Hospital Response to Disasters

1. Hospital Response to Disasters HARRT 2004

2. Hospital Preparedness • 9/11 had placed hospital preparedness under the microscope at the local, state, and federal levels • Although the “All Hazards” approach is the norm, hospitals have entered a new era in preparedness • At this point hospitals are amongst the last players to join the community efforts, prior to 9/11, hospitals had not viewed themselves as part of the local response system

3. Hospital Preparedness: • Clarification for HIPPA, EMATALA, and EPA regulatory requirements and their applications in emergency situations is vital • Relationship building amongst the stakeholders takes time and trust • Large scale events don’t just happen in major metropolitan areas---all hospitals are potential responders

4. Hospital Preparedness for large scale events: • Hospitals have always planned for disasters, but not large scale events • Since 9/11, hospitals have begun to focus on readiness for large scale terrorism events as well • Community involvement is necessary in large scale planning---something that hospitals have little experience with

5. Hospital Surge Capacity: Inventories • Just-in-time inventory models have become the norm • Pharmaceuticals (antibiotics, vaccines, anti-viral medications) • Food stores • PPE to handle large volumes • Hospitals lack ventilators • A recent GAO report revealed that most hospitals have <10 ventilators per 100 staffed beds

6. Hospital Surge Capacity: Inventories • A 48-72 “stand alone” capability is essential • Hospitals also lack the space necessary to accomodate enhanced caches, create additional triage, patient care, and morgue areas

7. Hospital Planning: • Planning is a dynamic process • A plan is NEVER complete • The best plans are based on predictable behaviors • Plans must be practiced • Disaster drills are not punitive activities • Disaster drills are learning laboratories • Disaster drills provide opportunities

9. HEICS and the Clinician • Do you know what your role is in a disaster? • Have you ever been part of a disaster drill? • Have you been educated on the disaster plan at your facility? • What would you do in the event of a disaster?

10. HEICS:Hospital Emergency Incident Command System • Incident Command System or Incident Management System characteristics • Universal language for all clinicians to use • Small span of control • Small span of control • Delineation of authority

11. Delayed Treatment Unit • Actions • Identification of Delayed Treatment Unit Leader • Assignment of roles and responsibilities • Increased responsibilities of care providers • Disaster Medical Care • A, B, C’s • Pain Management • ↑ Resource limitation utilization • Secondary Triage • Triage of patients in DTU • Triage of incoming

12. Emergency Operations Center:Hospital • Purpose----Under the direction of the EIC • To maintain overall command of the overall hospital operations • Oversight of the Emergency Operations Center • To maintain communications both internal and external • Data gathering both internal and external • Magnitude of event • Resource availability