Volunteers in Surge Functional Exercise

ScheduleTime Exercise Event Description Participants All Players/Observers

Start Exercise (STARTEX) All Controllers/Evaluators/Observers

Injects/Homework #1 Exercise Participants BREAK (Time) Part 2 “ESF8 WebConference”

Participants/Observers

BREAK (Time) Part 3 Injects/Homework #2-

Webconference

Exercise Participants

BREAK (Time) “ESF8 WebConference” Participants/Observers

ENDEX and Hotwash

All Controllers/Evaluators

ESF8 WebConference Agenda

• ESF8 situation status• Health Department surveillance

reports• Incident Command update• Health facility reports

– Hospital– Emergency Medical Supplies Warehouse

• DPHE/County coordination issues

Injects/Homework

• Will be basis of reporting to ESF8 WebConference

• Requests by other agencies (i.e., MRC, DPHE, HC Facilities, County EOC)

• Items necessary for future coordination

• Requests from Incident Command

Rules of conduct

• Real emergency actions take priority over exercise actions.

• “THIS IS AN EXERCISE”• “REAL WORLD EMERGENCY”• “TIMEOUT”• Identify YOURSELF and the

person/agency you wish to SPEAK TO.• Follow ESTABLISHED policies and

procedures WHENEVER PRACTICAL.

Objectives

• Volunteer activation, training, and management plans

• Rapid staffing analysis, situation assessment, and ESF8 coordination

• Surge staff planning using ICS/NIMS

Target Capabilities• Medical Surge is defined as rapid expansion

of the capacity of the existing healthcare system in response to an incident/event that results in increased need of personnel, support functions, physical space and logistical support.

• Volunteer Management and Donations is defined as the capability to effectively coordinate the use of volunteers and donations in support of domestic incident management.

Target Capability Assumptions

• Offers of assistance may not come from other cities, counties, organizations, jurisdictions.

• Allocation of resources – community, field, hospital.• Patient tracking/family reconciliation• Altered Standards of Care• Shortages: Staff, resources, space, equipment.• Healthcare practioner’s working in compromised

conditions• Public anxiety/risk communication• Emergency Medical Services are overwhelmed

Resources• <AGENCY NAME> Emergency Operations

Resource Manual (from the EOP Workshop.)– Associated Appendices as requested/provided or revised

• Functional EXPLAN– Maps, contacts, support as requested

• Virtual Healthcare Coordination Center (HCC)– ESF8 Partners, resources, data/info– First step in county-level requests– Data/Information portal for ESF8

– Contacts: <AGENCY CONTACT> ; FAX to HCC at <Fax Number> Attn: “Exercise-HCC”

STARTEX

Looking Back…

• During the peak illness period in October H1N1 there were only 52 hospitalizations in <COUNTY> County (tests for H1N1 were done only for hospitalizations).

Novel Influenza Situation Update• <YEAR> Novel Influenza virus-

originated in Mexico City with later outbreaks in major metropolitan areas.

• Attack rate is approx. 40%.

• Thought to be a possible H1 variant, mortality is near 15% in seasonal risk groups. However, secondary infection (i.e., pneumonia) has been high among healthy adults.

Coordinated Hospital Response

• Increased PPE usage and healthcare practitioner ILI policy similar to <YEAR> during H1N1.

• Visitor Restrictions• Daily Hospital Status Report data to <Agency

Name> ESF8 Liaison.– Inpatient/ED census (including ILI)

– Staff absenteeism monitoring (ILI/non-ILI)

– Medical Supply Monitoring/Antiviral counts

• HCP ILI illness staffing policy in non-essential services… with “flexible leave.”

Community Messages• “Call First”

• “ED is for Emergency!”

• Hand Hygiene

• “Shoo the Flu”

• “Stay Home if you are sick.”

To make matters worse• 0900: A train with an unknown liquid became

separated and derailed during a routine railcar connection. More than 50 students/staff are exposed to a “plume” while arriving for school.

• Numerous resources were dispatched through 911 and the ED at <Agency Name> was alerted. School staff is told to shelter-in-place for an “indefinite period of time”. It is projected that the operations will continue for at least the next 15 hours (until midnight.)

Situation (cont’d.)• <Agency Name> is the Emergency Operations Center

for the response due to the proximity to the incident, to medical care, and food service for responders and volunteers. Volunteer and EMS support will be crucial to maintaining support operations throughout the evening and the next day for all medical facilities within the surrounding <CITY> and <CITY> area.

• <Agency Name> ED began seeing arrivals by POV at 0935. <FIRE DEPT.> / <CITY> Police are joint Incident Command on scene. Right now they are trying to contain patients exposed to ensure tracking system is established.

Plum

ePlum

e

Wind Wind DirectionDirection

<CITY>

High SchoolHigh School

Location of Tanker with unknown liquid Time: 0935

Incident Command Post• <NAME> is

identified as the Incident Commander on scene. Incident Command Post is located downwind from the railcar.

ICP

<CITY>

High SchoolHigh School

Current Staff Shortages (HCC)

Facility Medical Staff ILI

Medical Staff Type

Non-Medical Staff ILI

Non-Medical Staff Type

<Agency Name>

16 RT, RN-CC, ED- various, Pharmacy, Lab Tech

12 Admissions, Environmental Services, Purchasing , [<Agency Name> ]

<Agency Name>

8 RN, CNA, PA 12 (3 Vol) Admin, Finance, Materials, Housekeep

<Agency Name>

2, 4 RN, CNA 2 , 1 Housekeeping, Front desk

<Agency Name>

12 ** 14 **

As of 0900 4/15/10 per Hospital Status Report

“Homework” #1• Hospitals have been asked by HCC to

do an assessment of staff and resources, taking into account:– Number of Staff affected by school

incident– Number of Staff Ill, options for coverage in

ED/Inpatient

• HCC has requested MRC to do a volunteer assessment for deployment to healthcare facilities.

Homework #1• EM has asked for ESF8 info:

– Plan for enforcement of existing hospital restrictions/ consequences of ILI absence policy

– Hospital activation levels with corresponding staffing/resource decisions

– Capacity for decontamination of patients from scene

– EMS coordination and assistance in planning for patient tracking

– Hospital Public Messaging through JIC (how/who).

ESF8 WebConference Agenda for 1200

• ESF8/HCC situation status• Health Department surveillance reports• Incident Command update- <Fire Dept> • Health facility reports

– <Agency Name>, <Agency Name> , <Agency Name> , <Agency Name>

– <Agency Name>

• DPHE/County coordination issues– Contacts: < Agency Contact> ; FAX to HCC at <Fax

Number> Attn: “Exercise-HCC”