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Hospital Response to Disasters. HARRT 2004. 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

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hospital preparedness
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
hospital preparedness3
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
hospital preparedness for large scale events
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
hospital surge capacity inventories
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
hospital surge capacity inventories6
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
hospital planning
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
heics and the clinician
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?
heics hospital emergency incident command system
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
delayed treatment unit
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
emergency operations center hospital
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