Chapter 7 COORDINATION WITH HMDOs [ENTER FACILITATORS NAME AND CONTACT INFORMATION] Developed by Troutman Sanders LLP Developed for the Virginia Department.

Ch

apte

r 7

COORDINATION WITH HMDOs

[ENTER FACILITATOR’S NAME AND CONTACT INFORMATION]

Developed by Troutman Sanders LLPDeveloped for the Virginia Department of Health

Funded by Centers for Disease Control and Prevention

2Coordination with HMDOs


Toolkit Presentations Instructions for Use

Toolkit Presentations are intended to be a companion to the Hospital Implementation Guide and should not be used in isolation.

The Presentations are intended to serve as a starting point for the facilitator. The facilitator should thoroughly review the Presentation prior to use in Implementation Team, CRAG or Subcommittee meetings and customize the Presentation to meet the unique needs of the meeting participants.

Pay particular to attention to the information provided in brackets ([ ]), which must be completed by the facilitator prior to use.

Included in the “Notes” section of each slide are the following types of information:

• Slide Type, which indicates whether the slide is for information or discussion, serves as a placeholder, or is some combination thereof

• Planning Guide Section(s), which will direct the facilitator to the corresponding sections of the Planning Guide and Hospital Implementation Guide for further information

• Special Instructions, which provides directions for the facilitator to customize the slide for the intended audience

• Speaker’s Notes, which provides more detailed information to supplement the material on the slide

Refer to the Hospital Implementation Guide for further guidance and helpful hints on effectively completing the process described in the Planning Guide.


CRAG Members

[Enter names and departments of each CRAG member]


Add slides from Altered Standards Overview and/or Chapter 1 presentation, as needed, to re-introduce the CRAG to the concept of altered standards and critical resource shortage response planning, especially if new members are involved.


Introduction


Chapter Overview

Identify HMDOs for coordination Create a communication strategy with other HMDOs Understand how HMDOs’ responses to the CRSE will

impact other HMDOs Engage in discussions regarding changes to scope of

services• Expansion of scope• Reduction of scope

Discuss cooperative initiatives with other HMDOs Establish parameters regarding “essential

documentation”


Other HMDOs

Hospital(s) in Planning Unit

Coordination During “Normal” Times


Other HMDOs

Hospital(s) inPlanning Unit

Patient Care in CRSE Without Coordinated Planning

Smaller degree of overlap

Each will retreat into its own silo and implement its own “disaster plan”

““Non-Productive Interaction”Non-Productive Interaction”


Other HMDOs

Hospital(s) in

PlanningUnit

Patient Care in CRSE With Coordinated Planning

Higher degree of overlap

Both entities will rely on each other to do more

““Productive Interaction”Productive Interaction”


OtherHMDOs

Hospital(s) in

PlanningUnit

Patient Care in CRSE With Coordinated Planning

What exactly does this coordination What exactly does this coordination look like during a CRSE?look like during a CRSE?


Decisions for the Planning Unit

With which HMDOs are we going to coordinate?How are we going to coordinate with the

selected HMDOs?Will we expect these HMDOs to change their

scope of services to support our response to the CRSE? If so, how?

Are there any cooperative initiatives that we want to pursue with other HMDOs?

What problems, if any, do we see with “essential documentation” between the hospital(s) in the Planning Unit and HMDOs?


Selecting HMDOs for

Coordination


Selecting HMDOs for Coordination

There are a vast number of other HMDOs in the [Planning Unit]

It will be difficult to coordinate with each type of HMDO

It will be almost impossible to coordinate with individual HMDOs (e.g., each EMS provider)

The CRAG will have to prioritize types of HMDOs for coordination efforts


Brainstorm a List of Other HMDOs

EMS Providers Community Physicians Ambulatory Surgery Centers Home Health Assisted Living Long Term Care Dialysis Facilities Community Health Centers FQHCs

Hospice Outpatient Lab Infusion Centers Outpatient Imaging Rehabilitation Hospitals Alternate Care Facilities Other Acute Care

Facilities Pharmacy


Prioritize the HMDOs for Coordination

Which HMDOs may be able to help protect the hospital(s) in the Planning Unit from being overwhelmed during a CRSE by providing certain types of care or early triage?

Which HMDOs may pose a risk to hospital(s) in the Planning Unit during a CRSE because they have the potential to transfer large numbers of patients to the hospital(s)?


Prioritizing HMDOs for Coordination

High Priority Medium Priority Low Priority


Coordination Strategy


Coordination Considerations

HMDO representative bodies v. each individual HMDO

CRAG v. selected representative(s) of the CRAG

Methods of communication with the HMDOs


Representative Body v. Individual HMDOs


CRAG v. Representative(s) of the CRAG


Communication Methods


Scope of Services


Changes to Scope of Services

HMDOs may be planning to change their scope of services as part of their critical resource shortage response plans

The Planning Unit’s CRSRP and associated Protocols may be more effective if other HMDOs change their scope of services • Expansion• Reduction


CRSRP and Associated Protocols

Ethical frameworkOperational infrastructureProtocols

• [LIST ALL RESOURCE-SPECIFIC PROTOCOLS]

Ad Hoc Protocol Development InfrastructureEvaluation and MaintenanceApproval and IntegrationCommunication


EXPANSION[Can any care be performed by other

HMDOs to provide relief to the hospital(s) in the Planning Unit?]

[Can any additional testing or services be performed at other HMDOs to facilitate the hospital’s implementation of Protocols?]


[Is there any care that may be provided by other HMDOs that will negatively impact a hospital’s ability to implement a Protocol?]

[If so, does it make sense to ask these other HMDOs to limit this type of care?]

REDUCTION


Other Collaboration

Issues


Are there any cooperative initiatives that we want to pursue with other HMDOs?

Cooperative stockpiling

Ambulance re-stocking

SNS distribution

Alternate care facility


What problems, if any, do we see with “essential documentation” between the

hospital(s) in the Planning Unit and HMDOs?

[INSERT DEFINITION OF “ESSENTIAL DOCUMENTATION” FROM SECTION 4.5]


EssentialDocumentation

What documentation is used today?

Is all of today’s documentation necessary during a CRSE?

What is the minimum amount of information needed?

What information is needed for reimbursement purposes?

“Essential Documentation” between the Hospital(s) in the Planning Unit and HMDOs


BREAK


HMDO Coordination


Summary of Discussions with HMDOs

[WHICH HMDOs WERE CONTACTED][NUMBER AND TYPES OF

COMMUNICATIONS/MEETINGS][PARTICIPANTS IN DISCUSSIONS][GENERAL TOPICS OF

COMMUNICATIONS/MEETINGS]


HMDO Response to a CRSE

HMDO’s response is designed to support its continuity of operations

[DETAILS REGARDING HMDO’S CRITICAL RESOURCE SHORTAGE RESPONSE PLAN, IF ANY]• [CHANGES TO SCOPE OF SERVICES]• [ASSUMPTIONS THAT HMDO IS MAKING

ABOUT THE HOSPITAL(S) IN THE PLANNING UNIT]


HMDO Response to a CRSE

[PRELIMINARY CONCLUSIONS ABOUT IMPACT THAT HMDO RESPONSE TO A CRSE WILL HAVE ON THE HOSPITAL(S) IN THE PLANNING UNIT]


HMDO’s Willingness to Change its Scope of Services

[SUMMARY OF THE “ASK” – HOW DID THE CRAG WANT THE HMDO TO CHANGE ITS SCOPE OF SERVICES TO SUPPORT THE PLANNING UNIT’S CRSRP AND ASSOCIATED PROTOCOLS?]

[SUMMARY OF THE HMDO’S RESPONSE]


[PRELIMINARY CONCLUSIONS ABOUT IMPACT THAT HMDO’S RESPONSE TO REQUEST TO CHANGE ITS SCOPE OF SERVICES WILL HAVE ON THE HOSPITAL(S) IN THE PLANNING UNIT]

HMDO’s Willingness to Change its Scope of Services


HMDO’S Interest in Pursuing Cooperative Initiatives

[SUMMARY OF PROPOSED INITIATIVES]

[SUMMARY OF HMDO’S INTEREST IN PURSUING SUGGESTED COOPERATIVE INITIATIVES]

[HMDO’S CONCERNS ABOUT COOPERATIVE INITIATIVES]


HMDO’s Ability to Provide “Essential Documentation”

[CHANGES THAT THE HMDOs ARE PLANNING TO MAKE TO THEIR DOCUMENTATION DURING A CRSE]

[SUMMARY OF COMPONENTS OF “ESSENTIAL DOCUMENTATION” FOR HMDO THAT CRAG IDENTIFIED]

[ABILITY TO SUPPORT THE SUGGESTED COMPONENTS OF “ESSENTIAL DOCUMENTATION” AS IDENTIFIED BY THE CRAG]


HMDO’s Ability to Provide “Essential Documentation”

[PRELIMINARY CONCLUSIONS ABOUT THE IMPACT THAT HMDO’S ABILITY TO SUPPORT COMPONENTS OF “ESSENTIAL DOCUMENTATION” WILL HAVE ON THE HOSPITAL(S) IN THE PLANNING UNIT]


Next Steps in Coordination with HMDOs

[Preliminary suggestions for next steps in the coordination effort with other HMDOs]


Modifications to CRSRP or Associated Protocols

[Preliminary suggestions for modifying the CRSRP or associated Protocols as a result of the coordination among the hospital(s) in the Planning Unit and HMDOs]


Questions?Questions?

Chapter 7 COORDINATION WITH HMDOs [ENTER FACILITATORS NAME AND CONTACT INFORMATION] Developed by Troutman Sanders LLP Developed for the Virginia Department.

Documents

hmdos slide

hmdos prioritizing hmdos

coordination slide

hmdos hospitals

types of hmdos

hmdos introduction slide

individual hmdos

hmdos decisions