Charles cefalu md
1 / 25

Charles Cefalu, MD - PowerPoint PPT Presentation

  • Uploaded on

Charles Cefalu, MD.

I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
Download Presentation

PowerPoint Slideshow about 'Charles Cefalu, MD' - lovey

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.

- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Charles cefalu md
Charles Cefalu, MD

  • Dr. Cefalu has been an academic clinician educator during his 32 year career including academic appointments at LSU, Tulane, Bowman Gray/Wake Forest and Georgetown University Schools of Medicine. He is currently Professor and Chief of the Section of Geriatric Medicine at LSU School of Medicine and Program Director for the Geriatric Medicine Fellowship. He is also the author of numerous regional, national, and international publications relative to Geriatric Medicine and has spoken at various local, regional, and national geriatric conferences. He is a Hartford/ADGAP Geriatric Scholar and is board certified in family medicine and geriatrics He was also elected in 2010 to serve a three year term on the Board of Directors of the American Geriatrics Society. He also currently serves as Chair of the Clinical Practice Committee of the American Medical Directors Association.

Disaster preparedness lessons learned from katrina and gustaz

Disaster Preparedness-Lessons Learned from Katrina and Gustaz

Charles A. Cefalu MD, MS

Professor and Chief, Section of Geriatric Medicine

Medical Director, LSU Affiliated Nursing homes


Statistics Gustaz

  • 300 nursing homes in La.

  • 120 in the NO Metro area affected by Mandatory Evacuation

  • 40 nursing home patients died in NO Metro area nursing home

  • Result-State law now mandates dual Responsibility of specific nursing home and oversight by DHH relative to Evacuation Procedures

La healthcare review organization
La. Healthcare Review Organization Gustaz

  • Serves as Medicare’s LTC review organization in Louisiana for nursing home quality care

  • Had weekly teleconferences with physicians across the state for several months after Katrina to provide assistance and communications/advise to displaced physicians, clinics, and hospitals

  • LTC Committee (Workforce) group also met monthly to provide assistance and advice to nursing homes

Workforce group recommendations
Workforce Group Recommendations Gustaz

  • Hurricane Preparedness-Advance Planning

    • Hurricane plans should be reviewed every year

    • Contract with 2 evacuation sites-one east and one west

    • Review your bus service contract

    • Stock extra medications during hurricane season; keep these supplies separate

    • Choose a pharmacy that keeps backup electronic medical records

    • Keep Hurricane supplies separate from regular supplies

Workforce recommendations
Workforce Recommendations Gustaz

  • Evacuating

    • Leave as early as possible

    • Make up emergency kits for each bus

    • Designate a person to be the first on arrival to direct activities at the evacuation site

    • Notify families regarding the evacuation

    • Staff buses by acuity of residents

    • Place roommates on bus together

    • Triage residents by ambulatory or functional status

    • Use of diapers versus catheters-make sure all residents toilet prior to getting on bus

Workforce recommendations1
Workforce Recommendations Gustaz

  • Identification of residents

    • Use of armbands

    • Make pictures of all residents

  • Supplies/Equipment

    • Each bus with separate supplies

    • Order extra medications

    • Have ice and water in each bus

    • Send large equipment ahead of bus

    • Make sure oxygen tanks are secure on bus

Workforce recommendations2
Workforce Recommendations Gustaz

  • Weathering the Hurricane

    • Use of some type of radio system; adequate communications-many hospitals or facilities could not communicate with each other

    • Designate a local hospital in route to serve as a common communications point

Workforce recommendations3
Workforce Recommendations Gustaz

  • Security-after the Hurricane, break-ins

  • Power-making sure a large enough generator is secured for after the Hurricane especially as it relates to powering the ice maker

Workforce recommendations4
Workforce Recommendations Gustaz

  • Vital identification and records

    • Armbands for residents and pictures

  • Supplies-chain saws, tarps, and plenty of IV fluids

  • Pharmacy supplies need some type of backup computer records stored in a different geographical area

  • Transportation-for employees coming to work after Hurricane-an emergency transportation system

  • Serving as an Evacuation Shelter

Quick break
Quick Break Gustaz

A short video clip will be shown shortly.

While waiting, please think please type in your questions for Dr. Cefalu on the dialog box to the left of your screen.

Send to “Everyone”. Thank you.

The big uneasy katrina s unsung heroes
The Big Uneasy: Katrina’s Unsung Heroes Gustaz

The Big Uneasy: Katrina’s Unsung Heroes (2009) is a tribute to the staff of Louisiana’s nursing homes who brought thousands of residents safely through the storm and its aftermath. The DVD was produced by Cathie Brady & Barbara Frank, B&F consulting, Inc. and Susan Wehry, MD with funding provided by a grant from the Louisiana Department of Health and Hospitals. The DVD may be purchased for a nominal fee and a pdf of the Facilitator’s Guide is available at no charge.

  • For DVD information and/or orders:

    • Linda Sadden, State Long-Term Care Ombudsman, Louisiana


  • For Facilitator’s Guide:


Workforce recommendations5
Workforce Recommendations Gustaz

  • Serving as an Evacuation Shelter

    • Resident population may double overnight

    • Triage residents upon arrival

    • Place residents in rooms and areas of the nursing home according to their needs-tube feeding versus bed bound which allows rooms to be stocked quickly

    • Arriving facility should bring identification of residents and medicine sheets

    • Partner with Schools of Nursing to use as a resource to man shelters or help out at nursing homes

Workforce recommendations6
Workforce Recommendations Gustaz

  • Need for local law enforcement early and security in the nursing home parking lot

  • Residents need to know how to file for FEMA assistance

  • Facilities should have business interruption insurance to cover overhead costs such as payroll, mortgage.

  • Consider a computer services contract for back up services in a separate geographic location

Disaster management
Disaster Management Gustaz

Disasters come in all shapes and sizes. Some are natural and some are accidents or purposeful actions.

Although hurricanes are most frequently associated with disaster management plan development in long term care facilities, we are engaged in all aspects to include fire, life safety, pandemic, terrorist, bomb threats, and other potentials.

Providers are encouraged to be self sufficient and to preplan
Providers are encouraged to be self sufficient and to preplan!

  • How will you handle:

    Emerging clinical crises? Infection control? Deaths? Possible staff shortages? Lack of power? Lack of communications?

  • Are supplies in appropriate amounts?

  • Will staff be able to travel?

  • How to externally communicate?

  • SNFs potentially become Special Needs

    Shelter ?

Disaster specific position descriptions
Disaster-Specific preplan! Position Descriptions

  • Administrator

  • Director of Nursing

  • Risk Manager

  • Maintenance

  • Housekeeping

  • Dietary

  • Social Services

  • Activities

  • Medical Director

  • Other?

Role of the medical director
Role of the Medical Director preplan!

  • Disaster Preparedness Planning

  • Evacuation Decision Considerations

  • Shelter in place Considerations

  • During the Event

  • Post Event

  • Look Back and CQI

Keys to clinical management
Keys to Clinical Management preplan!

  • Regardless if a disaster results in planned or unplanned response, including evacuation from entire facility or a part, the clinical care and critical services must go on…….

Identify conditions that may worsen with stress
Identify Conditions that may Worsen With Stress preplan!

  • Confusion

  • Pain

  • Anxiety

  • Diabetes

  • Constipation

  • Hospice or declared terminal services

    ? How will you manage infection control as a whole and for residents with infections?

Diabetic considerations
Diabetic Considerations preplan!

  • Blood Sugar MachineMedication Records

  • Oral Antihypoglycemic

  • Insulin Syringes

  • Insulin (Reg., NPH, etc.)

  • Glucerna

  • Instant Glucose

  • Urine Test Strips

  • Hydration/snacks

  • Other?

  • Batteries

  • Lancets

  • Test strips

  • Alcohol wipes

  • Testing Agents

  • Sharps container

  • Hand Gel

  • Gloves

  • Physician OrderSheet

More lessons learned
More Lessons Learned preplan! :

  • Develop state to state relationships

  • Identify what members have facilities in other states: This facilitates state to state sharing of supplies, services, and human resources

  • Affiliate with your state board of nursing

  • Advocate for licensure and reciprocity agreements for staffing;

  • Keep abreast of board openings and opportunities for LTC representation

  • Act as a central repository for provider ideas and offers: housing, employment for displaced workers

Question and Answer Period preplan!

Type your question on the dialog box to the left of your screen.

Send to “Everyone”

Thank You