HAYWOOD REGIONAL MEDICAL CENTER

ELECTRICAL FIRE&

HOSPITAL EVACUATIONNC Emergency Management Association Conference

Greg Shuping- Haywood County Emergency Management

Marty Stamey- Hospital Operations & Emergency Management

Hospital Demographics Main Structure- 7 Story, 190,000sf 169 Bed Facility 17 Bed Emergency Department 16 Bed Behavioral Health Unit County Population 60,000

Hospital Census Prior to the FIRE

TOTAL- 75PCU- 16ICU- 3Women’s Care- 4

○ Active Labor- 2Med Surg.- 18BHU- 16ED- 16

○ IVC- 4

June 19, 2014

18:28Pull Station Fire Alarm received at the 911

Center.Upgraded to a full alarm assignment based

on multiple callers reporting heavy smoke from the electrical room.

18:33First units arrive, smoke showing from rear

loading dock area.

June 19th, 2014

Incident Command established by Fire Department

• Hospital, EM, EMS, Law Enforcement leadership at the command post to ensure effective decision-making.

• Accountability an issue with such a large building.

• High stress and chaotic environment for the first 15-30 minutes.

June 19, 2014 18:53

Fire Under ControlSmall Fire confined to the Electrical Room area, but with

HUGE consequences to Hospital Operations.Additional Hospital administration arriving.Hospital Command Post established in another building

behind the main structure.

19:30H.I.C.S. established and initial briefing given by Hospital

CEO.Fire Department returns control of the building back to

Hospital Administration.

Initial Response Highlights Initial Response Command Post already identified

in response plans and exercises.We had recently conducted a disaster drill at the

hospital! Immediate notification of County Emergency

Management & EMS performed upon notification of “smoke showing”. Allowed a good transition from first responders to

hospital administration control. Incident occurred after most scheduled surgeries

and other outpatient services were complete.

19:40Emergency Department Diversion

20:25Code Black- Power Failure

20:33Code Silver- Patient Evacuation Decision

21:45EMS resources on scene

○ 11 unitsBuncombe County Mass Casualty Bus on

Standby.

Hospital Evacuation Immediate Evacuation vs. Phased Evacuation

Decision to completely evacuate at 20:45

Evacuation Numbers/DestinationsHarris- 18 adults, 2 newborns, 4 BHUMission- 2 acute adults & 7 from EDHomestead- 113 Remaining BHU patients to Rutherfordton,

Balsam Center and Kings Mountain25 patients discharged

Hospital Evacuation Notification to area hospitals of a FULL

DIVERSION

Public and Family Notifications (perception issues)

EMS resource management- All patients & staff moved by 03:10 hours the following morning.

Final BHU patient evacuations complete at 08:00 hours.

1 meg generator to power 500 ton chiller

2- 2 meg generators on scene to power the hospital

The NEXT MORNING Establishing a mobile Emergency Department in

the parking lot.Resources needed to make this happen?

○ Mobile Tractor Trailer units (SMAT, MED 1, etc.)○ Additional supporting tents (SMAT, DPR cache, etc.)○ Restrooms, medical supplies, pharmacy, X-ray, labs, etc.○ SIGNS○ Public Information○ Emergency Lighting○ Staffing

06:10- Decision to deploy MED-1

Relationships Prior to the Incident Local Emergency Planning Committee

Monthly Emergency Services team meetings with hospital administration

Multiple Exercises and consolidated training throughout the years.

Attrition at Hospitals, especially in key positions.

Completely out of main hospital for 3 weeks.

• June 19- July 8- 12 hour operational periods at the command post.

• August 17- Final electrical testing and return of primary hospital power. External support demobilized.

• August 22- Hospital ICS terminated.

I. Communications YES NO N/A

Was the appropriate staff notified when emergency measures initiated? (Code announced or paged)

8 2 2

Were emergency communications set up? 11 1

Were community emergency response agencies efforts incorporated/ coordinated? 10 2

Did the hospital communicate with patients and families during the emergency? 9 3

Did the hospital communicate to the media during the emergency? 11 1

Comments: Extensive effort and emphasis was placed on up-to-date information

Communications 1x1 2x2 3x2 4 x 3 5 x 4 Score (Circle One) Poor Fair Good Very Good Excellent 3.58

Communications Score of 3.58

Internal

II. Resources/Assets YES NO N/A

Did hospital have enough supplies on hand? (medical, pharmaceutical, emergency) 10 1 2

Did hospital manage support activities appropriately? (housing, transportation, communication, stress debriefing)

10 1 1

Did hospital obtain additional resources from another entity? (Corporate, another hospital, health department, etc.)

12

Resources/Assets 1 2 3x2 4 x7 5 x2 Score (Circle One) Poor Fair Good Very Good Excellent 4.0

Resources/Assets Score of 4.0

Internal

InternalIII. Safety/Security YES NO N/A

Was adequate security provided? 12

Were emergency vehicles and personnel able to have access to all areas, equipment, and supplies required?

12

Were unauthorized personnel kept away from the areas? 11 1

Did facility take steps to identify and address hazards created by this event? 11 1

Safety/Security 1 2x2 3x1 4 x4 5 x4 Score (Circle One) Poor Fair Good Very Good Excellent 3.91

Safety/Security Score of 3.91

InternalIV. Staff Management YES NO N/A

Were provisions for the management of staff, including distribution and assignment of responsibilities and functions, adequate?

11 1

Was there adequate staffing and call-in response? 10 2

Was staff competent to perform assigned duties? 11 1

Was staff support needed, provided and adequate? 10 2

Staff Management 1 2x2 3x2 4x4 5 x2 Score (Circle One) Poor Fair Good Very Good Excellent 3.78

Staff Management Score of 3.78

InternalV. Utilities Management YES NO N/A

Were any of the following disrupted?

Electricity ( or Emergency Generator) Water Fuel HVAC Medical Gas/Vacuum Systems Other (Specify):

12

12

8

12

7

12

4

5

If any of the above were disrupted, were the appropriate actions taken? Describe:

Numerous generators brought on site and wired in, outside support from CHS and DLP, periodic downtimes during testing and repairs Details in HICS documentation

X

Utilities Management 1x1 2x2 3x1 4x4 5 x1 Score (Circle One) Poor Fair Good Very Good Excellent 3.25

Utilities Management Score of 3.25

InternalVI. Patient Clinical & Support Activities YES NO N/A

Were provisions for the management of patient including scheduling of services, control of patient information, admission, transfer, and discharge adequate?

10 2

Were all patients accounted for, triaged, and prioritized? 10 2

Was all necessary medical treatment readily available and adequate? 10 2

Was patient transfer plan effective? 10 2

Was temporary shelter needed? 5 5 2

If temporary shelter was needed but inadequate, please describe:

Was alternate care site needed? 10 2

If alternate care site was needed, was site identified and was it available, accessible and adequate?

10 2

If alternate care site was not identified, available, accessible or adequate, please describe: Local Hospitals

Patient Clinical & 1x1 2x1 3x1 4 x4 5 x4 ScoreSupport Activities 3.82(Circle One) Poor Fair Good Very Good Excellent

Patient Clinical & Support Activities Score of 3.82

Overall Score for Incident from Internal Responses

3.74

ExternalI. Communications YES NO N/A

Was the appropriate staff notified when emergency measures initiated? (Code announced or paged)

5

Were emergency communications set up? 5

Were community emergency response agencies efforts incorporated/ coordinated? 5

Did the hospital communicate with patients and families during the emergency? 1 4

Did the hospital communicate to the media during the emergency? 5

Communications 1 2 3 4 x 1 5 x 4 Score (Circle One) Poor Fair Good Very Good Excellent 4.80

Communications Score of 4.80

ExternalII. Resources/Assets YES NO N/A

Did hospital have enough supplies on hand? (medical, pharmaceutical, emergency) 2 3

Did hospital manage support activities appropriately? (housing, transportation, communication, stress debriefing)

4 1

Did hospital obtain additional resources from another entity? (Corporate, another hospital, health department, etc.)

5

Resources/Assets 1 2 3 4 x3 5 x2 Score (Circle One) Poor Fair Good Very Good Excellent 4.4

Resources/Assets Score of 4.4

ExternalIII. Safety/Security YES NO N/A

Was adequate security provided? 5

Were emergency vehicles and personnel able to have access to all areas, equipment, and supplies required?

5

Were unauthorized personnel kept away from the areas? 5

Did facility take steps to identify and address hazards created by this event? 5

Safety/Security 1 2 3 4 x2 5 x3 Score (Circle One) Poor Fair Good Very Good Excellent 4.6

Safety/Security Score of 5.0

ExternalIV. Staff Management YES NO N/A

Were provisions for the management of staff, including distribution and assignment of responsibilities and functions, adequate?

3 2

Was there adequate staffing and call-in response? 3 2

Was staff competent to perform assigned duties? 3 2

Was staff support needed, provided and adequate? 3 2

Staff Management 1 2 3 4x1 5 x2 Score (Circle One) Poor Fair Good Very Good Excellent 4.67

Staff Management Score of 4.67

ExternalV. Utilities Management YES NO N/A

Were any of the following disrupted?

Electricity ( or Emergency Generator) Water Fuel HVAC Medical Gas/Vacuum Systems Other (Specify):

5

5

1

1

1

4

1

4

4

4

If any of the above were disrupted, were the appropriate actions taken? Describe:

(1) The disruption only occurred due to the actual incident.(2) Temporary generators and security lighting was in place

5

Utilities Management 1 2 3 4x1 5 x2 Score (Circle One) Poor Fair Good Very Good Excellent 4.67

Utilities Management Score of 4.67

ExternalVI. Patient Clinical & Support Activities YES NO N/A

Were provisions for the management of patient including scheduling of services, control of patient information, admission, transfer, and discharge adequate?

2 3

Were all patients accounted for, triaged, and prioritized? 2 3

Was all necessary medical treatment readily available and adequate? 2 3

Was patient transfer plan effective? 1 1 3

Was temporary shelter needed? 3 2

If temporary shelter was needed but inadequate, please describe:

Was alternate care site needed? 3 2

If alternate care site was needed, was site identified and was it available, accessible and adequate?

3 2

If alternate care site was not identified, available, accessible or adequate, please describe:

The establishment of an alternative site was based upon the decision to divert patients to Harris Regional Hospital and Mission Hospital in Asheville.

Patient Clinical & 1 2 3x1 4 x2 5 ScoreSupport Activities 3.67(Circle One) Poor Fair Good Very Good Excellent

Patient Clinical & Support Activities Score of 3.67

Overall Score for Incident from External Responses

4.47

Questions

marty.stamey@haymed.org 828-400-4812gshuping@haywoodnc.net 828-508-8387

Thank You!

Haywood Regional Medical Center