1.
Emergency Preparedness:
Training and Testing for Best Outcomes
UAHC UHPCOConference
August 28, 2017
Presented by:
Lois A. Sucher, RN,DON, COS-C
Jenny Nelson, PT, MSG, MCS

2.
877.399.6538 |

3.
EP Training
• Training plans must specifically address each one of the
agency’s identified risks
• The training plan must be written and must extend to all
staff members – at least one training each year
• The training plan must have a means of demonstrating
staff knowledge and retention
• Training must be rooted in applicable policies/procedures and
how they will be implemented

4.
The Agenda
• Gaining a basic understanding of the
Emergency Preparedness Rules
• Performing the Risk Assessment
• Developing Policies and
Procedures
• Implementing the Communication
Plan
• Training and Testing Requirements

5.
KEY
DEFINITIONS
Emergencies vs. Disasters
• EMERGENCY = A hazard impact causing
adverse physical, social, psychological,
economic or political effects that challenges
the ability to respond rapidly . . . requiring
stepped-up capacity and capability to meet the
expected
outcome . . . requiring a change from
routine management to incident
command.
• DISASTER = An emergency with greater
magnitude, longer duration and generally
lower outcomes.

6.
Policies and Procedures
• E0013 – Policies and procedures based
on the emergency plan, risk assessment
and communication plan
• Policies and procedures must be
updated annually
• Can be incorporated into the standard
manual set, but the agency must be able to
demonstrate that they are kept in a central
place

7.
SURVEYREADINESS
E-Tags to Know
E-Tag HHA Hospice Tag Requirement
E-0001 Y Y Establishment of the Emergency Program (EP)
E-0004 Y Y Develop and Maintain the EP Program
E-0006 Y Y Maintain Annual EP Updates – Risk Assmnt w/all hazards + strategies for
addressing emergency events
E-0007 Y Y EP Program Patient Population – Types of emergency services, continuity of
operations, delegation of authority and succession planning
E-0009 Y Y Process for Collaboration – Coordination and collaboration with local, tribal,
regional, State and Federal emergency officials/offices
E-0013 Y Y Development of EP Policies and Procedures – Based on the overall plan, risk
assessment and communications plans with at least annual review
E-0015 Y Y Subsistence Needs for Staff and Patients – Food, water, medical supplies,
meds, alternate energy sources for maintaining temperature, lighting, fire
detection systems, sewage and waste disposal

8.
• Process to assess and document hazards
• Those that are likely to impact the geographic
region or community
• Those that present gaps and capacity challenges
• Hazard Vulnerability Analysis
KEY
DEFINITIONS
Risk Assessment

9.
HAZARD VULNERABILITY
ANALYSIS
Scoring the Risks
• Measure the probability – High, Moderate or
Low Risk?
• Measure the vulnerability and potential
disruption – High, Moderate or Low Risk?
• Measure your agency’s level of preparation –
Poor, Fair or Good
• Each level for each category has a score from 1
to 3 (Green to Red)
• The total score indicates the priority that
should be placed on risk assessment and
planning

10.
Assessing Patient Risk
• For home health agencies –
Needs to be done as a part of the comprehensive
assessment
• For both home health and hospice –
! How will clinical information and patient care requirements be
communicated?
! Consider evacuation requirements
! Limitations on patient mobility
! Limitations on transport of life-saving equipment
! Special needs/limitations – language barriers, diet, intellectual
ability

11.
PATIENT RISK
LEVELS
High Risk Patients
• No available caregiver or family present – patient
cannot be left alone for extended periods
• Bedbound or chair bound patients with
physical assistance needs
• Unable to administer meds – self-injections of
daily meds
• Wound care patients who are unable to
perform dressing changes
• Infusion patients – IV therapy or feedings

12.
PATIENT RISK
LEVELS
Moderate Risk Patients
• Patients with assistive devices or stable in the
use of medical equipment – able to manage
for a short period of time
• Stable with administration of meds
• Patients with reasonably managed chronic
disease
• Patients for whom a visit can be postponed
for up to 3 days without jeopardizing safety

13.
PATIENT RISK
LEVELS
Low Risk Patients
• Patients with family and/or caregiver support systems in place
who can manage for longer than three days
• Patients with less complicated wound care or other care needs
• Patients for whom the patient or a caregiver is already
managing and administering medications

14.
COMMUNICATIONS
PLAN
Sharing Medical Information
• Plan for sharing medical record
information to ensure continuity of
care
• Must include the means for sharing
information about the general
condition and location of patients

15.
Insert photo of Vial of life and FEMA Flags

16.
Patient Preparedness (see attached handout)
Be prepared for 96 hours—food, water, medications
• Vial of Life—Code Status, Med Profile, Physicians, Emergency Contact numbers
VIAL of LIFE sticker on front window, Refrigerator
• Emergency Preparedness for People Receiving Home Care
Review this pamphlet with pt / caregiver
• FEMA Communication Model: Instruct on how to use flags
Keep in closet closest to front door
• VACCINES: Flu and Pneumonia up to date. Most elderly die of pneumonia during a
pandemic due to weakening of the immune system.
• Emergency Supplies: See handout for more comprehensive list. Lighting in home to
prevent falls during a power outage—especially important
• Emphasize the IMPORTANCE of a 7 DAY Supply of MEDICATIONS
• Protect your FEET—Keep a pair of sturdy shoes/socks in a zip lock bag under bed.
• Secure list of FINANCIAL accounts, insurance policies, Titles, VA Info—CD, Thumb Drive, etc
• Emergency Exits
Notify Power Company in advance on oxygen, vents, pumps for infusions, etc.
https:www.specialneedsutah.org/reg.php
OASIS—code TRIAGE for clinical risk (i.e. likelihood of clinical exacerbation)
code DISASTER for enhanced risk with outside emergencies
(i.e. assess pt. independence with meds, oxygen, competent caregivers, etc.)

17.
Clinician Preparedness (see attached in Handouts)
Be prepared for 96 hours (changed by FEMA)
• Secure Yourself First
• Secure your Family
• Report to Agency Command Center in your respective county via phone, text, internet or
in person at the designated area.
• Secure your Patients
COMMUNICATION PLAN:
• Cell phone chargers, Battery Chargers or Solar Chargers
• FEMA communication flag kit
• GMRS 2 way radios—2-10 mile range. Have an Agency Designated Channel & back up.
• Keep a copy of your clinical license on you. This will help get you across police lines.
• Keep your gas tank at least ½ full AT ALL TIMES
• Stay Healthy! Vaccinations—stay up to date (Flu, Tetanus, Shingles, Pneumonia)
CAR SUPPLIES: (see handout for more complete list)
• Water – High Energy Bars – Shelter (Blanket/Tarp)—zip bag with clean clothes
• Car stock of Basis First Aid bandages, etc. incl BIO-HAZARD BAGS
• Emergency money in low denominations (no change is given in disasters)
• Long Life Flashlight, back up batteries, solar charger / hazard light
• First Aid Kit WITH Protective Gear—N95 masks may be expired! Alcohol Hand Sanitizer
• Extra-Sticky Post-it Notes and a pencil to leave messages—Sharpie
• Box of plastic gloves and pair of work gloves (Protect your hands)
• Portable radio with fresh batteries, crank or solar

18.
EP Testing Requirements
• The agency must conduct at least
one full-scale exercise annually
• When community-based testing is not
feasible an individual full-scale test
can be substituted
• An additional exercise must be done
and can include a table-top exercise
led by a facilitator with clinically
relevant emergency scenarios

19.
In Closing . . .
• Remember that your agency must be ready by November 15th.
• Perform the risk assessment using an easy to use template.
• Develop your plan based on the risk assessment results.
• Make sure that your policies and procedures address the E-Tag
requirements that are applicable to your agency.
• Develop and document the communication plan.
• Train the staff.
• Make sure that the elements of the emergency plan are tested and
that the testing process is documented.
• Document the analysis of your Drill or Disaster