Enhancing Hospital Emergency Preparedness and Response

Utilizing Online Tools

Mitchell BrownMPH Candidate

University of FloridaSpring 2014

Mass Casualty Incidents and Surge Capacity

Mass Casualty Incident or Event (MCI/MCE)› “A situation in which a hospital receiving

multiple casualties does not have the resources to deal with the patients simultaneously.”

McAlister, 2011

Surge Capacity› “A health facility’s ability to rapidly expand

beyond normal services to meet increased demand for bed space, qualified personnel, medical services and public health programs in the event of a large scale disaster.”

Norman et al, 2012

Literature Review

Hospital emergency preparedness and response was “inadequate.”› Lack of comprehensive plans› Lack of training› Evolution of MCEs

“Learn from the mistakes of others. You can’t live long enough to make them yourselves.”

Eleanor Roosevelt

Relationship to Public Health Values

“There is a quantitative relationship between increasing casualty load and gradual degradation of the level of trauma care in multiple casualty incidents”

Norman, 2012

EM HICS

Set up EM HICS› Owned by Intermedix

Provides technology support to connect heathcare providers, public health agencies, and emergency management

› Funded by CDPHE OEPR Requires participation in a healthcare

coalition for integrated, coordinated, and organized response

Objectives

Emergency preparedness follows the EOP and HICS

Enhance the EOP

Improve hospital emergency preparedness

Ensure quality of care

H

Hypothesis

Improve hospital emergency preparedness for Saint Anthony Hospital › Quicker response› Staff is more comfortable with Hospital

Incident Command (HICS)› Better management of the event

Methods

Evaluate EM HICS

Survey HICS during debriefing

Implement EM HICS

Used during an active shooter exercise

Provide staff trainingProvided during routine emergency preparedness meetings

Set up EM HICS database

Contact database Assign HICS positions

Set up initial job actions

Insert files into IRGs

Incident Commander

Operations Section Chief

Staging Area Manager

Security Branch Director Medical Director

Nursing Services Director

Planning Section Chief

Logisitics Section Chief

Communication Unit Leader

Facilities Unit Leader

Admin/Finance Section Chief

Scribe Public Information Officer

Safety Officer Liaison Officer

St. Anthony Hospital Hospital Incident Command Org Chart

EM HICS

Required as part of the health care coalition

Mostly data entry which is time consuming

No stakeholders

Results

Data entry completed

Results following implementation and evaluation

Interpretation

Databases entered into EM HICS

No data collected

Strengths

Enhance EOP› Notification› Guidance› Organization

Communication

Limitations Funding canceled further development

Time and effort

Web based

Acceptance

Generalizability

Adopted throughout all Colorado hospitals

Required for the Foothills Health Care Coalition

Implications

Relationship experience› Application to my workplace

Contribution to Public Health› Improve emergency preparedness and

response› Assure quality health care

Competencies Core competencies strengthened

› Development of plans to support health efforts

› Assurance of the provision of health care› Evaluation of effective, accessible, and

quality health services

Concentration competencies strengthened› Application of programming planning principles› Monitor and evaluation of program effectiveness

Competencies

Other competencies› Environmental Health› Public Health Management› Biostatistics/Epidemiology

Lessons Learned

“Learn from the mistakes of others. You can’t live long enough to make them yourselves.”

Auf der Heide, E. (2006). The Importance of Evidence-Based Disaster Planning. Annals of Emergency Medicine, 47(1), 34-49. doi:10.1016/j.annemergmed.2005.05.009

Barbisch, D.F., and Koenig, K.L. (2006). Understanding Surge Capacity: Essential Elements. Society for Academic Emergency Medicine, 13(11), 1098-1102. doi:10.1197/j.aem/2006.06.041

Bayram, J.D., Sauer, L.M., Catlett, C., Levin, S., Cole, G., Kirsch, T.D., … Kelen, G. (2013). Critical Resources for Hospital Sure Capacity: An Expert Consensus Panel. PLOS Current Disasters, (1). doi:10.1371/currents.dis.67c1afe8d78ac2ab0ea52319eb119688

Djalali, A., Castren, M., Hosseinijenab, V., Khatib, M., Ohlen,G. and Kurland, L. (2012). Hospital incident command system (HICS) performance in Iran; decision making during disasters. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 20, 14. doi:10.1186/1757‑7241‑20‑14

McAlister, V.C. (2011). Drills and exercises: the way to disaster preparedness. Canadian Journal of Surgery, 54 (1), 7-8. doi:10.1503/cjs.036910

Norman, I.D., Aikins, M., Binka, F.N., and Nyarko, K.M. (2012). Hospital All-Risk Emergency Preparedness in Ghana. Ghana Medical Journal, 46(1), 34-42.