Emergency Response Procedures - Code Brown - South West ... · • the control of any media personnel and release of information • liaison between media and other hospital staff

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Emergency Response Procedures

Code Brown South West Health Campus

Date of Last Review: November 2017 Page 1 of 55 Date Next Review: November 2022

Effective: 17 November 2017

WACHS SOUTH WEST South West Health Campus

Code Brown – External Emergency

Table of Contents

1. Code Brown ........................................................................................................ 2

2. Introduction ......................................................................................................... 4

3. Code Brown Procedures ..................................................................................... 5

4. Action Cards - Code Brown Procedures ........................................................... 12

5. References ........................................................................................................ 36

6. Related Documents ........................................................................................... 36

7. Appendices ....................................................................................................... 37

CODE BROWN EXTERNAL EMERGENCY ........................................................... 42

ETHANE CUE CARD .............................................................................................. 42

Emergency Response Procedures - Code Brown – South West Health Campus


1. Code Brown

An external emergency is defined as a multi-casualty incident that stretches or overwhelms the available health resources, e.g. aircraft crash, structural collapse, explosion.

The Code Brown, External Emergency Response Procedure applies to all tenants of the South West Health Campus (SWHC) under the control of the WA Country Health Service South West (WACHS-SW) Emergency Controller Organisation.

At the South West Health Campus, Bunbury Hospital (BH), as the Regional Resource Centre, will play the primary role in treating casualties in an external emergency. St. John of God Bunbury Hospital (SJGBH) will provide support and assistance should the potential number of casualties from such a disaster appear to be beyond the resources of Bunbury Hospital. Administration and Governance

1.1 Authority to Plan

The South West Health Campus, Code Brown Emergency Response Procedure have been prepared and issued under the authority of the WACHS-SW Regional Director in accordance with applicable legal and other requirements. These Emergency Response Procedures have been formally recommended by the Bunbury Hospital, Emergency Controller endorsed by the Bunbury Hospital Operations Manager and approved by the WACHS-SW Regional Director as the Standard Operating Procedures to be followed in an emergency of any type at the Bunbury Hospital.

Recommended SWHC SSEG

Approved Jeremy Higgins

A/Operations Manager Bunbury Hospital

Date: 17 November 2017

Endorsed Kerry Winsor

Regional Director WACHS-South West

Date: 17 November 2017



1.2 Distribution and Availability

The current editable version of this Code Brown Emergency Response Procedure is held by the WACHS Policy unit. The procedures are available electronically to all staff via the WA Health intranet facility - HealthPoint. Hard copies of the SWHC Code Brown Emergency Response Procedure are to be held in Emergency Response Manuals.

Distribution and Availability Emergency Department Short Stay / Fast Track Intensive Care Unit / High Dependency Unit Subacute Unit Primary Health Service Ambulatory / Outpatient Services Medical Ward Paediatric Ward Surgical Ward Maternity Ward Theatre / HSSU Complex Hospital Management Patient Information Department Acute Psychiatric Unit Community Mental Health Local Emergency Operations Centre (LEOC) PathWest Pharmacy Security Supply SWHC Radiation Oncology Service SJGBH Administration

Action Cards for Code Brown are to be available across the facility at Muster Points. These Emergency Response Procedures have been distributed to the following:

NAME ORGANISATION POSITION Online Access via HealthPoint WACHS

Online Access vis EPPL SJGBH

https://healthpoint.hdwa.health.wa.gov.au/policies/Pages/default.aspx

https://healthpoint.hdwa.health.wa.gov.au/policies/Pages/default.aspx



2. Introduction

2.1 Aim

The South West Health Campus Code Brown, External Emergency Response Procedure details the arrangements adopted by the SWHC to coordinate the local response to an external emergency. The SWHC Code Brown procedure operates under the South West Regional Disaster Management Support Plan (draft at time of publication), WACHS Emergency (Disaster) Management Arrangements Plan and the State Health Emergency Response Plan (SHERP). The provision of emergency health services shall be based on the principle of a graduated response. The response should start at a local level with a gradual escalation to district and state (Western Australian) level as required with time.

2.2 Scope

The Bunbury Hospital Code Brown, External Emergency Response Procedure describes the prevention, preparedness, response and recovery for Code Brown where the resources of the facility are required as a part of a health response to an external emergency.



3. Code Brown Procedures

3.1 Activation

3.1.1 The Emergency Controller and Regional Health Disaster Coordinator

(RHDC) have the authority to activate a Code Brown and may do so: a) On the request of the State Health Coordinator (SHC), or nominated delegate. b) When large numbers of casualties present to the hospital unannounced, or c) On receipt of information relating to mass casualties from a credible source. d) The RHDC has authority to activate a regional wide emergency.

3.1.2 In the event of b), c) or d) the Emergency Controller and/or Regional

Health Disaster Coordinator shall notify the DPMU On Call Duty Officer (OCDO) contact (08) 9328 0553 of the Code Brown activation.

3.1.3 The decision to stand down a single or multiple health service(s) from an

external emergency shall be made by the SHC. 3.1.4 The Department of Fire and Emergency Services (DFES) or WA Police

(WAPOL) may advise on the evacuation of an area, floor or building.

3.1.5 The Emergency Controller will activate the Bunbury Hospital Code Brown in consultation with the Regional Health Disaster: External Emergency Procedure.

3.2 Resources

Should additional resources be required, the (or delegate) and Emergency Department (ED) Consultant in collaboration with, the Regional Disaster Health Coordinator will activate the WA Country Health Service - South West Regional Disaster Management Support Plan (draft at time of publication) or if necessary request activation of the State Health Emergency Response Plan (SHERP).

3.3 Local Emergency Operations Centre

The Local Emergency Operations Centre when activated will be located in: · Bunbury Hospital Management corridor – Bunbury Hospital Education Room · Analogue Phone: 9791 9824, · Fax: 9722 1017

3.4 Communication Arrangements

The preferred mode of communication is via landline.



3.4.1 Radio Communications § Document all radio transmissions relating to the emergency as per

Appendix 7.11 Communication log within the Emergency Control Centre.

§ All non-essential radios to be recalled to the Emergency Control Centre.

§ Radios are not to be used for general communication and this must be advised to regular internal radio users (security, PCAs, Health Commander).

§ Call sign for the Local Emergency Operations Centre: LEOC (“lima, echo oscar, Charlie”). Appendix 7.1 Phonetic Alphabet Chart.

§ Care needs to be taken regarding information relayed over the two-way radio; this is not a secure frequency and may have other people listening.

§ Do not use patient names/details. § List of all communication to and from the emergency controller on

Appendix 7.11 Communication log. 3.5 Media Enquiries

· Media communication is coordinated by the Bunbury Hospital, Operations Manager. A Media area should be established by the Emergency Controller for the WACHS-SW Regional Director / Operations Manager.

· The Conference Room at St. John of God Bunbury Hospital, via the Main Entrance, is recommended.

The Bunbury Hospital Operations Manager is responsible for: · the control of any media personnel and release of information · liaison between media and other hospital staff · responding to enquires of a non-official nature from the Health Service,

community or the general public · assistance with preparing media statements is provided by WACHS

Communication. 24/7 Phone - 6145 4166.

3.6 WebEOC

3.6.1 Log in at https://myeoc.health.wa.gov.au/eoc7/ Appendix 7.2 Logging onto WebEOC

3.6.2 WebEOC is a web based Incident Management System that facilitates response and recovery agencies to access relevant incident information. It allows agencies to communicate and collaborate in real time during special events and disasters.

3.6.3 The primary functionalities of the WebEOC are: § Internet based Incident Management System. § Supports multiple incidents and Emergency Operation Centre's (EOCs). § Information sharing between agencies (government, non-government

and private sector) if required. § Ability to effectively and efficiently manage information, tasks and

resource allocation. § Common operating picture. § Information gathering outside an EOC. § Common incident control system across all agencies (terminology). § Real time information sharing.

https://myeoc.health.wa.gov.au/eoc7/



3.7 Hospital Response Team

· Where the State Health Coordinator or the Regional Health Disaster Coordinator requests a Hospital Response Team (HRT) to attend the site and provide medical assistance, the Emergency Department will provide a team. The make-up of the team will depend on staff availability. Regional hospitals minimum capability is for the team to consist of one doctor and two nurses. (Reference: p16 State Health Emergency Response Plan (SHERP) .

· The Emergency Controller in consultation with the St John Ambulance (SJA) Commander will arrange for SJA to collect and transport the team to the incident sites Casualty Clearing Post (CCP).

· Disaster Response Kits (DRK’s) shall be in accordance with Operational Directive OD 0483/14.

3.8 Call in Procedure for Staff

· On confirmation of a major incident staff maybe called in. · Staffs rostered for the next shift are not usually contacted in the first instance. · All Heads of Departments will be expected to call in their own staff as

necessary. · Appendix 7.7 Staff call in log

Note: Staff called in must remember to present with ID.

3.9 Decanting of Patient

· Decanting is the discharging or transferring of patients out of the hospital, in order to make beds available for casualties that will require hospital admission because of a major incident. No patients are to be discharged or transferred until authorised by the Emergency Controller.

· Patients are reviewed by medical officer and Nurse Unit Manager (NUM) / Shift Coordinator to determine transfer or discharge.

· Patients considered suitable for discharge, where possible will have prescriptions supplied. Appropriate discharge letters, instructions and arrangements are made. Relatives or friends may be requested to collect patients.

· Patients for transfer have medical records, medications and belongings made available to go with them. The Emergency Controller and Regional Health Disaster Coordinator and/or State Health Incident Coordination Centre make arrangements for transfer and transport.

3.10 Hospital Set Up for Reception of Casualties

3.10.1 Relative Reception Area § Purpose – provide coordinator and support to relatives of casualties. § Located at the Primary Health Service Occupational Therapy Area. § Managed by the Senior Social Worker or delegate.

3.10.2 Survivor Area § Purpose – provide coordination and support to survivors of the incident. § Located at the Primary Health Department. § Managed by the Medical NUM or delegate.

http://graylands.health.wa.gov.au/emergency/STATE%20HEALTH%20EMERGENCY%20RESPONSE%20PLAN%20(INTERIM)%20MAY%202016.pdf

http://www.health.wa.gov.au/circularsnew/pdfs/13046.pdf

http://www.health.wa.gov.au/circularsnew/circular.cfm?Circ_ID=13046



3.10.3 Media Announcements

§ Purpose – provide coordinated media announcements. § Located at the Conference Room at SJGBH. § Managed by the Senior Social Worker or delegate.

3.10.4 Volunteer Coordination

§ Purpose – provide coordination of volunteers. § Located at the SJGBH Meeting Room or other nominated venue. § Managed by the Admin Assistant to the Medical Administrator or

delegate.

3.11 Phases of an Emergency

Typically, phases occur in a sequential order but significant overlap in phases often occurs. While an emergency response would normally be activated in phases, in an impact event these phases may be condensed with phases being activated concurrently. Phase 1 - Alert (there is a possible Emergency which is being confirmed) The alert phase is activated when advice of an impending or potential emergency is received or when following the occurrence of an event, it is unclear as to whether a health response is required. During this stage the situation is monitored by the Emergency Controller to determine the likelihood and nature of the health emergency response and resource requirements assessed.

Actions: § The Emergency Controller liaises with effected services to determine the extent

of the health response required. § The Emergency Controller alerts own personnel, placing site on Code Brown -

Alert. § Follow local escalation process to inform management staff including after

hours. § Review Medical and Nursing staff availability. § Review Bunbury Hospital bed availability and identify patients for discharge or

transfer. § Review Theatre availability. § Preparation of the Emergency Department.

Phase 2 - Standby (the emergency is imminent, prepare for response) Standby is activated when the information received is sufficient to warrant preparatory activities in readiness for a response.

Actions § The Emergency Controller alerts own personnel, placing site on Code Brown -

Standby, hospital begins to prepare resources and receive patients. § Preparations, which may include: § Standby for the most appropriately located Hospital Response Team (MIMMS

trained).



§ It should be recognised that medical and nursing resources at Bunbury Hospital may be best utilised in the ED rather than deploying essential staff to the site of the incident.

§ Hospital Response Team preparation of Disaster Response Kits Disaster Response Kits

§ SJGBH Incident Controller (Chief Executive Officer or After Hours Hospital Coordinator) are notified and confirmation of number of casualties able to be accepted and theatre capacity is determined by SJGBH.

§ The SJGBH Incident Response team will locate to a designated area as determined by the BH Emergency Controller for briefing and management of incident. It is preferable that this area is within close proximity to the Local Emergency Operations Centre at Bunbury Hospital

Phase 3 - Response (the emergency exists and a response is required) Response phase is activated when a health emergency management response is required and resources are deployed accordingly.

Actions may include: § patients are received and / or § deployment of the Hospital Response Team /s (MIMMS trained staff) to attend

the emergency site. If this occurs, upon arrival the first team from Bunbury should then return to the Bunbury Hospital.

Phase 4 - Stand Down (the emergency has abated and recovery activities can begin) The stand down phase is activated by the State Health Centre once there is confirmation that Bunbury hospital response is no longer required and WACHS-SW can resume normal business, despite continuing to provide recovery services.

Actions may include: § Emergency Controller informs site of “stand down”. § Debriefing occurs – see individual Action cards. § Resources restocked. § Reports written and tabled at the WACHS-SW South West Executive

Emergency and Disaster Sub-Committee Emergency and South West Health Campus Safety, Security and Emergency Governance Committee for action plan development.

§ Alterations to plans, procedures and processes made as necessary.





3.12 Chain of Command

Level of Response WA Country Health Service (WACHS) Response

Hospital Response The Emergency Controller (EC) is the

Coordinator of Nursing and Midwifery or the Clinical Nurse Manager After Hours (holder of 1262) The EC activates the Code Brown emergency, manages the emergency response and contacts the Regional Health Disaster Coordinator

(RHDC) when local capacity to manage is exceeded or a Hospital Response Team

is required.

Regional Response The Regional Director is the RHDC. The RHDC activates the WACHS, Regional Emergency Operations Centre (REOC)

and notifies the SHICC On Call Duty Officer (OCDO) and the Chief Operating Officer (Area Health Disaster Coordinator

– AHDC)

Area Response The Chief Operating Officer (COO), or

their delegate, acts as the WACHS Area Health Disaster Coordinator (AHDC). The

AHDC maintains communications with the RHDC and the State Health Coordinator (SHC). The AHDC

represents WACHS at State Health Incident Coordinator Centre (SHICC).

State Response State response coordinated through the On Call Duty officer (OCDO) and State

Health Coordinator (SHC) at State health Incident Coordination Centre (SHICC).

WACHS LOCAL RESPONSE

Emergency Department

Coordinated by the ED Coordinator

WACHS REGIONAL RESPONSE

Activation of a Hospital Response Team is a Regional

Response that occurs through the hospital by the EC

and RHDC.

Incident Site Health Commander,

if deployed, commands Hospital Response Team/s.

SJGBH CEO/After Hours Hospital Coordinator

WACHS AREA RESPONSE

STATE RESPONSE

State Health Incident

Coordination Centre activated by

State Health Coordinator.



3.13 Incident Notification

Receiving Incident Notification

§ Upon receiving any call pertaining to an external emergency, the staff member should have this call transferred to the ED designated analogue phone (9791 9827) if not received by Code Brown phone.

§ If call obtained in ED the following information shall be obtained: § The Emergency Department Shift Coordinator (Area Warden) or

appropriate/clinical staff member in ED will obtain the following information and document on the CETHANE Card: Appendix 7.3 - Caller’s name, position, location, service and telephone number. - Exact location of the incident. - Type of Incident (e.g. Road, rail, air incident). - Hazards that are present and anticipated. - Access road for emergency vehicles to use. - Number and severity of casualties (may be a rough estimate). - Emergency services that are already present and those that are

required.

Initial Communication Summary

CETHANE received in ED on 9791 9827. Verify the call, by contacting the organisation that the caller is representing (ED Shift Coordinator). The ED shift coordinator (Area Warden) briefs the ED Consultant (ED Medical Coordinator). ED Shift Coordinator (Area Warden) contacts Emergency Controller on 1262. Emergency Controller (holder of 1262) activates Code Brown, advises the stage and the LEOC.



4. Action Cards - Code Brown Procedures

4.1 Action Card 1: ED Medical Coordinator

ED Medical Coordinator: Senior Medical Officer < Ext 1290 >

Reporting to: Chain of command The ED Medical Officer will take direction from the Emergency Controller and keep the following roles informed: § Critical Care Directorate NUM < Ext 2257 > Mobile < 0428282709 > § ED Shift Coordinator < Ext 1216 >

Responsibilities: The ED Medical Officer will direct and communicate with the following roles – § ED Medical Staff § Relevant Specialties

ON ALERT: Advice of an impending emergency. Initial and Time

1. Put on the tabard and take command of the ED medical response

2. Carry the DECT 1290 phone at all times.

3. Confirm the CETHANE report and any updates with the Emergency Controller (Appendix 7.3)

4. Commence the Decisions / Events Log (Appendix 7.4)

STANDBY: Commence preparatory activities in readiness for a response. Initial and Time

1. Brief the medical staff and prepare to receive victims/review current patient and dispositions

2. Allocate doctors to teams as necessary

CONFIRMED: A health disaster management response is required. Initial and Time

1. Communicate with LEOC via the Critical Care NUM re any relevant updates from the scene arriving directly to the ED via radio, person or phone.

2. Determine need and feasibility of sending a Hospital Response Team and/or a Site Health Commander. (Current list displayed in LEOC)

3. Ensure Triage and Treatment of patients and establish patient flow through the ED in liaison with Shift Coordinator

4. Assist in collecting and recording of numbers and types of injured on patient tracking board EDIS/WEBPAS.



5. Determine need for extra medical resources.



6. In conjunction with Critical Care NUM, determine an appropriate holding area for patients awaiting transfer. Communicate decision to LEOC and Critical Care staff.

7. Ensure medical staff safety, welfare and refreshment.

8. Ensure Triage and Treatment of patients and establish patient flow through the ED in liaison with Shift Coordinator

9. Refrain from patient contact.

STAND DOWN: The disaster response is no longer required. Initial and Time

1. Inform staff of Stand Down from Code Brown

2. Identify and facilitate actions required to return department to normal operational function.

3. Facilitate organisational debrief for the department ensuring staff complete all formal documentation before being released from duty

4. Finalise all formal documentation

Signature:

Forms Required: · Major Incident Medical Log (Appendix 7.5) and / or · Decisions / Events Log (Appendix 7.4) · Staff contact list · CETHANE (Appendix 7.3)



4.2 Action Card 2: ED Area Warden

ED Area Warden: Emergency Department Shift Coordinator < Ext 1216 >

Reporting to: Chain of command The ED Shift Coordinator will take direction from and keep the following roles informed: § Emergency Controller < Ext 1262 > Mobile < 0417904903 > § Critical Care NUM < Ext 2257 > Mobile < 0428282709 >

Responsibilities: The ED Shift Coordinator will direct and communicate with the following roles: § ED Nursing staff § ED PCA’s § ED Clerical staff § ED Medical Coordinator


1. Record all information received on the CETHANE form (Appendix 7.3)

2. Confirm information received from credible source (SJA, Police, FESA)

3. Brief the Emergency Controller (holder of 1262) of CETHANE information

4. Brief ED Senior Medical Officer who will assume role of ED Medical Coordinator.

5. Brief Emergency Department

6. Delegate the ED Shift Coordinator’s usual responsibilities to an appropriate nursing staff member within the Emergency Department.


1. 1262 confirm standby

2. Don the Area Warden vest and maintain “communication log”

3. Liaise with the ED Medical Coordinator regarding required resources

4. Initiate Disaster Module of EDIS (utilise whiteboard in case of ICT failure).

5. Brief staff and delegate roles within Emergency Department

6. Escalate and prioritise patient disposition from Emergency Department via NUM/CNS

7. Brief Emergency Controller on capacity and resources required via NUM/CNS




1. Provide regular updates to Emergency Controller; including a summary of arrivals linked to code brown, triage categories dispositions linked to Code Brown, need for additional resources. Delegate to staff member/NUM

2. Ensure staff safety, welfare and refreshment.

3. Refer any media enquiries to Operations Manager

4. Monitor and establish appropriate contingencies as they arise




3. Participate in organisational debrief for the department


Signature:

Forms Required: · Major Incident/Medical Log (Appendix 7.5) and / or · Decisions / Events Log (Appendix 7.4) · Patient (tracking) Log (Appendix 7.6) · Staff Call In Log (Appendix 7.7) · CETHANE Cue Card (Appendix 7.3)



4.3 Action Card 3: ICU Area Warden

ICU Area Warden: ICU Shift Coordinator < Ext 1217 >

Reporting to: Chain of command The ICU Area Warden will take direction from and keep the following roles informed: § Emergency Controller < Ext 1262 > Mobile < 0417904903 > § Critical Care NUM < Ext 2257 > Mobile < 0428282709 > § ICU Shift Coordinator < Ext 1217 > § ED Shift Coordinator < Ext 1216 >

Responsibilities: The ICU Area Warden will direct and communicate with the following roles: § ICU Nursing Staff § ICU PCA’s § ICU Clerical Staff

The ICU Area Warden will have responsibility for coordinating the transfer of patients from the ICU area.


1. Don the Sticker/Tabard “ICU Coordinator”

2. Carry DECT phone 1217


1. Brief staff on expected roles including allocation of patients and preparation for admissions.

2. Liaise with medical staff to determine resources availability.

3. Establish a Medical Coordinator for ICU


1. Determine in conjunction with the ICU Medical Coordinator, initial resources required for ongoing management of patients.

2. Communicate regularly with the ED regarding the situation in the ICU.

3. Ensure staff safety, welfare, and refreshment.

4. Requests go to the LEOC for more resources as needed.

5. Communicate regularly with LEOC at a regular predetermined time.








Signature:

Forms Required: · Major Incident/Medical Log (Appendix 7.5) and / or · Decisions / Events Log (Appendix 7.4)



4.4 Action Card 4: Survivor Area Coordinator

Survivor Area Coordinator: Medical NUM < Ext 1355 >

Reporting to: Chain of Command The Survivor Area Coordinator will take direction from and keep the following roles informed: § Emergency Controller < Ext 1262 > Mobile < 0417904903 >

Responsibilities: The Survivor Area Coordinator will provide support and assistance to patients in this area.

Location: Primary Health Department (following clearance from Emergency Department)


1. Medical NUM is to organise further staff as required

2. Patient Information Coordinator will delegate a clerk to assist with record management

3. Medical NUM to liaise with PCA Coordinator for provision of beverages as required

4. For assistance in setting up this area contact the Social Worker covering the Relatives Reception Area located in the Primary Health Services Occupational Therapy area






Signature:




4.5 Action Card 5: Relative Reception Area Coordinator

Relative Reception Area Coordinator: Senior Social Worker < Ext 1302 >

Reporting to: Chain of command The Relative Reception Area Coordinator will take direction from and keep the following roles informed: § Emergency Controller < Ext 1262 > Mobile < 0417904903 > § Allied Health Manager < Ext 1423>

The Relatives Reception Area Coordinator will direct and communicate with the following roles: § Allied Health Manager < Ext 1423 >

Responsibilities: The Relative Reception Area Coordinator will support and coordinate relatives within this area. Location: The Relative Reception Area will be located in the Primary Health Service – Occupational Therapy Area (e block and zone)


1. Setting up of tables, chairs, coffee/tea dispenser.

2. Call in other staff as needed

3. On arrival to the designated area, relatives/friends will be asked to register on Relative Register (Appendix 7.8).






Signature:

Forms Required: · Major Incident/Medical Log (Appendix 7.5) and / or · Decisions / Events Log (Appendix 7.4) · Relative Register (Appendix 7.8)



4.6 Action Card 6: Volunteer Registration Coordinator

Volunteer Registration Coordinator: Admin Assist to Medical Administrator < Ext 1420 > Reporting to: Chain of Command The Volunteer Registration Coordinator will take direction from and keep the following roles informed: § Emergency Controller < Ext 1262 > Mobile < 0417904903 >

Responsibilities: The Volunteer Registration Coordinator will monitor and track all volunteers. Location: SJGBH Meeting Room or nominated place.


1. In the event of a major incident it is likely that BH will have many people volunteering assistance, including in many instances off-duty staff.

2. Proceed to nominated Volunteer Registration Area,

3. Inform Local Emergency Control Centre and Switchboard of the confirmed location and contact details.

4. Arrange for all volunteer name badges to be forwarded to location (currently in front office) LEOC.

5.

It is vital to maintain a register of all volunteers (including off-duty staff) listing the following information – refer to Form Number 3 in this plan:

· Full name

· Address

· Contact number

· ID details e.g. Staff ID, nursing registration card, drivers licence etc.

· Special skills e.g. first aider, counselling, nurse etc.

· Date and time available for.

· Any special requirements e.g. dietary, medical conditions that may impact on tasks allocated.

· Allocation of WACHS-SW volunteer badge ID number.

6

Volunteers who are assisting with transport should be asked to report to Supply or Security who will arrange a motor vehicle. Note: Volunteers need to take their driver’s licence to Supply if they have not previously been registered.

7 Track all volunteer shift lengths. Consider that volunteers may be unsafe to drive home and will require transport home and back to site.




· Arrange for volunteers to attend defusing prior to leaving site and inform of arrangements for debriefing.





Signature:

Forms Required:

· Volunteer registration log (Appendix 7.9)



4.7 Action Card 7: Theatre Area Warden

Theatre Area Warden: Theatre Coordinator or delegate < Ext 1224 >

Reporting to: Chain of Command The Theatre Area Warden will take direction from and keep the following roles informed: § Emergency Controller < Ext 1262 >Mobile < 0417904903 >

Responsibilities: The Theatre Coordinator is the NUM or a senior nurse rostered in Theatre; their role is to co-ordinate the management of all staff and patients within the operating suite, including Day stay.


1. Note: Role is not be involved in direct patient care.

2. Attend the LEOC for briefing and to establish the extent of Theatre involvement in the emergency.

3. Determine the availability of each theatre (time and staff).

4. Calling in theatre staff. Ensure a call in register is maintained and that the LEOC has been informed.

5. Cancel elective theatre cases under direction of LEOC.

6. Liaise with Day stay to clear the day procedure area in preparation to receive patients as directed.

7. Liaise with LEOC about providing staff as necessary (medical, nursing, anaesthetic techs, patient care assistants) or SJGBH.

8. Contact LEOC to organise all resources. E.g. Radiology, Blood, pathology, beds, stores or SJGBH

9. Discuss with HSSU availability of equipment and resource required compile inventory summary.

10. Be at the centre of communication for the available team.

11. Monitor staff for fatigue and implement fatigue management strategies.

12. Participate and facilitate staff debriefing prior to staff leaving the shift and in the formal debriefing post event








Signature:

Forms Required: · Major Incident/Medical Log (Appendix 7.5) and / or · Decisions / Events Log (Appendix 7.4) · Staff Call in Log (Appendix 7.7)



4.8 Action Card 8: Emergency Controller Emergency Controller: CONM or delegate (Hospital Coordinator After Hours until relieved by a more senior staff member) < Ext 1262 > Reporting to: Operations Manager < Ext 1421 >Mobile<0408219331 and Regional Health Disaster Coordinator < Ext 2309 >Mobile< 0407988161

Responsibilities: Alert and control the health response to an external emergency.


1. DON the tabard and commence the role of SWHC Emergency Controller.

2. Assess the situation using the information provided using a CETHANE (Appendix 7.3).

3. Notify the SHICC ODCO Ph: (08) 9328 0553

4. Proceed to and activate the LEOC (Ph: 9791 9824)

5. Activate the Communication Plan in conjunction with the Code Brown

6. Provide a CETHANE to Regional Health Disaster Coordinator (Regional Director). Operations Manager, NUMS, SJGHB Incident Controller

7.

Operations manager to provide CETHANE and updates to coordinators of: § HSSU § Patient Information § Pharmacy § Engineering § Clerical/ administration staff


1. Determine the level of response required in consultation with the ED FACEM (ED consultant on duty).

2. At this point the Emergency Controller must consider if the hospital is able to manage within existing resources or consider if a regional response is required.

3. Ensure communication update times (1/2 hourly) are established with key personnel (Operations Manager, SJGBH CEO, NUMS, HCAH etc.)



4.

Notify § Switchboard Operator to advise staff via PA/ pager to be on Code

Brown standby. § Liaise with the Emergency Department Shift Coordinator and / or

Senior Doctor in the Emergency Department of updated details (CETHANE) (Appendix 7.3)

§ Ensure RFDS and SJA have been notified. § Consult with ED Shift Coordinator/NUM regarding resources required

5. Request the NUMs/Ward Coordinators to deploy staff to the Emergency Department to assist with disaster preparedness if deemed appropriate by ED Coordinator/NUM

6. Authorise the cancellation of elective surgery and elective admissions.

7.

Respond to requests for dispatching a Health Commander / Hospital Response Team to the disaster site are to be coordinated through the Emergency Controller in consultation with the ED Medical Coordinator. A list of WACHS-SW MIMMS trained staff to attend disaster sites is contained in the Emergency Control Operation Centre, ED Disaster Supply Room and the website.

8. Receive document and respond to all communications


1. Instruct the Communications Officer to activate the Emergency Management Team ‘Confirmed Code Brown’ via All Call Group page

2.

Activate the PA system for the facility and make the Confirmed announcement. “Attention all areas (2): This is the Emergency Controller. This is to notify of a Code Brown Confirmed status. Can all Clinical Nurse Managers and Heads of Department please assemble in the LEOC in 5 minutes for a SITREP. (Repeat)

3. Confirm contact with the State Health Incident Coordinator Centre (SHICC) OCDO by dialling (08) 9328 0553 if appropriate

4. In conjunction with the allocated Medical Officer provide instructions to clear the Hospital of all non-urgent patients.

5. Where a health response is required, activate Code Brown disaster plan

6. Where notified by a relevant authority that a health response is not required carry out Code Brown all clear actions






3. Facilitate organisational debrief for the department ensuring staff complete all formal documentation before being released from duty


Signature:

Forms Required: · Major Incident/Medical Log (Appendix 7.5) and / or · Decisions / Events Log (Appendix 7.4) · CETHANE cue Card (Appendix 7.3)



4.9 Action Card 9: Switchboard Operator

Switchboard Operator: Switchboard Operator < Ext 9 >

Reporting to: Emergency Controller < Ext 1262 > Mobile < 0417904903 >

Responsibilities: To assist with communication, clerical and record maintenance during and emergency response.


1. Note: All media enquiries will be directed to WACHS-SW Operations Manager. * Calls to Emergency Department are to be filtered

2.

Alert ALL pagers advising “Code Brown External Emergency” with the relevant status state: § Alert, or § Standby, or § Initial response, or § Stand down.

Announce the same over the PA system.

3.

The alert stage is activated when advice of an impending or potential emergency is received or when following the occurrence of an event, it is unclear as to whether a health response is required. During this stage the situation is monitored to determine the likelihood and nature of the health emergency response.

4. The switchboard operator will be notified by the Emergency Controller of Alert status.

5. Switchboard operator notifies: NUMs, PCA Coordinator, Security, and Patient Information Manager of Code Brown alert.

6. Ensure there is an updated list of essential staff listed in Stage 2 “Standby”




1. Standby is activated when information received is sufficient to warrant preparatory activities in readiness for a response.

2.

As directed by the Emergency Controller request attendance on-site from the South West Management Group, SJGBH, Path West and Global Diagnostics. inform each person they have to log in with the Emergency Controller once they have arrived on-site:

· Coordinator Of Nursing (if not already in the hospital)

· On-call Emergency Department Consultant

· On-call Theatre Team (if not already in the hospital), including Surgeon, Anaesthetist and Orthopaedic Surgeon.

· All the Nursing Unit Managers – Critical Care, Theatre, Surgical, Medical, Paediatrics, Maternity and Sub Acute Restorative Unit.

· Operations Manager.

· GDA - Radiologist and CT

· Hotel Services Manager

· Path West Manager

· HSSU Coordinator

· Pharmacist

· Combined Facilities Manager (may require immediate notification)

· Patient Information Manager

· ICT Manager

· Security

· SJGHB Hospital Co-Ordinator (notification only). Note: All Heads of Departments will be expected to call in their own staff as necessary.


1. Initial response stage is activated when a health emergency management response is required and resources are deployed accordingly.

2. Switchboard may be directed by Emergency Controller / LEOC to announce Code Brown Response.




1. Switchboard may be directed by Emergency Controller / LEOC to announce Code Brown Stand Down.

2. When emergency situation has ended and when instructed by the Emergency Controller, activate “Code Brown External Emergency – Stand Down” on all pagers and PA announcement.

3. Direct all volunteers, including off-duty staff to the Volunteer Registration Area. Location: Acute Care Meeting Room





Signature:

Forms Required: · Decisions/ Events Log (Appendix 7.4) · Staff contact lists · Specialists Availability list (Appendix 7.10)



4.10 Action Card 10: Area Wardens

Area Wardens: NUMs (or delegates) / Managers of services

Reporting to: Emergency Controller < Ext 1262 > Mobile < 0417904903 >

Responsibilities: It is anticipated that an area warden will have delegated responsibility for their ward /department and must carry allocated DECT phone for their area.


1. The area warden contacts the LEOC and nominates incoming and outgoing phones numbers

2. AW is the primary contact for that area to communicate with the LEOC and provide continuous update reports to the Emergency Controller at times predetermined in the initial briefing.

3. Perform location and emergency specific actions required to ensure the safety of patients, staff, visitors and property.

4. The AW is to liaise with medical staff re; potential discharges or transfers and communicate this information to LEOC.

5. Determine requirement for volunteers and tasks that may be allocated from each ward area e.g. feeding, toileting patients, first aid, cleaning etc.

6. Ensure delegated areas of responsibility are staffed for this shift and next.

7. In the event of ongoing disaster management – longer shifts may be required. It is important to negotiate with staff time on and off requirements, contact details etc.

8.

Monitor staff for fatigue and implement fatigue management strategies, including Track shift length of staff and consider that staff / volunteers may be unsafe to drive home and will require transport home and back to the site.

9. Any staff member called in to assist in an emergency needs to be listed on Daily Planning sheets with details of designation, time on/off duty.

10. Provide updated information regarding expected patient case mix and any other changes that affect resource requirements to the Emergency Controller BH LEOC.

11. Inform the Emergency Controller of outstanding issues that require direction or decision, utilizing the Decisions / Events Log








Signature:




4.11 Action Card 11: Communication Officer/s

Communication Officer/s: Administration Assistants < Ext 1428 >

Reporting to: Emergency Controller < Ext. 1262 >

Responsibilities: To assist with communication, clerical and record maintenance during and emergency response.


1.

Notify and confirm with Switchboard the Emergency Control Operations Centre extension number(s) and fax number if standard numbers are not able to be used

· Extension number for internal call

· Extension number for external calls

2. Document all telephone/fax communications related to the emergency within the Emergency Control Operations Centre, as per form Phone Communication Log Appendix 7.11 or into WEBEOC.

3. Responsible for maintenance of Emergency Response Resource Telephone.

4.

Activate the “call forward” numbers from the ECC dedicated analogue line number 97919824 to extra phones within the admin corridor as required. Procedure: Press*24 on 97919824 (which is a dedicated analogue line separate to PABX) and enter forward number followed by #. To deactivate press #24# and hang up. To activate call forward from the internal number nominated (now part of the PABX system) press *3 enter the next number and hang up Repeat this *3 procedure to activate other internal phones Press *3 to deactivate the call forward option on all internal phones

5. Refer to communication instruction sheet and action card

6. Document all communication including date, time, caller, calling to and summary of information provided / requested. Inform the caller that you will get back to them with a decision / information.

7. Relay all requests for information, supplies etc. to the Emergency Controller for decision and instruction.

8. Inform the Emergency Controller of all outstanding issues that still require decision / instruction.



9. Take Dictaphone to theatre for use by Surgeon (a dedicated one is available in theatre).

10. Access list of accredited GPs as required.

11. Access the list of MIMMS qualified staff from the Executive Secretaries in the LEOC as required.






Signature:

Forms Required: · Major Incident/Medical Log (Appendix 7.5) and / or · Decisions / Events Log (Appendix 7.4) · Phone Communication Log (Appendix 7.11)



4.12 Action Card 12: Medical Administrator

Medical Administrator: Medical Administrator or Delegate < Ext 1426 >

Reporting to: Regional Health Disaster Coordinator < Ext 2309 > Mobile < 0407988161 > and Operations Manager < Ext 1421 > Mobile < 0408219331 > Responsibilities: Medical Administrator will attend the LEOC and ensure close communication with Emergency Controller, ED Medical Coordinator, Surgical Coordinator all relevant medical staff and coordinate medical resources as directed by the LEOC


1. Medical Administrator will attend the LEOC and ensure close communication with Emergency Controller and all relevant medical staff

2. Coordinate medical resources as directed by the Emergency Controller






Signature:

Forms Required: · Major Incident/Medical Log (Appendix 7.5) and / or · Decisions / Events Log (Appendix 7.4) · Available Specialists and GPs (Appendix 7.10)

Volunteer Registration Coordinator



5. References

WA Health System Management Arrangements

SHERP

WACHS Emergency (Disaster) Management Arrangements Policy

6. Related Documents

WA health system:Mandatory Policy MP 0073/17 Emergency Management Policy

WACHS South West Emergency Management Plan WACHS South West Emergency Management Manual Business Continuity Plan – Bunbury Hospital Emergency Response Procedures – South West Health Campus Western Australian Disaster Hospital Response Team Subplan (May 2012) Department of Health (WA) Surge Management Plan 2010

Australian Standard: AS 4083-2010: Planning for Emergencies – Health Care Facilities Australian Standard: AS 3745-2010: Planning for Emergencies in Facilities

Contact: Coordinator of Nursing (Y. Bagwell) Directorate: Operations TRIM Record # ED-CO-17-73706

Version: 1.00 Date Published: 17 November 2017

http://ww2.health.wa.gov.au/%7E/media/Files/Corporate/general%20documents/emergency%20disaster/PDF/WA-Health-Emergency-Management-Arrangements.pdf

http://www.google.com.au/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&uact=8&ved=0ahUKEwjxzoGT9LzXAhUMgrwKHSkRByYQFggsMAE&url=http%3A%2F%2Fww2.health.wa.gov.au%2F%7E%2Fmedia%2FFiles%2FCorporate%2Fgeneral%2520documents%2Femergency%2520disaster%2FPDF%2FState-health-emergency-response-plan.pdf&usg=AOvVaw2ChYgZZKDvRkeSderroVxs

https://healthpoint.hdwa.health.wa.gov.au/policies/_layouts/DocIdRedir.aspx?ID=TS4KSNFPVEZQ-89-1435

http://www.health.wa.gov.au/CircularsNew/circular.cfm?Circ_ID=12559







http://www.public.health.wa.gov.au/cproot/2527/2/wa-health_disaster-hospital-response-team-subplan-final-may-2012.pdf

http://www.public.health.wa.gov.au/cproot/3732/2/20100728%20Metro%20Surge%20Plan%202010-%20FINAL.pdf

http://www.saiglobal.com.wachslibresources.health.wa.gov.au/online/





7. Appendices

South West Forms

Appendix 7.1 Phonetic Alphabet Chart

Appendix 7.2 Logging onto WebEOC

Appendix 7.3 CETHANE cue sheet

Appendix 7.4 Decisions / Events Log

Appendix 7.5 Major Incident / Medical Log

Appendix 7.6 Patient Log (replicates EDIS disaster module in case data entry required)

Appendix 7.7 Staff Call in Log

Appendix 7.8 Relative Register

Appendix 7.9 Volunteer Register

Appendix 7.10 Available Specialists and General Practitioners

Appendix 7.11 Phone Communication Log

Appendix 7.12 Bed Occupancy Status (bed management system or census)

Appendix 7.13 MIMMS Sites Disaster Phone Numbers

Appendix 7.14 MIMMS trained staff list

Appendix 7.15 Notification of Incident



APPENDIX 7.1 PHONETIC ALPHABET



APPENDIX 7.2 LOGGING ON TO WEBEOC https://myeoc.health.wa.gov.au/eoc7/

https://myeoc.health.wa.gov.au/eoc7/







APPENDIX 7.3 ETHANE CUE CARD

CODE BROWN EXTERNAL EMERGENCY

ETHANE CUE CARD

Caller identified …………………………………………………………………………

Exact location of disaster ……………………………………………………………………………

Type of incident ……………………………………………………………………………

Hazards present ……………………………………………………………………………

Access to the site ……………………………………………………………………………

Number of casualties ……………………………………………………………………………

Emergency Services (present and required)…………………………………………………………



APPENDIX 7.4 DECISIONS / EVENTS LOG

Decisions / Events Log

DATE / TIME EVENT / ISSUE KEY DECISIONS AND ACTIONS OUTCOME SIGN



APPENDIX 7.5 MAJOR INCIDENT / MEDICAL LOG

Major Incident / Medical Log · Once completed this is a Legal Document.

Date and Time Key Decisions and Actions





APPENDIX 7.6 Patient Log

Replicate EDIS disaster module in case data entry required

Used in conjunction with the triage board in ED by the triage nurse (and used to update the Emergency Controller)

NAME TIME IN AREA CATEGORY PRESENTING COMPLAINT TREATMENT TIME

OUT DESTINATION



APPENDIX 7.7 STAFF CALL-IN LOG Staff “Call In” Log

Name Role Time In Time Out Sign



APPENDIX 7.8 RELATIVES REGISTER

Relatives Register Name Contact Address Contact Numbers Person waiting for



APPENDIX 7.9 VOLUNTEER REGISTER

Volunteer Register

Completed by clerical staff. Credentialing completed by Bunbury Hospital ECC

Name Address Contact Number

ID (D/L, Nursing

Reg) Special Skills

Date and Time

Available

Any Special Requirements E.G. Dietary,

Medical

ID Badge Issued

Copy Of Driver's License



APPENDIX 7.10 AVAILABLE SPECIALISTS AND GENERAL PRACTITIONERS

Available Specialists and General Practitioners

Completed by clerical staff and used to update the Emergency Controller

NAME CONTACT NUMBER SPECIALTY TIME AVAILABLE ID BADGE ISSUED



APPENDIX 7.11 COMMUNICATION LOG

Phone Communication Log NAME of Officer Completing Log._________________________

Date Time Phone call FROM:

Phone Call TO:

Purpose in Calling Actions Arising Sign



APPENDIX 7.12 BED OCCUPANCY STATUS Bed Occupancy Status (bed management system or census)

Compiled by ward staff and provided to the Emergency Controller

Bed Number Bed Available Potential Discharge Time Bed Available Comments



APPENDIX 7.13 MIMMS SITE DISASTER PHONE NUMBERS MIMMS Sites Disaster Phone Numbers – Please refer to Emergency Control Centre for current list



APPENDIX 7.14 MIMMS TRAINED STAFF

MIMMS Trained Staff Please refer to the Emergency Control Centre for the current list



APPENDIX 7.15 NOTIFICATION OF INCIDENT Notification of Incident – Sit Rep can be found below http://wachs.hdwa.health.wa.gov.au/index.php?id=6509

http://wachs.hdwa.health.wa.gov.au/index.php?id=6509


This information is available in alternative formats for a person with a disability. Copyright to this material is vested in the State of Western Australia unless otherwise indicated. Apart from any fair dealing for the purposes of private study, research, criticism or review, as permitted under the provisions of the Copyright Act 1968, no part may be reproduced or re-used for any purposes whatsoever without written permission of the State of Western Australia.