Mass Fatality Management Guide for Healthcare Entities

Mass Fatality Management Guide for Healthcare Entities

Mass Fatality Management Guide for Healthcare Entities

AGENDA• Project Overview

– History– Goal and Objectives– Methodology

• Guide Review– Scope– Organization– Content

• Next Steps– Implementation

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Mass Fatality Management Guide for Healthcare Entities

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2008 MFI GUIDE REVIEW• The 2008 goal was to develop a guidance

document for hospitals to enhance the ability of Los Angeles County and its healthcare partners to manage a surge in the number of decedents as a result of pandemic flu outbreak

• Developed by EMS, Coroner and DPH

Mass Fatality Management Guide for Healthcare Entities

2011-2013 GOAL AND OBJECTIVES• Revise/Enhance Guide

– Brings in best practices/lessons learned • Expanded throughout 2012

– Provides specific, tangible, and quantifiable recommendations • Tested during Statewide exercise

– Provides an accompanying online toolkit • Expanded as part of vetting process

– Addresses the nexus between healthcare entities, and other local agencies in the fatality management planning process• Tested during Statewide Medical and Health Exercise

– Addresses the legal and regulatory issues

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Mass Fatality Management Guide for Healthcare Entities

RELEVANCE TO OTHER MASS FATALITY RESOURCES• The 2008 version was consistently

recognized as one of the best resources available on mass fatality management at the time of its release. It is regularly referenced in other jurisdictional mass fatality plans

• The new version is a benchmark in mass fatality planning efforts

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Mass Fatality Management Guide for Healthcare Entities

METHODOLOGY• Identify Key Stakeholders

– Project Oversight Group– Interviewees/SME– Reviewers

• Timeline: September 2011 to January 2013

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Mass Fatality Management Guide for Healthcare Entities

BASE • Acknowledgements• Overview

– Background, Scope, Objectives– Guide Development Process– How to Use Guide

• Plan Development– Writing the Plan– Training, Exercise– Special Considerations

• Activation– Tiered Escalation Levels– Logistics, Staffing– Notify Stakeholders– JIT, Initial Briefing

• Operation– NOK Notification– Decedent Identification,

Processing, Transfer, Tracking• Demobilization

Mass Fatality Management Guide for Healthcare Entities

APPENDICES • Community-wide

Response Matrix• Key contacts• HIPAA• Security• Internet Resources• Refrigeration Truck

Storage• Mental and Behavioral

Health Resources• Religious and Cultural

Resources• Fact Sheets• Glossary• Acronyms

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ONLINE RESOURCES• Mass Fatality Management

Guide for Healthcare Entities Forms

• Triage Tag Training• Mass Fatality Management • Plan Template• Job Action Sheet• Guide Slide Presentation

Mass Fatality Management Guide for Healthcare Entities

KEY SECTION REVIEW• Plan Activation

– Key Position Checklist– Physician-in-Charge Concept– Witness Form

• Decedent Processing• Death Certificates & CA-EDRS• Decedent Tracking• Decedent Handling and Storage• Community-wide Response Matrix• Refrigeration Truck Storage• Religion and Culture• Fact Sheets

Mass Fatality Management Guide for Healthcare Entities

PLAN ACTIVATION• Identify triggers for

plan activation & escalation

• Plan activation likely in concert with ICS activation

• Actions organized via six step process

• Staffing Guidelines– Organized by facilities

with/without morgues and escalation tier

Mass Fatality Management Guide for Healthcare Entities

KEY POSITION CHECKLIST• Decedent Affairs Group Supervisor

– Based on HICS, can (and should!) be tailored – Developed as part of larger emergency response approach– Tasks in chronological order

Mass Fatality Management Guide for Healthcare Entities

PHYSICIAN-IN-CHARGE• Certain physicians are

designated to sign death certificates – NOT for Coroner’s cases

• Most MFIs involve Coroner cases

– May pertain to widespread communicable disease events

ADMIN STAFF• Gather as much

information as possible regarding patient– Witness Form

Mass Fatality Management Guide for Healthcare Entities

DECEDENT PROCESSING• Organized in two steps

– Step 1– Understand process– Step 2 – Identify ways to expedite

• Flow chart provided

DEATH CERTIFICATES AND CA-EDRS• Organized in two steps

– Step 1– Understand & document death certificate parameters• Non-Coroner’s case process• Coroner’s case process

– Step 2 – Identify ways to expedite

• See Fact Sheets– Death Certificates– CA-EDRS– County Public Administrator

Mass Fatality Management Guide for Healthcare Entities

DECEDENT TRACKING• Organized in four steps

– Step 1 – Understand tracking process for your facility• MCI Example

– Step 2 – Document process• Hospitals w/ ReddiNet MCI

module• Hospitals w/o ReddiNet MCI

module• Medical Clinics• SNFs

– Step 3 – Identify ways to direct decedents to mortuaries

– Step 4 – Identify ways to accommodate NOK who cannot pay

Mass Fatality Management Guide for Healthcare Entities

DECEDENT HANDLING AND STORAGE• Organized in four steps

– Step 1 – Determine your surge storage capacity• See Surge Storage Capacity

Assessment

– Step 2 – Ensure decedent handling processes are in place

– Step 3 – Expand surge capacity• Primary morgue• Unused service areas• External morgues• Temporary burial (ONLY when

directed by Coroner)

– Step 4 – Ensure P&P

Mass Fatality Management Guide for Healthcare Entities

COMMUNITY-WIDE RESPONSE MATRIX• High-level roles/responsibilities matrix

– Healthcare partners, and local, State, Federal partners– Tool for healthcare entity partners to enhance understanding

of their role in a community-wide response

Mass Fatality Management Guide for Healthcare Entities

REFRIGERATION TRUCKS FOR STORAGE• Capacity

– # of decedents that can be stored by truck size

– NOT for transportation – storage only

– Increase capacity with shelving

• Procurement– Can procure own– Can request via NIMS/SEMS– Information to provide

• Reimbursement– Requesting facility to pay– HPPs MAY qualify for

reimbursement

Mass Fatality Management Guide for Healthcare Entities

RELIGION AND CULTURE• Organized in two steps

– Step 1– Obtain and include information regarding death practices• Tailor for your population• Sample material included

– Step 2 – Confer with cultural and religious organizations in your area

FACT SHEETS• Death Certificates• CA-EDRS• Health risks• County Public Administrator• Recommendations• Considerations• Decomposition

Mass Fatality Management Guide for Healthcare Entities

NEXT STEPS• Guide implementation

– See Plan Development Section

– Review existing policy– Review Guide– Revise facility mass fatality

plan based on Guide

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Mass Fatality Management Guide for Healthcare Entities

Mass Fatality Management Guide for Healthcare Entities Questions? Thank you!