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Profiting From Hospital Disaster Preparedness: A Process Enhancement Model
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Profiting From Hospital Disaster Preparedness: A Process Enhancement Model

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Hospital Disaster Preparedness is an expensive process that traditionally yields little or no return on investment. This innovative approach utilizes Process Enhancement rather than Event Response ...

Hospital Disaster Preparedness is an expensive process that traditionally yields little or no return on investment. This innovative approach utilizes Process Enhancement rather than Event Response models to meet Disaster Preparedness benchmarks while improving daily operations thus yielding a net profit from the investment.

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    Profiting From Hospital Disaster Preparedness: A Process Enhancement Model Profiting From Hospital Disaster Preparedness: A Process Enhancement Model Presentation Transcript

    • The Time is Now Profiting from Hospital Disaster Preparedness: A Process Enhancement Model
      • Contact Info:
        • Maurice A. Ramirez, DO, PhD hire @ mauricearamirez.com www.High-Alert.com 866-231-4755
    • Preparedness Balance Sheet
      • Process Enhancement
        • Process Analysis
          • Business Processes
          • Healthcare Processes
          • Income Streams
        • Daily Needs/Resources Inventory
        • Benchmark Triggered
        • Targeted Process Enhancement
      • Event Response
        • Vulnerability Analysis
          • Hazard Based
          • Kaiser Model
          • Income Insensitive
        • Centered on Recognized Events
        • Event Triggered
        • Untargeted Response and Expenditure
    • Preparedness Balance Sheet Event Response Model
      • Costs
        • Equipment
        • Staff Training
        • Salaries for Training
        • Resource Stockpiles
        • Externally Validated Drills and Exercises
        • Extra Personnel
      • Dollars and Sense
        • $1400/Licensed Bed
        • $3920/Licensed Bed/yr.
        • $1780/Licensed Bed/yr.
        • $1400/Licensed Bed
        • $530/Licensed Bed/drill (2 per year)
        • $1350/Licensed Bed/day
      • Total Cost = $10400/bed/yr
    • Preparedness Balance Sheet Event Response Model
      • Dollars and Sense
        • $0.00
        • $0.00
        • Priceless
      • Total Revenue = $0.00
      • Business Benefits
        • Joint Commission
        • NIMS Compliance
        • Legal Protection
          • Qui Tam
          • Sarbanes Oxley
    • Preparedness Balance Sheet Event Response Model
      • Costs
        • Equipment
        • Staff Training
        • Salaries for Training
        • Resource Stockpiles
        • Externally Validated Drills and Exercises
        • Response Personnel
      • NET LOSS = $10400/bed/yr
      • Business Benefits
        • Joint Commission
        • NIMS Compliance
        • Legal Protection
          • Qui Tam
          • Sarbanes Oxley
    • Preparedness Balance Sheet Process Enhancement Model
      • Costs
        • Equipment
        • Staff Training
        • Salaries for Training
        • Resource Stockpiles
        • Externally Validated Drills and Exercises
        • Extra Personnel
      • Dollars and Sense
        • $1400/Licensed Bed
        • $4920/Licensed Bed/yr.
        • $1800/Licensed Bed/yr.
        • $1400/Licensed Bed
        • $530/Licensed Bed/drill (1 per year)
        • $1350/Licensed Bed/day
      • Total Cost = $11500/bed/yr
    • Preparedness Balance Sheet Process Enhancement Model
      • Business Benefits
        • Joint Commission
        • NIMS Compliance
        • Legal Protection
          • Qui Tam
          • Sarbanes Oxley
        • Improved Customer Satisfaction
        • Fewer AMA/LWOT
        • Increased Admits
      • Dollars and Sense
        • $0.00
        • $0.00
        • Priceless
        • Priceless
        • One Admission per Bed/yr
        • $17374/Licensed Bed/yr
      • Total Revenue = $17374/Bed/yr
    • Preparedness Balance Sheet Process Enhancement Model
      • Costs
        • Equipment
        • Staff Training
        • Salaries for Training
        • Resource Stockpiles
        • Externally Validated Drills and Exercises
        • Extra Personnel
      • Business Benefits
        • Joint Commission
        • NIMS Compliance
        • Legal Protection
          • Qui Tam
          • Sarbanes Oxley
        • Improved Customer Satisfaction
        • Fewer AMA/LWOT
        • Increased Admits
        • Targeted Response reduces cost of response
      • NET PROFIT = $5874/Bed/yr
    • Preparedness Balance Sheet
      • Process Enhancement
        • Process Analysis
          • Business Processes
          • Healthcare Processes
          • Income Streams
        • Daily Needs/Resources Inventory
        • Benchmark Triggered
        • Targeted Process Enhancement
      • Net Profit: $5874/Bed/yr
      • Event Response
        • Vulnerability Analysis
          • Hazard Based
          • Kaiser Model
          • Income Insensitive
        • Centered on Recognized Events
        • Event Triggered
        • Untargeted Response and Expenditure
      • Net Loss: $10400/Bed/yr
      • The Return on Investment (ROI)
        • $16274/Licensed Beds/yr
        • $5874/Licensed Bed/yr Profit
        • Improved Customer Satisfaction
        • Fewer AMA’s/LWOT’s
        • More Admissions
        • Shorter Response Phase
        • Quicker Return to Full Operations
        • Greater Surge Capacity
      Preparedness Balance Sheet
    • Planning In Light of New Realities
      • Healthcare planning traditionally based on “same day last year” and “last time this happened” parameters.
      • Healthcare disaster planning too often looks to change operational procedures.
      • “Practice the way you will play” - Vince Lombardi
      • “ Play the Way You Will Play!” - Maurice A. Ramirez
      • Learning from the past is rare
      Planning In Light of New Realities  Lessons Occurred  Lessons Observed  Lessons Learned  Lessons Applied
      • Lessons Learned
        • 120 hours of self sufficiency
        • Unified Incident Command System
        • Inter-Facility and Inter-Agency Planning
        • Facility Wide / Community Wide Preparation
        • Unified Multichannel Communications
        • Common Language Communications
        • Externally Validated and Reviewed Community Wide Drills
      Planning In Light of New Realities
      • Lessons Applied
      Planning In Light of New Realities ?
    • Strategic Thinking
      • L4  Interstate, Regional and/or Federal
      • L3  Intrastate, Multi-County
      • L2  County
      • L1  City, Township, Interfacility
      • L0  Facility
    • Strategic Thinking
      • L4 aka Macro-Strategic
        • “ 10,000 foot view”
        • Functionally analogous to the Leadership Role of a CEO
        • Planning, Logistics and Operations at a Federal, Interstate and/or Regional Level
          • NDMS – MRC – FEMA – DoD
          • Red Cross – Faith Based National Organizations
          • Insurance Companies – Corporate COOP’s
    • Strategic Thinking
      • L3 aka Strategic
        • “ 1,000 foot view”
        • Functionally analogous to the Leadership Role of a COO, CTO, CFO
        • Planning, Logistics and Operations at a State, and/or Intercounty Level
          • SMRT – MRC – State EOC’s – State Guard
          • Red Cross – Faith Based State Organizations
          • Insurance Companies – Corporate COOP’s
    • Strategic Thinking
      • L2 aka Microstrategic / Macrotactical
        • “ 100 foot view”
        • Functionally analogous to the Leadership Role of a Departmental Director
        • Planning, Logistics and Operations at a County and/or Intercity Level
          • SMRT – County Medical Association
          • County EOC’s – County EMS
          • Local Red Cross – Local Faith Based Organizations
          • Insurance Companies – Corporate COOP’s
    • Strategic Thinking
      • L1 aka Tactical
        • “ 10 foot view”
        • Functionally analogous to the Leadership Role of a Shift Supervisor
        • Planning, Logistics and Operations at a City and/or Interfacility Level
          • SMRT – County Medical Association – Local Providers
          • City EOC’s – City EMS
          • Local Red Cross – Local Faith Based Organizations
          • Insurance Companies – Corporate COOP’s
    • Strategic Thinking
      • L0 aka Microtactical
        • “ 1 foot view”
        • Functionally analogous to the Operational Role of a Nurse Interacting with a Patient
        • Planning, Logistics and Operations at a Facility and/or Interdepartmental Level
          • Local Providers
          • Facility Employees
          • Facility Volunteers
          • Facility COOP’s
    • Concentric Ring Concept
      • Network – Centric Approach
      • Concentric Ring Approach to Care
      • Concentric Ring Approach to Management
      L1 L2 L3 L4
    • Concentric Ring Concept
      • Global Approach to Planning
      L1 L2 L3 L4
        • Macrostrategic  L4 aka: Regional
        • Strategic  L3 aka: State
        • Macrotactical  L2 aka: County
        • Tactical  L1 aka: City
        • Microtactical  L0 aka: Facility
    • Concentric Ring Concept
      • Planning becomes progressive and “Bottom-Up” Facility  City  County  State  Regional
      • Planning also becomes “Top Down” Regional  State  County  City  Facility
      L1 L2 L3 L4
        • Macrostrategic  L4 aka: Regional
        • Strategic  L3 aka: State
        • Macrotactical  L2 aka: County
        • Tactical  L1 aka: City
        • Microtactical  L0 aka: Facility
    • Concentric Ring Concept L1 L2 L3 L4 INCIDENT
    • Concentric Ring Concept
      • After the Event
        • L1 & L2 Facilities Absorb Immediate Surge
        • L3 & L4 Facilities Provide Supplemental Capacity
        • All L1, L2, L3 & L4 Support Requires MSA’s
      L1 L2 L3 L4
        • Macrostrategic  L4 aka: Regional
        • Strategic  L3 aka: State
        • Macrotactical  L2 aka: County
        • Tactical  L1 aka: City
        • Microtactical  L0 aka: Facility
    • Steps to Preparedness
      • Vulnerability Analysis
        • All Hazards Review
      • Didactic Education
        • All Hazards Preparedness
        • All Hazards Planning
      • Immersion Simulation
        • Institute of Medicine Standard ( To Err is Human )
        • All Hazards Exercises (Disaster Drills)
      • Continuous Plan Review and Revision
    • The Mathematics of Public Opinion ( Impact + Vulnerability ) Hazard
    • The Mathematics of Public Opinion [ Probability x ( Impact + Vulnerability ) ] Hazard Risk Fear is Risk Raised to the Power of Outrage
    • The Mathematics of Public Opinion [ Probability x ( Impact + Vulnerability ) ] Outrage = Fear Hazard Risk Risk Doubles  Fear Only Doubles Outrage Doubles  Fear Increases Exponentially
    • The Mathematics of Public Opinion Hazard Risk Outrage = Zero  Fear Abates  People Don’t Care [ Probability x ( Impact + Vulnerability ) ] Outrage = Fear
    • The Mathematics of Public Opinion Hazard Risk The Secret  Control OUTRAGE !! [ Probability x ( Impact + Vulnerability ) ] Outrage = Fear
    • The Mathematics of Public Opinion Hazard Risk The Secret  Control OUTRAGE !! Outrage = Enthusiasm – Reality [ Probability x ( Impact + Vulnerability ) ] Outrage = Fear
    • The Mathematics of Public Opinion Hazard Risk Control Public Opinion = Control OUTRAGE !! [ Probability x ( Impact + Vulnerability ) ] Outrage = Fear
    • The Flood of Humanity 7 Patients by EMS 28 Self Transport 140 Psychological Casualties 175 Patients in the First Hour
    • The Flood of Humanity 175 Patients in the First Hour But Wait There’s More!
    • The Flood of Humanity 175 Patients in the First Hour 350 Family, Friends & Bystanders 525 Searching for the Missing
    • The Flood of Humanity Total Surge: 1050 From Only 7 EMS Patients
      • Characteristics of a Mass Triage System
        • It Must Be Fast
          • Improved Survival through Early Care
        • It Must Be Scalable
          • Cannot Slow Due to Surge
        • It Must Be Recurring
          • Cannot Miss Evolving Conditions
        • It Must Include Medical and Behavioral
          • Improved Recovery through Early Intervention
        • It Must Anticipate Exclusion From Care
      Continuous Integrated Triage
    • Continuous Integrated Triage
      • Triaging 5387 Patients
        • Emergency Severity Index (ESI)
          • 1 – 5 Resource and Complaint Balanced System
          • Developed by AHRQ
          • 8 minutes per patient
        • Simple Triage and Rapid Treatment (START)
          • Color Coded Triage based on RPM’s
          • Developed by Fire Rescue – Modified by Military
          • 1 minute per casualty
      x 5387 = 2 months x 5387 = 1 week
      • 540 per hr. x 8 mins. = 5 months behind per day
      • 540 per hr. x 1 mins. = 2 weeks behind per day
    • Continuous Integrated Triage
      • Move (5387)
        • If you can hear the sound of my voice...
        • 80% Rise and Walk (4310)
        • Green
          • Conscious – Alert - Oriented
          • Ambulatory - Following Commands
            • NYHC = 1
            • GOLD Pulmonary = 1
            • NIHSS = 0
            • GCS = 15
        • STABLE for Transport First!!!
    • Continuous Integrated Triage
      • Move (1077)
        • If you can hear the sound of my voice...
        • 16% Wave an Arm or Leg (862)
        • Yellow
          • Conscious – Alert - Oriented
          • NON-Ambulatory - Following Commands
            • NYHC = 1 or 2
            • GOLD Pulmonary = 1 or 2
            • NIHSS < 2
            • GCS = 15
        • STABLE to Wait for Care!!!
    • Continuous Integrated Triage
      • START (215)
        • 4% Who Did Not Move
        • Respirations
          • No Respirations = DEAD
            • CPR Contra-Indicated in Mass Casualty
          • Abnormal (<12 or >20 in an Adult)
            • Red or Black (We’ll come back to this...)
          • Normal (12 to 20 in an Adult)
            • Check Pulse
    • Continuous Integrated Triage
      • START (215)
        • 4% Who Did Not Move
        • Pulse
          • No Pulse = DEAD
            • CPR Contra-Indicated in Mass Casualty
          • Abnormal (<60 or >100 in an Adult)
            • Red or Black (We’ll come back to this...)
          • Normal (60 to 100 in an Adult)
            • Check Mentation
    • Continuous Integrated Triage
      • START (215)
        • 4% Who Did Not Move
        • Mentation
          • Conscious, Alert, Oriented, Ambulatory Follows Commands, but not Paying Attention
            • Green
          • Conscious, Alert, Oriented, Non-Ambulatory, Follows Commands
            • Yellow (Includes Special Needs)
          • Unconscious, Disoriented, Unresponsive
            • Red or Black
    • Continuous Integrated Triage
      • Psych-Triage (5387)
        • All Triage is Continuous and Repeated
        • Expands to Include Behavioral Health
          • Exposures
            • Witnessed Death or Serious Injury  PsyRED vs. PsyBLACK
            • Family Member Died  PsyRED vs. PsyBLACK
            • Entrapment or Delayed Rescue  PsyRED vs. PsyBLACK
            • HAZMAT Exposure  PsyYELLOW
            • Decontamination  PsyYELLOW
    • Continuous Integrated Triage
      • Psych-Triage (5387)
        • All Triage is Continuous and Repeated
        • Expands to Include Behavioral Health
          • Observations
            • Family Member Died  PsyRED vs. PsyBLACK
            • Injury / Illness of Self or Family  PsyRED vs. PsyBLACK
            • Unaccompanied Minor  PsyYELLOW
            • Missing Family Member  PsyYELLOW
            • Separated from Immediate Family  PsyYELLOW
            • Home Uninhabitable  PsyYELLOW
            • Displaced from Home  PsyYELLOW
            • Parent of Child Under 18 years  PsyYELLOW
    • Continuous Integrated Triage
      • Psych-Triage (5387)
        • All Triage is Continuous and Repeated
        • Expands to Include Behavioral Health
          • Reactions
            • Felt / Expressed Extreme Fear or Panic  PsyRED vs. PsyBLACK
            • Felt Direct Threat to Life (Self / Family)  PsyRED vs. PsyBLACK
            • Thought or Intent of Self Harm  PsyRED vs. PsyBLACK
            • Concerns of HAZMAT Exposure  PsyYELLOW
    • Continuous Integrated Triage
      • Red vs. Black
        • Resource Based Ethical Decision
        • Resources Available to Treat WITHOUT Endangering Two or More Other Patients
          • Red Treatment Areas
            • Red (Critical) Medical Treatment Area
            • PsyRED (Critical) Behavioral Health Treatment Area
        • Resources NOT Available to Treat WITHOUT Endangering Two or More Other Patients
          • Black Treatment Areas
            • Black (Expectant) Medical Treatment Area
            • PsyBLACK Behavioral Health Treatment Area
    • Expanding the Healthcare Highway HOSPITAL
    • Expanding the Healthcare Highway HOSPITAL
    • Expanding the Healthcare Highway HOSPITAL FAMILY CENTER
    • Expanding the Healthcare Highway PRE-DECON TRIAGE
    • Expanding the Healthcare Highway DECONTAMINATION AMBULATORY NON-AMBULATORY
    • Expanding the Healthcare Highway DECON DECON START TRIAGE AMBULATORY NON-AMBULATORY
    • Expanding the Healthcare Highway REPEAT TRIAGE EMERGENCY ROOM GREEN TREATMENT AREA GREEN RED RED YELLOW BLACK EXPECTANT TREATMENT AREA
    • Expanding the Healthcare Highway ADMISSION FAST TRACK EMERGENCY ROOM GREEN TREATMENT AREA
    • Expanding the Healthcare Highway DECON DECON BEHAVIORAL TRIAGE MEDICALLY CLEARED - STABLE
    • Expanding the Healthcare Highway DISCHARGE HOME HOSPITAL BASED SUPPORT CENTER “ PSYCH-RED” “ PSYCH - GREEN”
    • Expanding the Healthcare Highway DECON DECON BEHAVIORAL TRIAGE HOSPITAL BASED SUPPORT CENTER
    • Expanding the Healthcare Highway DISCHARGE HOME BEHAVIORAL HEALTH ADMISSION “ PSYCH-RED” “ PSYCH - GREEN”
    • Preparedness Balance Sheet
    • Preparedness Balance Sheet
      • Sticks
        • NIMS-IC for Hospitals
        • Joint Commission
        • Medicare/Medicaid
          • CMS Attestations
          • Willful Blindness
          • Qui Tam
          • Sarbanes-Oxley
      • Carrots
        • Public Relations
        • Community Relations
        • Employee Relations
        • Customer Service
        • Preferential Billing
        • Rapid Recovery
    • Preparedness Balance Sheet
      • Process Enhancement
        • Process Analysis
          • Business Processes
          • Healthcare Processes
          • Income Streams
        • Daily Needs/Resources Inventory
        • Benchmark Triggered
        • Targeted Process Enhancement
      • Event Response
        • Vulnerability Analysis
          • Hazard Based
          • Kaiser Model
          • Income Insensitive
        • Centered on Recognized Events
        • Event Triggered
        • Untargeted Response and Expenditure
    • Preparedness Balance Sheet
      • Process Enhancement
        • Process Analysis
          • Business Processes
          • Healthcare Processes
          • Income Streams
        • Daily Needs/Resources Inventory
        • Benchmark Triggered
        • Targeted Process Enhancement
      • Net Profit: $5874/Bed/yr
      • Event Response
        • Vulnerability Analysis
          • Hazard Based
          • Kaiser Model
          • Income Insensitive
        • Centered on Recognized Events
        • Event Triggered
        • Untargeted Response and Expenditure
      • Net Loss: $10400/Bed/yr
    • From Preparedness to Profitability
      • Given that the investment is required
        • NIMS Compliance
        • Joint Commission
        • Medicare/Medicaid
          • CMS Attestation
          • Qui Tam
          • Sarbanes-Oxley
      • Given that the investment is the same
        • Process Enhancement / Process Analysis Model
        • Event Response Model
    • From Preparedness to Profitability
      • The Return on Investment (ROI)
        • $16274/Licensed Bed/yr Savings
        • $5874/Licensed Bed/yr Profit
        • Improved Customer Satisfaction
        • Fewer AMA’s/LWOT’s
        • More Admissions
        • Shorter Response Phase
        • Quicker Return to Full Operations
        • Greater Surge Capacity
      • Learn more about using a Process Enhancement Model Compatible with LEAN and Six Sigma to meet your Disaster Preparedness Benchmarks by contacting:
      • Dr. Maurice A. Ramirez email: hire@mauricearamirez.com phone: 866-231-4755
      From Preparedness to Profitability