HOSPITAL EVACUATION EXERCISE

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MUTAL AID AGREEEMENTS FOR HOSPITAL EVACUATION
Presented By Emergency Management
Professionals Dee Grimm RN, JD
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Presentation Objectives

• Examine the need for mutual cooperative efforts
  between healthcare agencies
• Review different approaches to developing mutual
  aid agreements
• Examine components of a mutual aid agreements
  between facilities
• Discuss potential issues that can arise during
  hospital to hospital evacuations

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Need For Cooperative Efforts

• We can no longer operate in a silo
• Best care for patients
• Federal trend for grant funding
• NIMS/NRF
• Streamlines evacuation process

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Mutual Aid Evacuation Agreement Purpose

• To coordinate transportation and care of
  patients who have been evacuated from a member
  hospital in a qualified disaster, with minimal
  disruption to the provision of acute emergency
  care to the community

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Elements of the Plan

• Assumptions and definitions
• Evacuation criteria/Disaster declaration process
• Patients distribution/transportation
• Pre determined distribution charts
• Hospital responsibilities
• Cross Privileges
• Supplies, personnel, equipment, records

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Basic Assumptions

• Only one hospital evacuating at a time
• No other emergency occurring in community
• Emergency Departments will not be receiving sites
• Evacuating hospital is at high average census
  minus a 10 reduction by discharge
• Emergency Manager of the jurisdiction will seek
  an emergency declaration
• Transfer will be to a facility with similar
  services
• Non-ambulance transport may need to be used
• Special care patients will be sent directly to
  receiving hospitals, not to external holding
  areas (may be the last patients sent)

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Definitions

• Immediate evacuation requires immediate, prompt
  departure due to life threatening conditions.
  Rapid movement of patients to external holding
  areas
• Urgent evacuation quick, but orderly hospital
  departure. May allow for period of internal
  holding

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Notification and Transfer Decisions

• Accepting numbers have been pre-determined
• Decision about where patients go made by EMS
  authority
• Disbursement based on type of patients not red,
  yellow, green

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Types Not Color Codes

• Disbursement of patients based on types, not
  standard MCI color codes
• Why wont red/yellow/green categories work?
• Based on transportation needs and special needs

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ROLE OF MEDICAL DISPATCHand TRANSPORTING AGENCY

• Make notifications to hospitals and others
• Notify receiving facilities of patient
  information and ETA
• Receive updated acceptance information from
  receiving facilities
• Provide updated acceptance information to field
  personnel
• Final record to go to evacuating facility for
  patient tracking

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Evacuating Facility Responsibilities

• Evacuating Facility will
• Reduce patient census
• Track patients and document
• Send records with patient
• Send equipment, medications and staff
• Maintain list of supplies, equipment transferred
• Maintain SNF transfer agreement if applicable
• Notify family, doctors of patient transfers

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Receiving Facility Responsibilities

• Receiving Facility will
• Reduce patient census
• Obtain additional equipment and staff
• Update Medical Dispatch of acceptance numbers if
  needed
• Set up non-ER reception sites to receive patients
• Maintain patient tracking
• Notify family, doctors of patients received
• Be responsible for safety of staff received and
  maintenance of equipment
• Return patients, equipment, and staff when
  appropriate

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Hospital Agency Representative

• Assigned by evacuating hospital
• Reports to field IC or Liaison Officer and
  requests to participate in Unified Command
• Speaks for hospital with full authority
• Makes decisions in all matters affecting hospital
• Provides information for media release
• Participates in development of Incident Action
  Plan
• Shares incident management information with
  Hospital Incident Commander

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Hospital Planning Technical Specialist

• Assigned by evacuating hospital
• Reports to IC or Liaison to participate in
  Medical Branch Operations as technical specialist
  to Patient Transportation Group Supervisor
• Obtains information from hospital on patients
  medical acuity, transportation requirements,
  equipment, and staffing needs
• Acts as liaison with evacuating hospital to share
  patient tracking information from the field and
  to obtain updated hospital information for the
  medical branch

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Special Issues

• Liability (declared emergency to initiate limited
  liability)
• Confidentiality/HIPAA
• Cross privileges of staff/credentialing
• Worker Compensation and staff payment
• Notification to Bureau of Health Facilities,
  Licensure, and Certification
• Transfer of medications (scheduled drugs)

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Guidelines for Hospital Participants

• Become familiar with your hospitals own plan
• Become familiar with the evacuation annex and
  your field ICS roles/responsibilities
• Review the pre-planned patient distribution
  scheme your agency agreed to
• Your hospital agreed to make best efforts to
  accommodate evacuated patients

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Overall Responsibilities

• Develop facilitys own internal plan
• Use same Patient Evacuation Tracking Sheets
• Inform Health Department of changes of hospitals
  information in the annex
• Maintain adequate business interruption insurance
• Attend training, drills and participate in
  debriefing processes