Download Hospital Response to Disasters

Hospital Response to
Disasters
HARRT 2004
Hospital Preparedness

9/11 had placed hospital preparedness under
the microscope at the local, state, and federal
levels
 Although the “All Hazards” approach is the norm,
hospitals have entered a new era in
preparedness
 At this point hospitals are amongst the last
players to join the community efforts, prior to
9/11, hospitals had not viewed themselves as
part of the local response system
Hospital Preparedness:
 Clarification
for HIPPA, EMATALA, and
EPA regulatory requirements and their
applications in emergency situations is
vital
 Relationship building amongst the
stakeholders takes time and trust
 Large scale events don’t just happen in
major metropolitan areas---all hospitals
are potential responders
Hospital Preparedness for large
scale events:

Hospitals have always planned for disasters, but
not large scale events
 Since 9/11, hospitals have begun to focus on
readiness for large scale terrorism events as
well
 Community involvement
is necessary in large scale
planning---something
that hospitals have little
experience with
Hospital Surge Capacity:
Inventories
 Just-in-time
inventory models have
become the norm



Pharmaceuticals (antibiotics, vaccines, anti-viral medications)
Food stores
PPE to handle large volumes
 Hospitals

lack ventilators
A recent GAO report revealed that most
hospitals have <10 ventilators per 100 staffed
beds
Hospital Surge Capacity:
Inventories
“stand alone” capability is
essential
 Hospitals also lack the space necessary to
accomodate enhanced caches, create
additional triage, patient care, and morgue
areas
 A 48-72
Hospital Planning:
 Planning
is a dynamic process
 A plan is NEVER complete
 The best plans are based on predictable
behaviors
 Plans must be practiced



Disaster drills are not punitive activities
Disaster drills are learning laboratories
Disaster drills provide opportunities
HEICS and the Clinician
 Do
you know what your role is in a
disaster?
 Have you ever been part of a disaster
drill?
 Have you been educated on the disaster
plan at your facility?
 What would you do in the event of a
disaster?
HEICS:
Hospital Emergency Incident
Command System
 Incident
Command System or Incident
Management System characteristics




Universal language for all clinicians to use
Small span of control
Small span of control
Delineation of authority
Delayed Treatment Unit

Actions

Identification of Delayed Treatment Unit Leader
• Assignment of roles and responsibilities
• Increased responsibilities of care providers

Disaster Medical Care
• A, B, C’s
• Pain Management
• ↑ Resource limitation utilization

Secondary Triage
• Triage of patients in DTU
• Triage of incoming
Emergency Operations Center:
Hospital
 Purpose----Under




the direction of the EIC
To maintain overall command of the overall
hospital operations
Oversight of the Emergency Operations
Center
To maintain communications both internal and
external
Data gathering both internal and external
• Magnitude of event
• Resource availability