Planning for Healthcare Facility Evacuations: Developing County-wide Nursing Home and


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Speaker: Danica Little, Training and Exercise Manager, King County Healthcare Coalition
Public Health- Seattle & King County and the King County Healthcare Coalition have engaged with 61
nursing homes to develop a regional evacuation and mutual aid plan. This addresses how nursing homes
will assist each other during a disaster and how they will coordinate with external support agencies. This
includes: 1. Providing a clear and concise plan activation process. 2. Strategies to prevent evacuation if
possible. 3. Strategies and protocol for the placement, tracking, and support care for evacuated patients.
4. Protocol for the disaster struck facility in the event of an evacuation. 5. Protocol for the patient
accepting facility. 6. Documentation of specific resource requirements and available assets. 7. Protocol
for staff and resource sharing This presentation provides an overview of our planning activities and
will review the planning and mutual aid model used, and the benefits to local partners - including public
health, EMS And emergency management.

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Planning for Healthcare Facility Evacuations: Developing County-wide Nursing Home and

  1. 1. Planning for Healthcare Facility Evacuations:Developing County-wide Nursing Home and Patient Tracking Mutual Aid Agreements Danica Little King County Healthcare Coalition
  2. 2. Objectives• Outline planning process• Describe plan components• Id if role(s) of S Identify l ( ) f Steering C i Committee M b i Members and integration with Health and Medical Area Command C d• Define plan implementation
  3. 3. Developing the Plan• King County and Pierce County entered into the g y y planning process together through the RCPG• Hired Russell Phillips and Associates to develop the l th plan• Conducted surveys of all participating LTC agencies – Patient categories of care – Bed and surge capacity numbers – Transportation assets• Developed Mutual Aid Plan and collected signatures
  4. 4. Developing the Plan• Purpose: – To create a voluntary plan to serve as the foundation for the coordination of long term care facility o e coo d a o o o g e ca e ac y evacuation(s)• Facilitates ability for long term care providers to y g p place patients in like beds and share resources• Plan provides mutual aid for over 50 large nursing homes – Does not cover adult family homes or smaller organizations at this time
  5. 5. Developing the Plan• Plan Scope – To place and support care of patients evacuated from a Disaster Struck Facility – To provide supplies as needed to a Disaster Struck Facility – To assist with transportation of evacuated patients – To provide staffing support as needed to Disaster Struck Facility, whether evacuating or facility is directly impacted by the disaster y – To provide stop over points and transportation to evacuated patients or to provide supplies from member facilities f iliti geographically removed f hi ll d from th region-wide the i id disaster area
  6. 6. Developing the Plan• Memorandum of Understanding – The Memorandum of Understanding (MOU) is the Agreement among Region 6 – King County long term care facilities that commit the healthcare facilities to voluntarily provide support to accept evacuated patients and/or provide assistance to Member Facilities with needed supplies, equipment, staffing and transportation. ff d
  7. 7. Developing the Plan• Mutual Aid Plan – All members required to accept 10% of their total beds – Required to attend annual meeting and participate in regional long term care drills and exercises – If evacuating, members must use the forms identified in the plan for tracking residents, medical records and equipment
  8. 8. Components of the Plan• The plan outlines: – Alert and notification process – Resources available in the region – Patient care categories available by facility – Steps that each f ilit (Disaster Struck and P ti t St th t h facility (Di t St k d Patient Accepting) should follow in an event that requires an evacuation
  9. 9. Components of the Plan• Table of Contents – Actions of Disaster Struck Facility and Patient Accepting Facilities – Plan Activation and Communications – Transportation p – Medical Records and Patient Information – Staff, Pharmaceuticals, Supplies and Equipment – Mutual Aid Plan
  10. 10. Components of the Plan• Actions of Disaster Struck Facility – Implement census reduction strategies – Identify stop over points (if necessary) – Send staff to receiving facilities as soon as possible – Utilize Resident Tracking Forms Utili R id t T ki F – Send medications and patient record/chart – Notify family d N f f l and primary care physician of h f resident
  11. 11. Components of the Plan• Actions of Patient Accepting Facility – Must have internal plan to appropriately receive and care for incoming patients – Once admitted, a patient falls under the care of the Patient Accepting Facility’s admitting physician Facility s – Provide all beds, linens, food, supplies and equipment as necessary q p y
  12. 12. Components of the Plan• Actions of Patient Accepting Facility – Notify Disaster Struck Facility of arrival of patients and any of their staff who accompany patients – At the end of the disaster, return all patients, with their medical records and equipment, to the facility of origin
  13. 13. Components of the Plan• Transportation – Coordinated by EMS in the local jurisdiction – Attachment A in plan identifies available transportation assets that reside at various LTC facilities – Liaison officer at Disaster Struck Facility, with EMS Transportation Officer/MSO, work with Health and p / , Medical Area Command to place patients
  14. 14. Components of the Plan• Transportation – Transportation officer at disaster struck facility will: • Communicate to receiving facilities • Coordinate pick up and arrange for any special need accommodations for transport (bariatric, critical care transport/ventilator, behavioral issues, etc) • Arrange discharge orders for any patients able to go home
  15. 15. Components of the Plan• Transportation – Special transportation concerns are outlined in the plan (facilities that care for vented patients, etc) – Tracking forms must be used
  16. 16. Components of the Plan• Medical Records and Patient Information – When a patient leaves a facility, the following must go with them: • Patient/Resident Evacuation Tracking Form • Patient Medical Record (which at the end of a disaster is ( returned to original facility, along with the patient) • Patient Medical Record and Equipment Tracking Sheet • Stickers on medical record and equipment stating facility name, address, and phone number of evacuating facility
  17. 17. Components of the Plan• Medical Records and Patient Information – Necessary medications: package with personal items and send with patient • Label with patient name and medical identification number – In some cases, a licensed healthcare professional may accompany a patient – All patients must have wristband or some form of identification
  18. 18. Components of the Plan• Staff Pharmaceuticals, Supplies and Equipment Staff, Pharmaceuticals – May be needed by: • A disaster struck facility who is not evacuating but in evacuating, need of resources • A patient accepting facility • A stop-over point to which a disaster struck facility has evacuated
  19. 19. Components of the Plan• Staff Pharmaceuticals, Supplies and Equipment Staff, Pharmaceuticals – Process for requesting staff assistance are outlined in plan, including considerations for collecting documentation/credentials – Supervision of staff is assigned by borrowing facility senior administrator or designee – Demobilization procedures are outlined in the plan p p
  20. 20. Components of the Plan• Staff Pharmaceuticals, Supplies and Equipment Staff, Pharmaceuticals – Joint Commission standards for disaster privileging are outlined in the plan – Process for requesting pharmaceuticals, supplies and equipment outlined in plan, including: • How to request • Transport • Safety/security • Documentation
  21. 21. Coordination Tools• Algorithms – Outline process for requesting resources to avoid evacuation id i – Outline process for alerts/notifications and actions if evacuation is necessary – Identify actions to activate assistance outside y local region
  22. 22. Coordination Tools• Patient Categories of Care – Beds and surge capacity numbers – Stop over points – Transportation resources p – Evacuation sites
  23. 23. Coordination Tools• Forms – Resident Evacuation Tracking Form – Patient/Medical Record and Equipment Tracking Sheet – Controlled Substance Receiving Log – Influx of Patients Log
  24. 24. Plan Activation• Disaster struck facility – Call 911 – Activate internal Command Center – Assess need to evacuate vs. need for additional resources to stay in place – Notify Health and Medical Area Command – Notify DSHS
  25. 25. Plan Activation• Patient Accepting Facility – Report number of available beds – Verify if a transportation vehicle is available to assist the Disaster Struck Facility – Verify supplies, equipment and staff that may be supplies available to support another facility – to avoid evacuation• Communications Plans – Outlined process for single facility evacuations and multiple facility evacuations
  26. 26. Steering Committee• Provide guidance to Coalition staff on LTC planning and tool implementation• Ad ocate on behalf of the Mutual Aid Plan and Advocate M t al subsequent planning activities – M i i i contact i f Maintaining information i – WATrac training• Serve in Health and Medical Area Command as a Coordinating Team during a facility evacuation
  27. 27. Steering Committee• Area Command Structure Provides: – Direction and control of health and medical decisions, resources and services – Access to medical staff and resources in a coordinated manner – Timely, useful, credible information to decision makers, partners, and the public – Ability to create additional system capacity utilizing system-wide expertise
  28. 28. Operations Section Structure Operations Section ChiefAlternate Care Medical Mass Fatalities Long Term Care Call Center Facilities Countermeasures Branch Branch Branch Branch Branch
  29. 29. Steering Committee• Long Term Care Branch Objectives: – Establish and maintain contact with Disaster Struck Facilities – Make connections with available Patient Accepting Facilities – Track Patient movement between evacuating and receiving facilities g
  30. 30. Steering Committee• Long Term Care Branch Actions – Manage communications with facilities – Notify DSHS of situation – Collect and collate available beds, resources and status of LTC facilities – Coordinate with Logistics on resource requests to support the event
  31. 31. Implementation• Activation of the plan occurs when the Public p Health D Officer i H l h Duty Offi is notified by a Disaster ifi d b Di Struck Facility• WATrac Alert is sent to LTC Mutual Aid Plan group• Operations Section of Health and Medical Area Command activated to support the event• Long Term Care Branch activated and staffed g by S b Steering Committee members C b – LTC Branch can work in HMAC or remotely
  32. 32. Implementation• LTC Branch – Primary objective upon activation is to collect and collate data – Phones are primary method of communication – WATrac is utilized for virtual communication – All forms and tools are stored in Knowledgebase in WATrac
  33. 33. Implementation• Plan was exercised in March 2010 with Long Term Care partners, emergency management agencies and EMS organizations• Data collected in surveys to support plan (transportation assets, categories of care, etc) assets care migrated into WATrac• S Steering C Committee members exercised their b d h role in March 2011
  34. 34. Questions?King County Healthcare Coalition Website eparedness/hccoalition/healthcare.aspx#longterm Danica Little, Training and Exercise Manager King County Healthcare Coalition