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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. ProMedica Coldwater Regional Hospital Incident Command Structure  Alternate Incident Commander Command Center #: 5285 Muster Area #: 5283 or 5284 1/2012COMMUNITY 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 5 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 |
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