Hospital Preparedness & Epi’sas partners in support of

Public Health Preparedness

Richard Bartlett, B.S., M.Ed.Emergency Preparedness & Trauma Coordinator

Kentucky Hospital AssociationKentucky Hospital Research & Education Foundations

ASPR HPP & CDC PHEPIn response to the National Preparedness Goals ASPR

(Assistant Secretary for Preparedness and Response) aligned the Hospital Preparedness Program (HPP) with CDC’s Public Health Emergency Preparedness (PHEP) program.Defined a set of Healthcare Preparedness Capabilities to assist

healthcare systems, Healthcare Coalitions, and healthcare organizationswith preparedness and response.

1. Healthcare System Preparedness2. Healthcare System Recovery3. Emergency Operations Coordination5. Fatality Management6. Information Sharing10. Medical Surge14. Responder Safety and Health15. Volunteer Management

• Interoperable Communications Systems• Tracking Bed Availability (HAvBED)• ESAR-VHP (KHELPS in KY)• Medical Evacuation/Shelter in Place• Alternate Care Sites (ACS)• Mobile Medical Assets • Pharmaceutical Caches • Personal Protective Equipment • Decontamination• Medical Reserve Corps (MRC) • Critical Infrastructure Protection (CIP)

Sub-Capabilities

Healthcare Coalitions• Collaborative network of HC organizations, and their

respective public and private sector response partners, within a defined region.

• Coalitions serve as a multi-agency coordinating group– Participating agencies include, but are not limited to:

Hospitals, Urgent Care Centers and FQHCLocal/district Health DepartmentsEMS, coroners, medical societiesMental Health and crisis response groupsLong-Term CareRed Cross & NGO’s

– Assists with Emergency Management, ESF-6 and ESF-8• Partner specific and regional HVA development

– Coordinates preparedness, response, recovery and mitigation related to HC disaster operations.

– Jointly plan, exercise and train as a region– Regional information sharing & information development– Provides situational awareness

Severe Weather Lessons Learned

Example HVA     SEVERITY = (MAGNITUDE - MITIGATION)        

EVENTPROBABILITY HUMAN

IMPACTPROPERTY

IMPACTBUSINESS

IMPACTPREPARED-

NESSINTERNAL RESPONSE

EXTERNAL RESPONSE

RISK

  Likelihood this will occur

Possibility of death or injury

Physical losses and damages

Interuption of services

PreplanningTime,

effectivness, resouces

Community/ Mutual Aid staff

and suppliesRelative threat*

SCORE

0 = N/A 1 = Low 2 = Moderate 3 = High

0 = N/A

1 = Low

2 = Moderate

3 = High

0 = N/A 1 = Low 2 = Moderate

3 = High

0 = N/A

1 = Low

2 = Moderate

3 = High

0 = N/A

1 = High

2 = Moderate

3 = Low or none

0 = N/A

1 = High

2 = Moderate

3 = Low or none

0 = N/A

1 = High

2 = Moderate

3 = Low or none

0 - 100%

Mass Casualty Hazmat Incident (From historic events at your MC with >= 5 victims)

2 3 3 3 2 3 2 59%

Small Casualty Hazmat Incident (From historic events at your MC with < 5 victims)

3 2 1 1 1 1 1 39%

Chemical Exposure, External

3 2 1 1 1 1 1 39%

Small-Medium Sized Internal Spill

3 1 1 1 1 1 1 33%

Large Internal Spill 2 2 2 2 2 2 1 41%

Terrorism, Chemical 2 3 3 3 2 2 2 56%

Radiologic Exposure, Internal

2 1 1 1 1 1 1 22%

Radiologic Exposure, External

2 1 1 1 1 1 1 22%

Terrorism, Radiologic 1 2 2 3 2 2 2 24%

AVERAGE 2.22 1.89 1.67 1.78 1.44 1.56 1.33 40%

8

Joint Commission requires a hospital to have an alternate site outside the hospital setting in case of evacuation

Very few facilities have actually had to implement these types of plans.

Statewide Mobile Treatment Center

Medical Evacuation

Trust for America’s HealthReady or Not 2012

http://healthyamericans.org/assets/files/TFAH2012ReadyorNot10.pdf

Cumberland Valley Outbreak• Started with reports of some unusual deaths,

some involving people who had been in jail• Regional EPIs worked with local hospital ICP and

ED staff to build/refine case definition• Coordinate access and review of current and

past medical records• Worked with MDs in private practice and local

coroners• Worked with state PH in adjoining states• Confluence of circumstances, but not

necessarily a new disease.

BECKY• Long range effort to collaboratively build EPI

capacity throughout the state• Encourage academic programs, and internships• Recent question:

Can BECKY help create the next generation of Hospital ICP’s?– Discussions about create working sub-committee of

the regional HCC of local and regional EPIs and ICPs from regional HCO

– Networking, education, partnerships for outbreak investigations

What can you do?• Become engaged with the regional coalitions• Find and get to know the key hospital POCs

– Emergency preparedness coordinator– Hospital ICP & ED managers

• Work within the regional JIS to coordinate messaging and information sharing– HD, hospital, EMS, coroner and other PIOs– Consistency with State PH and CDC

Richard Bartlett, B.S., M.Ed.Emergency Preparedness & Trauma Coordinator

Kentucky Hospital Association(rbartlett@kyha.com)