Operational Period

Page 30: Disaster Preparedness Workgroup

Position Actions-Operational Period

Operations 1. Conduct clinic census/determine patients to send home/reschedule

2. Provide facility security, traffic and crowd control

3. Activate surge capacity plan and patient emergency procedures

4. Rapidly triage/prioritize patient care and resources

Immediate Operational Period

Page 31: Disaster Preparedness Workgroup

Position Actions-Operational PeriodPlanning 1. Prepare and implement patient, room, material

and personnel tracking2. Establish operational periods and Incident

Action Plan with ICLogistics 1. Initiate staff call procedures

2. Conduct inventory of supplies, equipment, medication

3. Ensure IT functionality

Immediate Operational Period

Page 32: Disaster Preparedness Workgroup

Position Actions-RecoveryIncident Commander

1. Oversee and direct demobilization and system recovery operations

Public Information Officer

1. Provide final briefings as needed to patients/visitors/staff/media

Liaison Officer 1. Prepare summary of the status of the Clinic and disseminate to Command Staff, as appropriate

Safety Officer 1. Oversee safe restoration to normal operationsOperations 1. Return patient care and services to normalPlanning 1. Finalize IAP

2. Complete AAR3. Ensure file of incident documentation

Logistics 1. Provide for mental health services for staff and patients

Finance/ Administration

1. Submit final response expenses to IC for approval2. Submit for reimbursement

Recovery

Page 33: Disaster Preparedness Workgroup

 

Conduct participant hot washConduct controller, data collector/evaluator critiqueCollect observation/data collection forms (notes)Develop initial after action report (AAR) Coordinate and evaluate findingsConduct senior management post-exercise briefingPrepare final AAR POST EXERCISEDevelop improvement planTrack corrective actionsShare lessons learned

EVALUATE THE EXERCISE