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Posted May 06 2009 12:27pm

Once again we have fire in Santa Barbara in the mountains above our community.  I can see the fire from my office and will keep a close eye on it today.  We are just outside of the evacuation warning area and no hospitals are involved.  However, this is probably a good time to share a few things from my current work on the topic of hospital evacuation.

  • It is important to have a clear understanding and the role of your local EMS agency described in the plan.  Make sure you have had conversations with each other prior to an event to avoid any gaps or misunderstandings.  Then clearly document the key points in your plan so it can be implemented by anyone who finds themselves in the role of Incident Commander.

  • While it is ideal to coordinate access to resources with your local EOC, be prepared to initiate an evacuation on your own if they are overwhelmed by the incident or cannot be reached.  You will want to shelter-in-place as long as possible, but be prepared to get out on your own if needed.

  • Security during and after an evacuation is important for safeguarding assets and helping to ensure that every is removed from unsafe areas or the facility.  Also be prepared to secure and shut off utilities as appropriate or as the sections of the facility are evacuated.

  • When evacuating patients, plan for the transportation of needed medications, supplies, equipment and staff, even if your destination is another hospital.  Some patients can be removed from medical gasses and equipment during the evacuation period, but will need this support at the destination.  The receiving facility will be in a surge mode and resources may be limited initially.

  • If you have electronic health records, how will you access patient information at the destination facility or alternate site.  What minimum set of records should be printed out if time permits for each patient?

  • In advance of an evacuation, identify holding areas (safe areas for patients awaiting transportation) and staging areas (for loading patients onto transportation that has arrived.)  Consider different holding and staging areas for different patient types and transportation needs (ie. critical patients are evacuated through the ER via ambulance, ambulatory patients are evacuated through the main entrance via bus, non-ambulatory patients are evacuated through the side entrance via wheelchair vans and ambulances, etc)

  • Keep track of patients, but also the evacuation of employees and visitors.

  • Plan for demobilization, recovery and re-entry soon after the plans for evacuation begin.  Establish criteria

  • Outline key tasks and responsibilities for each of the HICS roles that you expect to be initiated in an evacuation event.   Train staff and conduct drills that test their response to the six critical areas of emergency management:

      •  communications

      • resources and assets

      • safety and security

      • staff responsibilities

      • utilities management

      • patient clinical and support activities
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