Pandemic Influenza Response: Ketchikan's Alternate Care Site Exercise.

Pandemic Influenza Response: Ketchikan's Alternate Care Site Exercise

Learner Objectives

1. Discuss the planning process required to supply and staff an Alternate Care Site (ACS).

2. List the staffing challenges of operating an Alternate Care Site.

3. Discuss lessons learned.

Polling Question #1

Participants, have you ever participated in setting up an Alternate Care Site, either in a drill or as a real event?

A. Yes

B. No

Where is Ketchikan Alaska?

Ketchikan is on an island in Southeast Alaska

Primary Community Partners in the Exercise

Ketchikan Fire Department (KFD) Ketchikan General Hospital

(KGH)

Ketchikan Indian Community (KIC) Ketchikan Public Health Nursing

Additional Community Partners in the Exercise

City of Ketchikan Law Enforcement Public Works Ketchikan Public Utilities

GuardianFlight, Inc.

Ketchikan Gateway Borough

Ketchikan Gateway Borough School District

Ketchikan Pastoral Association

Laidlaw Transit Inc.

North Tongass Volunteer Fire Department

State of Alaska Behavioral Health

South Tongass Volunteer Fire Department

Temsco Helicopters, Inc.

University of Alaska at Anchorage (UAA), Certified Nursing Assistant (CNA) Program

Additional Community Partners in the Exercise

Community Goal

Our goal is to create an “All Hazards” plan—an Emergency Operations Plan (EOP) that will allow our managers to perform their duties with confidence and efficiency.

This exercise will help guide our responders and managers and will provide us, the authors of the “New EOP,” a means to create a document that is useful for all types of events and for all departments or agencies involved.

City of Ketchikan Objective

To exercise evacuation policies and procedures

To test mutual aid agreements

To simulate an actual Emergency Operations Center (EOC) activation that will include a training session

To exercise large-scale incident management procedures

To assist any associated agency for the duration for the exercise

This will help us in the completion of the “re-write of the emergency operations plan.”

Ketchikan Indian Community Tribal Health Clinic Objective

To exercise and evaluate its ability to set up, staff, supply, and operate an Alternate Care Site for overflow of triaged “walking wounded” patients from the Ketchikan General Hospital ER.

Ketchikan General Hospital Objective

To work with community partners to exercise and evaluate the:

Establishment and set up of the ACS

Supply and transport of resources to the ACS

Communication at the ACS

Record keeping of care/services rendered at the ACS

Ketchikan Public Health Nursing Objective

For Alternative Care Sites, public health officials will take the lead in:

Establishment (identifying a site)

Set-up

Staffing

Operations

Funding Funding was provided by The City

of Ketchikan through the United States 2005 Homeland Security Grant and the Alaska Division of Homeland Security and Emergency Management. Grant # 2005-GE-T5-0031.

Disposable supplies, sleeping bags, and pillows were provided by the Alaska State Hospital and Nursing Home Association grant.

12/05 to 10/06

Planning Timeline

6/06 site visit to the proposed site at Fawn Mountain School

KGH & KIC are located 3 miles north.

Evacuation area (red)

South Tongass Hwy: Fawn Mountain School is 4 miles south

Bridges destroyed

Ketchikan Creek

The damMobile command post

Scenario

Exercise: KPD

Mobile Command Center

Exercise: Set Up Tent & Security

Exercise: Tent & Patients

A nurse was assigned to monitor patients awaiting transfer to Fawn Mountain Alternate Care Site (FM ACS).

Ten influenza patients are taken to the isolation tent outside of the ER to await transportation to FM ACS.

Exercise: Materials Materials Management readies supplies according

to the pre-determined lists.

Categories include: CS Disposables, Equipment, Pharmacy-Meds

Description Quantity Needed Per Day UOM Order Quantity Dispensed

Set Up

Hospital maintenance staff

Transfers equipment andsupplies to Fawn Mountain school

Sets up the beds, privacy curtains

Set Up: Signage

Bus Loading

Bus Leaves KGH

The influenza patients arrive.

Bus arrives at Fawn Mountain ACS

The cots are ready!

FM ACS Care: Registration

Charts

FM ACS Care: Triage

FM ACS Care: Bed Board

FM ACS Care

Discharge Station

Pastoral Care

The Group Photo

KGH Command Center

KGH: Patients Arrive

KIC ACS

KIC ACS: Pharmacy

Helicopter: Fawn Mountain to KGH

Depart FM ACS

Arrive KGH

Road blocks

Funding sources through KGH were not available; Home Land Security Grant money withdrawn

Volunteer patients: age, family, rules Timing of the exercise was shorter than

planned Other community events: Health Fair, Mass

Immunization Clinic, Auction

Lessons Learned

Lessons Learned Staffing

Hospital Community

Supplies Transport Trial

Registration Process

Equipment List

KIC Activate, communicate, transport

Medical Reserve Corp

Lessons Learned: Nutrition/Hydration For the volunteer

patients and staff

KGH, DEC, sack lunches

Lessons Learned: Participant ResponsesActors in Fawn Mountain ACS Exercise (10 responses)

It's nice to know that we are preparing for a disaster before one appears. Thank you.

You did a great job practicing your job and taking care of us and fulfilling our needs, and I would enjoy doing this again.

They took really good care of me and made me feel comfortable.

I felt like I was well cared for and would definitely go to this hospital if I really did get sick. Everyone was nice.

You did a great job taking care of your patients.

Actors in Hospital Exercise: KGH & KIC (7 responses)

KIC staff were more thorough than KGH staff.

Great staff.

Lessons Learned: Participant Responses

Lessons Learned: Dolls

Blow up dolls before buying them outfits!

Lessons Learned

Emergency Operations Plan Completed Approved locally Currently pending

State of Alaska “OK”

Ketchikan Healthcare Community Comes Together

Ketchikan General Hospital

Primary Care ProvidersClinics

Public Health

EMS