Courses & Speaking Engagements: Hospital Evacuation - The Last Resort

Synopsis:  This course will delineate the circumstances under which hospital evacuation should be considered; basic procedures for horizontal and vertical evacuation; resources needed; and the preference for shelter-in-place alternatives.

Objectives:  At the completion of this course attendees will be able to:

  1. List the complexities and risks involved in healthcare facility evacuation
  2. List strategies to assist other community facilities (nursing    homes, assisted living facilities and group homes) from having to evacuate residents to the Hospital
  3. Discuss each of the major components of developing a comprehensive Hospital Evacuation Plan (planning, coordinating and testing)
  4. Develop a cogent well coordinated Hospital Evacuation Plan (Exercise)

Who should attend?

  1. Safety Officers
  2. Plant Engineers
  3. Directors of Nursing
  4. Environmental Services Officers
  5. Nursing Unit Managers
  6. Department Directors
  7. Materials Managers
  8. Chief Executive Officers
  9. Chief Financial Officers

Course Modules:

1. Shelter in place vs. Evacuation

  1. Is the risk to patients, visitors, and staff greater to stay within the hospital or to move them?
  2. When are such actions necessary? – natural disasters; hazardous material release; terrorism
  3. Where will the data originate?
  4. Who will make the decision? – internal or external

1. Hospital Shelter in Place

  1. What is it and why is it the preferred option?
  2. Considerations – type of event; location; siting of facility
  3. Procedural actions – sand bags; ventilation system controls; location of personnel; emergency supplies
  4. Pre-disaster steps to take to fortify the hospital
  5. Hospital support of patients and staff – food; water; safety; etc.

1. Hospital Evacuation

  • Only when absolutely necessary!
  • Immediate danger
  • Orderly/priority evacuation
  • Risks – evacuation process, interim staging, transportation, receiving facilities

EXERCISE 1:  Hospital groups “A” “B” and “C” will be assigned basic incident scenarios.  Each group will determine and justify whether to shelter in place or evacuate, list the risks associated with each decision, and identify basic resource considerations.  Convince your hospital administrator that your suggested decision is the correct one.

1. The Hospital Evacuation Plan

  1. Vertical evacuation
  2. Horizontal evacuation
  3. Total evacuation – patient discharge; facility lock-down
  4. Staff and departmental roles
  5. Patient tracking and safety considerations
  6. Staff tracking and safety considerations
  7. Each plan is “customized”

1. Evacuation Plan Coordination

  1. Requisite resources for evacuation – partial and complete
  2. Integration with alternative treatment sites – local and regional healthcare facilities/organizations
  3. Transportation
  4. Coordination with overall Incident Command and support activities
  5. Acquisition and utilization of resources – staff; volunteers; supplies; etc.
  6. Development of support agreements for needed services
  7. Communication – internal and external
  8. Information management

EXERCISE 2:  Attendees will return to their hospital groups “A” “B” and “C”.   Each group/hospital will develop an effective hospital evacuation plan for their individual facility.  Hospital personnel will brief their hospital evacuation plan to the attendees.

1. Assisting Other Healthcare Activities within the Community - Why it is imperative

  1. Types of facilities – nursing homes; assisted living; hospices
  2. Assistance available – notification; expertise; personnel; support agreements: etc.
  3. Shelter in place
  4. Evacuation
  5. Impact on hospitals if support remains absent

1. Recovery Operations

  1. Structural/facility evaluation
  2. Safety considerations
  3. Infection control procedures
  4. Support services capabilities
  5. Documenting financial loses and insurance
  6. Critical review of actions – strengths and vulnerabilities

EXERCISE 3:  Table-top hospital evacuation exercise.  Hospital groups “A” “B” and “C” will conduct an evacuation scenario for their facilities using a “phased approach” to understand the challenges and develop solutions at each phase and to identify potential weak areas in their EP.  Following the exercise, each hospital group spokesperson will brief the attendees on the challenges, solutions and lessons learned to improve weak areas which manifested themselves during the Table-Top Exercise.

Course Critique

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