Second National Emergency Second National Emergency Management SummitManagement Summit

Presented by: Scott Aronson, MSPrincipal 860-793-8600 saronson@phillipsllc.com

Full Building Full Building EvacuationEvacuation

Evacuation From a Evacuation From a Healthcare Facility Is the Healthcare Facility Is the

EXCEPTION, Not the RuleEXCEPTION, Not the Rule

It Could Be More It Could Be More DangerousDangerous

However, “Just in Case”However, “Just in Case”

2007 CA Wildfires2007 CA Wildfires 2006 MA and NY hospitals & nursing homes2006 MA and NY hospitals & nursing homes 2005 Hurricanes Katrina & Rita2005 Hurricanes Katrina & Rita 2004 Florida Hurricanes 2004 Florida Hurricanes

Preplanned MethodologyPreplanned Methodology

Prepare patients within units / departmentsPrepare patients within units / departments

Move to an internal Holding AreaMove to an internal Holding Area

Transport from the Holding Area to Transport from the Holding Area to receiving facilities, or dischargereceiving facilities, or discharge

Key Components of the PlanKey Components of the Plan

Activation of FBE Plan – Staff AwarenessActivation of FBE Plan – Staff Awareness Activation of a Labor PoolActivation of a Labor Pool Establishment of Internal Holding AreasEstablishment of Internal Holding Areas Coordination of Transportation (internal & Coordination of Transportation (internal &

external)external) Patient Preparation on UnitsPatient Preparation on Units Evacuation Path of TravelEvacuation Path of Travel Determination of Receiving SitesDetermination of Receiving Sites Patient Tracking (internal and external)Patient Tracking (internal and external)

Decision MakingDecision Making

Full Building Evacuation or Internal “Surge/Relocation”Full Building Evacuation or Internal “Surge/Relocation” Should staff call-backs go into effect (remember staff Should staff call-backs go into effect (remember staff

burnout)?burnout)? Are we transporting directly to EMS transports or can Are we transporting directly to EMS transports or can

internal Holding Areas be utilized to stabilize and track?internal Holding Areas be utilized to stabilize and track? Is this a regional incident or are we going to have local Is this a regional incident or are we going to have local

and state assets supporting us?and state assets supporting us? Is the building infrastructure impacted (earthquake, Is the building infrastructure impacted (earthquake,

flooding, internal explosion, no power)flooding, internal explosion, no power) How does this affect means of travel? Vertical?How does this affect means of travel? Vertical?

Are area healthcare facilities prepared for a surge?Are area healthcare facilities prepared for a surge?

Was this initial thinking just completed Was this initial thinking just completed without Incident Command in place?without Incident Command in place?

Patient Preparation – On UnitPatient Preparation – On Unit

Complete top portion of the Patient Evacuation Complete top portion of the Patient Evacuation Tracking FormTracking Form

Department-specific Plan should include:Department-specific Plan should include: Package chart (including MAR, face sheet & nursing notes) Package chart (including MAR, face sheet & nursing notes)

– customized for unique records in depts. – i.e. baby chart– customized for unique records in depts. – i.e. baby chart Package with personal belongings (i.e. glasses, dentures, Package with personal belongings (i.e. glasses, dentures,

hearing aids, etc.)hearing aids, etc.) Evacuation Stairs and Elevators specific to the unitEvacuation Stairs and Elevators specific to the unit Medications and Supplies that MUST goMedications and Supplies that MUST go Special Considerations:Special Considerations:

Intra-aortic Balloon Pump PatientIntra-aortic Balloon Pump Patient Ventricular Assist Device PatientVentricular Assist Device Patient Non-ambulatory Bariatric PatientNon-ambulatory Bariatric Patient Special PrecautionsSpecial Precautions Staff to Patient Ratio (suicide risk; aggressive/violent; complex Staff to Patient Ratio (suicide risk; aggressive/violent; complex

equipment)equipment)

Holding Areas Holding Areas PATIENT ACUITY PATIENT ACUITY

LEVELLEVEL

HOLDING AREA HOLDING AREA LOCATIONLOCATION

PATIENT PICK-UP PATIENT PICK-UP LOCATIONLOCATION

Red (High Acuity)Red (High Acuity) PACUPACU ASU EntranceASU Entrance

Yellow (Mid Yellow (Mid Acuity)Acuity)

EDED ED Ambulance BayED Ambulance Bay

Green (Low Green (Low Acuity)Acuity)

Cardiac RehabCardiac Rehab North EntranceNorth Entrance

BehavioralBehavioral

Stay on Unit and go Stay on Unit and go direct to Transport direct to Transport

(Back-up is (Back-up is Outpatient Gym)Outpatient Gym)

Main Lobby Main Lobby EntranceEntrance

Holding Areas cleared prior to evacuation initiatingHolding Areas cleared prior to evacuation initiating

Police Roadblock

Route

8

Bus Staging – Blessed Sacrament Church - Roberts Street

Ambulance Staging – Opticom Parking Lot - Grand Ave.

Red Holding Pick-up

Green Holding Pick-up

Yellow Holding Pick-up

Behavioral Holding Pick-up

PriorityPriority of Evacuation of Evacuation Consider:Consider:

AmbulatoryAmbulatory Non-ambulatory, low to mid acuity (stable)Non-ambulatory, low to mid acuity (stable) Non-ambulatory, high acuity/high intensityNon-ambulatory, high acuity/high intensity Non-ambulatory, unstable high acuity/high Non-ambulatory, unstable high acuity/high

intensity/non-ambulatory bariatricintensity/non-ambulatory bariatric Consider (Behavioral Health):Consider (Behavioral Health):

Low RiskLow Risk High Risk - SuicidalHigh Risk - Suicidal High Risk – AggressiveHigh Risk – Aggressive

Consider bypassing the Holding Area with those that Consider bypassing the Holding Area with those that should not be mixed with the general populationshould not be mixed with the general population

Once a Unit is EvacuatedOnce a Unit is Evacuated

Once evacuation of the unit / department is Once evacuation of the unit / department is completedcompleted

Check unit / department to ensure evacuation is Check unit / department to ensure evacuation is complete – YELLOW TAGScomplete – YELLOW TAGS

Account for all staffAccount for all staff Direct all staff to report to the Labor Pool (or they Direct all staff to report to the Labor Pool (or they

may be leaving with patients)may be leaving with patients) Report evacuation status to the Command Center Report evacuation status to the Command Center

and the Holding Areaand the Holding Area Deliver Patient Destination form to Command Deliver Patient Destination form to Command

CenterCenter