Transcript Evacuation/Shelter-in-Place (SIP) Tabletop Exercise

OHIO CENTRAL REGION HOSPITALS
Evacuation/Shelter-in-Place (SIP)
Tabletop Exercise (TTX)
PRESENTED BY
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BEFORE WE BEGIN
 Restrooms
 Exits
 Drinks
 Materials
 Breaks
TODAY’S AGENDA
• Introductions
• Purpose and Scope of Exercise
• Exercise Objectives
• Exercise Participants & Guidelines
• Presentation of the Exercise Scenario
• Hot wash & Close Out
PURPOSE AND SCOPE
 Purpose

To measure response effectiveness against current response
concepts, written plans, procedures and capabilities for
evacuation/shelter-in-place (SIP).
 Scope

This exercise examines Central Region Hospital (CRH) plans
to effectively evacuate and/or receive patients from an
evacuation, and also evaluates decision-making regarding
evacuation and SIP.
EXERCISE OBJECTIVES
 Incident Command
 Evacuation and/or Shelter-in-Place Protection
 Resource Management
 Communications
 Medical Surge
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PARTICIPANTS
 Players
 Evaluators
 Facilitators/Controllers
 Observers
EXERCISE STRUCTURE
 Module 1:
Decision Making and Notifications
 Module 2: Shelter-in-Place (SIP) Response
 Module 3: Evacuation Response
 Module 4: Hospital Receipt of Evacuees
TYPES OF EXERCISE
 Full Scale
 Functional
 Table Top
 THIS IS A TABLE TOP EXERCISE
EXERCISE GUIDELINES
 This is a low-stress, no-fault environment. Varying
viewpoints, even disagreements, are expected.
 Respond based on your knowledge of your hospital’s
current plans and capabilities, (i.e., you may use only
existing assets) and insights derived from training.
 Decisions are not precedent setting and may not
reflect your organization’s final position on a given
issue. This is an opportunity to discuss and present
multiple options and possible solutions.
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ASSUMPTIONS
 The scenario is plausible.
 Events occur as they are presented.
 Everyone gets the same information.
 There are no trick questions.
 There are no hidden agenda.
 There is no one right answer.
Questions before we begin??
MODULE 1
DECISION MAKING AND
NOTIFICATIONS
APRIL 20, 2011
1630 HOURS
 Predicted storms have arrived in the
Central Region with a vengeance. Heavy rain
and high winds are wreaking havoc with
power lines. Rush hour traffic is at a
standstill.
 Tornado warnings have been issued until
1830 Hours but no touchdowns have as yet
been reported.
 Shift change has just occurred at the hospital. Many first shift staff
have decided to wait out the storm at the hospital rather than
wade into traffic.
 The hospital still has full power and is monitoring the weather
radio.
 The hospital is at 85% capacity.
APRIL 20, 2011
1710 HOURS
 Tornado sirens begin blaring and emergency weather
reports indicate that a tornado has just touched
down 10 miles west of the hospital with reports that
another, one mile north, has also touched down.
Both are heading east towards the hospital at 25
miles per hour.
 Code Gray – Tornado Warning is paged overhead and
patients are moved into hallways away from danger
of shattering glass.
APRIL 20, 2011
1740 HOURS
 Sounds of wind outside are
deafening. Debris in the air is hurl
against the west side of the
hospital and shattering glass can
be heard inside the building.
 The electricity goes out briefly and comes back on.
 Emergency power is operational in many areas but
is not functioning in some areas requiring the need to
pass out flashlights to be able to see at all.
 The noise outside begins to slowly fade.
APRIL 20, 2011
1815 HOURS
 A building assessment has been made.
All glass on the west side of the hospital,
mostly patient rooms (50% of hospital
total) and administrative offices has
been blown out.
 A switch on the generator’s panel has
blown leaving some areas of the hospital
without emergency power including the
Med/Surg unit and ICU.
 A replacement switch for the generator is not onsite. Hospital
vendors report at least a 36-hour timeframe for delivery of the
new one.
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MODULE 1 DISCUSSION
 Would the Hospital Incident Command System be
activated at this point. If so, what is the activation
process? Which positions would currently be in play?
 Would the hospital consider evacuation or SIP at this
point? Who would make this decision based on what
critical factors?
 What notifications would you make at this point?
 Would you request additional resources at this point?
If so, what and from whom?
MODULE 2 DISCUSSION
 What other hospital plans, if any, would be activated?
 Would the hospital go on diversion?
 How will you keep yourselves current regarding the
event.
 What other actions would you take at this point?
MODULE 2
SHELTER-IN-PLACE (SIP)
RESPONSE
APRIL 20, 2011
1850 HOURS
 Hospital Incident Commander has decided to
immediately evacuate 50% of your inpatients due to
limited patient care areas left in the hospital.
 Critical care patients have been evacuated to other
areas within the hospital capable of continuing their
care.
 The Hospital Incident Liaison (HIL) has been
contacted for support assistance.
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APRIL 20, 2011
1905 HOURS
 Fifteen minutes after the request for assistance from the
HIL, the HIL responds that the Emergency Management
Agency has indicated that transportation to support the
evacuation is currently unavailable due to damaged
infrastructure, and debris clogged traffic arteries around
the hospital.
 The EMA recommends
that the hospital SIP until
further notice.
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MODULE 2 DISCUSSION
 Would the Hospital Incident Command System be
activated or changed at this point? In what ways?
 What activities would now need to occur for SIP?
 Would you continue preparations for an eventual
evacuation? If yes, what activities would be included
in this preparation.
 Would you have any security issues at this point?
 What other hospital plans, if any, would be activated?
MODULE 2 DISCUSSION
 Would the hospital go on or stay on diversion?
 How will you keep yourselves current regarding the
event.
MODULE 3
EVACUATION RESPONSE
APRIL 21, 2011
0330 HOURS
 The hospital’s Liaison Officer has just received word
from the HIL (via EMA) that the roadways are
becoming more clear though some areas are still
impassable.
 The HIL reports that the Ohio Fire Chiefs’ Association
(OFCA) Emergency Response Plan has been activated
and they are standing by to assist with transportation
for your hospital’s evacuation. They are requesting a
contact for transportation coordination.
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APRIL 21, 2011
0330 HOURS
 The OFCA has 20 + ambulances for immediate
assistance with more available as necessary.
 The local community transportation agency is also
standing by with several city buses.
Staff that stayed to avoid
storm traffic is now
involved in the emergency
response.
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MODULE 3 DISCUSSION
 Now that the evacuation can proceed, what
notifications will you make?
 Would you call in any additional staff?
 What security measures would you take now.
 What HICS positions would you consider activating
now?
 How will you find destinations for your evacuating
patients?
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MODULE 3 DISCUSSION
 How will you coordinate internal patient movement
for transportation out of the hospital?
 How will you locate the appropriate transportation
you need to evacuate?
 How will you track patients throughout the
evacuation process (internally and to the receiving
hospital)?
 How will you notify patient family members regarding
transfer location of loved ones?
 Who else needs to be notified?
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MODULE 4
HOSPITAL RECEIPT OF
EVACUEES (SURGE)
APRIL 20, 2011
1920 HOURS
 You have been watching the news and hearing
reports about severe damage to a large hospital in
your County.
 You realize that your hospital will likely be receiving a
surge of community injured as well as evacuees from
this hospital.
 Just as you realize this, a page comes through from
the HIL…
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MODULE 4 DISCUSSION
 What types of information do you think the HIL will
be requesting?
 Would HICS be activated at this point? If yes, in what
capacity or positions?
 How would you accommodate an influx of patients to
your hospital when these patients are from an
evacuating facility?
 Would you call in additional staff at this time?
 Would you require additional resources?
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THANKS
FOR
PLAYING!!
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HOT WASH
EVALUATORS
PARTICIPANTS