Policy Title: Code Orange - Disaster Plan (DRAFT)
Category: Safety – Emergency Codes
POLICY: Parkview Regional Medical Center will provide a safe and secure environment for patients, employees, volunteers, physicians and visitors.
SCOPE: All personnel working at Parkview Regional Medical Center and the Parkview North Campus.
SCOPE OF SERVICES - General Statement
A disaster is an event which requires expansion of facilities, staff and services to receive and care for a large number of casualties from any number of man-made or natural disasters, such as a plane crash, chemical spill, tornado, mass food poisoning or civil riot. It can also include events that cause or threaten to cause physical damage to the hospital buildings and/or injury to all hospital personnel, licensed independent practitioners, patients, visitors and volunteers.
Definitions:
"Code Orange Standby" - A Code Orange Standby is called when the hospital has been notified of a potential incident involving the possibility of numerous patients. Alert should include: review of census and bed distribution, assessment of personnel needs according to disaster responsibilities and reviewing the departmental call list available. Do not send personnel to the Staging Area.
"Code Orange Mobilize" - A Code Orange Mobilize is called when the alert has been confirmed and the hospital has been notified that patients will be transported there. Staff already working should NOT report to *Staging Area.
"Code Orange Drill" - A Code Orange Drill is called when there has been a scheduled drill by the Safety/Environment of Care Committee.
AUTHORIZATION
The Administrator on Call or the Senior Administrator, after consultation with the Nursing Shift Supervisor, will authorize the implementation of the Disaster Plan and assume the responsibilities of INCIDENT COMMANDER. Until their arrival, the Nursing Shift Supervisor will assume the role of INCIDENT COMMANDER.
ADMINISTRATOR ON CALL/NURSING SHIFT SUPERVISOR:
Based on the available information, the executive on call or the Nursing Shift Supervisor will become the INCIDENT COMMANDER and shall decide when to activate the hospital disaster plan. The INCIDENT COMMANDER dials 1911 to activate "Code Orange Standby" and/or "Code Orange Mobilize". The decision will be made at this time to implement the HICS (Hospital Incident Command System).
INTERNAL COMMUNICATIONS:
When information is received of an actual/potential disaster, the emergency operator will:
A. Request:
ü the type and location of the disaster
ü the estimated number of casualties
ü the name and phone number of the person reporting the situation.
B. Verify (if necessary) the disaster situation by returning a call to the above name and number.
C. Upon authorization from the INCIDENT COMMANDER, announce over the PA system three times:
"ATTENTION ALL PERSONNEL"
"CODE ORANGE STANDBY"
"ALL AVAILABLE PHYSICIANS AND STAFF REMAIN AT THE HOSPITAL UNTIL FURTHER NOTICE.”
OR
"CODE ORANGE MOBILIZE”
“ALL AVAILABLE PHYSICIANS, DIRECTORS AND MANAGERS REPORT TO THE COMMAND CENTER.”
OR
"CODE ORANGE DRILL IS NOW IN EFFECT"
D. Voice Services will activate the IntelliDesk cascade paging list for Code Orange – Disaster
E. When incident has ended and upon authorization from the INCIDENT COMMANDER, Voice Services announce over the PA system three times:
"ATTENTION ALL PERSONNEL"
"ALL CLEAR CODE ORANGE"
IMPLEMENTATION AND NOTIFICATION
I. Command Center:
The Command Center shall be located in the Emergency Department Medical Billing Unit area when conditions allow. The Board Room has been identified as the back-up Command Center if necessary, and the Emergency Supply Room in the lower level near the Safety Coordinators office shall be the tertiary site. Communications with the Command Center will involve spectra-link phones, Smart Phones, email and radio communications.
The phone number for the Command Center is 266-1890. There are four incoming lines designated for this number and one roll over line for voice mail
There has also been an email address created specifically for disaster situations. This address is: This email account can be accessed by command center staff if needed. To access this email account, please do the following:
§ Go to Team Parkview from any computer
§ Type: email.parkview.com in web browser address field.
§ OUTLOOK user name: control
§ OUTLOOK password: control
Individual log-in and usernames have also been created for the 4 computers located in the Command Center. Those are ic1, ic2, ic3, and ic4. The password is the same for each computer. That is disaster. These log ins and user names are case sensitive.
Once a user is logged into a computer, there are specific icons on the desktop which will assist that person in completing assigned duties for their Command Center role. One of those icons is WebEOC. Due to restricted access, only one person may log into WebEOC. The username is: Marsh, Anna (D3H). The password is: Emergency12 These are case sensitive and must be typed exactly as typed above, including parenthesis.
There are also magnets on each overhead cabinet in the Command Center that include all log-in and password information.
II. Staging Areas:
· LABOR STAGING AREA - The staging area for staff responding to the hospital shall be located in the Quality Resources / Bed Management Area – lower level. Staff reporting to the PRMC to work should report to this staging area (unless otherwise instructed). They will be given their assigned responsibilities from here. This allows for the best utilization of resources. Staff should enter through the SOUTH STAFF ENTRANCE of the PRMC.
· FAMILY STAGING AREA - The staging area for the worried well and family of patients/victims will be the Conference Rooms A/B/C or Comprehensive Cancer Center Lobby. Should the event last longer than 24 hours, the American Red Cross will assist in establishing an area for family and worried well.
· MEDIA STAGING AREA - The staging area for Media will be the PCO parking lot. Any television, newspaper or other media reporter shall be directed to the PCO.
III. Radio Communications:
The Command Center and most hospital departments have been equipped with two-way radios to facilitate communications during a disaster. These radios are equipped with the following frequencies or channels:
1. Emergency Repeater (EMERG RP)
2. Emergency 1 (EMERG 1)
3. Emergency 2 (EMERG 2)
4. Emergency 3 (EMERG 3)
5. Emergency 4 (EMERG 4)
6. Maintenance Repeater (MAINT)
7. PCO Security (PCO SEC)
8. PRMC Security Direct (PRMC SEC)
The “EMERGENCY” channels on these two-way radios are designed to handle Command Center traffic and may be assigned as needed by the Incident Commander. Due to the size of the north campus and PRMC, please use the EMERG RP channel for communication. For communication within a department or in limited range, you may use one of the EMERG 1, 2, 3 or 4 channels.
When a Code Orange is announced overhead, it will also state which channel staff should turn to on their radios. Should departments require radio contact with the Command Center, they will utilize this channel.
For more information regarding use of these radios, please refer to the Emergency Radio Operations – Disaster Radios policy/procedure in the Emergency Codes and Safety Manual on Team.Parkview.com
RESPONSIBILITIES:
MANAGEMENT STAFF RESPONSE:
One manager/supervisor from each department will immediately report to the Conference Room, upon hearing "Code Orange Standby", to assume a specified role as determined by the INCIDENT COMMANDER. They should bring a department update which lists their available staff, beds and critical resources. At this point, leaders should prepare their areas of responsibility for the disaster in anticipation of confirmation of the disaster.
COMMAND CENTER STAFF:
Based on available information, including advisement from the Emergency Department Physician, and the Director of Nursing or designee, and/or EMS Personnel on the Scene, the Nursing Shift Supervisor will contact the Administrator on call and advise of the situation. If the Nursing Shift Supervisor is not able to make contact with the Administrator on Call in a reasonable amount of time, the Nursing Shift Supervisor will initiate the disaster plan and will become the Incident Commander. This is done by contacting the Hospital emergency operator (ext. 1911), identifying self and asking them to announce "Code-Orange" when informed that patients are about to arrive at PRMC. The Incident Commander will report to the Command Center located at the Emergency Department Medical Billing Unit to implement incident command center operations.
· Administrator on Call/Nursing Shift Supervisor – Will assume role of INCIDENT COMMANDER and will coordinate all disaster activities, facilitates allocation of staff resources with the help of the assigned officers. Will assign the following:
· OPERATIONS CHIEF - Coordinator of all patient care assignments including responsibilities involving inpatients, outpatient activities and casualties.
· LOGISTICS CHIEF – Coordinator of all support activities during the incident. Including labor pool, communications, materials, transportation and nutritional supply.
· PLANNING CHIEF – Oversee all incident-related data gathering and analysis regarding incident operations and assigned resources, develop alternatives for tactical operations, conduct planning meetings, and prepare the Incident Action Plan (IAP) for each operational period. In basic terms, the Planning team determines what is needed during the event.
· FINANCE CHIEF – The role of the Finance Section Chief is to monitor the utilization of financial assets and the accounting for financial expenditures. Supervise the documentation of expenditures and cost reimbursement activities.
· LEAD SECURITY OFFICER - Facilitates security measures during the disaster.
· SAFETY OFFICER - The Safety Coordinator or his/her designee shall assume responsibility for the identification and prevention of conditions that might create the risk of accident or endanger the safety and well being of a patient, employee, or visitor upon the premises of the Hospital.
· PUBLIC INFORMATION OFFICER - Facilitates the media interface during the disaster.
· LIAISON OFFICER – Coordinates communications between facility and outside emergency response agencies.
· MEDICAL/TECHNICAL SPECIALIST - The Chief of Staff and any other physician will report to the Command Center. They will assist or assign other physicians to assist the Emergency Room Physician. A charge nurse or designee needs to review patient inventories and dismiss inpatients when warranted. They should also assist with triage if available.
DEPARTMENTAL FUNCTIONS:
ALL DEPARTMENTS:
Upon notification of the Code Orange alert, all department managers/supervisors should conduct a quick assessment of their area(s). This should include the number of available staff, available beds and critical resources and bring with them to the Conference Room for the initial briefing. Other staff should turn on disaster radios and remain in their areas for further instruction from their leader. ONLY DEPARTMENT LEADERS SHOULD REPORT TO COMMAND CENTER.
TRIAGE AND TREATMENT AREA:
Disaster victims will be received and evaluated by Triage Physicians or Nurses at both the Emergency Department and EMS entrances. These Triage Physicians and Nurses will evaluate disaster victims transported by ambulance and direct to the appropriate TREATMENT AREA. In the event of a bioterrorism or chemical event, these individuals should have on full personal protective equipment (PPE).
An employee or employees from the labor pool will be assigned as a registrar(s) to record all incoming patients on a log sheet. Request this person from LOGISTICS CHIEF.
A TREATMENT AREAS SUPERVISOR will be assigned to monitor the activities of all treatment areas and will report information to the MEDICAL/TECHNICAL SPECIALIST. Each patient's name, an evaluation of the patient's condition, and the treatment area to which the patient is assigned will be recorded on a log sheet.
DESIGNATED TREATMENT AREAS
Category Area Definition
Immediate Care Emergency Care Center Patients who require prompt life-saving treatment.
Delayed Care Emergency Care Center Patients requiring attention, but for
whom definitive treatment could be delayed.
Minor Care MOB 11 Patients who can be discharged after a minimal amount of treatment.
Expectant or DOA TBD Patients who are critically injured and have a very poor prognosis, patients that have died after arrival, and those who have died at the scene.
Families of victims/patients will be sent to the Conference Rooms A/B/C or Comprehensive Cancer Center Lobby for updates from Incident Command Representatives.
Each treatment area will log all incoming patients and any subsequent movement from their area.
Pending surgical cases will be admitted to the surgery center for preparation.
Patients requiring further care other than surgery will be admitted to the inpatient-nursing center
PATIENT DISCHARGE AND TRANSFER CENTER:
Patient Registrars will meet with patients being discharged after treatment to verify information.
ED patients will be discharged through the Information Desk and will exit through the main front entrance. MOB 11 patients will exit through the main entrance of the medical office building.
Patients requiring transfer to another facility will be transferred according to the usual hospital procedure.
RECOVERY
The INCIDENT COMMANDER will coordinate efforts through the LOGISTICS, PLANNING, FINANCE and OPERATIONS CHIEFS for quick and effective resumption of normal activities. Each Section Chief will be asked to evaluate their area for specific needs or requests. The Safety Coordinator as well as the Director of Hospitality will determine the readiness of the facility to establish normal operating conditions. The final decision on resumption of normal activities will rest on the INCIDENT COMMANDER.
Note: Because policies are updated regularly through the Safety Committee, any policy that is printed is valid for 24 hours. Please check the on-line, electronic version to ensure that you have the most current policy.
The Environment of Care or Emergency Preparedness Committees reserves the right to amend or discontinue any or all of the provisions of this policy.
Effective Date: March 2012 / Authorized By: Sue Ehinger, CEOReview Date: / Issued By: Safety Coordinator
Source: Environment of Care Committee / Page 8 of 9