Regulatory Compliance and Emergency Management Is being Joint Commission compliant enough to be able to prepare, respond and recover from a disaster? Expla
Regulatory Compliance and Emergency Management Is being Joint Commission compliant enough to be able to prepare, respond and recover from a disaster? Explain your answer.Review the JC Lessons Learned. What lesson learned resonated with you? Why? Review the following websites:https://www.jointcommission.org/emergency_management.aspx Image source: www.ucdenver.edu
Emergency Management Update Team 2016- 1
© Copyright, The Joint Commission
Emergency Management Debrief
Lessons Learned
Planning & Leadership
Emergency Program
Emergency Management Update Team 2016- 2
© Copyright, The Joint Commission
EMERGENCY MANAGEMENT
CHAPTER OUTLINE
Foundation for the Emergency Operations Plan
[EM.01.01.01]
The Emergency Operations Plan (EOP)
General Requirements [EM.02.01.01]
Specific Requirements
Six Critical Areas [EM.02.02.01-EM.02.02.11]
Disaster Volunteers [EM.02.02.13-EM.02.02.15]
Evaluation
Evaluating the planning activities [EM.03.01.01]
Evaluating the Emergency Operations Plan through exercises
[EM.03.03.03]
Emergency Management Update Team 2016- 3
© Copyright, The Joint Commission
1.
Communication
[EM.02.02.01]
2.
Resources & Assets
[EM.02.02.03]
3.
Safety & Security
[EM.02.02.05]
4.
Staff responsibilities
[EM.02.02.07]
5.
Utilities Management
[EM.02.02.09]
6.
Patient, clinical & support activities [EM.02.02.11]
Emergency Management Update Team 2016- 4
© Copyright, The Joint Commission
SIX CRITICAL AREAS
2016
Emergency Management Update Team
The Joint Commission
© Copyright, The Joint Commission
WHAT HAS THE JOINT COMMISSION
BEEN UP TO?
EMERGENCY MANAGEMENT TEAM
Cross-divisional team
Review of large-scale events
Improvement
Field and surveyor education
Survey process and standards
Emergency Management Update Team 2016- 6
© Copyright, The Joint Commission
Debriefs
Lessons learned
Education and process improvement
DEBRIEFS WITH HEALTH CARE ORGANIZATIONS
Hurricane Sandy
West Texas Fertilizer Explosion
West Virginia Water Contamination
Boston Marathon Bombing
Ebola Outbreak
Baltimore Civil Unrest
San Bernardino Terrorist Event
Ferguson Civil Unrest
Emergency Management Update Team 2016- 7
© Copyright, The Joint Commission
South Carolina Flooding
LESSONS LEARNED – PLANNING/PREPAREDNESS
Establish relationships w/law enforcement
& back-up security agencies
Joint education,
drills, etc.
Activate ICS early in incident to support
situational awareness
Plan / drill for escalating events
Mass shooting plus bomb threat.
Emergency Management Update Team 2016- 8
© Copyright, The Joint Commission
Communication.
LESSONS LEARNED – PLANNING/PREPAREDNESS
Identify & reach out to staff living in hot
e.g., laundry service
Know actual usage of utilities on ‘normal’
day, in evening, on weekends.
Emergency Management Update Team 2016- 9
© Copyright, The Joint Commission
zones during unrest to identify support
needs in advance.
Consider supply chain and alternate
service providers during water
contamination.
LESSONS LEARNED – PLANNING/PREPAREDNESS
Plan for most emerging infectious diseases
rather than new ‘outbreak of the week’ plan.
IC plan,
surge plan, all hazards plan, decon plan,
pan-flu plan
Don’t overlook common risks that could go
on the HVA
in community or region
CBRNE: Fertilizer storage facilities throughout
the region that could pose risk of
combustion/explosion.
Emergency Management Update Team 2016- 10
© Copyright, The Joint Commission
Risks
LESSONS LEARNED – PLANNING/PREPAREDNESS
Planning for civil unrest focused primarily on:
Communications (with staff, patients,
community incident command, the
public/media)
Security
Transit (to the facility for patients and staff)
Emergency Management Update Team 2016- 11
© Copyright, The Joint Commission
Reviewing EOP annually
Policies addressing utility disruption, including
approach to clinical interventions
Water
LESSONS LEARNED – PLANNING/PREPAREDNESS
Don’t overlook home care, outpatient
services and other ancillary providers
home care providers were held
back from entering certain communities
where there were clients with chronic
conditions – care arrangements can be
addressed proactively.
Emergency Management Update Team 2016- 12
© Copyright, The Joint Commission
During unrest
LESSONS LEARNED – GENERAL RESPONSE
hospital & campus to identify flood issues
early.
Divert spontaneous volunteers (even
clinical) from ED to avoid congestion
during trauma response.
Community-based & mobile services (e.g.,
addiction services) need to choose their
locations during unrest to preserve safety
of staff/patients.
Emergency Management Update Team 2016- 13
© Copyright, The Joint Commission
Conduct frequent tours (every 2 hours) of
LESSONS LEARNED – COMMUNICATIONS
command/control, staff, patients/families,
media & the public.
Don’t presume that all staff have smart
phones or use social media; use redundant
methods of staff communication.
Manage staff stress and access to
misinformation via proactive staff
communication strategy.
Emergency Management Update Team 2016- 14
© Copyright, The Joint Commission
Have separate lines of communication for
LESSONS LEARNED – COMMUNICATIONS
with cell phone during response and
recovery.
Proactive media/social media outreach
plan mitigates intrusions from reporters
that consume leaders’ time during
response.
Regular joint calls with local providers, city
& state support situational awareness
during unrest.
Emergency Management Update Team 2016- 15
© Copyright, The Joint Commission
Carry extra batteries and/or chargers along
During unrest:
Monitor social media used/sponsored by
protest groups to anticipate crowd movement
and potential impact on transit or
emergency/urgent care.
Reinforce with staff – verbally and in written
messaging/scripts used as needed in
patient/family interactions – values of diversity
and role to care for all people to help mitigate
safety concerns or racial tension impacting
community.
Emergency Management Update Team 2016- 16
© Copyright, The Joint Commission
LESSONS LEARNED – COMMUNICATIONS
LESSONS LEARNED – SECURITY
Definition of ‘lock-down’ with response
partners
Security forces
have one meaning, hospitals may vary
Civil unrest response from small community
hospital
& secured it’s perimeter – closed all off-site
locations
Security to central site
Moved vehicles
Removed from public access items that could be
removed/damaged
Emergency Management Update Team 2016- 17
© Copyright, The Joint Commission
Reduced
LESSONS LEARNED – SECURITY
Reinforced with staff use of de-escalation
techniques during civil unrest.
Train/exercise with local law enforcement
During terrorist shooting over 40 officers were
onsite in minutes
Conducted bomb search and provided essential
support. No need to arm hospital security.
Separate ED waiting area for injured police
officers & their families during unrest
Emergency Management Update Team 2016- 18
© Copyright, The Joint Commission
LESSONS LEARNED – STAFF
Senior leadership
Prioritize time and resources for staff training
Emergency Management Update Team 2016- 19
© Copyright, The Joint Commission
Weather/natural disasters
Prepare for staff rotations & shift relief
Designated sleeping areas, adequate meals
Shuttle system to/from homes
LESSONS LEARNED – STAFF
Monitor local/county/state agencies
Road closures, curfews, etc. that impact staff
movement to & from work
community conditions change
Place Critical Incident Stress management
staff in EOC
Provide real-time support
& guidance to chain
of command during unrest
Emergency Management Update Team 2016- 20
© Copyright, The Joint Commission
Adjust shifts, allow sheltering in place as
LESSONS LEARNED – PATIENT CARE
Flooding
Review IC plan to assess patient risk for HAI.
Emergency Management Update Team 2016- 21
© Copyright, The Joint Commission
Water contamination
Home health & DME partners proactively
monitor at-risk patients
Facilitate patient education on O2
concentrators, CPAP machines, & water
sourcing.
LESSONS LEARNED – EXERCISES
Stress & test system, staff, leaders with
escalating complications & patients with
different functional needs.
Train & practice staff in active shooter
response
with in-house security & law
enforcement.
Emergency Management Update Team 2016- 22
© Copyright, The Joint Commission
Joint exercise
LESSONS LEARNED – LEADERSHIP
Leaders met frequent w/staff to discuss
quality of care and safety during flood
response/recovery.
Leaders facilitated visible presence of security
in and around building during unrest
Increased
sense of security.
managerial assistance; identified & addressed
staff morale/support needs in process after
terrorist attack.
Emergency Management Update Team 2016- 23
© Copyright, The Joint Commission
Leaders rounded & provided hands-on
LESSONS LEARNED – PSYCHOSOCIAL SUPPORT/COPING
Reinforced w/staff & community role of
hospital as safe zone for all injured.
Emergency Management Update Team 2016- 24
© Copyright, The Joint Commission
Civil unrest/recovery
Town hall meetings for information & support
and to dispel myths/rumors
Made available EAP & pastoral care
Routed routine monthly prayer walk
through vulnerable community.
During unrest response & recovery
Invited staff discussion (individual or small
group) on racial tension
Sense of safety at home in impacted
community
Need for safety tips or security/transit support
(alter work hours, shelter at hospital, etc.).
Emergency Management Update Team 2016- 25
© Copyright, The Joint Commission
LESSONS LEARNED – PSYCHOSOCIAL SUPPORT/COPING
LESSONS LEARNED – INFECTIOUS DISEASE
Plan, train, & exercise for infectious
disease emergencies:
initial screening
of PPE, including don and dof
safe patient flow (entry point to isolation)
iterative training of care teams
dedicated equipment
safe transfer of patients
disposal & transport of waste
Emergency Management Update Team 2016- 26
© Copyright, The Joint Commission
use
LESSONS LEARNED – UTILITIES
Water
Processes for cleaning water systems after
loss of water
Supply for systems management
Potable vs. non-potable
• Equipment use, i.e. sterile processing
• Human consumption
Emergency Management Update Team 2016- 27
© Copyright, The Joint Commission
Fuel
Increase run time through load-shedding
LESSONS LEARNED – HEALTH CARE PARTNERS
Water contamination:
Ambulatory dialysis company deployed water
tanker truck to supply hospital
Dialysis biochemist supported hospital in
sampling & testing water
Emergency Management Update Team 2016- 28
© Copyright, The Joint Commission
Nursing home destroyed in industrial blast:
Other homes contacted hospital to offer beds
Hospital worked with case manager,
behavioral health staff and home care to place
patients 2 weeks post-disaster
LESSONS LEARNED – HEALTH CARE PARTNERS
Maintain access to care
Chronic care patients
Medications from pharmacies outside of
impacted area of emergency
• Civil unrest, weather emergencies, etc.
Emergency Management Update Team 2016- 29
© Copyright, The Joint Commission
Reinforce IC preparedness
Affiliated clinics and physician offices where
at-risk patients may be seen.
Screening, use of PPE and other precautions
LESSONS LEARNED – EVACUATION
Practice evacuation drills using evacuation
equipment:
equipment is required?
Where will equipment be deployed (which
units, floors, etc.)?
Who needs to be trained in its use?
Emergency Management Update Team 2016- 30
© Copyright, The Joint Commission
How much
LESSONS LEARNED – RECOVERY
Recovery
Ancillary / offsite / support departments that
were impacted by event or that contribute to
resiliency.
Business continuity
Timely engagement with FEMA and insurers
Emergency Management Update Team 2016- 31
© Copyright, The Joint Commission
Leadership engagement
Avoid fatigue and silos
Accountability
Link: http://www.jointcommission.org/emergency_management.aspx
Emergency Management Update Team 2016- 32
© Copyright, The Joint Commission
EMERGENCY MANAGEMENT PORTAL
Purchase answer to see full
attachment
