Incident R esponse Guide: Utility F ailure Mission T o safely manage patient car e through eecti ve and ecient hospital operatio ns during the loss of a major utility within the hospitalDirections Read this entire response guide and review the !ospital Incident "anagement Team #ctivation chartUse this response guide as a chec$list to ensure all tas$s are addressed and completedObjectives Identify e%tent of outage and consider evacuation "aintain patient care capa&ilities "inimi'e impact on hospital operations and clinical services (ommunicate the situation status to patients) sta) and the pu&lic Incident Response Guide * Utility Failure+age ,
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Mission To safely manage patient care through e ective and e cient hospital operations duringthe loss of a major utility within the hospital
DirectionsRead this entire response guide and review the !ospital Incident "anagement Team#ctivation chartUse this response guide as a chec$list to ensure all tas$s are addressed and completed
ObjectivesIdentify e%tent of outage and consider evacuation"aintain patient care capa&ilities"inimi'e impact on hospital operations and clinical services(ommunicate the situation status to patients) sta ) and the pu&lic
-sta&lish operational periods) o&jectives)and regular &rie/ng schedule (onsiderusing the Incident #ction +lan 0uic$ 1tartfor initial documentation of the incident
2etermine the need for shelter3in3place orevacuation and activate appropriateincident response plans
(onsider limiting nonessential services
4otify the hospital (hief -%ecutive . cer)5oard of 2irectors) and other appropriateinternal and e%ternal o cials of situationstatus
#ub!icIn$ormation
Ofcer
#ctivate the Ris$ (ommunication +lan andmedia staging area
+repare a media release to inform thecommunity a&out the utility outage
"aintain communication with patients)sta ) and families regarding the currentsituation and what is &eing done toaddress it
(onduct a hospital census and identifypossi&le discharges) transfers and surgeryor procedure cancellations
Update internet) intranet) and socialmedia to disseminate information a&outhospital status and alteration in servicesto patients) sta ) families) andsta$eholders
"onitor media outlets for updates on theincident and possi&le impacts on thehospital (ommunicate information viaregular &rie/ngs to 1ection (hiefs and theIncident (ommander
4otify community partners in accordancewith local policies and procedures 7e g )consider local -mergency .perations(enter) other area hospitals) localemergency medical services) andhealthcare coalition coordinator8) todetermine incident details) communitystatus) and esta&lish contacts forre9uesting supplies) e9uipment) orpersonnel not availa&le in the hospital
(ommunicate with other hospitals todetermine situation status) a&ility toaccept patients if transfer) hospitala&andonment) or evacuation is ordered
Sa$et& Ofcer(omplete the !I(1 6, # to assign) direct)and ensure safety actions are adhered toand completed
Immediate Response (0 – 2 hours)
Section'ranch nit Tim
ection Initi
a!s
OperationsSection "hie$
Implement the -vacuation) 1helter3in3+lace) and !ospital #&andonment +lan asneeded and in cooperation with theIncident (ommander
Medica! "are'ranch
Director
Re9uest diversion if needed
Identify evacuation priorities and transferre9uirements
Implement downtime documentationprocedures for patient care and incidentmanagement documentation as re9uired
(onduct a hospital census and determinedischarges) transfers) and surgery orprocedure cancellations
#ssess patients for ris$ and prioriti'e care
and resources) as appropriateIn$rastructure
'ranchDirector
Implement emergency support proceduresto sustain critical services 7i e ) power)water) medical gasses) communications8until utility restoration can &eaccomplished
#ctivate damage assessment teams todetermine the impact and severity ofutility outage
Securit&'ranch
Director
Initiate emergency procedures to supporthospital and campus security in responseto a utility outage
#!annin*
Section "hie$
-sta&lish operational periods) incidento&jectives) and the Incident #ction +lan incolla&oration with the Incident(ommander
Resources nit%eader
+repare for personnel and e9uipmenttrac$ing
Situation nit%eader
"onitor and document all actions andactivities
+repare for patient trac$ing includingpatient transfers
%o*istics
Section "hie$ Refer to the <o& #ction 1heet forappropriate tas$s
Service 'ranchDirector
#ssess the impact of the utility outage oncommunications and informationtechnology systems
Initiate &ac$up documentation systems ifelectronic systems are not functioning
Support'ranch
Director
Respond to re9uests for supplies ande9uipment= distri&ute appropriatee9uipment throughout the hospital 7e g )porta&le lights) >ashlights) &lan$ets8
+inancedministratio
nSection "hie$
#ctivate vendor "emoranda ofUnderstanding
Trac$ all costs and e%penditures ofresponse) and estimate lost revenues dueto canceled procedures) surgeries) andother services
Intermediate Response (2 – ,2 hours)
Section OfcerTim
ection Initi
a!s
"ommand Incident"ommander
.&tain assessment of sta ng) e9uipment)and supply needs and the overall impactfrom the ongoing utility outage on patientcare) remaining sta ) and the hospital
#ctivate "edical3Technical 1pecialists ifneeded 7e g ) Ris$ "anagement) @egal8
#ub!icIn$ormation
Ofcer
(ontinue media &rie/ngs and updates
(ontinue &rie/ngs and situation updateswith patients) sta ) and families
Update internet) intranet) and social
media to disseminate information a&outhospital status and alteration in servicesto patients) sta ) families) andsta$eholders
%iaison Ofcer
(ontinue to update local emergencymanagement and the -mergency.perations (enter of situation status andcritical issues) and to re9uest assistanceas needed
(ontinue communications with area
hospitals and facilitate patient transfers
Sa$et& Ofcer
(onduct ongoing analysis of e%itingresponse actions for safety issues)implement corrective actions) and updatethe !I(1 6, #
Intermediate Response (2 – ,2 hours)
Section'ranch nit Tim
ection Initi
a!s
Operations Section "hie$ Refer to the <o& #ction 1heet forappropriate tas$s
Medica! "are'ranch
Director
(ontinue the evaluation of patients andpatient care= reevaluate the need tocurtail or cancel nonessential services
Reevaluate sta ng needed to maintainessential services and to provide patientcare
-valuate sta wor$ing in alternate roles
and all supplemental staReevaluate the need to continueam&ulance diversion
(ontinue to assess e%tent of damage oroutage= if possi&le) provide the Incident(ommander and 1ection (hiefs withprojected length of the serviceinterruption
Initiate repairs as re9uiredSecurit&'ranch
Director
(ontinue to provide hospital security=develop plans to alter security services ifphone or power is interrupted
#!annin*
Section "hie$
+repare the Incident #ction +lan for thene%t operational period= engage allsections to provide updates on sta ngand alterations in strategies and tactics
Resources nit%eader
(ontinue sta and e9uipment trac$ing
Situation nit%eader
(ontinue patient and &ed trac$ing
Documentation nit %eader
-nsure complete documentation of allpostponed and canceled appointmentsand procedures
%o*istics
Section "hie$ Refer to the <o& #ction 1heet forappropriate tas$s
Support'ranch
Director
(ontinue to provide sta for essentialoperations
"onitor) report) follow up on) anddocument patient or sta injuries
+inancedministratio
n
Section "hie$ Refer to the <o& #ction 1heet forappropriate tas$s
Time nit%eader
Trac$ hours associated with theemergency response
#rocurementnit %eader
Facilitate contracting for resources andservices
"ost nit%eader
Trac$ costs) sta hours) e%penditures) andlost revenue
-.tended Response (*reater than ,2 hours)
Section OfcerTim
ection Initi
a!s
"ommand Incident"ommander
(ontinue to monitor operations) considerthe length of onsite operations) anddetermine the need for e%pandedpostponement of procedures
"aintain contact with the local -mergency.perations (enter) other area hospitals)local emergency medical services) andregional medical health coordinator torelay status and critical needs to receiveincident and community updates
(ontinue monitoring of the utility failure
impact to hospital and home careservices= coordinate information with the.perations 1ection
Sa$et& Ofcer
-nsure entry and e%it points are open andfunctioning
-nsure /re doors and alarms are inwor$ing order
"onitor and maintain a safe environmentduring the return to normal operations
Demobi!i/ation S&stem Recover&
Section'ranch nit Tim
ection Initi
a!s
Operations Section "hie$ .versee the restoration of normal patientcare operations
Medica! "are'ranch Director
2iscontinue am&ulance diversion) ifapplica&le
Reschedule canceled surgeries)
procedures) and outpatientappointments
Repatriate evacuated or transferredpatients
In$rastructure'ranch Director
(omplete a hospital damage report)including the progress of repairs) andestimated timelines for restoration topre3incident condition
1chedule and oversee a test of thehospital alarm systems
.versee the restoration of essentialservices including internet connectivityand communications .versee the entryof information and data into electronicrecords if necessary
If record $eeping included the use of paper&ased records) ensure all clinical
information is entered into electronicmedical records
#atient +ami!&ssistance
'ranch Director
+rovide &ehavioral health support andinformation a&out community services forpatients and families) if needed
#!annin*
Section "hie$
Finali'e and distri&ute the 2emo&ili'ation+lan
-nsure that the status of all impactedclinical and support operations arerelayed to appropriate sections forresolution
(onduct de&rie/ngs and a hotwash with:
(ommand 1ta and section personnel#dministrative personnel#ll sta #ll volunteers
Brite an #fter #ction Report and(orrective #ction and Improvement +lanfor su&mission to the Incident(ommander) including:
1ummary of the incident1ummary of actions ta$en#ctions that went well#ctions that could &e improvedRecommendations for future responseactions
Documentationnit %eader
(ollect) collate) /le) and securecompleted documentation of actions)
decisions) and activities+repare a summary of the status andlocation of all incident patients) sta ) ande9uipment #fter approval &y the Incident(ommander) distri&ute it to appropriatee%ternal agencies
Section "hie$ Inventory all !ospital (ommand (enterand hospital supplies and replenish asnecessary) appropriate) and availa&le
Support 'ranchDirector
Release temporary sta and otherpersonnel to normal positions
(omplete documentation and follow upof personnel injuries if needed
+inancedministratio
n
Section "hie$
(ompile a /nal summary of all responseand recovery costs and e%penditures)and estimated lost revenues 1u&mit tothe +lanning 1ection (hief for inclusion inthe #fter #ction Report
"ompensation"!aims nit
%eader
(ontact insurance carriers to initiatereim&ursement and claims procedures
(oordinate with Ris$ "anagement foradditional insurance and documentation
Documents and Too!s-mer*enc& Operations #!an inc!udin*1
Utility Failure +lan-mergency .perations +lan-vacuation) 1helter3in3+lace and !ospital #&andonment +lan#lternate (are 1ite plan5usiness (ontinuity +lan"emoranda of Understanding with appropriate entities2ischarge +olicy+aper charts and electronic medical record downtime procedures+atient) sta ) and e9uipment trac$ing procedures!ospital and campus maps) &lueprints and >oor plansRis$ (ommunication +lanInteropera&le (ommunications +lan2emo&ili'ation +lan