Emergency Preparedness Education Series

ONLINE EMERGENCY PREPAREDNESS EDUCATION
EMERGENCY PREPAREDNESS EDUCATION SERIES
Emergency Preparedness
Education Series
Online Emergency Preparedness
Education
April 2015
OBJECTIVES
Introduce and highlight emergency
preparedness concepts here at Robert
Wood Johnson University Hospital.
Develop a basic understanding of the
hospitals Emergency Management
program.
Understand The Joint Commissions
requirements for Emergency
Management
EMERGENCY PREPAREDNESS
Emergency Preparedness here at RWJUH is a multi-faceted and
multi-disciplinary collaboration designed to promote hospital-
wide readiness to the potential hazards faced.
While lead for hospital preparedness is the EP department itself,
the hospital has several committees that provide not only a multi-
disciplinary but departmental and specialty influence on
institutional preparedness:
Hospital Emergency Management Committee
Multi-disciplinary administrative committee responsible for overall hospital
policy and procedure review related to emergency preparedness
Emergency Department Special Operations Team
Multi-disciplinary educational committee specific to the adult and pediatric
Emergency Departments responsible for review and feedback on ED related
policies and procedures as well as assisting with departmental education
related to specific capabilities
Environment of Care Committee
Multi-disciplinary committee responsible for overseeing safe operations
within hospital emergency preparedness policies and procedures
Infection Prevention
Multi-disciplinary committee responsible for development and review of
emergency preparedness policies and procedures that relate specifically to
biological incident
EMERGENCY PREPAREDNESS
The Department of Emergency
Preparedness, in conjunction with hospital
and regional partners:
Develops and provides in-house education on
RWJUH Emergency Operation Plans as well as
plans and hosts outside courses related to
emergency and disaster management.
Develops and hosts a variety of unit-specific
drills and hospital-wide full-scale exercises to
promote hands on comfort with low-
frequency/high-impact scenarios.
Evaluates drills and exercises for areas of
improvement and implements changes where
appropriate
DEFINITIONS
Emergency Management
Organized analysis, planning, decision-
making, and assignment of available
resources to mitigate (lessen the effect of or
prevent) prepare for, respond to, and
recover from the effects of all hazards. The
goal of emergency management is to save
lives, prevent injuries, and protect property
and the environment if an emergency
occurs. (FEMA)
DEFINITIONS
Disaster
Any event in which the need for resources
exceeds the ability to provide those resources.
Can lead to an emergency
The Joint Commission defines an emergency as a
natural or man-made event that suddenly or
significantly:
Disrupts the environment of care
Disrupts care and treatment of patients
Changes or increases demand for the hospitals services
Can occur at any level institutional, local,
county, State, or national
DEFINITIONS
Hazard
Any source of danger
Risk
The possibility that something bad or
unpleasant will happen
Impact
To have a strong and often bad effect on
TYPES OF DISASTERS
Disasters fall into a combination of
categories:
Internal: disasters that occur within or on
the RWJUH campus
External: disasters that occur in the
community
Natural: disasters that occur as a result of a
natural incident
Man-made: disaster that occur as a result of
an accidental or intentional event of human
origin
TYPES OF DISASTERS
Examples of Internal (RWJUH) include:
Fires
Explosions
Chemical spills
Flooding
Utility failure (Power, Water, Telephone, Etc.)
Loss of healthcare staff due to strike or significant
illness
Examples of External disasters include:
Weather related (Hurricanes, Snow storms, Floods,
Etc.)
Other natural (Earthquakes)
Man-made (Accidents, Fires, Collapses, Terrorist
attacks, Etc.)
TYPES OF DISASTERS
Reporting incidents:
All incidents should be reported to an
immediate supervisor or director
For life threatening emergencies (fire,
smoke, chemical spills, etc.) dial extension
2222 as quickly and safely as possible and
provide the following:
What the emergency is
Where the emergency is
What kind of help is needed (if known)
HOSPITAL EMERGENCY MANAGEMENT
To address the impacts and risks associated with
the each potential hazard the hospital faces
RWJUH maintains Emergency Operations
Procedures for multiple possible scenarios,
including:
Medical Surge
Utility outage
Inclement weather
Chemical attack scenario
Biological attack scenario
Mass Casualty Incident
Staff housing
Etc.
Internal code terminology and definitions and general information
for common EOPs can be found in the Emergency Preparedness
Procedure manuals located on each unit/department, including:
Fire plan
Fire extinguisher use
Oxygen shut off
Hazard communication
Bomb threat
Patient/visitor evacuation
Employee injury
Visitor/volunteer incidents
Hazardous Materials spill
Chemotherapy spill
Code Triage
Utility failure
Medical equipment malfunction
Weapons on hospital property
Water disruption
Principles of hospital Emergency

Management
Disaster management cycle
All-hazards planning
Incident Command System
Hospital Incident Command
PREPARING FOR DISASTER
Disaster management is not a sprint,
but rather a marathon with no end
Unknown
Management of disasters is a cyclical
process that is always ongoing and
includes:
Planning and preparedness
Mitigation
Response
Recovery
Planning and Preparedness
Longest, and often least recognized, stage of
cycle
Key events
Hazard and Vulnerability Assessment
Education and training
Process and procedure evaluation
Improvement planning
Rinse and repeat
Planning and Preparedness
Hazard and Vulnerability Assessment
Used as an assessment tool to direct
preparedness operations
Impact (Human, Property, and Business)
Preparedness and Response
Performed annually to ensure accurate hospital
preparedness
Allows for development and adaptation of all-
hazard plans to address different types of
events
Serves as foundation for institutional education
and training
Education / Training
Discussion
Brief introduction to principles of institutional emergency
preparedness
Seminars
In-services and educational session designed to promote
knowledge of institutional emergency preparedness
procedures
Tabletop exercises
Designed exercise based on a developed scenario and specific
objectives to evaluate procedures and processes that allows
for improvements with limited institutional impact
Full scale exercises
Designed exercise based on a developed scenario and specific
objectives to evaluate institutional real-time response based
on established procedures and processes that allows for
improvements based on a realistic response
Process and procedure evaluation
During each exercise evaluators are assigned
to evaluate specific aspects of the
procedures and processes to assess for
readiness or areas of improvement
Improvement planning
After each exercise evaluations and
comments are reviewed and areas for
improvement are identified, based on these
a plan is developed to improve institutional
readiness
Mitigation
Mitigation is defined as - the action of
reducing the severity and seriousness of a
hazard
Emergency Management here at RWJUH
utilizes the approved HVA as well as lessons-
learned to promote investments in systems
designed to decrease the impact of an
event, such as:
Potable water failure - water filtration system
Electrical failure connections for external
whole-house generators
Response
The action stage of the emergency
management cycle
Effective response is based on:
Knowledge and implementation of established
processes
Establishment of an incident command system
Inter-departmental/Inter-agency cooperation
and collaboration
Response correlates to training
Recovery
Can be longest stage
Parallel with Planning and Mitigation
Requires planning to return to normal
Return to Normal
4 Rs
Returning to routine operations
Resumption of elective procedures
Repairs
Restock
Recovery
Can be longest stage
Parallel with Planning and Mitigation
Requires planning to return to normal
Return to Normal
4 Rs
Returning to routine operations
Resumption of elective procedures
Repairs
Restock
EMERGENCY PREPAREDNESS EDUCATION SERIES MANGING CHAOS
COMMON PROBLEMS IN DISASTERS
Communication
Communication is the most frequently
identified area for improvement during a
disaster and includes:
Failure to share appropriate information
Overloaded communication systems
Failures to communicate resources (equipment,
staff, etc.)
Poor communication with media or the public
Command
Lack of clear direction and authority
COMMON PROBLEMS IN DISASTERS
Staffing
Knowledge and comfort with emergency
procedures
Reporting to areas where resources are not needed
at that time
Large number of volunteers (both healthcare and
non-healthcare) arriving at the hospital looking to
assist
Media
Large number of news media converging on the
hospital
General population
Large number of family members and other
concerned/interested individuals converging on the
hospital to gather information
INCIDENT COMMAND
Organized approach
Designed to meet defined objectives and needs of
agency
Defined and predictable structure under five
management functions
Incident Command: Sets incident objective, and has
overall responsibility for the incident or event
Operations: Conducts tactical operations and directs all
tactical resources to achieve defined objectives
Planning: Prepares all appropriate documents including
the Incident Action Plan, collects and evaluates
information, and maintains resource status
Logistics: Obtains resources and provides all other
services necessary to support operations
Finance/Administration: Provides accounting,
procurement, time recording, and cost analysis for an
incident
INCIDENT COMMAND
Pre-hospital origin
Hospitals have adapted the Hospital Incident Command System
(HICS)
Commonality
Terminology and positions common across different agencies and
agency types
Provides a common ground for inter-agency communication
Span of control
Structure is expandable and contractible to maintain an optimal span
of control of 5 reporting groups per position to meet objectives
Each ICS unit/group has a single supervisor/leader and information is
passed up and down established lines of communication
Direct reporting
Unity of command has one individual or group reporting to one
person only to decrease confusion
Each ICS unit/group has a single supervisor/leader and information is
passed up and down established lines of communication
Assignment within ICS structure is based on experiencenot
managerial position
INCIDENT COMMAND
Incident Command System - Positions
Incident Commander (IC)
Only ICS position required for every incident
Provides overall leadership and direction for
incident response
Approves incident objectives
Responsible for all aspects of incident response
unless delegated
Provides information services to internal and
external stake holders
Establishes and maintains liaisons with other
organizations participating in the incident
INCIDENT COMMAND
Command Staff
Public Information Officer serves as the conduit
for information to internal and external
stakeholders, including the media
Safety Officer monitors safety conditions and
develops measures for assuring the safety of all
assigned personnel based on expected tasks
Liaison Officer serves as the primary contact for
support organizations that are assisting at an
incident but are not participating within the ICS
structure
INCIDENT COMMAND
General Staff
Individuals responsible for overseeing the four
management functions
The person in charge of each Section is
designated as a Section Chief and have the
ability to expand their section to meet the needs
of the situation and may appoint Deputies as
needed
INCIDENT COMMAND
General Staff
Operations Section Chief
Directs and coordinates all tactical operations
May have Staging Areas and/or Labor Pools for
resources based on potential need
Planning Section Chief
Collects, evaluates, and displays incident information
Prepared and documents Incident Action Plans
Develops plans for demobilization (releasing of
resources/staff)
Maintains incident documentation
Tracks resources assigned to the incident based on
status
INCIDENT COMMAND
General Staff
Logistics Section Chief
Orders, obtains, maintains, and accounts for all
essential personnel, equipment, and supplies
necessary to support operations
Provides communication planning and resources
Sets up support services including
Food
Incident facilities (sleeping, showers, etc.)
Transportation
Medical services for responding personnel
INCIDENT COMMAND
General Staff
Finance/Administration Section Chief
Responsible for contract negotiation and monitoring
Timekeeping
Cost analysis
Compensation for injury or damage to
property/resources
INCIDENT COMMAND
RWJUH Hospital Incident Command
System
Aids RWJUH with rapidly establishing a
uniform structure to guide responses to
emergencies and disasters
Establishes a predictable chain of command
and authority
Establishes clear lines of communication
that enhance transfer of information within
RWJUH and with external authorities
INCIDENT COMMAND
RWJUH Hospital Incident Command
System
Delineates positional roles and
responsibilities of RWJUHs emergency
response based on Job Action Sheets
The chain of command starts with your
immediate supervisor and goes up the chain
to the General and Command staff assigned
to the HCC.
INCIDENT COMMAND
RWJUH Hospital Incident Command System
Hospital Command Center (HCC)
The location within the hospital where command
staff gather during an event to manage the incident
Contains all equipment necessary to meet tasks
including:
Communication Equipment (Radios, Phones, Other)
Documentation
References
RWJUH has two area pre-designated for HCC
purposes:
Clinical Administration Office: this area serves as the
initial HCC for primary incident information gathering
and assessment as well as incident management
1st Floor Administration Conference Room: this area
serves as the primary HCC for the hospital and is open at
the discretion of the Administrator on Duty when an
incident requires full activation of the ICS to manage it
EMERGENCY PREPAREDNESS EDUCATION SERIES RESPONDING TO DISASTER
STAFF ROLES AND RESPONSIBILITES
The Emergency Preparedness Plan manual must be
readily available to all staff at any time.
Should not be locked in an office
Should be easily found on unit/department
Know the role you and your department/unit plans
in the overall hospital plan and response.
If no pre-directed role exists know who to report to for
an assignment
Know the limits of your knowledge and skills.
Know your job and function only within your scope
of practice realizing that you may be called upon to
perform work that is not part of your routine job or
tasks.
All RWJUH staff are considered essential personal during
an incident and may serve roles as assigned by General
staff to achieve defined objectives
In a disaster:
Use staff, equipment, and supplies efficiently
Wear your hospital identification badge.
Your travel may be restricted
Within RWJUH to limited areas
In case of external disaster by State law, your RWJUH
ID may allow you to travel NJ roadways during an
emergencyBE SURE TO FOLLOW DIRECTION OF ALL
LAW ENFORCEMENT
Emergency Notification
Depends on recognizing an incident has
occurred
Require staff members to immediately report
any potential or real emergencies to the
appropriate unit
Notification types
External event notification usually comes from EMS
or other public safety agency
Direct calls to units/departments can occur and should
be managed appropriately
Internal event notifications usually come from
RWJUH employees and should be reported to
extension 2222 as appropriate
Emergency Notification
Hospital administration will decide if an incident
is appropriate to activate the appropriate
Emergency Operations Plan
If a plan is activated:
Appropriate notifications will be made through either
overhead or electronic means
Staff and departments should respond per
established guidelines
Potential staffing adjustments may be made
including:
Suspension of breaks
Holding of staff
Reassignment to other duties based on hospital needs
and objectives
Thank you
If you have any questions please feel free

to contact any member of the Department
of Emergency Preparedness at
emergency_preparedness@rwjuh.edu
CONTACTS
For more information or questions
regarding RWJUH emergency preparedness:
Paul Mikita Emergency Preparedness
Educator
Extension: 732-418-8129
E-mail: paul.mikita@rwjuh.edu
Louis Sasso Director of Emergency
Preparedness
Extension: 732-937-8728
E-mail: louis.sasso@rwjuh.ed
24-hour: 732-937-8687

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Principles of hospital Emergency

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