Emergency Preparedness in the Workplace Financial Affiliations: - PDF document

3/9/18 Disclosure Jacob McCarty Emergency Preparedness in the Workplace Financial Affiliations: Jacob McCarty is currently compensated to serve as the President & COO for Innovations Health Systems. Presented By: Jacob M. McCarty, MPH, MPA March 9 th , 2018 1 2 Background About Innovations Health Systems Current Innovations Health Systems (IHS), LLC is a diversified healthcare company • •President & COO – Innovations Health Systems focused on providing high acuity care and products to medically fragile •Hospital CEO – Children’s Hospital of Northern California (CHONC) Californians. IHS owns and operates the Pediatric Recovery Network for catastrophically • Previous injured and severely disabled, machine dependent children, and is •Hospital CEO – Kindred Hospital San Francisco Bay Area currently building California’s first congregate living health community for •Hospital COO – Kindred Hospital Westminster catastrophically injured and severely disabled, machine dependent adults. •Administrative Residency – Kindred Healthcare, Inc. Education & Credentials •University of California, Davis •BA •University of Southern California (USC) •MPA, Healthcare Administration •University of California, Berkeley •MPH, Public Health 3 4 1

3/9/18 What is Emergency Preparedness Emergency Preparedness in the to Me? Workplace 5 6 Emergency Preparedness What is Emergency Preparedness? Definitions Preparedness is defined by DHS/FEMA as "a continuous cycle of planning, organizing, training, equipping, exercising, evaluating, and taking corrective action in an effort to ensure effective coordination during incident response." This cycle is one element of a broader National Preparedness System to prevent, respond to, and recover from natural disasters, acts of terrorism, and other disasters. 7 8 Image retrieved from: https://www.dhs.gov/topic/plan-and-prepare-disasters 2

3/9/18 Key Definitions Emergency Disaster Catastrophe •Immediate threat to health, life, property, or the environment Emergency •An event that overwhelms local resources- beyond those generally needed to respond to emergencies situations. Almost always affects the Public’s Health and Well Being. •Disasters can be natural, man-made or complex. Disaster •FEMA expects local jurisdictions to manage without additional assets for 72 hrs. •Any natural or man-made event that results in extraordinary levels of mass casualties, damage, or disruption that severely affects environment, economy, government functioning Catastrophe 9 10 Images retrieved from: https://www.thesun.co.uk/news/4127619/giant-crane-collapses-in-reading-on-an-old-primark-as-hundreds-of-shoppers-are-evacuated-from-city-centre/, https://northdallasgazette.com/2015/08/29/10-years-after-hurricane-katrina-a-look-back-at-how-9-key-players-responded/ (Cabinet Office, nd.d) Turning Point Question Types of Disasters Pulse Check #1 How many of you feel confident that the organization in which you work for has a competent and comprehensive strategy to effectively manage most emergency situations specific to your geographic location? A) I feel 100% confident B) I am about 75% confident C) I am about 50/50 on our organization’s strategy D) I have no idea. 11 12 Images retrieved from: https://www.eqgroup.com/flood-insurance/, http://thinkingsidewayspodcast.com/tag/1918-flu-pandemic/, https://www.mirror.co.uk/news/uk-news/victim-911-identified-16-years-10949175 3

3/9/18 Historical Context Why is this Information Important to Medical Professionals? Organizationally Professionally Personally 13 14 Image retrieved from: : http://training.fema.gov/hiedu/docs/chapter%201%20-%20intro%20to%20crisis,%20disaster%20and%20risk%20mgmt%20concepts.doc Image retrieved from: http://alumnihealthcarestaffing.com/ Natural Disasters Bring Changes to Emergency Increasing National Focus on Management: 1960s Emergency Management: 1970s 15 16 Image retrieved from:: http://training.fema.gov/hiedu/docs/chapter%201%20- Image retrieved from: https://www.cheatsheet.com/entertainment/john-f-kennedy-movies.html/?a=viewall %20intro%20to%20crisis,%20disaster%20and%20risk%20mgmt%20concepts.doc 4

3/9/18 FEMA in Trouble The FEMA/Witt Revolution: 1989 – 1992 1993 - 2001 17 18 Image retrieved from: : http://training.fema.gov/hiedu/docs/chapter%201%20-%20intro%20to%20crisis,%20disaster%20and%20risk%20mgmt%20concepts.doc Image retrieved from: http://training.fema.gov/hiedu/docs/chapter%201%20-%20intro%20to%20crisis,%20disaster%20and%20risk%20mgmt%20concepts.doc Terrorism as the Major Focus: 2001 Post 9/11 Defense Spending 19 20 Image retrieved from: http://www.ibtimes.co.in/remembering-9-11-16th-anniversarythese-images-twin-towers-attack-still-haunt-world-741628 5

3/9/18 Creation of the Department of Hurricane Katrina: 2005 Homeland Security (DHS): 2005 Largest and 3 rd strongest hurricane ever recorded in ● U.S. ● 1,836 people died ● Displaced 770,000 residents 21 22 CNN (2013). Retrieved from: https://www.cnn.com/2013/08/23/us/hurricane-katrina-statistics-fast-facts/index.html Post Katrina Leading Up to the Katrina Disaster Six Major Statutes Enacted Post Katrina Emergency Management Reform Act of 2006 SAFE Port Act of 2005 The Pets Evacuation and Transportation Standards Act of 2006 The Federal Judiciary Emergency Special Sessions Act of 2005 The Student Grant Hurricane and Disaster Relief Act The John Warner National Defense Authorization Act for Fiscal Year 2007 23 24 (Bea, Hogue, Halchin, Schwemle, 2006) 6

3/9/18 Post Katrina Emergency Natural Disaster Economic Trends Long Term: 1900-2011 Management Reform Act 2006 25 26 (Fema, 2017) Natural Disaster Trends Natural Disaster Economic Trends Short Term: 1980 - 2014 Short Term: 1980 - 2014 27 28 (The Watchers, 2016) 7

3/9/18 Trial and Error Trial and Error Case Study: Hurricane Katrina Case Study: Hurricane Katrina 29 30 Five Days at Memorial Turning Point Question Sheri Fink, MD, PhD Pulse Check #2 When considering all types of disasters (i.e. man-made, natural, or complex) which one of the following do you fear the most? A) Terrorist attack B) 6.0+ Magnitude Earthquake C) Hurricane/Flood D) Forest Fire 31 32 (Beaumont, 2014) 8

3/9/18 Hospital Emergency Operations Plan Main Components Emergency Preparedness in the Workplace Today 33 (California Hospital Association, 2017) 34 Emergency Operations Plan Hospital Incident Command System (HICS) Org Chart Hazard Vulnerability Analysis (HVA) 35 36 (California Hospital Association, 2017) (California Hospital Association, 2017) 9

3/9/18 Federal - State - Local Community Response Coordination We are part of the national system: HHS, CDC, VA, President FEMA etc. •Individual Hospital •Hospital System State Governor’s Emergency •Community/County Office Management State DOH Office •State •Federal LHD Local Official Local OEM Federal State Volunteer Org Fire Police Local and Vol Hosp 37 Other 38 Thinking Outside of the Box Thinking Outside the Box Optional EOP Support Tools Optional EOP Support Tools Color Coded Flip Chart Synopsis: Internal Emergencies External Emergencies 39 40 10

3/9/18 Thinking Outside of the Box CMS Emergency Preparedness Optional EOP Support Tools Final Rule Comprehensive Contact List 41 42 CMS Emergency Preparedness CMS Emergency Preparedness Final Rule Final Rule Effective Date November 15, 2017 Purpose To establish national emergency preparedness requirements to ensure adequate planning for both natural and man-made disasters, and coordination with federal, state, tribal, regional and local emergency preparedness systems. 43 44 (Centers for Medicare and Medicaid Services, 2018) (Centers for Medicare and Medicaid Services, 2018) 11

3/9/18 Joint Commission Standards for Emergency Preparedness vs. CMS Joint Commission • Requires two active drills per year • Requires log information during an incident so surveyors have reference point CMS • Requires one active drill and one table top • Tracking information during an incident that involved the outside community 45 46 (Everbridge, 2015) Individual Emergency Personal Emergency Preparedness Preparedness Kit 47 Image retrieved from: www.redcross.org/get-help/prepare-for-emergencies/be-red-cross-ready/get-a-kit 48 12