Utility Failure Irg

8/9/2019 Utility Failure Irg

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Incident Response Guide: Utility Failure

Mission To safely manage patient care through e ective and e cient hospital operations duringthe loss of a major utility within the hospital

DirectionsRead this entire response guide and review the !ospital Incident "anagement Team#ctivation chartUse this response guide as a chec$list to ensure all tas$s are addressed and completed

ObjectivesIdentify e%tent of outage and consider evacuation"aintain patient care capa&ilities"inimi'e impact on hospital operations and clinical services(ommunicate the situation status to patients) sta ) and the pu&lic

Incident Response Guide * Utility Failure+age ,



Immediate Response (0 – 2 hours)

Section OfcerTim

ection Initi

a!s

"ommand

Incident"ommander

#ctivate the hospital -mergency.perations +lan) Utility Failure +lan) the!ospital (ommand (enter andappropriate !ospital Incident "anagement

Team positions

-sta&lish operational periods) o&jectives)and regular &rie/ng schedule (onsiderusing the Incident #ction +lan 0uic$ 1tartfor initial documentation of the incident

2etermine the need for shelter3in3place orevacuation and activate appropriateincident response plans

(onsider limiting nonessential services

4otify the hospital (hief -%ecutive . cer)5oard of 2irectors) and other appropriateinternal and e%ternal o cials of situationstatus

#ub!icIn$ormation

Ofcer

#ctivate the Ris$ (ommunication +lan andmedia staging area

+repare a media release to inform thecommunity a&out the utility outage

"aintain communication with patients)sta ) and families regarding the currentsituation and what is &eing done toaddress it

(onduct a hospital census and identifypossi&le discharges) transfers and surgeryor procedure cancellations

Update internet) intranet) and socialmedia to disseminate information a&outhospital status and alteration in servicesto patients) sta ) families) andsta$eholders

"onitor media outlets for updates on theincident and possi&le impacts on thehospital (ommunicate information viaregular &rie/ngs to 1ection (hiefs and theIncident (ommander

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%iaison Ofcer

4otify community partners in accordancewith local policies and procedures 7e g )consider local -mergency .perations(enter) other area hospitals) localemergency medical services) andhealthcare coalition coordinator8) todetermine incident details) communitystatus) and esta&lish contacts forre9uesting supplies) e9uipment) orpersonnel not availa&le in the hospital

(ommunicate with other hospitals todetermine situation status) a&ility toaccept patients if transfer) hospitala&andonment) or evacuation is ordered

Sa$et& Ofcer(omplete the !I(1 6, # to assign) direct)and ensure safety actions are adhered toand completed

Immediate Response (0 – 2 hours)

Section'ranch nit Tim

ection Initi

a!s

OperationsSection "hie$

Implement the -vacuation) 1helter3in3+lace) and !ospital #&andonment +lan asneeded and in cooperation with theIncident (ommander

Medica! "are'ranch

Director

Re9uest diversion if needed

Identify evacuation priorities and transferre9uirements

Implement downtime documentationprocedures for patient care and incidentmanagement documentation as re9uired

(onduct a hospital census and determinedischarges) transfers) and surgery orprocedure cancellations

#ssess patients for ris$ and prioriti'e care

and resources) as appropriateIn$rastructure

'ranchDirector

Implement emergency support proceduresto sustain critical services 7i e ) power)water) medical gasses) communications8until utility restoration can &eaccomplished

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#ctivate damage assessment teams todetermine the impact and severity ofutility outage

Securit&'ranch

Director

Initiate emergency procedures to supporthospital and campus security in responseto a utility outage

#!annin*

Section "hie$

-sta&lish operational periods) incidento&jectives) and the Incident #ction +lan incolla&oration with the Incident(ommander

Resources nit%eader

+repare for personnel and e9uipmenttrac$ing

Situation nit%eader

"onitor and document all actions andactivities

+repare for patient trac$ing includingpatient transfers

%o*istics

Section "hie$ Refer to the <o& #ction 1heet forappropriate tas$s

Service 'ranchDirector

#ssess the impact of the utility outage oncommunications and informationtechnology systems

Initiate &ac$up documentation systems ifelectronic systems are not functioning

Support'ranch

Director

Respond to re9uests for supplies ande9uipment= distri&ute appropriatee9uipment throughout the hospital 7e g )porta&le lights) >ashlights) &lan$ets8

+inancedministratio

nSection "hie$

#ctivate vendor "emoranda ofUnderstanding

Trac$ all costs and e%penditures ofresponse) and estimate lost revenues dueto canceled procedures) surgeries) andother services

Intermediate Response (2 – ,2 hours)

Section OfcerTim

ection Initi

a!s

"ommand Incident"ommander

.&tain assessment of sta ng) e9uipment)and supply needs and the overall impactfrom the ongoing utility outage on patientcare) remaining sta ) and the hospital

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#ctivate "edical3Technical 1pecialists ifneeded 7e g ) Ris$ "anagement) @egal8

#ub!icIn$ormation

Ofcer

(ontinue media &rie/ngs and updates

(ontinue &rie/ngs and situation updateswith patients) sta ) and families

Update internet) intranet) and social

media to disseminate information a&outhospital status and alteration in servicesto patients) sta ) families) andsta$eholders

%iaison Ofcer

(ontinue to update local emergencymanagement and the -mergency.perations (enter of situation status andcritical issues) and to re9uest assistanceas needed

(ontinue communications with area

hospitals and facilitate patient transfers

Sa$et& Ofcer

(onduct ongoing analysis of e%itingresponse actions for safety issues)implement corrective actions) and updatethe !I(1 6, #

Intermediate Response (2 – ,2 hours)


ection Initi

a!s

Operations Section "hie$ Refer to the <o& #ction 1heet forappropriate tas$s

Medica! "are'ranch

Director

(ontinue the evaluation of patients andpatient care= reevaluate the need tocurtail or cancel nonessential services

Reevaluate sta ng needed to maintainessential services and to provide patientcare

-valuate sta wor$ing in alternate roles

and all supplemental staReevaluate the need to continueam&ulance diversion

Incident Response Guide * Utility Failure+age



In$rastructure'ranch

Director

(ontinue to assess e%tent of damage oroutage= if possi&le) provide the Incident(ommander and 1ection (hiefs withprojected length of the serviceinterruption

Initiate repairs as re9uiredSecurit&'ranch

Director

(ontinue to provide hospital security=develop plans to alter security services ifphone or power is interrupted

#!annin*

Section "hie$

+repare the Incident #ction +lan for thene%t operational period= engage allsections to provide updates on sta ngand alterations in strategies and tactics

Resources nit%eader

(ontinue sta and e9uipment trac$ing

Situation nit%eader

(ontinue patient and &ed trac$ing

Documentation nit %eader

-nsure complete documentation of allpostponed and canceled appointmentsand procedures

%o*istics


Support'ranch

Director

(ontinue to provide sta for essentialoperations

"onitor) report) follow up on) anddocument patient or sta injuries

+inancedministratio

n


Time nit%eader

Trac$ hours associated with theemergency response

#rocurementnit %eader

Facilitate contracting for resources andservices

"ost nit%eader

Trac$ costs) sta hours) e%penditures) andlost revenue

-.tended Response (*reater than ,2 hours)

Section OfcerTim

ection Initi

a!s

"ommand Incident"ommander

(ontinue to monitor operations) considerthe length of onsite operations) anddetermine the need for e%pandedpostponement of procedures

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Bith the +u&lic Information . cer)prepare to spea$ with patients) sta )visitors) media) and sta$eholders

Update the hospital (hief -%ecutive. cer) 5oard of 2irectors) and otherappropriate internal and e%ternal o cialsof situation status

#ub!icIn$ormation

Ofcer

(ontinue to hold regularly scheduledmedia &rie/ngs in conjunction with the

<oint Information (enter

#ddress social media issues as warranted=use social media for messaging assituation dictates

Sa$et& Ofcer

Update the !I(1 Form 6, # for e%tendedoperations -nsure an updated safety planis incorporated into the Incident #ction+lan

-.tended Response (*reater than ,2 hours)


ection Initi

a!s

Operations

Section "hie$

(ontinue the evaluation of patients and

the a&ility to provide patient care) and&egin to plan for the restoration ofutilities

-nsure that all documentation) includingdamage assessments) repair costs) andtrac$ing materials) are su&mitted to the+lanning 1ection

Medica! "are'ranch

Director

(ontinue the evaluation of patients andpatient care) and &egin to plan forrestoration of normal sta ng and

services

In$rastructure'ranch

Director

(ontinue to provide regular updates to1ection (hiefs on repairs) restoration ofservices) or continued serviceinterruptions

Incident Response Guide * Utility Failure+age C



#!annin*

Section "hie$

-nsure that updated information andintelligence is incorporated into theIncident #ction +lan -nsure the2emo&ili'ation +lan is &eing readied

Resources nit%eader

(ontinue e9uipment and personneltrac$ing) including resources transferredto other hospitals

Situation nit%eader

(ontinue patient and &ed trac$ing)including resources transferred to otherhospitals

Documentation nit %eader

-nsure appropriate documentation ofongoing activities

(ollect and collate documentation ofactions) decisions) and activities

Demobi!i/ationnit %eader

+repare for demo&ili'ation and systemrecovery

+inancedministratio

nSection "hie$

(ontinue to record ongoing and projectedcosts from postponements andmodi/cations in operations

Demobi!i/ation S&stem Recover&

Section OfcerTim

ection Initi

a!s

"ommand

Incident"ommander

2etermine hospital status and declaretermination of the incident

#pprove the 2emo&ili'ation +lan

.versee the hospitalDs return to normaloperations

#ssess if criteria for partial or completereopening of hospital are met) and orderreopening and repatriation of patients

Bith the +u&lic Information . cer prepareto spea$ with the media

#ub!icIn$ormation

Ofcer

(onduct a /nal media &rie/ng to provideincident resolution= wor$ with the <ointInformation (enter

Incident Response Guide * Utility Failure+age E



%iaison Ofcer

"aintain contact with the local -mergency.perations (enter) other area hospitals)local emergency medical services) andregional medical health coordinator torelay status and critical needs to receiveincident and community updates

(ontinue monitoring of the utility failure

impact to hospital and home careservices= coordinate information with the.perations 1ection

Sa$et& Ofcer

-nsure entry and e%it points are open andfunctioning

-nsure /re doors and alarms are inwor$ing order

"onitor and maintain a safe environmentduring the return to normal operations

Demobi!i/ation S&stem Recover&


ection Initi

a!s

Operations Section "hie$ .versee the restoration of normal patientcare operations

Medica! "are'ranch Director

2iscontinue am&ulance diversion) ifapplica&le

Reschedule canceled surgeries)

procedures) and outpatientappointments

Repatriate evacuated or transferredpatients

In$rastructure'ranch Director

(omplete a hospital damage report)including the progress of repairs) andestimated timelines for restoration topre3incident condition

1chedule and oversee a test of thehospital alarm systems

Securit& 'ranchDirector

"aintain hospital security and tra ccontrol

Incident Response Guide * Utility Failure+age



'usiness"ontinuit&

'ranch Director

.versee the restoration of essentialservices including internet connectivityand communications .versee the entryof information and data into electronicrecords if necessary

If record $eeping included the use of paper&ased records) ensure all clinical

information is entered into electronicmedical records

#atient +ami!&ssistance

'ranch Director

+rovide &ehavioral health support andinformation a&out community services forpatients and families) if needed

#!annin*

Section "hie$

Finali'e and distri&ute the 2emo&ili'ation+lan

-nsure that the status of all impactedclinical and support operations arerelayed to appropriate sections forresolution

(onduct de&rie/ngs and a hotwash with:

(ommand 1ta and section personnel#dministrative personnel#ll sta #ll volunteers

Brite an #fter #ction Report and(orrective #ction and Improvement +lanfor su&mission to the Incident(ommander) including:

1ummary of the incident1ummary of actions ta$en#ctions that went well#ctions that could &e improvedRecommendations for future responseactions

Documentationnit %eader

(ollect) collate) /le) and securecompleted documentation of actions)

decisions) and activities+repare a summary of the status andlocation of all incident patients) sta ) ande9uipment #fter approval &y the Incident(ommander) distri&ute it to appropriatee%ternal agencies

Incident Response Guide * Utility Failure+age ,



%o*istics

Section "hie$ Inventory all !ospital (ommand (enterand hospital supplies and replenish asnecessary) appropriate) and availa&le

Support 'ranchDirector

Release temporary sta and otherpersonnel to normal positions

(omplete documentation and follow upof personnel injuries if needed

+inancedministratio

n

Section "hie$

(ompile a /nal summary of all responseand recovery costs and e%penditures)and estimated lost revenues 1u&mit tothe +lanning 1ection (hief for inclusion inthe #fter #ction Report

"ompensation"!aims nit

%eader

(ontact insurance carriers to initiatereim&ursement and claims procedures

(oordinate with Ris$ "anagement foradditional insurance and documentation

needs) including photographs of damage)etc

Incident Response Guide * Utility Failure+age ,,



Documents and Too!s-mer*enc& Operations #!an inc!udin*1

Utility Failure +lan-mergency .perations +lan-vacuation) 1helter3in3+lace and !ospital #&andonment +lan#lternate (are 1ite plan5usiness (ontinuity +lan"emoranda of Understanding with appropriate entities2ischarge +olicy+aper charts and electronic medical record downtime procedures+atient) sta ) and e9uipment trac$ing procedures!ospital and campus maps) &lueprints and >oor plansRis$ (ommunication +lanInteropera&le (ommunications +lan2emo&ili'ation +lan

+orms inc!udin*1

!I(1 Incident #ction +lan 7I#+8 0uic$ 1tart!I(1 6 * Incident #ction +lan 7I#+8 (over 1heet!I(1 6 , * Incident 5rie/ng!I(1 6 6 * Incident .&jectives!I(1 6 ; * .rgani'ation #ssignment @ist!I(1 6 # * (ommunications @ist!I(1 6,? * #ctivity @og!I(1 6, # * Incident #ction +lan 7I#+8 1afety #nalysis!I(1 66, * 2emo&ili'ation (hec$list!I(1 6 , *Facility 1ystem 1tatus Report!I(1 6 ? * 2isaster Hictim +atient Trac$ing!I(1 6 * "aster +atient -vacuation Trac$ing

<o& #ction 1heets#ccess to paper forms for documentation) data entry) etc#ccess to hospital organi'ation chart

Television radio internet to monitor news Telephone cell phone satellite phone internet amateur radio 63way radio for communication

Incident Response Guide * Utility Failure+age ,6



!ospital Incident "anagement Team #ctivation: Utility Failure

#osition Immediate

Intermediate

-.tended

Recover&

Incident "ommander J J J J+u&lic Information . cer J J J J@iaison . cer J J J J1afety . cer J J J J

Operations Section "hie$ J J J J"edical (are 5ranch 2irector J J J JInfrastructure 5ranch 2irector J J J J1ecurity 5ranch 2irector J J J J5usiness (ontinuity 5ranch2irector

J

+atient Family #ssistance5ranch 2ir

J

#!annin* Section "hie$ J J J JResources Unit @eader J J J J1ituation Unit @eader J J J J2ocumentation Unit @eader J J J2emo&ili'ation Unit @eader J J

%o*istics Section "hie$ J J J J1ervice 5ranch 2irector J J J J

1upport 5ranch 2irector J J J J

+inance dministrationSection "hie$

J J J J

Time Unit @eader J J J+rocurement Unit @eader J J J(ompensation (laims Unit@eader

J

(ost Unit @eader J J J

Incident Response Guide * Utility Failure+age ,;