An Attack. Event - Response - Continuity of Operations - Recovery - Looking Ahead

Transcription

1 An Attack Event - Response - Continuity of Operations - Recovery - Looking Ahead Middlesex Hospital 2018

2 About Middlesex Hospital Main Hospital Campus Historic Middletown, CT Opened in 1904 Licensed for 275 beds employees across the Health System Top 100 Hospital by Thomson Reuters 4 time Magnet awarded Connecticut s only Mayo Clinic Network member

3 About Middlesex Hospital Services at the Main Campus Inpatient Medical / Surgical Inpatient Psychiatry Pregnancy & Birth Critical Care 44 bed Emergency Department with 8 bed BH CIU ~41K annual visits Sleep disorders center Surgical Services Outpatient Services

4 About Middlesex Hospital Additional Middlesex Health System features Outpatient & Cancer Center Middletown, 5 minutes from the main campus Two stand-alone emergency receiving facilities Marlborough, 20 minutes east Outpatient Lab and Radiology ~21K annual visits Westbrook, 30 minutes south on the shore Outpatient Lab, Radiology, and Cancer Center ~23K annual visits

5 About Middlesex Hospital Environmental Safety & Protective Services Proprietary Security Force 53 officers Mix of per diem & full time Based at 4 locations Main Campus, Westbrook, Marlborough, Outpatient Center Protective Items Pepper gel, batons, handcuffs, MOAB No firearms Premysis, Avigilon, and Hugs

6 Office of Environmental Safety & Protective Services VP, HR VP, Operations Director, Environmental Safety & Protective Services Safety & Emergency Management Coordinator Division of Employee Health and Safety (Workers Comp / Employee Safety Manager) Division of Environmental Safety Division of Protective Services (Security Operations Manager) Division of Incident Management

7 Emergency Management Hospital Incident Command System (HICS) Typical organizational chart Mass notification systems Everbridge Snapcomms Activations - routine & emergency Average 12+ per year Command Center Protective Services vs. main conference room Community Middletown Fire Department - Local EMD

8 Prevention & Preparedness Evacuation Plans Lateral vs. vertical Facility construction Exercise planning ED Garage Plans Closing / restricting access Cameras & Proximity Readers Over 100 of each Visitor Management ID for all persons in facility

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14 Response - Short Term Our response: ED - CCU - CIU - Radiology Employees came in from home: Security, nursing Perimeter established by law enforcement: rapidly Command and Control: need to remind operations and other sections to keep a rep in the command center Unified command: providing a field liaison for Fire, PD, Fed, State Plans used: Fire [evacuation], Surge [alternate care] Crime scene challenges: Evidence collection, turning over, entry Media control: Police & security officers Joint Information Center: Briefings by City, with Middlesex

15 Response - Short Term Fire Protection System 3 sprinkler heads activated 150 gallons/minute 50 GPM) Active for 60 minutes 9000 gallons Fire department hoses 450 gallons/minute for 10 minutes 4500 gallons + interior hose usage Fire fighting foam Stable mass of small air-filled bubbles Water, foam concentrate, air Lower density than oil, gas, or water Increases absorption of water into sheetrock Depth: ¾ over 32,000 square feet

16 Response - Mid Term Temporary Emergency Department Main Lobby Many complicating factors IT, supplies, pharmacy, clinical engineering, traffic direction and control Media control Hospital still open Assess damage Outside consultant Plan cleaning and construction Phasing based on needs, damage, population served CT DPH presence Daily

17 Response - Mid Term Temporary ED/assessment area Opened by 11am the day of the attack - 1 hour

18 Response - Long Term CT DPH mobile hospital Delivered day of attack Pros/cons of deploying Regular updates Staff, media Emergency Department moved From lobby to outpatient surgery From outpatient surgery to ED with restrictions No waiting room No main entrance

19 Recovery Crisis Services Employee Assistance Program Clean-up/renovation Floors, surfaces Equipment HVAC returns Environmental testing Moisture Supply salvaging Most items discarded Infection Prevention involvement

20 Noteworthy Successes Relationships Personal/local Government Relationships Internal We know each other and work together every day The importance of emergency response structure Command and control for scheduled and unscheduled events Luck? Blessed? Meant to be??

21 Mitigation & Improvements The new normal Risk assessments Consultant Facility hardening Bollards, 3M film Communications Fire radios Staff communication Facility security Cameras, locking departments, visitor management Driving preoccupation with failure

22 Areas for Improvement Immediate communications to staff All employees- On duty and off Centralized communications Migrate from Switchboard concept Improve radio communications Fire Department while inside Hospital Continuity of Operations Department level Engage other departments for resilience Depth

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24 Questions?