  Mass Casualty Incident or Event (MCI/MCE) › “A situation in which a hospital receiving multiple casualties does not have the resources to deal with the patients simultaneously.” McAlister, 2011 Surge Capacity › “A health facility’s ability to rapidly expand beyond normal services to meet increased demand for bed space, qualified personnel, medical services and public health programs in the event of a large scale disaster.” Norman et al, 2012

 Hospital emergency preparedness and response was “inadequate.” › Lack of comprehensive plans › › Lack of training Evolution of MCEs “Learn from the mistakes of others. You can’t live long enough to make them yourselves.” Eleanor Roosevelt

“There is a quantitative relationship between increasing casualty load and gradual degradation of the level of trauma care in multiple casualty incidents” Norman, 2012

 Set up EM HICS › Owned by Intermedix  Provides technology support to connect heathcare providers, public health agencies, and emergency management › Funded by CDPHE OEPR  Requires participation in a healthcare coalition for integrated, coordinated, and organized response

 Emergency preparedness follows the EOP and HICS  Enhance the EOP  Improve hospital emergency preparedness  Ensure quality of care

H

 Improve hospital emergency preparedness for Saint Anthony Hospital › Quicker response › › Staff is more comfortable with Hospital Incident Command (HICS) Better management of the event

Contact database Set up EM HICS database Assign HICS positions Set up initial job actions Insert files into IRGs Provide staff training Provided during routine emergency preparedness meetings Implement EM HICS Used during an active shooter exercise Evaluate EM HICS Survey HICS during debriefing

Scribe Incident Commander Public Information Officer Safety Officer Liaison Officer Staging Area Manager Operations Section Chief Planning Section Chief Logisitics Section Chief Admin/Finance Section Chief Security Branch Director Medical Director Communication Unit Leader Nursing Services Director Facilities Unit Leader

 Required as part of the health care coalition  Mostly data entry which is time consuming  No stakeholders

 Data entry completed  Results following implementation and evaluation

 Databases entered into EM HICS  No data collected

 Enhance EOP › Notification › › Guidance Organization  Communication

 Funding canceled further development  Time and effort  Web based  Acceptance

 Adopted throughout all Colorado hospitals  Required for the Foothills Health Care Coalition

 Relationship experience › Application to my workplace  Contribution to Public Health › Improve emergency preparedness and response › Assure quality health care

 Core competencies strengthened › › Development of plans to support health efforts Assurance of the provision of health care › Evaluation of effective, accessible, and quality health services  Concentration competencies strengthened › › Application of programming planning principles Monitor and evaluation of program effectiveness



Other competencies

› › › Environmental Health Public Health Management Biostatistics/Epidemiology

“Learn from the mistakes of others. You can’t live long enough to make them yourselves.”

 Auf der Heide, E. (2006). The Importance of Evidence-Based Disaster Planning. Annals of Emergency Medicine, 47(1), 34-49. doi:10.1016/j.annemergmed.2005.05.009

 Barbisch, D.F., and Koenig, K.L. (2006). Understanding Surge Capacity: Essential Elements. Society for Academic Emergency Medicine, 13(11), 1098-1102. doi:10.1197/j.aem/2006.06.041

 Bayram, J.D., Sauer, L.M., Catlett, C., Levin, S., Cole, G., Kirsch, T.D., … Kelen, G. (2013). Critical Resources for Hospital Sure Capacity: An Expert Consensus Panel. PLOS Current Disasters, (1). doi:10.1371/currents.dis.67c1afe8d78ac2ab0ea52319eb119688

 Djalali, A., Castren, M., Hosseinijenab, V., Khatib, M., Ohlen,G. and Kurland, L. (2012). Hospital incident command system (HICS) performance in Iran; decision making during disasters. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 20, 14. doi:10.1186/1757-7241-20-14  McAlister, V.C. (2011). Drills and exercises: the way to disaster preparedness. Canadian Journal of Surgery, 54 (1), 7-8. doi:10.1503/cjs.036910

 Norman, I.D., Aikins, M., Binka, F.N., and Nyarko, K.M. (2012). Hospital All-Risk Emergency Preparedness in Ghana. Ghana Medical Journal, 46(1), 34-42.