Alan Dick has 21 years experience as a social worker and is currently with Sunnybrook Health Science Centre in Toronto, Ontario. Alan’s interest in disaster response was developed through a variety of psychosocial response training programs, but it was the opportunity to respond to the 9/11 attack in New York that got his interest locked in. For this event, Alan was honoured to work for the National Organization for Victims Assistance (NOVA) with the families impacted by the tragedy, including accompanying them to the Ground Zero. He is the PS end-user lead for the CBRNE Collaborative and PS Supervisor for Ontario’s Emergency Medical Assistance Team. Alan is considered a subject matter expert with regards to the psychosocial issues involved in hospital responses to major incidents including mass casualty incidents.

1. Family Reunification
When hospital surges are more then just medical

2. Five Essential Elements
• Promote sense of safety.
• Promote calming.
• Promote sense of self and collective efficacy.
• Promote connectedness.
• Promote hope.
Ref: Stevan Hobfoll et al, Five Essential Elements of Immediate and Mid–Term Mass Trauma Intervention:
Empirical Evidence, Psychiatry 70(4) Winter 2007
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3. The Social Reality
• Social Support is considered one of the most
important elements in the recovery from trauma.
• Family and friends will surge on the hospital looking
for loved ones.
• Reconnection with family members can be a greater
priority then meeting individual basic needs.
• Information can be the most effective intervention
on its own, provide it early and often. Providing
consistent information builds relationship and trust
with families
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4. Five Psychosocial Considerations
1. Perceptions Matter
2. Routines predict behaviour
3. People behave in Purposeful and Adaptive Ways
4. People are differently affected
5. People want to connect and help
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5. Family Information and Support Centre (FISC)
• Though already observed anecdotally, it has been well
documented in several major incidents that families surge at
hospitals looking for loved ones.
• Preparation for this surge includes planning for space, a FISC,
where families can provide and receive information on a
possible patient, hopefully to expedite reunification of family
with the loved one.
• This Family Information and Support Centre (FISC) would
provide information with regards to community resources, in
addition to providing short term Psychological First Aid and
emotional support.
• Staffing for FISC has typically been provided by Social Work,
Chaplaincy and Volunteers.
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6. A FISC will provide:
• Registration
• Up to date Information
• Psychological First Aid/counselling/chaplaincy
• Resources on Traumatic Stress
• Referral to community resources
• Counseling breakout rooms
• Child care?
• Special Need services: ie translation, ambulatory issues,
etc.
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Services Provided

7. Sample Documentation
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8. Other Issues to Consider
• Remember there are already Patients in the hospital
and their families, how do you mitigate the affect of
the Code Orange on them.
• There is currently no system in place to track the
whereabouts of a patient through multiple hospitals.
(G20 planning looked at family reunification plans)
• Providing families with ID (nametags/bracelets) after
registration will increase security and safety.
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9. Other Issues to Consider (2)
• Some families may not find their loved ones in the
first 24 hours. They may not find them at all. They
may have died on the scene and may remain on
scene for hours. When removed they would go
straight to the city morgue or coroner.
• And in some cases though still alive it may take time
to extract all patients from the scene.
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10. Family Separation
9/11 Missing Persons Posters
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11. The Common Process of Reunification
• The process for reuniting a family has changed over
the years. The standard is for everyone to register
with a response organization such as Red Cross and
then over time match family members together.
• In recent years the online search engine Google’s
Person Finder. It can be found at Google Crisis
Response
http://www.google.org/crisisresponse/index.html
• But in some cases searching for a loved one is not
so straight forward.

12. Hospitals Reunification- Current Situation
• Families can only register at one hospital at a time
when looking for a loved one in code orange.
• If the person they are looking for is not found in the
first hospital families can potentially, and in many
cases, visit many different hospitals in their search.
• This searching surge has been known to go on for
weeks in some circumstances.

13. Elements of a Hospital Reunification Plan
• All participating hospitals must have a way of
registering families, such as a Family Info and Support
Centre (FISC)
• All hospitals must be willing and able to collect and
share identifying info on patients involved in the event
• A way of communicating information between
hospitals must be developed, such as an online portal
• Ideally the plan would also have a way of
communicating the information to evacuation centres

14. The Information to Collect
• There is a difference in information collected from
conscious aware patients (identified) or unconscious
unaware and without identification patients
(unidentified)
• Privacy issues
– Sharing patient info between hospitals
– What info is to be shared
– Scope and duration
– Data sharing agreements
– Where would the information be stored