Crisis Standards of Care A Toolkit for Indicators and Triggers (2013) / Chapter Skim
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3: Toolkit Part 1: Introduction
3: Toolkit Part 1: Introduction
Pages 75-92
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From page 75... ...
. Public engagement is also a key element of CSC planning; a toolkit for community 75
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From page 76... ...
This may warrant further monitoring, analysis, information sharing, and/or select implementation of emergency response system actions. conversations on CSC is available in the Institute of Medicine's report Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response (IOM, 2012)
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From page 77... ...
This chapter provides part 1 of the toolkit, which covers material that is relevant to all components of the emergency response system, including the scenarios and a set of overarching questions. Part 2 of the toolkit is provided in Chapters 4-9, which are each aimed at a key component of the emergency response system: emergency management, public health, behavioral health, emergency medical services (EMS)
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From page 78... ...
; • State and local emergency management agencies; • Health care coalitions (HCCs) and their representative health care organizations, and where appro priate, U.S.
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From page 79... ...
; CDC = Centers for Disease Control and Prevention; CSC = crisis standards of care; EOC = emergency operations center; HCC = health care coalition; HCF = health care facility; HHS = Department of Health and Human Services; MAC = Medical Advisory Committee; RDMAC = Regional Disaster Medical Advisory Committee; RMCC = Regional Medical Coordination Center; SDMAC = State Disaster Medical Advisory Committee. SOURCE: Adapted from IOM, 2012, p.
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From page 80... ...
In particular, it is important to highlight that the two government entities, emergency management and public health, should review the other sections and ensure that the activities they have outlined would support the activities described in the other sections. This would solidify the intent that local and state governmental agencies will need to support health care organizations and HCCs during CSC.
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From page 81... ...
At the request of local EOCs and the State Health Emergency Coordination Center, the State Emergency Operation Center has been activated. The key areas of focus are coordinating volunteers, providing security, maintaining and augmenting communications, and facilitating coordination of efforts in support of the Emergency Support Function (ESF)
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From page 82... ...
The lead for this incident is the ESF-8, and communications between local and state EOCs in collaboration with the State Health Emergency Coordination Center have been augmented and standardized. Declarations of emergency have been released from the state, including public health emergencies or executive orders consistent with state authorities.
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From page 83... ...
Hospital Hospitals have activated their hospital incident command system and moved from conventional care to contingency care as the pandemic worsens. These modifications have been communicated through their regional health care coalition to their local EOC with anticipated support and possible waivers.
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From page 84... ...
Patients and residents are being relocated to alternate care centers; however, these options are unsuitable for those requiring a higher level of medical support due to lack of potable water and loss of electrical power at several facilities. Outpatient clinics and private medical practices are woefully understaffed or simply closed.
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From page 85... ...
The State Health Emergency Coordination Center is fully activated to support the health and public health sectors. Public health authorities are working to initiate "patient tracking" capabilities, and have been asked to support activation of family reunification centers.
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From page 86... ...
Health care coalitions in the affected area, as well as neighboring regions, are activated to support response. Out-of-Hospital Care Ambulatory care clinics, private medical practices, skilled nursing and assisted living facilities, dialysis centers, and home health care services are all significantly impacted by the earthquake.
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From page 87... ...
. At the request of local EOCs, the state EOC activates six Medical Special Needs Shelters, which are staffed with behavioral health assessment and intervention teams, and activates behavioral health crisis response teams to assist first responders active in rescue-and-recovery and evacuation activities.
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From page 88... ...
During a response, proactive monitoring of the "temperature" of staff is needed by supervisory personnel, with reports back to the IC, and aggressive measures to maintain morale, manage fatigue, and manage home-related issues for staff. Table 3-1 below outlines indicators, triggers, and tactics related to worker functional capacity and workforce behavioral health protection.
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From page 89... ...
2012. Crisis standards of care: A systems framework for catastrophic disaster response.
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From page 90... ...
reported disruption organizational practices by unit supervisors or implied by • Role conflict (relative priorities of • Evaluate, enhance, and continue regular infrastructure damage, school closings, home/family well-being and job and accurate surveillance of stress-related or communications systems failures function) results reach a point where issues • Workplace accidents increase units are unable to maintain staffing, • Continue integration of various • Workers express doubts/problems with patients are transferred to other stakeholders in strategy development their perceived safety or education/ facilities, personnel refuse to come to and implementation (e.g., direct care training for current tasks work leadership, administration, HR, general • Negative media coverage/public • Unable to give workers time off counsel, EAP, etc.)
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From page 91... ...
, etc.) • Initiate staff appreciation activities • Explore specialized consultation from content experts in workplace stress in extreme situations • Review personnel policies and practices to explore ways in which stress on workers may be reduced, including rotations through other areas of the facility or variable responsibilities • Review and update plans for mutual aid or other means of supplementing human resources 91
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