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Coronavirus - Protecting You & Your Family:First Responder & Family Briefing

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Emerging Threats Community of Practice

Med Tac Bystander Rescue Care

Bystander Rescue Care CareUniversity Series

May 21, 2020CareUniversity Webinar #139

For resource downloads go to: www.MedTacGlobal.org

Coronavirus Survive & Thrive Guide for Caregiver & Critical Worker Families

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Charles Denham, MDChairman, TMIT GlobalFounder Med Tac Bystander Rescue Care

Med Tac Bystander Rescue CareMarch 21, 2020

CareUniversity Webinar #139

Welcome

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To optimize webinar sound volume, please check:• WebEx volume• Computer volume• External speaker volume

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If you are still having difficulty hearing the webinar:

Please click on Participants

Then the “Request Phone” button to receive a toll dial-in


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Our Purpose Statement

Our Purpose: We will measure our success by how we protect and enrich the lives of families…patients AND caregivers.

Our Mission: To accelerate performance solutions that save lives, save money, and create value in the communities we serve and ventures we undertake.

CAREUNIVERSITY ®

EMERGING THREATSCOMMUNITY OF PRACTICE

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Speakers & Reactors

Dr. Charles Denham

Chief William AdcoxDr. Gregory Botz

Becky Martins

Heather Foster RN

Dr. Christopher Peabody

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www.MedTacGlobal.org

Bystander Rescue Care for Failure to Rescue

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Disclosure StatementThe following panelists certify that unless otherwise noted below, each presenter provided full disclosure information; does not intend to discuss an unapproved/investigative use of a commercial product/device; and has no significant financial relationship(s) to disclose. If unapproved uses of products are discussed, presenters are expected to disclose this to participants. None of the participants have any relationship medication or device companies discussed in their presentations.

• Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center. He received his medical degree from George Washington University School of Medicine in Washington, DC. He completed an internship in internal medicine at Huntington Memorial Hospital and then completed a residency in anesthesiology and a fellowship in critical care medicine at Stanford University in California. He also completed a medical simulation fellowship at Stanford with Dr. David Gaba and the Laboratory for Human Performance in Healthcare. Dr. Botz is board-certified in anesthesiology and critical care medicine. He is a Fellow of the American College of Critical Care Medicine. He has nothing to disclose.

• William H. Adcox serves as the Chief of Police and CSO at The University of Texas MD Anderson Cancer Center and The University of Texas Health Science Center. He has nothing to disclose.

• Becky Martins has nothing to disclose.• Heather Foster has nothing to disclose.• Charles Denham, MD, is the Chairman of TMIT; a former TMIT education grantee of CareFusion and AORN with co-production by Discovery Channel for Chasing

Zero documentary and Toolbox including models; and an education grantee of GE with co-production by Discovery Channel for Surfing the Healthcare Tsunami documentary and Toolbox, including models. HCC is a former contractor for GE and CareFusion, and a former contractor with Siemens and Nanosonics, which produces a sterilization device, Trophon. HCC is a former contractor with Senior Care Centers. HCC is a former contractor for ByoPlanet, a producer of sanitation devices for multiple industries. He does not currently work with any pharmaceutical or device company. His current area of research is in threat management to institutions including conflict of interest, healthcare fraud, and continuing professional education and consumer education including bystander care. Dr. Denham is a collaborator with Professor Christensen at Harvard Business School.

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Becky Martins

Founder, Voice4Patients.comTMIT Patient Advocate Team MemberWarren, ME

Voice of the Patient

© 2006 HCC, Inc. CD000000-0000XX 12 Med Tac Bystander Rescue Care

Meaningful Use is dead. Long live something better!The 4 P’s to Address Emerging Threats

EMERGING THREATSCOMMUNITY OF PRACTICE

Global Patient Safety Forum

SAFETYLEADERS ®


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Cardiac Arrest

Meaningful Use is dead. Long live something better!High Impact Care Hazards to Patients, Students, and Employees

Opioid Overdose

Common Accidents

Bullying

A Medical-Tactical Approach undertaken by clinical and non-clinical people can have enormous impact on los of life and harm from very common hazards:

• High Impact Care Hazards are frequent, severe, preventable, and measurable.

• Lifeline Behaviors undertaken by anyone can save lives.

Choking & Drowning

Anaphylaxis

Major Trauma

Transportation Accidents

Med Tac Story Article

Active Shooter Healthcare Article

AED & Bleeding Control Gear Article

Rapid Response Teams Article

Battling Failure to Rescue

Automated External Defibrillator

& Bleeding ControlGear Placement

14© 2020 TMIT

Meaningful Use is dead. Long live something better!In the News: Med Tac Updates

Source: Campus Safety Nov/Dec Issue - https://www.campussafetymagazine.com/public/med-tac-training-bystanders/

Nov/Dec 2018 Issue



15© 2006 HCC, Inc. CD000000-0000XX Med Tac Bystander Rescue CareCareUniversity

Ann Rhoades

Dr. Charles DenhamChief William AdcoxDr. Gregory Botz

Randy StynerDr. Chris Fox Tom Renner David Beshk

Dennis QuaidJohn Nance JD Beth Ullem

John Little

Dr. Casey Clements

Dr. Steve Swensen Perry Bechtle IIIFred Haise

Nancy Conrad

Dr. Mary Foley

Heather Foster

Dr. Chopra

Betsy DenhamBecky Martins

Debbie Medina

Preston Head III

Charlie Denham III

Dr. McDowell

Tyler Sant Avarie Pettit Bob Chapman

Dr. C Peabody



16© 2006 HCC, Inc. CD000000-0000XX Med Tac Bystander Rescue CareCareUniversity

Dan Ford

C Sullenberger Charlotte Guglielmi

Bill George Penny George

Dr. Don Berwick

Contributions Through Segments of Documentaries

Dr. Howard KohJim Collins Dr. Jim Bagian

Arlene Salamendra Jennifer Dingman

Dr. Harvey Fineberg

Hilary Schmidt PhD

Prof Christensen

Paul Bhatia EMT


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Heather Foster RNDr. Gregory H. Botz William Adcox, MBA

Coronavirus Survive & Thrive Guide


Meaningful Use is dead. Long live something better!Essential Critical Infrastructure Workers


Meaningful Use is dead. Long live something better!Essential Critical Infrastructure Workers

40% of Work Force

No FamilyTraining Provided

© 2006 HCC, Inc. CD000000-0000XX Med Tac Bystander Rescue CareCareUniversity

Meaningful Use is dead. Long live something better!Survive & Thrive Guide: Protecting Your Family

Survive & Thrive Guide: Preparing for Care at Home


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Survive & Thrive Guides

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Heather Foster RNDr. Gregory H. Botz William Adcox, MBA



Meaningful Use is dead. Long live something better!Survive & Thrive Guide: Keeping Your Family Safe

Understand the Basics

The Basics

Form Family Team & Health Security Plan

Care of Your Loved Ones

Leadership Practices

• Why Checklists?

• Setting up Care Room

• Protecting Caregivers

• Protecting the Family

• Family Health Security Plan

• The Family CFO

• Engaging Family: Head, Heart, Hands, & Voice

• Critical Concepts

• Prevention, Preparedness, Protection, & Performance Improvement – The 4 P’s

• How the Virus Spreads

Putting Supplies & Gear to Work

Technologies

• Supplies & Gear Checklist

• Seniors & At-Risk Care Checklists to be Safe

• Innovating Solutions

Preparing for Care at Home




The Basics





Technologies



• Prevention, Preparedness, Protection, & Performance Improvement – The 4 P’s



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The Basics




Technologies



• The Family CFO






The Basics




Technologies



• Why Checklists?







The Basics




Technologies



Putting Supplies& Gear to Work






Understandthe Basics

The Basics


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Gregory H. Botz, MD, FCCMProfessor of Anesthesiology and Critical CareUT – MD Anderson Cancer CenterAdjunct Clinical Associate Professor,Department AnesthesiologyStanford University Medical School




Sources of Infections

Days Since Infection

Presymptomatic45%

Symptomatic40%

Environment 10%Asymptomatic 5%

New Infections Caused by Day

0.3

0.2

0.1

00 2.5 5.0 7.5 10.0 12.5

Source: Chart Graphically adapted by Charles Denham from Quantifying SARS‐CoV‐2 transmission suggests epidemic control with digital contact tracing Ferretti et al., Science 368, 619 (2020) 8 May 2020 and Tomas Pueyo adaptation

Presymptomatic Patient Transmission before infected patients experience symptoms

45%





Presymptomatic45%

Symptomatic40%

Asymptomatic 5%


0.3

0.2

0.1

00 2.5 5.0 7.5 10.0 12.5


Symptomatic Patient Transmission from infected

patients experiencing symptoms40%

Environment 10%





Presymptomatic45%

Symptomatic40%

Asymptomatic 5%


0.3

0.2

0.1

00 2.5 5.0 7.5 10.0 12.5


Environmental Sources are likely from Contact Surfaces

10%

Environment 10%


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Presymptomatic45%

Symptomatic40%

Asymptomatic 5%


0.3

0.2

0.1

00 2.5 5.0 7.5 10.0 12.5


Asymptomatic Patients who are infected and never get symptoms 5%

Environment 10%


Meaningful Use is dead. Long live something better!Keeping You and Your Family Safe


The Basics


• The 4 P’s: Prevention, Preparedness, Protection, & Performance Improvement



SOURCE: CDC Website

Social Distancing

Hand Washing

DisinfectingSurfaces

Care atHome

CDC Guidelines

Survive & Thrive Guide: Protecting Your Family Meaningful Use is dead. Long live something better!

Impact of Social Distancing

Social Distancing

For COVID-19, this hasbeen estimated at 2.5

R0 is the average numberof people a sick person will infect

To Illustrate the potential of social distancing, the following assumptions are made:

There is a linearcorrelation betweensocial exposure and R

The median incubation period of COVID-19 is approximately five days - after this period, a person will experience symptoms and self quarantine.

o

5 Days

Source: The Math Behind Social Distancing https://www.visualcapitalist.com/the-math-behind-social-distancing/


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Meaningful Use is dead. Long live something better!Social Distancing

DAY 1

1 Person

INFECTS

DAY 5

0.625 PeopleINFECTED

DAY 30

2.5 PeopleINFECTED

REDUCING SOCIAL EXPOSURE BY 75%

With these in mind, here’s how distancing measures can control the spread of the disease:



DAY 1

1 Person

INFECTS

DAY 5

1.25 PeopleINFECTED

DAY 30

15 PeopleINFECTED

Reducing Social Exposure by 50%



DAY 1

1 Person

INFECTS

DAY 5

2.5 PeopleINFECTED

NO SOCIAL DISTANCING MEASURES IN PLACE

406 PeopleINFECTEDIN 30 DAYS

No Social Distancing At 30 Days

DAY 1

1 Person

INFECTS

DAY 5

2.5 PeopleINFECTED

© 2006 HCC, Inc. CD000000-0000XX Med Tac Bystander Rescue CareCareUniversity 40

Stay-at-Home

DO NOT ENTERSocial Distance

Separating Infected from Not Infected

Critical Concepts

CALL or TEXT__________

SELF QUARANTINED

VIRUS FREE

ISOLATIONAREA

Coronavirus COVID-19

DO NOT ENTER


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The Basics



• How the Virus Spreads© 2006 HCC, Inc. CD000000-0000XX Med Tac Bystander Rescue CareCareUniversity


Presence of VirusOn SurfacesUnderstand

the Basics

The Basics





Meaningful Use is dead. Long live something better!Infection Targets: Flu and Common Cold versus Coronavirus

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Influenza“Common Cold”

Upper Respiratory Infection


Meaningful Use is dead. Long live something better!Infection Targets: Flu and Common Cold versus Coronavirus

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Influenza“Common Cold”

Upper Respiratory Infection

Coronavirus (SARS CoV-2)

Lower RespiratoryInfection


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Meaningful Use is dead. Long live something better!Person-to-Person Transmission

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Infectious Droplets & Droplet Nuclei Travel Length

1-3 Feet 3-5 Feet 5-160+ Feet


Meaningful Use is dead. Long live something better!__________

The Centers for Disease Control and Prevention recommends a 6-foot (2-m) separation. However, these distances are based on estimates of range that have not considered the possible presence of a high-momentum cloud carrying the droplets long distances. Given the turbulent puff cloud dynamic model, recommendations for separations of 3 to 6 feet (1-2m) underestimate the distance, timescale, and persistence over which the cloud and its pathogenic payload travel, thus generating an underappreciated potential exposure range for a health care worker. For these and other reasons, wearing of appropriate personal protection equipment is vitally important for health care workers caring for patients who may be infected, even if they are farther than 6 feet away from a patient.


Meaningful Use is dead. Long live something better!__________

The Centers for Disease Control and Prevention recommends a 6-foot (2-m) separation. However, these distances are based on estimates of range that have not considered the possible presence of a high-momentum cloud carrying the droplets long distances. Given the turbulent puff cloud dynamic model, recommendations for separations of 3 to 6 feet (1-2m) underestimate the distance, timescale, and persistence over which the cloud and its pathogenic payload travel, thus generating an underappreciated potential exposure range for a health care worker. For these and other reasons, wearing of appropriate personal protection equipment is vitally important for health care workers caring for patients who may be infected, even if they are farther than 6 feet away from a patient.

Given the turbulent puff …

3 to 6 feet (1-2m) underestimate the distance…

underappreciated potential exposure range for a health care worker…


Meaningful Use is dead. Long live something better!

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Survive & Thrive Guide: Protecting Your Family


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Loud Speech can emit thousands of droplets per second. They can remain in stagnant air environment for 8-14 minutes.



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Loud Speech can emit thousands of droplets per second. They can remain in stagnant air environment for 8-14 minutes.



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“substantial probability normal speaking causes airborne virus transmission in confined environments”


Source: New Yorker Magazine May 13, 2020

Atul Gawande

Survive & Thrive Guide: Keeping Your Family Safe


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Source: Nature Medicine 04-03-20



Source: Nature Medicine 04-03-20

Surgical Masks likely block 99% of Respiratory Droplets by people with Coronaviruses or Influenza Viruses.



Source: https://fastlifehacks.com/n95-vs-ffp/


Surgical Mask Composition: Melt Blown Fibers


Source: Disaster Medicine and Public Health


Efficacy of Cloth Masks“Surgical masks did three times better than homemade masks at blocking outward transmission of respiratory viruses” Dr Gawande, New Yorker Magazine


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Source: https://www.preprints.org/manuscript/202004.0203/v1


Impact of Cloth Masks

A recent, extensive review of the research from an international consortium of scientists suggests that if at least sixty per cent of the population wore masks that were just sixty-per-cent effective in blocking viral transmission—which a well-fitting, two-layer cotton mask is—the epidemic could be stopped. Dr. Gawande, New Yorker Magazine


Source: https://www.medrxiv.org/content/10.1101/2020.04.17.20069567v2.full.pdf/


Benefit of Surgical & Cloth Masks to Wearer

Benefit to the wearer may be limited, but it’s likely not insignificant: laboratory research has found that surgical masks reduce inhalation of respiratory-droplet-size particles by about three-quarters. Two-layer cotton masks filter about half as much on average, though a good fit can improve that considerably.

Dr. Gawande, New Yorker Magazine




The Takeaway: Masks WorkN 95 Mask Surgical Mask Cloth Mask




The Takeaway: Masks Work

“I protect you; you protect me”.Dr. Gawande, New Yorker Magazine

N 95 Mask Surgical Mask Cloth Mask


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SOURCE: CDC Website

Social Distancing

Hand Washing


Care atHome

CDC Guidelines



Source: https://pubmed.ncbi.nlm.nih.gov/11457626/ and Atul Gawande, New Yorker Magazine May 13, 2020


Handwashing Really Works

A 45% reduction in total outpatient visits for respiratory illness was observed after implementation of the handwashing program. 1,089,800 person-weeks were reviewed.


Source: https://www.bmj.com/content/336/7635/77 and Atul Gawande, New Yorker Magazine May 13, 2020


Handwashing Really Works

Research on the 2002 SARS coronavirus outbreak found hand washing more than ten times per day reduced the infection rate substantially.


How Long Does Corona Virus Live on Surfaces?

*At 71 to 65 relative humidity

Adapted From Business InsiderSource: New England Journal of Medicine (NEJM) and The Lancet Microbe (L-M)

*At 69.8 to 73.4 degrees F (21 to 23 Degrees C) and 40% Humidity

Paper and TissuePaper**

Copper*

Cardboard*

Wood**

Cloth**

3 hours

4 hours

24 hours

2 days

2 days

Stainless Steel*

Polypropylene Plastic*

Glass**

Paper Money**

Outside ofsurgical mask **

2-3 days

3 days

4 days

4 days

7 days

Contact Surfaces


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Contact Surfaces


Copper*

Cardboard*

Wood**

Cloth**

3 hours

4 hours

24 hours

2 days

2 days

*At 69.8 to 73.4 degrees F (21 to 23 Degrees C) and 40% Humidity*At 71 to 65 relative humidity




Contact Surfaces


Copper*

Cardboard*

Wood**

Cloth**

3 hours

4 hours

24 hours

2 days

2 days





Contact Surfaces


Copper*

Cardboard*

Wood**

Cloth**

3 hours

4 hours

24 hours

2 days

2 days





Contact Surfaces


Copper*

Cardboard*

Wood**

Cloth**

3 hours

4 hours

24 hours

2 days

2 days





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Contact Surfaces



2-3 days

3 days

4 days

4 days

7 days


Stainless Steel*


Glass**

Paper Money**



Contact Surfaces



2-3 days

3 days

4 days

4 days

7 days


Stainless Steel*


Glass**

Paper Money**



Contact Surfaces



2-3 days

3 days

4 days

4 days

7 days


Stainless Steel*


Glass**

Paper Money**



Contact Surfaces



2-3 days

3 days

4 days

4 days

7 days


Stainless Steel*


Glass**

Paper Money**



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Coronavirus Test

Serum Antibody Test

AB



WHO do we test?

WHAT is tested?

WHY test?

HOW do tests work?

Testing: Who, What, Why, and How?

Infected Not Infected Infected andAsymptomatic

Recovered and Maybe Immune



TEST for COVID & AB

TRACE Contacts

TREAT Infected Early

ISOLATE the Infected

QUARANTINE those At Risk

TEST, TRACE, TREAT, ISOLATE, and QUARANTINE

Not Infected

Infected

Infected andAsymptomatic


Meaningful Use is dead. Long live something better!Survive & Thrive Guide: Seniors Unusual Symptoms

0 5 7 14 21 28 35

PresenceOf

Antibodies

COVID-19 RNA and Antigen

IgM Antibody

Days After Infection

IgG Antibody

No Symptoms

Symptoms Recovery


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Meaningful Use is dead. Long live something better!Survive & Thrive Guide: Antibody Presence

0 5 7 14 21 28 35

PresenceOf

Antibodies


IgM Antibody


IgG Antibody

No Symptoms

Symptoms Recovery



IgM Disappears


0 5 7 14 21 28 35

PresenceOf

Antibodies


IgM Antibody

IgM Antibody Detectable


IgG Antibody

No Symptoms

Symptoms Recovery



IgM Disappears


0 5 7 14 21 28 35

IgG Antibody Remains in the

blood MAY provide long-term immunity

PresenceOf

Antibodies


IgM Antibody



IgG Antibody

No Symptoms

Symptoms Recovery



IgM Disappears


14 21 28 35

IgG Antibody Remains in the

blood MAY provide long-term immunity


IgM Antibody



IgG Antibody

Recovery The Big Question:

How much immunity do

these provide?


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Heather Foster RN

Infection Prevention NurseICU NursePatient Safety AdvocateCortez Colorado


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William Adcox, MBAChief Security Officer & Chief of Police MD AndersonCancer Center & The University of TexasHealth Science Center

Coronavirus Survive & Thrive Guide:




LeadershipA Miracle on the Hudson

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Leadership


• The Family CFO


HEAD

HEART

HANDS

VOICE

EngagingYour

Family




Leadership


• The Family CFO



Response

Rescue

Recovery

Resilience

ReadinessActivate

Mobilize

CareMonitor

Family Health Security Plan



The Waves that Follow



TRUTH

TRUST

TEAMWORK

TRAININGAnn Rhoades

Jim Collins

Bob Chapman

Clayton Christensen



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HEAD

HEART

HANDS

VOICE

What do you want them to KNOW?

What do you want them to FEEL?

What do you want them to DO?

What do you want them to SAY?

TRUTH

TRUST

TEAMWORK

TRAINING

The Science of Spread and Safety.

The Fight for Life for your loved ones.

Plan the Work &Work the Plan

All Teach & All Learn





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Charles R Denham III

Co-founder Med Tac Bystander Rescue ProgramJunior Instructor


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Heather Foster RN




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Care of YourLoved OnesPractices

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© 2006 HCC, Inc. CD000000-0000XX 96© 2006 HCC, Inc. CD000000-0000XX Med Tac Bystander Rescue CareCareUniversity

Meaningful Use is dead. Long live something better!Survive & Thrive Guide: Editable Checklists


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Checklists for Care at Home



Checklists for Care at Home


SOURCE: CDC Website

Social Distancing

Hand Washing


Care atHome

CDC Guidelines





Practices

• Why Checklists?


• Protecting the Home Caregivers Giving Care

• Protecting the Family During Care at Home



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Practices

• Why Checklists?








Practices

• Why Checklists?




Cleaning Image


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Heather Foster RN



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Technologies




Technologies




HandWashing

Soap

WashThoroughly

AwaitDrying




Technologies






Care of the At Risk & Seniors at Home Coronavirus ResponseCareUniversity Series


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Care of the At Risk & Seniors at Home Coronavirus ResponseCareUniversity Series

Supplies Checklist: Prescription Medications On Hand: Have at least 90 days of prescription medications on hand. If

insurance will allow it, get a 120‐day supply. If not, keep track of when they can renew them and then have them filled so they have them on hand.

Over the Counter Medications: Make sure they have over the counter medications for headache, colds, and other ailments they may have not needing prescriptions.

Thermometers: Every home should have a thermometer on hand to so that inhabitants can monitor their temperature whether healthy or sick. Many will get colds or the flu and may be frightened they may have Coronavirus.

Food and Bottled Water: It is important to have food on hand that will not spoil. If power goes out as it can in ordinary circumstances, it may take longer to repair if service personnel are sick. Food that does not require refrigeration or to be stored in freezers needs to be on‐hand.

Flashlights and Batteries: (better than candles for reasons of risk) and batteries incase power goes out.

Cleaning and Disinfectant Supplies: Soap and water is very effective to kill the virus because it dissolves fats and the virus has a fat layer. Liquid Soap and water is even better than alcohol disinfectants for both hands and for contact surfaces for killing the Coronavirus. • If alcohol and soap runs out, bleach may be diluted to 1:10 Bleach to Water concentration for

contaminated clothing.• Dilution of 1:50 Bleach to Water concentration fordisinfecting contact surfaces.• Dilution of 1:100 Bleach to Water for skin cleaning. • Having plenty of liquid soap, buckets, and rags are important if caring for someone at home.

Paper towels may be in short supply – rags and towels cleaned in washing machines are safe. Kitchen Rubber Gloves: Two to three pairs of rubber gloves will be good to have on hand if one

has to take care of someone in the home. They should be used for disinfecting the surfaces. Some surfaces will sustain the virus for a few hours. Some, however, can sustain the virus for three to nine days. The virus lasts longer on‐porous surfaces like door handles

Full Tank of Gas: If the supply chain is disrupted by illnesses of those transporting or operating gas stations, you may have a hard time getting fuel. We need to be as prepared as we would with a storm or during any natural disaster or emergency.

Reading Materials & Recordings: In the extreme case cable systems and internet providers may go down and seniors should have access to reading materials and recordings to inspire them and maintain hope. Our faith‐based communities can provide tremendous support of them here.

Process Checklist: In Case of Emergency ‐ ICE Contact List: Phone numbers and email addresses of friends and

family members who know they are going to be called if an individual experiences an emergency should be on an accessible list. The In Case of Emergency phone numbers should be generated. It should include those who have a Power of Attorney for healthcare and for business issues.

All Caregivers Contact Information: A master list of the doctors, nurse practitioners, pharmacists, and caregiver's office phone numbers, emergency numbers, and addresses should be on an easy to read list.

Local Support Individuals: Names and mobile numbers of friends and family who can pick up supplies for them, transport them, care for them, and check on them.

“If I Get Sick Plan”: A plan of “what if I get sick” directions. For instance – what signs and symptoms should prompt them to call for help. A certain temperature or other developments to drive action.

Hospital of Choice: If an individual has been under the care of a hospital, their medical records are very important to future care. They may identify that hospital or a hospital as a first choice for care.

Medical Power of Attorney: Everyone over the age of 18 will need to execute a medical power of attorney if they are to allow another person to make decisions regarding care if the victim is unable to do so. For instance, college students going to school in another state who are in another state get sick, parents will need one to get medical records.

Regular Expenses & Payment Mechanism: Create a list of regular bills and how to pay them if a person is in the hospital and unable to take care of them.

Regular Home Chores: A list of tasks that must be undertaken if residents become ill and are taken to the hospital should be created. They might include watering indoor and outdoor plants, pet care, and pet care.

Daily Check In Calls: Seniors and those with underlying conditions such as heart, lung, or kidney disease as well as those with immune compromised conditions such as chemotherapy and transplant patients should have someone check in on them if they are alone.

Food Replenishment Process: A process for regular replenishment of food and supplies should be set up.

Meals on Wheels & Support Programs: If seniors and those who qualify can be added to such programs, they should consider such support.

Sick Care Room: A room or section of the home should be identified where a family member can be treated in case, they become ill. This is whether they get the Coronavirus, a cold, or the flu.




Technologies




Charlie & BetsyMilk

Carton



Source: C Denham

The 5 Rights of Emergency Care ®

Right Provider

Right Diagnosis

Right Treatment

Right Monitoring

Right Prevention Test

Treat

DiagnoseMonitor

Watch

Rx

Right Diagnosis

Right Treatment

Right Discharge

Right Follow Up

H

MD

ED

Meds

F O

NEW

DCPLAN

PHRHome

Images

ICE

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Christopher Peabody MD MPH

Assistant Clinical Professor of Emergency Medicine,University of California San Francisco

Coronavirus Survive & Thrive GuideBy Zoom Recording


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Heather Foster RN



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115© 2020 TMIT

National Survey QuestionsI would like to attend the

CORONAVIRUS CARE & SAFETY Webinar Series

VeryStrongly

Agree

10Strongly

Agree

9Agree

8Agree

7Very

Strongly Disagree

1

Disagree

3Strongly Disagree

2Neutral

6Neutral

5Negative to Neutral

4

The topics I wish to have covered in theCORONAVIRUS CARE & SAFETY Webinar Series

115 © 2006 HCC, Inc. CD000000-0000XX Med Tac Bystander Rescue CareCareUniversity




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117© 2020 TMIT

National Survey QuestionsI would like to invite individuals or groups toCORONAVIRUS CARE and SAFETY Series

VeryStrongly

Agree

10Strongly

Agree

9Agree

8Agree

7Very

Strongly Disagree

1

Disagree

3Strongly Disagree

2Neutral

6Neutral


4

The topics I wish to have covered in WEBINAR onCORONAVIRUS CARE and SAFETY in this series

117 118© 2020 TMIT

National Survey QuestionsI believe there is value in

Locally Led Coronavirus Safety Programs

VeryStrongly

Agree

10Strongly

Agree

9Agree

8Agree

7Very

Strongly Disagree

1

Disagree

3Strongly Disagree

2Neutral

6Neutral


4

I recommend the following individuals or groupsFor the Opportunity be Informed About the Program

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Speakers & Reactors

Dr. Charles Denham

Chief William AdcoxDr. Gregory Botz

Becky Martins

Heather Foster RN

Dr. Christopher Peabody

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Becky Martins

Founder, Voice4Patients.comTMIT Patient Advocate Team MemberWarren, ME

Voice of the Patient


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RESOURCES



Flattening the Curve: Avoid the Surge

www.GlobalPatientSafetyForum.org Emerging Threats Community of Practice

Readiness for Epidemics including preparedness for testing and volume surges

MW1

MW1 Microsoft Windows, 3/17/2020


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Gregory H. Botz, MD, FCCMProfessor, Department of Critical CareDivision of Anesthesiology and Critical CareThe University of Texas MD Anderson Cancer CenterAdjunct Clinical Associate Professor Stanford University School of Medicine



A Critical Care Perspective


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Emerging Threats•Threat Velocity: The speed of new threats challenging us are appearing much faster than ever before.

•Threat Spectrum: The range of different threats challenging us are increasing as well.• Invisible and Visible Threats: Many of the threats are invisible to us until they are upon us. The Coronavirus COVID-19 is an example of a threat that is invisible. Many who are infected with the virus are asymptomatic AND contagious.

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Chief William Adcox, MBAChief Security OfficerMD Anderson Cancer CenterChief of Police at University of Texas at Houston



The Security Leader’s Perspective


Meaningful Use is dead. Long live something better!The Security Leader’s Perspective

Major Medical Centers – What you might expect to encounter:1. Limited access points 2. Exterior access screening for everyone 3. Lines and delays4. Limiting patient visitors and access to only patients and person

involved in direct patient care of the support of direct patient care. 5. No visitors under 18 years of age6. Reducing and cancelling of elective surgery7. Off-site screening and testing for COVID198. Public areas limited with social distancing recommended9. Limited food services within the hospitals for visitors10. Limited or eliminated valet services11. Crowding and delays


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Hospital Challenges for Security1. PPE, Sanitizing and cleaning supplies are now in greater demand

and harder to obtain. The value of these has gone up and now must be protected in ways not previous done.

2. Reduced access point while controlling access into the hospitals3. Limiting visitors4. Utilization of PPE5. Patient surges6. Reduced staffing7. Fear8. Added responsibilities



Police and Security – Changes occurring:1. Non‐violent crimes and misdemeanors not being accepted

by jails and Juvenile centers2. Diversion programs for habitual trespassers, alcohol

intoxication, etc. closing3. Some reporting of problems with Emergency

Commitments due to illness4. Setting up alternatives to first responders' homes for

quarantine 5. Establish “drive up” testing and prioritized first responders

and health care workers6. Enhanced Sanitizing of police buildings, prisoner holding

areas and vehicles7. Staffs supplied with additional disinfecting wipes and

hand sanitizer8. PE deployments and testing (Nationwide shortages) 9. Communication Centers asking screening questions of

callers to better inform responding personnel and establish social distancing.

10. Limiting police responses to non‐life threatening or crimes in progress calls

11. Taking more Reports over the phone instead of a police officer response.

12. Performing “Doorway Triage” at the scene of all 911 calls and asking complaints to come outside on calls.

13. Modified and reduced staffing plans14. Civilian employees working from home where

possible15. Repurposing of police officers assigned to special

assignments16. Require social distancing inside police facilities to

include modified roll calls17. Recommending officers sanitize their duty belts

and equipment, changing out uniforms at work or immediately upon reaching home to avoid contact with family



What we all can do:1. Understand the virus and obtain information from credible sources only

2. Educate our children. Answer their questions. Understand their fear. Establish new routines and expectations

3. Explain basic hygiene practices to our families and everyone’s responsibility to practice good hygiene and help more frequently clean the most touched surfaces

4. Support each other, their families and your community

5. Don’t try to over stock thus emptying out grocery stores


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Meaningful Use is dead. Long live something better!Protecting You And Your Family

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Objectives: Background Information Current Situation Facts vs. Fiction What can you do to stay safe? How can you protect yourself and your families?

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