Download UWMC Active Shooter Exercise

Danica Little, MHA
Emergency Preparedness Manager
UW Medical Center
Preparing for the Exercise
• Executive buy-in
• Renown Regional Medical
Center, December 17, 2013
• SPU shooting, June 5, 2014
• Training
• Shots Fired Video
• Staff buy-in
• Multiple open-house training
sessions with Q&A
• Staff meeting/education day
training
• Messages over intranet and to
all staff
Organizing the Exercise
• Exercise Design Team
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UWMC Emergency Department
UWMC Public Safety
UW Police Department
UW Office of Emergency
Management
• Hazard Vulnerability Analysis
• Mass Casualty Incident
• Close proximity to campus
• Across the street from Husky
Stadium (70,000+ seats)
Organizing the Exercise
• Exercise Goals
• Test MCI Plan
• Test Code Silver Response
• Pre-Exercise Communication
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Leadership and Management Teams
In-patient Nurse Managers
Visitors and Outpatients
911 Dispatch, UWPD and SPD
News and Community Relations
Organizing the Exercise
Exercise Control
Organizing the Exercise
• Signage
• Staging Area for Law Enforcement
• Creating Patient Profiles
• Moulage
• Refreshments
• Assignments
• Evaluation
Importance of Partners
Setting the Stage
Organizing volunteers and moulage
Setting up tables, chairs, and signs
Exercise Control
Exercise Evaluation
Photography
Exercise Objectives
Joint Commission Standard and
Exercise Objective
Communication
Determine effectiveness of communication to UWMC
staff about event and response measures
Assess response rate to disaster page to Group 1
Joint Commission
Element of Performance
EM 02.02.01
How staff will be notified that emergency
response procedures have been initiated
Resources and Assets
Evaluate ability to manage resources and assets
needed for response
EM 02.02.03
The hospital’s arrangements for transporting
some or all patients, their medications,
supplies, equipment, and staff to an alternative
care site when the environment cannot support
care, treatment, and services
Safety and Security
Evaluate coordination with UWPD and other law
enforcement organizations
Assess implementation of Code Silver response
EM 02.02.05
How the hospital will coordinate security
activities with community security agencies
The hospital’s arrangement for internal security
and safety
Staff Responsibilities
Evaluate implementation of disaster plan
EM 02.02.07
Hospital trains staff for their assigned
emergency response roles
Utilities Management
Identify impact of vacuum disruption in the Emergency
Department
EM 02.02.09
Hospital identifies alternative means of
providing medical gases/vacuum systems
Patient and Clinical Support Activities
Evaluate effectiveness of early discharge
EM 02.02.11
How the hospital will manage the activities
required as part of patient scheduling, triage,
assessment, treatment, admission, transfer,
and discharge
Running the Exercise
• Exercise playbook
• Timeline of Events
• Master Scenario Event List
• Used spectralink phones from Hospital Command Center, to
give all controllers and evaluators ability to communicate
with each other
• Made Incident Command a training opportunity, rather than
a test
• Leveraged Emergency Management Committee members to
evaluate Code Silver response in their Departments
• Tiered response for Mass Casualty, to keep scope limited
Exercise Play
Scenario
Simulated Saturday night Husky football game. Shooter at
the game opens fire, causing victims to self-refer across the street to
UWMC. After 3 rd wave of victims arrives, UWPD notifies UWMC
Public Safety that shooter may have fled with the crowd. They
request we search victims for weapons. Shooter is discovered and
continues his search for his intended target, shooting staff in the ED
and eventually hiding and shooting himself.
Exercise Play
Response
Initial: Mass Casualty response and Code Triage
Second: Code Silver Active Shooter
Third: Continued Code Triage and Recovery for
Code Silver activities
Lessons Learned
• Code Silver was called too early
• Information given was “shooter at the stadium”
• Could be drill artificiality, could be realistic
• Triage and MCI response in ED went very well.
Physicians were engaged, professional and efficient
• More training needed with Charge Nurse on importance of Disaster
Binder
• Code Triage response was delayed, but once in play, the
floors identified 42 potential early discharge patients
• Early discharge process was managed extremely well by inpatient
units
Lessons Learned
• Situational awareness was poor
• Information coming to Hospital Command Center was limited
• Code Silver response delayed responders from coming
to Hospital Command Center
• Need to identify method for leadership to operate virtually for this
type of event
Lessons Learned
• Improve coordination with law enforcement
• Unified Command was not established
• Law Enforcement did not utilize maps and key cards available at
security desk
• Code Silver response was good, but can improve
• Units were evaluated and did a good job securing area
• ED responded to their injured co-worker before all-clear was given
Lessons Learned
• More education needed with staff about what to
expect in a Code Silver
• Overhead announcements
• Rescuing victims
• Include anatomic pathology and Code Team in planning
• Law enforcement cannot declare person deceased
• Law enforcement does not render aid
Lessons Learned
• Access security video feeds in the
Hospital Command Center
• Allows you to have eyes on what’s happening,
while securing your area
• Good exercise control cannot be stressed
enough!
Next Steps
• Recovery
• How to get hospital operations functioning, even at minimal
levels, while law enforcement clears the building
Questions?
Danica Little, MHA
Emergency Preparedness Manager
UW Medical Center
[email protected]
(206) 598-2837