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Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
Suspended Reality: Immersion Simulation in Healthcare Preparedness
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Suspended Reality: Immersion Simulation in Healthcare Preparedness

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The New Vista of Compliance – How to Save $13920/bed per yr, Increase Surge Capacity 400%, Decrease Emergency Room Wait 50%, and Meet the September 30, 2008 Deadline.

The New Vista of Compliance – How to Save $13920/bed per yr, Increase Surge Capacity 400%, Decrease Emergency Room Wait 50%, and Meet the September 30, 2008 Deadline.

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  • 1. Suspended Reality The New Vista of Compliance – Disaster Planning, Preparation, Response and Recovery Education through Immersion Simulation
  • 2. Suspended Reality The New Vista of Compliance – How to Save $13920/bed per yr, Increase Surge Capacity 400%, Decrease Emergency Room Wait 50%, and Meet the September 30, 2008 Deadline
  • 3. A Game of Numbers
    • What is the United States Population?
    • 300 million people
    • How Many Hospital Beds in the United States?
    • 955,768 (AHA, 2005)
    • How Many Hospital Beds are Staffed?
    • 726,384 (AHA, 2005)
    • What Percent are Occupied During Flu Season?
    • 96% -or- 917,537 (AHA, 2005)
    • What Surge Capacity is Required by HHS & HRSA?
    • 20% -or- 191,154 (HHS)
    • 500 beds per million -or- 150,000 (HRSA)
    • Only have 38,231 beds!!!
  • 4. A Game of Numbers
    • What is the United States Population?
    • 300 million people
    • How Many Ventilators in the United States?
    • 105,000 (M. Olsterholm – NEJM, 2004)
    • How Many are Out of Service for Cleaning or Repair?
    • 18% -or- 18,900 (M. Olsterholm – NEJM, 2004)
    • How Many are for Chronic Ventilator Dependent Patients?
    • 67% -or- 70,035 (M. Olsterholm – NEJM, 2004)
    • How Many Ventilators are Available for Acute Use?
    • 15% -or- 16,365 (M. Olsterholm – NEJM, 2004)
    • Only have 38,231 beds!!!
  • 5. A Game of Numbers
    • What is the United States Population?
    • 300 million people
    • How Many in the United States Will Become Sick in a Flu Pandemic?
    • 1 in 3 -or- 100 million (Historical Records 1918)
    • How Many of the Sick Will Require Assisted Care?
    • Half -or- 50 million (Historical Records 1918)
    • How Many of Those Requiring Care Will Require Hospital Care?
    • Half -or- 25 million (Historical Records 1918)
    • How Many of Those Requiring Hospitalization will need Intubation?
    • Half -or- 12.5 million (Historical Records 1918)
    • How Many of Those Requiring Intubation will Die?
    • Half -or- 6.25 million (Historical Records 1918)
    • Only have 38,231 beds and 16,365 ventilators!!!
  • 6.
    • What is the United States Population?
    • 300 million people and 100 million with Pan-Flu
    • Where did the CDC numbers come from?
    • 1 in 3 -or- 33% get sick
    • How Many of the Sick Will Require Assisted Care?
    • Half -or- 16%
    • How Many of Those Requiring Care Will Require Hospital Care?
    • Half -or- 8%
    • How Many of Those Requiring Hospitalization will need Intubation?
    • Half -or- 4%
    • How Many of Those Requiring Intubation will Die?
    • Half -or- 2%
    • Only have 38,231 beds and 16,365 ventilators!!!
    A Game of Numbers (CDC assumes these are NOT hospitalized) (CDC says 8% of the ill, but it actually is out of 300 million) (CDC says 2% die, but again this is out of 300 million) (CDC says 4% of the hospitalized, but it is out of 300 million)
  • 7. The Flood of Humanity 7 Patients by EMS 28 Self Transport 140 Psychological Casualties 175 Patients in the First Hour
  • 8. The Flood of Humanity 175 Patients in the First Hour But Wait There’s More!
  • 9. The Flood of Humanity 175 Patients in the First Hour 350 Family, Friends & Bystanders 525 Searching for the Missing
  • 10. The Flood of Humanity Total Surge: 1050 From Only 7 EMS Patients
  • 11. Building for Resilience
    • Emergency Preparedness
  • 12. Managing the Masses Total Surge of 1050 350 Family, Friends & Bystanders 525 Searching for the Missing 875 Sent to Family Center 175 Patients to Decon, Triage & Treat
  • 13. Managing the Masses 7 Patients by EMS 28 Self Transport 140 Psychological Casualties 175 Patients to Decon, Triage & Treat 35 Patients to Decon, Triage & Treat 7 Patients to Decon, Triage & Treat This is the Power of Integrated Triage
  • 14. Four Lessons in Life
    •  Lessons Occurred
    •  Lessons Observed
    •  Lessons Learned
    •  Lessons Applied
  • 15. Increasing Educational ROI Immersion Simulation Read and Hear (20% Retained) Books, Audios, Lectures See and Hear (50% Retained) – Video See (30% Retained) – Still Photos Say & Write (70% Retained) Demonstration, Workshop Table-Top (80% Retained) 90% Retained
  • 16. Immersion Simulation vs .
  • 17. 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
  • 18.
    • Currently: “All Hazards” = “All Disasters”
    • What if we redefine: “All Hazards” =
      • All Disasters
      • Patient Safety
      • Visitor Safety
      • Employee Safety
      • Facility Safety
    A New Definition of “All Hazards” “ All Hazards”
  • 19. 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 (Response Rehearsals)
    • Continuous Plan Review and Revision
  • 20. NRP – NIMS – CMS – JCAHO
    • National Response Plan (December 2004)
      • All Hazards / All Agencies
      • Defines the Function and Responsibility of Each Organizational Element under the Plan
        • Planning (Thinkers)
        • Logistics (Getters)
        • Finance (Payers)
        • Operations (Doers)
  • 21. NRP – NIMS – CMS – JCAHO
    • National Incident Management System
      • Framework for Incident Command
        • Single Common Command Structure
        • Common Organizational Structure
        • Outline for Disaster Response Planning
      • Mandates Classification of Resources
      • Implemented and Updated by the NIMS Integration Center (NIMS-IC)
  • 22. NRP – NIMS – CMS – JCAHO
    • NIMS Implementation for Hospitals and Healthcare Facilities
      • Element 1: Adoption of NIMS
      • Element 2: Incident Command System (ICS)
      • Element 3: Multiagency Coordination System
      • Element 4: Public Information System
      • Element 5: NIMS Implementation Tracking
      • Element 6: Preparedness Funding
  • 23. NRP – NIMS – CMS – JCAHO
    • NIMS Implementation for Hospitals and Healthcare Facilities
      • Element 7: Revise and Update Plans
      • Element 8: Mutual Aid Agreements
      • Element 9: ICS 700 NIMS Training
      • Element 10: ICS 800.A NRP Training
      • Element 11: ICS 100 & 200 Training
      • Element 12: Training and Exercises
  • 24. NRP – NIMS – CMS – JCAHO
    • NIMS Implementation for Hospitals and Healthcare Facilities
      • Element 13: All-Hazards Exercise Program
      • Element 14: Corrective Actions
      • Element 15: Response Inventory
      • Element 16: Resource Acquisition
      • Element 17: Standard & Consistent Terms
  • 25. 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
  • 26. 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
  • 27. 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
      • $1000/Licensed Bed
      • $2800/Licensed Bed/yr.
      • $1280/Licensed Bed/yr.
      • $1000/Licensed Bed
      • $500/Licensed Bed/drill (2 per year)
      • $960/Licensed Bed/day
    • Total Cost = $9000/bed/yr
  • 28. 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
  • 29. Preparedness Balance Sheet Event Response Model
    • Costs
      • Equipment
      • Staff Training
      • Salaries for Training
      • Resource Stockpiles
      • Externally Validated Drills and Exercises
      • Response Personnel
    • NET LOSS = $9000/bed/yr
    • Business Benefits
      • Joint Commission
      • NIMS Compliance
      • Legal Protection
        • Qui Tam
        • Sarbanes Oxley
  • 30. 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
      • $1000/Licensed Bed
      • $2800/Licensed Bed/yr.
      • $1280/Licensed Bed/yr.
      • $1000/Licensed Bed
      • $500/Licensed Bed/drill (1 per year)
      • <$480/Licensed Bed/day
    • Total Cost = $11380/bed/yr
  • 31. 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
      • $300/Licensed Bed/yr
      • $16000/Licensed Bed/yr
    • Total Revenue = $16300/Bed/yr
  • 32. 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 = $4920/Bed/yr
  • 33. Preparedness Balance Sheet
    • Process Enhancement
      • Process Analysis
        • Business Processes
        • Healthcare Processes
        • Income Streams
      • Daily Needs/Resources Inventory
      • Benchmark Triggered
      • Targeted Process Enhancement
    • Net Profit: $4920/Bed/yr
    • Event Response
      • Vulnerability Analysis
        • Hazard Based
        • Kaiser Model
        • Income Insensitive
      • Centered on Recognized Events
      • Event Triggered
      • Untargeted Response and Expenditure
    • Net Loss: $9000/Bed/yr
  • 34. 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 Model
      • Event Response Model
  • 35. From Preparedness to Profitability
    • Process Enhancement (ROI)
      • Higher Retention of New Knowledge
      • Better Implementation of New Skills
      • Greater Surge Capacity
      • Shorter Wait Times
      • Improved Customer Satisfaction
      • Fewer AMA’s/LWOT’s
      • More Admissions
      • Shorter Disaster Response Phase
      • Quicker Return to Full Operations
      • Gross Savings of $13920/Licensed Beds/yr

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