Healthcare Risk Management Module5 Disc 2

A traffic update is an alert that should be used when an explosion at a local distribution center occurs. Road closures are bound to happen in this case, portions of I-95 and 295 West have been shut down which means everyone should be notified. Drivers will be encouraged to find a different route to take. First responders are transporting these patients as this occurs and will be blocking roads to assess the situation. Any civilian should try. To avoid this, not to cause more traffic incidents or get caught up in the aftermath, which could result in more injuries. This will also help with staff needing to come in to help as well as patients knowing if they have an emergency they can go to other healthcare facilities.

Patient surge advisory: With an event like this there will be a surge in patients being brought in by rescue. This alert would be sent out to the staff at the healthcare facility to ensure all hands are on deck and prepared for what may come through the doors. This would also urge others to only come to that facility if it were an emergency due to the influx of patients coming from the accident. Staff will also make sure that they are equipped with enough supplies and there may be longer hours to be worked.

Policies

In the case that evacuation is not necessary, St Vincent Urgent Care needs to prepare for the surge of patients coming through. This would be when the surge plan that is in place will be activated. This involves having more staff come in to help, ensuring there are enough supplies, and preparing them to work longer shifts. Another action to be taken would be to contact other healthcare facilities nearby in case patients need to be transported there. The staff should be trained and prepared for triage and know the order to prioritize based on the severity of injuries.

Coordination

  Each healthcare facility has a specified Medical Emergency Action Plans (MEAPs). This plan is used for emergency situations that occur. For example, if a storm were coming near the location of a hospital, the whole facility would begin their MEAP for how they will prepare the location from any storm damage and keep the patients safe. The facility will then contact the necessary emergency services they may need. There are many aspects that go into creating a MEAP plan. This includes aspects such as communication, finding resources, and employee and facility responsibilities (Accruent, 2024). The facility must engage with the necessary emergent services like fire fighters or fire stations, JEA or Jacksonville Electric Authority, or the city of Jacksonville’s social services.

Communication and employees of the organization are incredibly significant pieces of the MEAP because if everyone is not understanding the overall plan of action then something is bound to go wrong, or patients may be harmed in the process. The facility will need to reach the necessary service providers outside of their facility to get the tools they need to conduct their MEAP. Effective communication skills ensure that the plan is carried out smoothly and correctly. Internal communication between employees and the organization, share messages between themselves and the emergent resources they need to reach (Accruent, 2024). Without an effective system, the whole MEAP is thrown off. St. Vincent’s has an emergency plan for the patients within their hospitals. St. Vincent’s begins preparing the initiation of their MEAP several days prior to any possible storms or severe weather that may occur. In accordance with their plan, they will begin by using their generators and any on-site tools they have to try to continue providing services to their patients. They may then need to contact the JEA to get their power back on to get back to its original working performance.

Having the necessary and effective resources is a crucial aspect of the MEAP. St. Vincent’s has resources set in place that they begin facilitating when any emergent situation occurs such as generators, extra rooms, and extra personnel they bring when needed. The employees and facility know when and where to transport their patients and how to maintain their services. For example, when a storm comes, they may transport patients to different rooms where they have better resources and facilities that their patients will still need in case of power outages, or something happens within the facility. If something like a fire occurs near or on-site, the facility will call 9-1-1 and the fire department will immediately respond. There are many fire stations around or near the facility that can get to the hospital to stop the fire from doing great damage. It is important that when using the MEAP the employees know where all their resources are for patients who will need them to continue their care. 

Within the city of Jacksonville, there are many emergency services all around town. Fire stations, emergency rooms, urgent care, emergency clinics, etc. It is crucial that all healthcare facilities know who to contact when dealing with all types of emergency situations. Power outages are managed by JEA, spontaneous fires are overseen by the fire department, and even something seemingly small like internet and WIFI providers. All employees must be trained to know their MEAP with any situation they may face and the necessary service providers they may need to contact to rectify these issues.

Shelter-In-Place (SIP) Plan

SIP plans are established within a healthcare facility where the patients will be transported and safety precautions while an emergency situation is occurring. An SIP plan is when a healthcare facility is going to keep employees and patients in the safest areas within the facility during emergencies. The Division of Emergency Management (DEM) develops all National Institutes of Health (NIH) facilities (Office of Research Service, 2024). This plan provides step-by-step actions in case of emergency to ensure the situation is deescalated rather than escalated. For instance, always remain calm and collected so patients do not overact and potentially harm themselves or others. Employees should begin making necessary calls to emergency services and protocols. Transporting patients and families to designated safe zones or areas. Temporarily stopping any operations or services for patients outside of safety protocols for the duration of the safety plan (Office of Research Service, 2024). Employees should make sure no patients leave the facility to ensure everyone is accounted for. The facility personnel should also be aware of emergency protocol outside of their facility that may affect them.

With this specific situation such as the bomb explosion it is critical to have the necessary personnel on site. Security, physicians/surgeons, and operative level employees such as nurses, medical assistants, and technicians that must be in place to ensure care is able to be given to all. With an explosion, there are many bound to be injured or killed. Once the injured people arrive at our facility, the Emergency Department is flooded with differently injured patients. Patients may need surgery performed on them by surgeons, wounds cleaned and dressed by nurses and medical assistants and will need to be protected by security from the threat that could have followed them here. Admitting such high-profile patients (patients who are being targeted) poses an even greater threat to the safety of our current patients and staff. These patients are likely to still be in danger from the bomber although they have left the previous location. Whoever committed this crime is likely to have technology that can hear these orders over the radio hearing that the injured will be transported to our facility. Our facility will begin initiating the SIP plan to protect the patients who are already in our facility and those entering from the continued threat from the person(s) who detonated the first bomb. We will take serious precautions prior to getting these new admissions by having police, fire and rescue, and possibly the bomb squad on standby on-site or near the facility. Security will be on high alert and have police called to secure the area of any other possible threats or threat of that criminal attempting to do harm to our facility. We will then transport our current patients to safer areas of the hospital to ensure their safety while still providing the care they need. Employees will remain calm, continue with simple patient care are needed, and ensure every patient is safe and cared for away from the scene.

Employees and facility workers must remain calm throughout the duration of the issue. This ensures patients and family members are aware an emergency is occurring but are not panicking. The last thing the facility needs is patients or family members doing something dangerous because they are panicked because they see employees panicking. Employees should immediately begin contacting the necessary safety personnel or services to quickly return the facility back to the previous functionality. A serious safety concern during emergencies within a facility is ensuring patients are aware of what is happening in a calm manner, so they do not try to leave in a panic, leading to a huge liability issue. It is important to cease all operations until it is safe to continue with practices as normal (U.S. Department of Labor, 2024). This is especially important because depending on the issue occurring this may hinder the completion of the services thus affecting the care and safety of the patients and employees. The facility should also be aware of any changes outside of their facility that may be occurring that may pertain to them or that changes their circumstances.

All aspects of a MEAP are important to ensure the safety of the patients and employees while maintaining the reputation of the organization. Facilities with a specific SIP plan will greatly benefit them in case of any emergency situation. The SIP plan will maintain the health and safety of everyone within the facility. Which will secure satisfaction among patients and their families who will find comfort in the care their loved one receives even in case of emergency.

Operations

Activation of Emergency Response Plan - The Incident Commander notifies a Code Triage, therefore activating the Emergency Operations Plan (EOP). The Incident Command Center (ICC) Establish the ICC to handle first responder communication, patient intake, and resource allocation. Triage and Patient Flow - Create triage zones close to the ER to evaluate and classify arriving patients. Set aside auxiliary zones—such as conference rooms or waiting areas—for overflow. Resource and Supply Management - Share trauma kits and guarantee supply availability. If needed, arrange resupplies after compiling a list of basics.

Remote Correspondence Protocol - Designed staff will operate remotely to guarantee necessary operations and information flow as the office might be useless. As necessary, these staff members will work with the Incident Command Center to keep staff members updated, notify stakeholders, and enable outside correspondence. They will be required to provide status updates to the incident Command Center every 30 minutes or as major developments occur. Secure email, encrypted messaging, and phone calls will be used to ensure confidentiality and reliability. Additionally, at the end of the shift, each remote employee will submit a summary report detailing their actions, communication updates, and any unresolved issues.

Remote Work Assignments and Designated Employees

In the event that the office is rendered unavailable, the following staff will be assigned to work from home, distributing important information and coordinating response actions via secure remote communication platforms (e.g., encrypted messaging, VPN-enabled access to hospital systems).

1. Kate Bowen – Communications Coordinator

2. Warren Smith – IT and Systems Specialist

3. Amanda Sanders – External Relations Officer

Given the magnitude of the disaster, personnel from various departments will be activated to manage the increased patient load. Emergency Department (ED) Staff: All available ED doctors, nurses, and support personnel will be summoned to handle initial triage, stabilization, and treatment. Trauma Surgeons and Surgical Team: Surgeons, anesthesiologists, and surgical nurses will be on standby to perform emergency surgeries on patients with severe injuries. Critical Care Staff: ICU personnel, including critical care doctors, nurses, and respiratory therapists, will assist patients with life-threatening injuries who require intensive care. Radiology and Imaging Technicians: Radiology personnel will be required to perform immediate diagnostic imaging (e.g., X-rays, CT scans) to assess internal injuries. Lab technicians and phlebotomists will help meet the increased demand for blood typing, cross-matching, and other lab analyses. The Mental Health and Social Work Team will offer emotional support to victims and their families.

An estimated 20-25 additional employees will be needed across departments to provide continuous patient care, administrative support, and operational management. On-call personnel, part-time employees, and any other available staff willing to volunteer for overtime may also provide additional assistance. Postponing elective surgeries and non-urgent procedures will be required to free up resources such as beds, surgical suites, and imaging equipment.

Duties

In this emergency situation, various essential departments and personnel must execute designated medical and rescue responsibilities to adequately address the surge of patients resulting from the bombing incident. These individuals and teams will be essential for overseeing triage, initial stabilization, and ongoing care for critically injured patients. The following personnel are assigned to execute critical responsibilities, along with additional departments and their functions in aiding this community disaster response.

1. Dr. Savannah James

Job Title: Emergency Medicine Physician

Contact information: 904-555-6690

Dr. James is an experienced ER physician with a strong background in trauma care, rendering her well-suited to oversee initial triage and resuscitation efforts. She will manage the prioritization of patients according to injury severity, direct trauma response in the emergency room, and coordinate with emergency medical services for incoming cases. Dr. James's expertise in emergency response will be essential for overseeing large numbers of critically injured patients in a time-sensitive setting.

2. Monica Crawford

Job title: Registered Nurse, Trauma Unit

Contact Information: 904-322-1010

Monica, a lead trauma nurse with Advanced Trauma Life Support (ATLS) training, will coordinate emergency response efforts in the trauma unit. Her responsibilities include aiding in initial wound care, overseeing airway stabilization, and coordinating communication between the emergency room and surgical teams. Monica's expertise and clinical proficiency makes her essential for swiftly stabilizing patients and priming them for surgery or intensive care.

3. Faith Johnson

Job Title: Respiratory Therapist

Contact Information: 904-897-4789

Faith's experience in airway management and respiratory care is essential in emergencies related to explosions, as numerous patients may experience inhalation injuries or require ventilator assistance. Faith will oversee the installation and supervision of ventilators, administer oxygen therapy, and manage patients suffering from smoke inhalation. Her expertise is crucial for maintaining respiratory stability and addressing complications arising from blast injuries.

The combination of personnel and department roles ensures a coordinated and comprehensive disaster response. These employees will collaborate closely to provide immediate, effective care and support to those affected by the bombing, while also communicating with local authorities and emergency management agencies to manage patient inflow, allocate resources, and support ongoing patient and family needs during the disaster response. The additional departments and personnel duties that will be required would be as follows:

Surgery Department: Surgeons, anesthesiologists, and surgical nurses will be prepared to perform emergency surgeries needed by life-threatening injuries. They will collaborate with the trauma team to facilitate the prompt transfer of patients requiring surgical intervention.

Radiology Department: Will deliver urgent diagnostic imaging services, such as X-rays and CT scans, to evaluate internal injuries and fractures. This department will function continuously to manage the influx of trauma patients needing immediate imaging for treatment planning.

Pharmacy Department: Pharmacists and pharmacy technicians will dispense critical medications, including painkillers, antibiotics, and intravenous fluids. The pharmacy team will facilitate prompt access to medications and prepare for possible shortages by collaborating with external suppliers if required.

Figures 1 and 2

References

Ascension St. Vincent’s emergency care - southside. Ascension. (2023). https://healthcare.ascension.org/locations/florida/fljac/jacksonville-ascension-st-vincents--emergency-room-southside

St. Vincent Urgent Care. (2023). Facility overview - Healthcare Ascension. (2024). https://www.stvincent.org/