Command Response Guide – Loss of Heating/ Ventilation/Air Conditioning (HVAC)

Mission

To ensure a safe environment for staff, patients, visitors and the facility during the loss of HVAC within the hospital

Objectives

Protect patients, families, staff and facility / Identify the extent and duration of the loss of HVAC
Minimize the impact of the loss of HVAC on patients and staff; consider evacuation
Communicate situation status & updates to staff, patients, visitors and facility
Immediate Operational Period
Time / Initials
Command / Hospital Incident Commander / Activate facility Loss of HVAC Plan
Activate HICS, as appropriate
Determine if necessary to
  • Divert ambulances
  • Divert ambulatory patients
  • Cancel elective procedures
  • Close non-mission critical services

Liaison Officer / Notify local emergency management/EOC of hospital situation status & obtain incident information and estimated time-lines for HVAC restoration
Notify local EMS and ambulance services of situation and possible need to evacuate
Communicate with other healthcare facilities (and/or regional resources) to determine:
  • Situation status
  • Surge capacity
  • Patient transfer/bed availability
  • Ability to loan needed equipment, supplies, medications, personnel, etc.

PIO / Inform staff, patients & families of situation & measures to cool/heat facility and protect life
Prepare media staging area
Maintain communication with staff/patients/families regarding current situation and what’s being done to address
Safety Officer / Consider immediate evacuation of affected section, if threat is identified
Monitor response activities to ensure safety of staff, patients and responders
Time / Initials
Operations / Assess patients for risk, prioritize care & resources as appropriate
Implement alternate cooling measures for patients, perishable supplies and the facility
Time / Initials
Secure facility and implement limited visitation policy
In cooperation with Logistics, aAssess the HVAC system and prepare a plan and time-line for repair and restoration of service
Ensure continuation of patient care & essential services
Consider evacuating personnel, patients and families to a safe area, either within facility or outside of facility as indicated by incident
Logistics / Assess HVAC system damage and project impacts of heat/cold on the facility, equipment and perishables
Maintain other utilities and activate alternate systems as needed
Investigate & provide recommendations for portable HVAC unit rental for cooling capability, portable filtration rental (HEPA units) for temporary isolation capability
Maintain communications systems/other utilities. Activate back-up systems, as appropriate
Provide for water, food and rest periods for staff
Monitor staff for heat/cold-related injuries & provide appropriate follow-up
Obtain supplemental staffing, as needed
Prepare for transportation of evacuated patients
Implement business continuity plans and protection of records
Planning / Establish operational periods, incident objectives and develop Incident Action Plan, in collaboration with Hospital Incident Commander
Implement patient & personnel tracking, as appropriate
Plan for sustained hospital operations in an alternate location (ACS)
Intermediate/Extended Operational Period
Time / Initials
Command / Hospital Incident Commander / Update & revise Incident Action Plan and prepare for demobilization
Continue to update senior officials on situation status
Monitor evacuation
Liaison Officer / Continue to notify local EOC of situation status, critical issue & request assistance, as needed
Continue communications with area hospitals & facilitate patient transfers
PIO / Continue with briefings & situation updates with staff, patients & families
Continue patient information center operations, in collaboration with Liaison Officer
Assist with notification of patients’ families about situation and evacuation, if activated
Develop, in conjunction with Hospital Incident Command, media releases regarding necessary diversions or cancellations
Safety Officer / Conduct ongoing analysis of existing response practices for health and safety issues related to staff, patients and facility and implement corrective actions to address
Time / Initials
Operations / Continue evaluation of patients and visitors for heat/cold impacts and maintain cooling/heating measuresof patients’ belongings, medications and records upon evacuation
As directed by Hospital Incident Command:
  • Cancel elective surgeries and procedures
  • Prepare the staging area for patient transfer/evacuation
  • Initiate ambulance diversion procedures
  • Continue or implement patient evacuation
  • Ensure the transfer

Time / Initials
Continue evaluation and provision of temporary HVAC systems and portable filtration units
Maintain facility security and restricted visitation
Provide water and food to patients, visitors and families
Monitor patients for adverse affects of health and psychological stress
Institute HVAC repairs and service
Logistics / Continue to maintain other utilities
Continue provision of portable HVAC units and filtration units
Continue to provide staff for patient care and evacuation
Monitor staff for adverse affects of health and psychological stress
Monitor, report, follow-up and document staff or patient injuries
Continue to provide transportation services for internal operations & patient evacuation/transfer
Planning / Continue patient, bed and personnel tracking
Update and revise Incident Action Plan
Prepare the demobilization and system recovery plans
Plan for repatriation of patients
Collect and collate documentation of actions, decisions and activities
Finance / Facilitate contracting for emergency repairs and other services
Demobilization/System Recovery
Time / Initials
Command / Hospital Incident Commander / Determine hospital status & declare restoration of HVAC services & termination of incident
Oversee restoration of normal hospital operations
Liaison Officer / Communicate final hospital status & termination of incident to local EOC, area hospitals & officials
Assist with repatriation of transferred/evacuated patients
PIO / Conduct final media briefing & assist with updating staff, patients, families and other of termination of event
Safety Officer / Monitor facility safety and restoration of normal operations
Facilitate facility repairs in conjunction with Operations & Logistics section
Time / Initials
Operations / Restore normal patient care operations
Restore HVAC services & negative pressure isolation rooms
Repatriate transferred/evacuated patients
Discontinue ambulance diversion & visitor limitations
Monitor business continuity of operations & return to normal services
Logistics / Restock supplies, equipment, medications, food & water
Monitor communications & IT/IS operations return to normal
Replace all damaged or soiled air handling filters (e.g. HEPA)
Conduct stress management , as necessary
Planning / Finalize Incident Action Plan and demobilization plan
Conduct after-action reviews and debriefing
Finance / Compile a final report of response costs, expenditures & lost revenue for submission to Planning
Contact insurance carriers to assist in documentation of structural and infrastructure damage & initiate reimbursement and claims procedures
Documents & Tools
Emergency Operations Plan, including
 Utility Emergency Plan
Evacuation Plan (as needed)
Forms, including:
HICS 201 – Incident Briefing
HICS 202 – Incident Objectives
HICS 203 – Organization Assignment List – OR – HICS 207 – Organization Chart
HICS 214 – Operational Log
HICS 215 A – Incident Action Plan Safety Analysis
HICS 251 – Facility System Status Report
HICS 253 – Volunteer/Staff Registration
HICS 254 – Disaster Victim/Patient Tracking
HICS 255 – Master Patient Evacuation Tracking
MI-HICS Notification Form
Job Action Sheets
Hospital Organization chart
Television/radio/internet to monitor news
Telephone/cell phone/satellite phone/internet/RACES for communication