Emergency Preparedness in the Workplace Financial Affiliations: - - PDF document

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Emergency Preparedness in the Workplace

Presented By: Jacob M. McCarty, MPH, MPA March 9th, 2018

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Disclosure Jacob McCarty

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Financial Affiliations: Jacob McCarty is currently compensated to serve as the President & COO for Innovations Health Systems.

Background

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Current

• President & COO – Innovations Health Systems
• Hospital CEO – Children’s Hospital of Northern California (CHONC)

Previous

• Hospital CEO – Kindred Hospital San Francisco Bay Area
• Hospital COO – Kindred Hospital Westminster
• 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

About Innovations Health Systems

• Innovations Health Systems (IHS), LLC is a diversified healthcare company

focused on providing high acuity care and products to medically fragile Californians.

• IHS owns and operates the Pediatric Recovery Network for catastrophically

injured and severely disabled, machine dependent children, and is currently building California’s first congregate living health community for catastrophically injured and severely disabled, machine dependent adults.

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Emergency Preparedness in the Workplace

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What is Emergency Preparedness to Me?

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Emergency Preparedness Definitions

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What is Emergency Preparedness?

Preparedness is defined by DHS/FEMA as "a continuous cycle

• f planning, organizing, training, equipping, exercising,

evaluating, and taking corrective action in an effort to ensure effective coordination during incident response." This cycle is

• ne element of a broader National Preparedness System to

prevent, respond to, and recover from natural disasters, acts

• f terrorism, and other disasters.

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Image retrieved from: https://www.dhs.gov/topic/plan-and-prepare-disasters

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Key Definitions

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Emergency

• Immediate threat to health, life, property, or the environment

Disaster

• 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.
• FEMA expects local jurisdictions to manage without additional assets for 72 hrs.

Catastrophe

• Any natural or man-made event that results in extraordinary levels of mass casualties,

damage, or disruption that severely affects environment, economy, government functioning

(Cabinet Office, nd.d)

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Emergency Disaster Catastrophe

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/

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Types of Disasters

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

Turning Point Question

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.

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Why is this Information Important to Medical Professionals?

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Organizationally Professionally Personally

Image retrieved from: http://alumnihealthcarestaffing.com/

Historical Context

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Image retrieved from: : http://training.fema.gov/hiedu/docs/chapter%201%20-%20intro%20to%20crisis,%20disaster%20and%20risk%20mgmt%20concepts.doc

Natural Disasters Bring Changes to Emergency Management: 1960s

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Image retrieved from: https://www.cheatsheet.com/entertainment/john-f-kennedy-movies.html/?a=viewall

Increasing National Focus on Emergency Management: 1970s

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Image retrieved from:: http://training.fema.gov/hiedu/docs/chapter%201%20- %20intro%20to%20crisis,%20disaster%20and%20risk%20mgmt%20concepts.doc

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FEMA in Trouble 1989 – 1992

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Image retrieved from: : http://training.fema.gov/hiedu/docs/chapter%201%20-%20intro%20to%20crisis,%20disaster%20and%20risk%20mgmt%20concepts.doc

The FEMA/Witt Revolution: 1993 - 2001

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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

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Image retrieved from: http://www.ibtimes.co.in/remembering-9-11-16th-anniversarythese-images-twin-towers-attack-still-haunt-world-741628

Post 9/11 Defense Spending

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3/9/18 6 Creation of the Department of Homeland Security (DHS): 2005

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Hurricane Katrina: 2005

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• Largest and 3rd strongest hurricane ever recorded in

U.S.

• 1,836 people died
• Displaced 770,000 residents

CNN (2013). Retrieved from: https://www.cnn.com/2013/08/23/us/hurricane-katrina-statistics-fast-facts/index.html

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Leading Up to the Katrina Disaster Post Katrina

Six Major Statutes Enacted

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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

• f 2005

The Student Grant Hurricane and Disaster Relief Act The John Warner National Defense Authorization Act for Fiscal Year 2007

(Bea, Hogue, Halchin, Schwemle, 2006)

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Post Katrina Emergency Management Reform Act 2006

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(Fema, 2017)

Natural Disaster Economic Trends Long Term: 1900-2011

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Natural Disaster Trends Short Term: 1980 - 2014

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Natural Disaster Economic Trends Short Term: 1980 - 2014

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(The Watchers, 2016)

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Trial and Error

Case Study: Hurricane Katrina

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Trial and Error Case Study: Hurricane Katrina

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Five Days at Memorial

Sheri Fink, MD, PhD

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(Beaumont, 2014)

Turning Point Question

Pulse Check #2

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When considering all types of disasters (i.e. man-made, natural, or complex) which one

• f the following do you fear the most?

A) Terrorist attack B) 6.0+ Magnitude Earthquake C) Hurricane/Flood D) Forest Fire

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Emergency Preparedness in the Workplace Today

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Hospital Emergency Operations Plan

Main Components

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(California Hospital Association, 2017)

Emergency Operations Plan

Hazard Vulnerability Analysis (HVA)

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(California Hospital Association, 2017)

Hospital Incident Command System (HICS) Org Chart

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(California Hospital Association, 2017)

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Community Response

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We are part of the national system:

• Individual Hospital
• Hospital System
• Community/County
• State
• Federal

Federal - State - Local Coordination

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President Governor’s Office Local Official Fire Police FEMA State Emergency Management Office Local OEM HHS, CDC, VA, etc. State DOH LHD Volunteer Org and Vol Hosp Federal State Local Other

Thinking Outside the Box

Optional EOP Support Tools

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Color Coded Flip Chart Synopsis:

Thinking Outside of the Box

Optional EOP Support Tools

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Internal Emergencies External Emergencies

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Thinking Outside of the Box

Optional EOP Support Tools

Comprehensive Contact List

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CMS Emergency Preparedness Final Rule

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CMS Emergency Preparedness Final Rule

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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.

Effective Date

November 15, 2017

(Centers for Medicare and Medicaid Services, 2018)

CMS Emergency Preparedness Final Rule

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(Centers for Medicare and Medicaid Services, 2018)

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Joint Commission Standards for Emergency Preparedness vs. CMS

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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

(Everbridge, 2015)

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Individual Emergency Preparedness

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Personal Emergency Preparedness Kit

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Image retrieved from: www.redcross.org/get-help/prepare-for-emergencies/be-red-cross-ready/get-a-kit

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Final Thoughts on Personal Preparedness

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Final Thoughts on Personal Preparedness

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Multiple Choice Questionnaire

#1. Continuity of operations planning is important for: A) Businesses B) Governments C) Schools D) All of the Above #2. Which one of the following is NOT a major component to the CMS Final Rule? A) Risk Assessment and Planning B) Communication Plan C) Color Coded Flip Charts D) Training & Testing #3. Which of the following is true regarding how to conduct a Hazard Vulnerability Analysis (HVA)? A) Must be specific to geographic location B) Must be done quarterly C) Should include as many “risk events” as possible D) HVA is not required

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References

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Beaumont, P. (2014). Five Days at Memorial by Sheri Fink – review. Retrieved February 21, 2018, from https://www.theguardian.com/books/2014/feb/17/five-days- memorial-sheri-fink-review Chetwynd, E. (2017). CMS emergency preparedness final rule comes with penalties. Retrieved February 21, 2018, from https://www.everbridge.com/cms- emergency-preparedness-final-rule-comes-penalties/ Definitions: emergencies. (n.d.). Retrieved February 21, 2018, from http://www.who.int/hac/about/definitions/en/ Emergency Operations Plan (EOP). (n.d.). Retrieved February 21, 2018, from https://www.calhospitalprepare.org/emergency-operations-plan Emergency-Prep-Rule. (2018). Retrieved February 21, 2018, from https://www.cms.gov/Medicare/Provider-Enrollment-and- Certification/SurveyCertEmergPrep/Emergency-Prep-Rule.html Get a Kit. (n.d.). Retrieved February 21, 2018, from http://www.redcross.org/get-help/prepare-for-emergencies/be-red-cross-ready/get-a-kit Hazards Vulnerability Analysis. (n.d.). Retrieved February 21, 2018, from https://www.calhospitalprepare.org/hazard-vulnerability-analysis Hospital Incident Command System (HICS). (n.d.). Retrieved February 21, 2018, from https://www.calhospitalprepare.org/hics Hurricane Katrina Statistics Fast Facts. (2017). Retrieved February 21, 2018, from https://www.cnn.com/2013/08/23/us/hurricane-katrina-statistics-fast- facts/index.html Plan and Prepare for Disasters. (2017). Retrieved February 21, 2018, from https://www.dhs.gov/topic/plan-and-prepare-disasters Post-Katrina Emergency Management Reform Act. (n.d.). Retrieved February 21, 2018, from https://emilms.fema.gov/IS230c/FEM0101200.htm Share and discover research. (n.d.). Retrieved February 21, 2018, from https://www.researchgate.net/

• T. (2016). The world is unprepared for impending natural disasters. Retrieved February 21, 2018, from https://watchers.news/2016/04/26/the-world-is-unprepared-

for-impending-natural-disasters/ "UK Government Advice on Definition of an Emergency" (PDF). Archived from the original (PDF) on 2007-06-06. Retrieved 2007-05-30. Welcome to National Preparedness. (n.d.). Retrieved February 21, 2018, from http://training.fema.gov/ https://www.youtube.com/watch?v=Zhmk8IEDSrs&t=20s https://www.youtube.com/watch?v=GgzK32M47Fk https://www.youtube.com/watch?v=IWVevsBhLBo