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Emergency Operations Plan

 

COMMUNITY HEALTH CENTER SUBJECT:  ANNEX A – Direction & Control
OF BRANCH COUNTY SOURCE:  Emergency Operations Plan
COLDWATER, MI  49036 EFFECTIVE DATE:  January 2012
SUPERSEDES: 3/01, 8/02; 8/03;7/04; 4/06; 12/08
DISTRIBUTION:  Emergency Operations Plan
POLICY NO.:


ANNEX A
DIRECTION AND CONTROL

PURPOSE:
To outline the chain of command when an incident is declared, describe the functions of the Command Center and designate key operational areas in a response situation.

CHAIN OF COMMAND:
The CEO/President is ultimately responsible for the hospital and the emergency response.  The Incident Commander is responsible for the EOC response for as long as the event lasts.  The chain of command is as follows when the organization is under emergency status:

Incident Commander
Safety Officer
Operations Section Chief

(See chart one (1).  In other than normal business hours, the Administrative Supervisor is in charge until the Command Staff arrives and assumes responsibility.

KEY OPERATIONAL AREAS:
The Command Center will function from Conference Room 3 and the muster area will be Conference Rooms 1 & 2.  The Facility Operations Department will be responsible for additional furniture and equipment as needed.  

Key operational areas for handling an emergency are designated in Chart two (2).  These areas are subject to revision if the emergency directly affects those locations.

The Command Center staffing will include the following at a minimum:

1. Incident Commander
2. Clerical support 
4. Public Information Officer until they can move to the Media Area
5. Operations Section Chief
6. Administrative Supervisor until the Command Staff arrives and assumes responsibility

OPERATING THE COMMAND CENTER
1. Set Up
a. Report to Conference Room 3.
b. Obtain laptop computers from cabinets
c. Set up, plug in the log on
d. Set up easels and dry erase boards
e. Make available supplies

COMMAND STAFF RESPONSIBILITIES
1. Incident Commander (IC)
a. Assumes total command of all actions and operations of the Command Center.
b. Establishes immediate priorities.
c. Assumes ultimate responsibility for incident safety.
d. Obtains briefing on incident from reliable sources.
e. Determines the level of organization necessary and activates Section Chiefs as  needed.
f. Determines incident objectives.
g. Approves Incident Action Plan (IAP)
h. Coordinates activities of Command and General Staff

COMMUNITY HEALTH CENTER SUBJECT:  ANNEX A – Direction & Control
OF BRANCH COUNTY  SOURCE:  Emergency Operations Plan

i. Continuously monitors the operation and effectiveness of the Command Staff  and General Staff
1) If IC chooses to assume role of Operations Section
a) Directs Switchboard Operator to announce implementation of  EOP.
b) Communicates to Department Directors and physicians  regarding size and scope of incident.
c) Approves initiation of “call trees”.
d) Assigns clerical assistance to take notes and chronologically  document times of decisions and activities.
e) Assigns clerical assistance to take incoming calls and make  outgoing calls.
f) Ensures set-up of muster area, family waiting, PIO area.
j. Approves request for additional resources or release of resource.
k. Activates mutual aid agreement as necessary.
l. Authorizes expenditure of funds for emergency acquisitions.
m. Authorizes “disaster” credentialing for physicians and other healthcare  providers unknown to the hospital arriving to the hospital offering to help.  See  Medical Staff Bylaws, Article 7, Section 8.
n. Authorizes release of information to the news media.
o. Order demobilization of incident when appropriate.
p. Ensures incident after-action reports are completed.

2. Safety Officer (SO)
a. Reports directly to the INCIDENT COMMANDER (IC).
b. Carries out functions within the whole CHC campus area.
c. Monitors incident operations and advises the IC on all matters relating to  operations safety, including the health and safety of responding personnel.
d. Is responsible to the IC for the set of systems and procedures necessary to  ensure ongoing assessment of hazardous environments and implementation of  measures to promote safety during incident operations.
e. Is authorized to stop and/or prevent unsafe acts during incident operations.

3. Public Information Officer (PIO)
a. Reports directly to the INCIDENT COMMANDER (IC).
b. Carries out functions in the Marketing offices.
c. Interfaces with public and media and/or with other agencies with incident- related information requirements.
d. Develops accurate and complete information on the incident’s cause, size and  current situation; resources committed; and other matters of general interest  for both internal and external consumption.
e. Performs key public information-monitoring role.

4. Liaison Officer (LNO)
a. Reports directly to the INCIDENT COMMANDER (IC).
b. Acts as CHC’s representative and carries out responsibilities at the Branch  County EOC.
c. Assumes the role of contact person for representatives of other governmental  agencies, non-governmental organizations and/or private entities.
d. Acts as the “go-between” to ensure the BC EOC and CHC work together  effectively.

SECTION CHIEF RESPONSIBLITIES:
In the event the Incident Commander desires to activate one or more of the Sections in support of response to the incident the following represents primary responsibilities of those Section Chiefs.





COMMUNITY HEALTH CENTER SUBJECT:  ANNEX A – Direction & Control
OF BRANCH COUNTY  SOURCE:  Emergency Operations Plan


1. Operations Section Chief:  Manages all tactical operations on the incident.  Reports directly to the Incident Commander.
a. Manages all tactical operations.
b. Assists in development of operations portion of the Incident Action Plan (IAP).
c. Supervises execution of the operations portion of the IAP.
d. Request additional resources to support tactical operations.
e. Approves release of resources from active assignment (not from the incident).
f. Make or approve expedient changes to the operations portion of the IAP.
g. Maintains close contact with the IC.

2. Planning Section Chief:  Provides planning services for the incident.  Collects situation and resource status information, evaluates it, and processes the information for use in developing action plans.  Disseminates information as necessary to  keep all sections up-to-date.  Reports directly to the Incident Commander.
a. Collect and manage all incident-relevant operational data.
b. Provide input to the IC and Operations Section Chief for use in preparing the  IAP.
c. Supervise preparation of the IAP.
d. Conduct planning meetings.
e. Assemble information on alternative strategies and contingency plans.
f. Provides periodic predictions on incident potential.
g. Report any significant changes in incident status.
h. Compiles and displays incident status information.
i. Oversee preparation of the Demobilization plan.
j. Incorporates Traffic, Medial Communications Plans and other supporting  material into the IAP.

3. Logistics Chief:  Provides all incident support needs.  Responsible for all support requirements needed to facilitate effective and efficient incident management, including 
ordering resources from off-site locations.  Reports directly to the Incident Commander.
a. Manages all incident logistics.
b. Identifies anticipated and known incident services and support requirements.
c. Requests/orders additional resources as needed.
d. Brief Logistics Branch Directors as needed.
e. Provides for:
~Facilities
~Transportation
~Communications
~Supplies
~Equipment (and maintenance and fueling of same)
~Medical services for responders
~Food services for responders
f. Oversees demobilization of the Logistics Section

4. Finance Section Chief:  Manages all financial aspects of an incident.  Not all incidents will require a Finance Section.  Only when CHC has specific need for finance services will this Section be activated.  Reports directly to the Incident Commander.
a. Manages all financial aspects of the incident.
b. Provides financial and cost analysis information as requested.
c. Ensure compensation and claims functions are being addressed relative to the  incident.
d. Meet with cooperating and assisting agencies as necessary.
e. Ensure that all personnel and equipment time records are accurately completed  and transmitted to home agencies.
f. Brief agency administrative personnel on all incident related financial issues  needing attention or follow-up.




COMMUNITY HEALTH CENTER SUBJECT:  ANNEX A – Direction & Control
OF BRANCH COUNTY  SOURCE:  Emergency Operations Plan

BRANCH DIRECTOR RESPONSIBILITIES

1. Resource Branch – Muster
a. Reports directly to the Planning Section Chief.
b. Assumes direct control of the Muster Area.
c. Creates, maintains and regularly updates a list of staff who report to the Muster Area.
d. Regularly updates those in the Muster Area of the situation as relates to the incident.
e. Responds to requests of the Planning Section Chiefs for additional assistance in their areas.
f. Maintains a list of staff being assigned to areas from the Muster Area to include the time each was sent to a new assignment.
g. Coordinates additional resources from the Patient Tracking Unit and the Medical  Specialties Unit.

2. I.T. Branch
a. Reports directly to the Operations Section Chief.
b. Assumes responsibility for all I.T. hardware and software.
c. Maintains sufficient staff available to individually assist others with I.T. needs.
d. Maintains sufficient equipment to meet an increase in demand for such devices.
e. Responds to requests for I.T. assistance from any area of the hospital.

3. Medical Care Branch
a. Reports directly to the Operations Section Chief.
b. Assumes responsibility for provision of medical care and diagnostics through the  hospital during the incident.
c. Ensures adequate staff to maintain essential medical care and diagnostics during the incident.
d. Ensures adequate supplies to maintain essential medical care and diagnostics during the incident.
e. Maintains control of Morgue Operations
• Maintains records for the Morgue Operations
f. Communicates staffing or supply needs to Operations Section Chief.

4. Supply Branch
a. Reports directly to the Logistics Section Chief.
b. Ensures an adequate supply of essential goods and supplies.
• Maintains open lines of communication with CHC suppliers.
c. Procures, as necessary, additional goods, supplies and equipment based on direction of  Logistics Section Chief.
• Medications
• Food
• Equipment
d. Communicates ETA of additional goods, supplies and equipment.
e. Maintains and submits required documentation to the Account Tracking Unit.

5. Account Tracking Branch
a. Reports directly to the Finance/Administrative Section Chief.
b. Provides necessary tools requested by the Finance/Administrative Section Chief.
c. Prepares documents and reports as requested by the Finance/Administrative Section Chief.
d. Maintains documents, receipts, requests that will aid in the preparation of a financial report of the incident response.
e. Maintains document, receipts, and requests that will allow CHC to properly recoup  costs expended during the incident response.





COMMUNITY HEALTH CENTER SUBJECT:  ANNEX A – Direction & Control
OF BRANCH COUNTY  SOURCE:  Emergency Operations Plan 

UNIT SUPERVISORS RESPONSIBILITIES:
1. Human Resources Unit:  
a. Reports directly to the Resource Branch Director.
b. Identifies labor pool for all CHC Divisions.
c. Prepares to contact any person needed within any of the Divisions.
d. Maintains a list of all employees available.
e. Maintains a list of all employees known to be unavailable.
f. Accepts all offers from non-employees offering to assist.
g. Updates Resource Branch Director as to available human resources.
• Maintains a list of names, telephone numbers and medical specialty of those non-employees offering to assist.
• Acquires, verifies and maintains credentials of those non-employee volunteers.
h. Accepts all offers from non-employees offering to assist.
i. Updates Resource Branch Director as to available human resources to include 
Medical Specialists.
j. Manages workman’s compensation issues of employees during the disaster situation according to hospital guidelines.

2. Patient Tracking Unit
a. Reports directly to the Resource Unit Supervisor:
• Maintains a census of all CHC patients.
• Current patients
• New admissions
• Discharges
• Room and/or bed changes
b. Maintains communication with Medical Care Branch Director to have current  information about all patients who: 
• Are eligible for discharge
• Are eligible for transfer
~Special needs of any patient eligible for transfer
• Are totally ineligible for discharge or transfer

c. Maintain a list of all transferred patients:
• Name
• Physician
• Transferred:
~To where
~To whom (Doctor)
~Condition at time of transfer
~Documents sent with patient
~Mode of transportation
~Date and time of transportation
d. Requests additional human resource support or transfer mode support, as necessary, from the Planning Section Chief.

3. Medical Specialist Unit
a. Reports directly to the Human Resources Unit Supervisor.
b. Maintains a list of professionals with certain specialties that may assist other CHC  employees 
• LIPs available
~General
~Specialty
• Physician Assistants
• Nurse Practitioners
• Other Professional Medical Staff
• Behavioral Health Professionals
• Biological Diseases
• Legal Affairs
• Risk Management

COMMUNITY HEALTH CENTER SUBJECT:  ANNEX A – Direction and Control
OF BRANCH COUNTY  SOURCE:  Emergency Operations Plan 


c.   Ensures credentials are authenticated and the volunteer is eligible to function in the capacity desired.
          d.   Assigns personnel to specific work areas based on requests and availability.
e. Maintains the Volunteer Practitioner’s Log.
f.     Ensures LIPs and non-LIPs performance is assessed completely and timely
• Assessment shall be performed within 72 hours
• An assessment shall be performed for each duty area assigned.
• Assessment shall be documented on the Performance Assessment of Volunteer Practitioners  form.

g.     Maintains communication with the Human Resources Unit Supervisor to respond to    requests from the Resources Branch Director for additional assistance of Medical  Specialists.

4. Ethics Unit
a. Reports directly to the Medical Care Branch Director.
b. Interfaces and draws assistance, as needed, from either or both the 
• Medical Specialties Unit
~Physician
~Legal affairs
~Risk Management
• Family/Grief Support Unit
c. Provides necessary accommodations and tools for meetings and discussion relevant to ethical issues during the incident.
d. Maintains records of all meetings and decisions.
e. Maintains records of all disseminated memos relative to actions based on decisions of this unit.

5. Family/Staff Grief Support Unit
a. Reports directly to the Medical Care Branch Director.
b. Draws on resources from either or both the Ethics Unit or the Medical Specialties  Unit.
c. Provides necessary counseling and support activities to minimize the mental and  emotional impact of an incident on:
• Staff
• Patients
• Families
• Visitors
• Responders

6. Infrastructure/Security Unit
a. Reports directly to the Supply Branch Director.
b. Assumes responsibility for:
• Utilities
~Water and Sewer
~Electricity
~Natural Gas
• Transportation
~Ensures operational condition of CHC vehicles.
~Requests from Supply Branch Director additional vehicles as necessary.
• Medical Gases
~Ensures operational viability of gas delivery system
~Ensures adequate supply of cylinders for back-up
~Requests from Supply Branch Director additional gases as necessary.
• Crowd Control
~Assigns CHC staff, as available and necessary, to monitor and control concentration of people who may impede effective operations of hospital and emergency operations


COMMUNITY HEALTH CENTER SUBJECT:  ANNEX A – Direction and Control
OF BRANCH COUNTY  SOURCE:  Emergency Operations Plan 

~Requests from Supply Branch Director additional personnel to carry out this function
• Law Enforcement
~Works in concert with local and State law enforcement personnel in providing assets for the performance of their assigned duties.
• Search
~Works in concert with authorities in providing what assistance CHC might be able to muster to aid in their efforts.





















































Community Health Center of Branch County  

Incident Command Structure

 




Alternate Incident Commander Command Center #:  5285   Muster Area #:  5283 or 5284     1/2012





COMMUNITY HEALTH CENTER SUBJECT:  ANNEX A – Direction and Control
OF BRANCH COUNTY  SOURCE:  Emergency Operations Plan 


EMERGENCY CONTACT INFORMATION:
After hours hospital contact is the hospital switchboard at 517-279-5400.

Process: Ask for the Administrative Supervisor on duty. Should the situation require an immediate response, the Administrative Supervisor may activate the EOP and open the EOC. If the situation allows sufficient time, the Administrative Supervisor shall contact the  “Administrator On-Call” who in turn will give direction for activation of the EOP and EOC.

             Incident Command Flow Chart for Off-hours, Weekends and Holidays
• Call is received by Administrative Supervisor (A.S.) as notification of incident.
• A.S. contacts the Administrator “on call”.
• A.S. and Administrator decide:
To Open the EOC NOT to Open the EOC

A.S. will act as Incident Commander  Assess “at hand” resources
(IC) until Relieved by a ranking person.

May activate selected 
A.S. shall open the EOC department call trees


Instruct the Switchboard Operator to make the  Maintain current intelligence
“Disaster” announcement. about situation


Obtain assistance from Behavioral Health Be prepared to open the EOC
to start making telephone calls. if situation deteriorates.

Make calls to Department Directors and 
activate the department call trees, with the discretion
of the Administrative Supervisor.


Make initial calls to the Public Information Officer, Liaison Officer, and Safety Officer


Assign staff to these areas/roles until additional staff arrive:

Security Facility Operations
Taggers Aides/LPNs
P.A.R. Dr., or Resident and RN
Amb. Care RN or LPN
Family Waiting LPN
Media IC

As others arrive, assign roles to them
based on the hospital Emergency Operations Plan.










COMMUNITY HEALTH CENTER SUBJECT:  ANNEX A – Chart 2
OF BRANCH COUNTY  SOURCE:  Emergency Operations Plan 

KEY OPERATIONAL AREAS

Conference Room 3 Becomes  Command Center
ER Ambulance Entrance Becomes Triage
ER Waiting Area Becomes Delayed Treatment
Conference Rooms 1&2 Becomes Muster Area
Outpatient Laboratory Becomes Physician Reporting Area
Marketing Department Becomes Public Information (Media Offices in the Seminar Room)
Main Lobby – Surgical Waiting Area Becomes Family Information Waiting Center

ADMINISTRATION – COMMAND CENTER
F L O W    C H A R T

1








Following receipt of information regarding an incident, the ranking person in the hospital will make a determination to activate the Emergency

3 Operations Plan and/or to announce it.

At the request of the ranking person, the Switchboard Operator will make the following announcement:

1. ANNOUNCEMENT
a. “Attention please, attention please, we are activating our Emergency Operations Plan.  All available 
physicians and Department Managers report to the 
Command Center.  Would all visitors and patients in the Lobby please move to the area nearest the main door to provide room for the emergency activities until the drill/emergency concludes.”  

b. After advising the hospital personnel that the Emergency Operations Plan is in effect, the Switchboard Operator will notify one department in each of the peripheral buildings about the disaster.  Personnel in these departments will inform other departments in that building.  They should be advised whether they are needed immediately or that they should stand by in case they are needed.  If these employees are needed in the hospital, they should report to the muster/command area for assignments.  Outbuildings are to be notified.

4








Functions to be performed:
•Operate the Command Center
•Monitor activities both within and outside the hospital.  Determine overall status of hospital facilities, supplies, equipment and personnel
•Activate mutual aid agreements as necessary •Make decisions on call up of additional personnel 
•Authorize media releases
•Monitor television and radio reports

As physicians become available, the following shall report to the Outpatient Laboratory:
1. Medical Chief of Staff
2. Staff physicians
3. Volunteer physicians






6
Example: Return to your area and make arrangements to receive x patients/services according to 
information given in #5 above.



7 Key locations and persons responsible 

Area Function              Staff
Conf. Rooms 1&2 Muster Area            CFO or
          Alternate

Main Lobby Family Chaplain
Surgical Waiting Information             Behavioral 
Area Waiting Center          Health 
        Professional

Command Center   Bed Availability           Nursing 
    Office Staff
 

Marketing Media - Public  Marketing
            Information                Director/
Office                       Alternate
















(Command Center Duty Roster is attached.)


*************************************************

8




9



10


COMMAND CENTER DUTY ROSTER

Task Location Ext. Person Assigned

Callers Muster Area 5283 1._______________________
     or   5284  

Bed Availability Command Center 5285 2._______________________

Incoming Calls 5483
3._______________________

Physicians Duty Roster Given To    _______________________
   Physician Assigned

Muster Area Conference Rooms 1&2 5283 1._______________________
Person in Charge         or 5284    Director - Human Resources
2._______________________
   (Alternate)
Public Information Offices Marketing 5395 1._______________________
Offices    Marketing Director

Engineering/ 5424 1._______________________
Maintenance/                 Director – Facility Operations
Security
2._______________________
   Alternate

Family Information Main Lobby 4334 1._______________________
and Waiting Center Surgical Family Waiting Area                Continuing Care

2._______________________
   Chaplain

3._______________________
          Director of Behavioral Health 
    or Designee










COMMUNITY HEALTH CENTER
OF BRANCH COUNTY SUBJECT:  ANNEX A –  Chart #4
 SOURCE:  Emergency Operations Plan 


PHYSICIAN DUTY ROSTER AND ASSIGNMENT

EMERGENCY PREPAREDNESS PLAN


PERSON MAKING ASSIGNMENTS__________________________________________
       MEDICAL CHIEF OF STAFF OR ALTERNATE
ER TRIAGE___________________________________________________________

ER CUBICLE: 1___________________________________________________________

2___________________________________________________________

3___________________________________________________________

4___________________________________________________________

5___________________________________________________________

6___________________________________________________________

7___________________________________________________________

PAR_____________________________________________________________

AMBULATORY/DELAYED TX__________________________________________________

CCU_________________________________________________________________

OTHER____________________________________________________________

  ____________________________________________________________










 
COMMUNITY HEALTH CENTER
OF BRANCH COUNTY SUBJECT:  ANNEX A – Command Center Message 
                Control Sheet – Chart #5
 SOURCE:  Emergency Operations Plan 

COMMAND CENTER MESSAGE
CONTROL SHEET

Time Message Follow-up





























 

COMMUNITY HEALTH CENTER
OF BRANCH COUNTY SUBJECT:  ANNEX A – Chart #6 – Off Hours/
                                            Weekends/Holidays            
 SOURCE:  Emergency Operations Plan


ANNEX A

OFF HOURS/WEEKENDS/HOLIDAYS

OFF HOURS/WEEKENDS/HOLIDAYS ADAPTATION OF CHC EMERGENCY OPERATIONS PLAN


PURPOSE: To outline the adaptations to the written disaster plan to be followed during off “hours”, weekends or holidays until additional personnel resources are available.

ACTION: Assignments to key areas as follows:

Command Center Administrative Supervisor

Taggers Aide or L.P.N.

Designated Caller Behavioral Health Unit Staff

Family Waiting Designated Ancillary Staff


Post Anesthesia Recovery Intern/R.N.

Media Center Designated by Command Center
as resources arrive

Ambulatory Care Area Designated RN or LPN


Disaster victims will be managed in the following manner:

After triage, if the victim/patient is deemed to need surgery by the physician, that patient will be transferred to the PAR for care, provided a nurse and a physician is available to staff that area.

All patients with non-life threatening injuries will be sent to the Ambulatory Care area following x-rays.

In all probability, inadequate resources will require immediate activation of call trees.













COMMUNITY HEALTH CENTER
OF BRANCH COUNTY SUBJECT:  ANNEX A –  Direction & Control
 SOURCE:  Emergency Operations Plan 




     References:


Approved by:      William D. Earl                                              2/22/11                           
Safety Officer Date


     Mary Rose, RN                                              2/24/11                            
Chief Clinical Officer Date


     Bruce W. Gregory                                          2/18/11                             
Emergency Preparedness Officer Date



                                          INITIAL      DATE
Reviewed:  No change required
Upgraded ICS Chart January 2012 without need for new signatures   (B.G., B.S.) 1/2012