Plans for Managing the Consequences of an Emergency

Good and effective leadership is crucial in the event of an emergency.

1. The hospitals leaders, including leaders of the medical staff, participate in planning activities to develop Emergency Management strategies:
   

   Representation from leadership and the medical staff at St. Mary Medical Center participate in emergency management planning by attending Emergency Management Committee meetings, disaster drills and reviewing strategies set forth by the organization in response to emergencies. They are all trained in ICS via FEMA online Emergency Management Institute.

2. The hospital conducts a Hazard Vulnerability Analysis (HVA) to identify potential emergencies that could affect demand for the hospital's services or its ability to provide those services, the likelihood if those events occurring, and the consequences of those events:
   
   

   The St. Mary Medical Center HVA is completed annually relative to its objectives, scope, performance, and effectiveness. The Emergency Management Coordinator, in conjunction with the Emergency Management Committee /EOC/Disaster Committee, coordinates the evaluation process.  Results of this evaluation process forms the basis for future performance improvement standards, strategic goal setting, planning, and verifying the continued applicability of program objectives and HVA elements. Annual drills are planned around the top three hazards on the HVA.

3. The hospital, together with its community partners, prioritizes the potential emergencies identified in its hazard vulnerability analysis and documents these priorities:
   
   

   St. Mary Medical Center coordinates with local emergency management planners for the purpose of prioritizing disaster preparedness efforts.  St. Mary Medical Center sits on the Disaster Committee for the City of Long Beach and works with all local fire, police, military and disaster agencies in a collaborative effort. St. Mary Medical Center as the regional Disaster Resource Center also cooperates with the City of Long Beach to create the City HVA.
   
   

4. The hospital communicates its needs and vulnerabilities to community emergency response agencies and identifies the community’s capability to meet its needs:
   
   

   St. Mary Medical Center meets with area hospitals at DRC meetings and attends meetings with local emergency response agencies. Ongoing communication occurs conveying the hospital’s needs and vulnerabilities and established expectations that the hospital will have from local response agencies in a disaster in terms of the local response agencies meeting the needs of the hospital. 

St. Mary Medical Center participates in several community wide emergency management activities, such as:

• Los Angeles County Disaster Resource Center meetings
• City of Long Beach Emergency Command Center meetings
• Department of Health and Human Services (Long Beach Public Health) meetings
• Long Beach area Disaster Resource Center meetings
• The Long Beach Airport Triannual Disaster Drill
• City of Long Beach Department of Health and Human Services Medical Reserve Corps
• Long Beach Fire Department drills and training
• Long Beach Police Department drills and training
• Port of Long Beach drills and training
• Naval Weapons Station HAZMAT and Civil Unrest Drills
  
  

The Director of the DRC sits as a Terrorism Liaison Officer position for the Joint Regional Information Center (JRIC) through Homeland Security

1. The hospital uses its HVA as a basis for defining mitigation activities:

The hospital uses its HVA as a basis for defining mitigation activities designed to reduce risk of and potential damage from an emergency.

The mitigation phase of the emergency operations plan involves proactive efforts to minimize the severity and impact of a potential disaster and reduce the potential for an event to occur.  Members of the Enviornment of Care/Disaster Committee assist with the identification and implementation of appropriate mitigation efforts. These efforts include, but are not limited to:

• Non-structural hazard mitigation, such as the proper arrangement, location and placement of items, as well as incorporating emergency management considerations in planning for renovations and construction.
• Construction designed to resist damage, where applicable and/or required under codes and regulations.
• Storage of hazardous materials, including placement, containers, secondary containment, diversionary structures, etc.
• Conforming to building and fire/life safety codes.
• Inspection, testing and maintenance of utility systems, including emergency systems such as generators, uninterrupted power supplies (UPS) and back up information systems.
• Implementation of security measures to reduce exposure.
• Assessment of supply needs for extended durations.
  
  
1. The hospital uses its HVA as a basis for defining the preparedness activities that will organize and mobilize essential resources:
   

   St. Mary Medical Center’s emergency management program utilizes the Hospital Incident Command System (HICS), the industry standard, as the basis for a coordinated organizational response to a disaster.  St. Mary Medical Center incorporates all levels of the organization in the disaster planning effort.  Specific plans, policies, and procedures are developed in collaboration with  leadership, physicians, and front-line HCWs.

   Preparedness planning includes the following:

   • A uniform command structure, HICS, for emergency management and coordination
   • Designated Hospital Command Center (HCC) and established guidelines and instructions for healthcare workers (Job Action Sheets)
   • Disaster supplies stored throughout St. Mary Medical Center and in DRC storage areas/Trailers
   • Written emergency response protocols
   • Alert and notification procedures
   • HCW training, to include plans, testing, drills and home preparedness
   • Coordination with local response agencies and authorities
   • Everbridge/Xmatters mass notification call lists
   • On site inventories and protocols in conjunction with the six critical areas (Communication, resources and assets, safety and security, staff responsibilities, utilities, and patient clinical and support activities) to sustain effective hospital operations for a minimum of 96 hours without community support
   • Identification of on campus alternate care sites
   • Maintaining decontamination capabilities for mass casualty emergencies

      

2. The hospitals incident command structure is integrated into and consistent with its community’s command structure:
   

   St. Mary Medical Center’s organizational and management framework used to execute an actual disaster response is fashioned after the Hospital Incident Command System (HICS) model.  Emergency management and communications functions within a Hospital Command Center (HCC), through the leadership of the Incident Commander, and are organized into various sections designed to optimize resources and skill.  The HICS model is consistent with the Los Angeles County Emergency Operations Center (EOC), Fire Department Incident Command System (ICS), Police Department ICS, military ICS as well as neighboring hospital HICS structures. 

   Utilization of HICS:

   HICS is an emergency management system that includes key positions identified in the hospital incident management team chart. Each identified position has a specific list of responsibilities and actions (Job Action Sheets) to take during an emergency. 

   The HICS plan is designed to be flexible and scalable. Only those positions, or functions, which are needed, should be activated. The HICS plan allows for the addition of needed positions, as well as the deactivation of positions at any time.  HICS may be fully activated for a large, extended emergency, or only partially activated for smaller or more localized emergencies.

   The following provides an overview of the key HICS positions and responsibilities:

   Command Positions: (Incident Management Team)

   • Incident Commander - provides oversight and delegation during an event
   • Liaison Officer - coordinates efforts with external agencies
   • Public Information Officer - communicates externally with the media and internally with HCWs, patients, family members, and vendors
   • Technical Specialists - provides assistance as needed
   • Safety and Security Officer
     

     
     General Staff Positions:
     

3. The hospital keeps a documented inventory of the resources and assets it has on site that may be needed during an emergency, including, but not limited to, personal protective equipment, water, fuel, and medical, surgical, and medication related resources and assets:
   
   
• Logistics Section – manages resources, means and methods
• Planning Section – collects intelligence, plans tactical responses and develops forecasts
• Finance Section – addresses funding and reimbursement issues
• Operations Section – directs resource application, patient care activities, infrastructure, hazmat, security, and business continuity.
  
  

St. Mary Medical Center maintains a documented inventory of assets and resources that are available on site for use in an emergency.  This inventory is updated on an on-going basis. A full inventory review is completed during HPP/ASPER audits and maintained PARR levels of pharmaceuticals and supplies are kept via the Disaster Resource Center.

Once the plan is activated, supply and equipment availability are closely monitored for depletion and replenishment.  Supply conservation activities may be required, and this will be done at the direction of the Logistics Chief in collaboration with other members of the General and Command Staff.