Working Together to Work Wonders. UTMB The Challenges of Recovering When the Patient is your Hospital Mike Mastrangelo: Program Director Institutional

Working Together to Work Wonders.

UTMBThe Challenges of Recovering

When the Patient is your Hospital

Mike Mastrangelo: Program Director Institutional Preparedness


Emergency Program

New Institutional Safety and Security Committee: Executive institutional oversight of emergency program (President and EVPs)

• Annual Review • Executive Input• Approval of annual program• Preparedness, Prevention, Protection, Mitigation, Response,

Recovery


Mitigation

General Approach:

• New Construction – critical Infrastructure: 25 feet above Base Flood Elevation

• Hot water rather than steam (more resilient)

• Combined heat and power system (if possible)

• Community Partners: Water and Power

• Mitigation Plan Approved and Adopted

• New Mitigation Projects Underway

• Flood and Wind Retrofits


FEMA Approved Mitigation (so far)

• Emergency Power Systems: Elevate generators

• Normal Power Distribution: Elevate lines, switchgear, distribution panels

• Chilled Water: Harden and elevate lines


Hospital Incident Command SystemHICS workshop (TEEX) for senior executives on HICS positions

(President, EVPs, Senior VPs, VPs)

• How UTMB would implement HICS (Hospital/Research Center/National Lab/Academic Enterprise)

• Filled positions (goal 5 deep)• Incident Commander for incidents with warning• Staffing of Command Center based on storm severity

(Alternate Command Center on Mainland if needed)


HICS / Resource Management

Incident Action Plan: Incident Commander’s Objectives

• Strategies and Tactics• Resources / Resource Request• Map Resources to each Objective

Documentation: Work done can be tracked back by date to specific Incident Command objectives


HICS / Resource Management and Documentation• HICS Documentation Training for Planning, Finance/Admin,

Logistics sections

• Knowledge of Public Assistance / Debris Removal rules and regulations

• Contract in place to provide Planning Section with documentation support if needed

• Contract in place to support Public Assistance claims process


Damage Assessment

• Developed a Damage Assessment Process to include contract photographic recording

• Damage Assessment Teams include Asset Management and Departmental Representatives

• No work until Damage Assessment is complete

• Use of Computer Aided Facilities Management software applications

• Estimating total damage (can you afford to rebuild?)


Hurricane Response

Saffir - Simpson Scale and 120 hour clock

Triggered Response Evacuation Plan based on Hurricane Severity Index

• 10 phase response plan

Coordination with response partners

• Ambulance Staging Area• Communications / COML Team• Regional Coordination with CMOC, EMTF-6, and

Regional Communications Center for asset mobilization

Phase: OR Traditional Time Line

UTMB Evacuation Planning Checklist

Assigned to Completed Impact Weather Date/Time InitialsTrigger Report

120 Hours

+ Prepare

1 Coordinate with Public Affairs on general communications as needed

Incident Commander

Review Evacuation Plan All Confirm Emergency Radio Communications Plan with state and local jurisdictions

Liaison

Notify Seton that there is a possibility of evacuation. Use UTMB Form A: Initial Patient Evacuation Estimate

Evacuation Support Team / Liaison

Notify Texas Division of Emergency Management on possibility of evacuation. (Mike Jones 979-864-9411 /David Popoff 713 504 4392) Provide a planning estimate of the support needs for a possible evacuationUse UTMB Form A: Initial Patient Evacuation Estimate

Evacuation Support Team / Liaison

Notify the Regional Trauma Advisory Council on possibility of evacuation / potential need to activate the Catastrophic Medical Operations Center (CMOC)

Liaison

2 120 Hours Activate Emergency Operations Plan Continue to provide updates through Public Affairs Incident Commander Activate the Emergency Operations Plan and Command Center and communicate situation and plans to all hospital and clinic departments

Incident Commander

Set up and test emergency communications equipment Operational Leaders, PIO, Information Services

Alert Health System Liaison Team of potential for deployment to Seton or other receiving hospital(s)

Health System Operations

Potential Rideout Team members identified: List to Logistics Section for Sheltering Plan

Health System Operations Section Chief

Request activation of the CMOC (main number 713-884-4408). This number will reach the City of Houston duty officer 24/7 who will contact the CMOC Chief on Call

Liaison

Provide hospitals in the region with an update on UTMB status - update EM Resource

Health System OperationsEmergency Department

Update planning information to Seton, other receiving hospitals, and TDEMUse UTMB Form A: Initial Patient Evacuation Estimate

Evacuation Support Team Leader / Liaison


Hurricane Response

Coordination with Receiving Hospital(s)

(Primarily Seton Hospital in Austin)

• MOUs in place• Joint Planning – including use of the Texas Emergency

Tracking Network• Exercises• Access to electronic medical records• Standardization of forms• Improve information flow• Staff to accompany patients• Equipment that accompanies patients


(Not Just) Hurricane Response

• Hazard Vulnerability Analysis

• High priority risks

• Industrial Incidents / Mass Casualty Incidents

• New Focus on Healthcare Coalitions

• Tabletops in February and March 2012• Regional Partners• Early emphasis on communications planning



On Call system for facilities and health system

• Response to after-hours no-notice incidents• Emergency plans for major scheduled outages and

construction activity (especially regarding utilities)• Event – outage or construction• Objectives• Organizational Assignment List (on-call if needed)• Communications (notification) Plan• Safety Plan



Active Shooter (Violence on Campus)

• New mass notification system• New voice capability – fire alarms• Active Shooter Exercises• Student / Student Government Participation in planning• Threat Assessment Team



Galveston National Lab support for H1N1 outbreak


Processes

• Rules for Force Account Labor

• Policies on ‘disaster pay’

• HICS - Track and certify Time & Effort records (be ready to integrate paper and electronic T&E systems)

• UT Mutual Aid – ‘a system can’t provide itself ‘mutual aid’’

• Use contractors

• State emergency procurement laws – (use competitive procurement and have contracts in place ready to go)

• Contract Monitoring Teams: Project Managers


Response Contractors

Expectation – knowledge of Public Assistance Rules and Regulations (meeting with major contractors)

Contractually - Integrate operations into HICS (at UTMB discretion)

• Work only with signed 213RR with scope of work• Any work in excess is volunteer work and will not be compensated• Contract amendments• Separate ‘supplies’ to degree possible• Headcounts included in documentation

Debris Removal and Debris Removal Monitoring Plan submitted to TDEM and FEMA

Protective Measures: Policy – no assets on ground floors without approval of facilities committee. If approved, a continuity plan is required (Contracts to protect assets)

No Time and Materials Contracts


Questions

Documents

Working Together to Work Wonders. UTMB The Challenges of Recovering When the Patient is your Hospital Mike Mastrangelo: Program Director Institutional