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UWHC,

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Departments & Programs,UW Medical Foundation,Patient Resources,Social Work Services Quick Guide,Social Work Manual,Crisis/Disaster and Trauma Response

External Disaster Plan: Social Work Services, Spiritual Care Services and Health Psychology Services

External Disaster Plan: Social Work Services, Spiritual Care Services and Health Psychology Services - Departments & Programs, UW Medical Foundation, Patient Resources, Social Work Services Quick Guide, Social Work Manual, Crisis/Disaster and Trauma Response

Focus

Social Work Services, Spiritual Care Services and Health Psychology Services

PURPOSE

To ensure University of Wisconsin Hospital and Clinics is prepared to address the medical needs of victims and associated significant others in the event of a disaster.

POLICY

The Hospital Incident Command System (HICS) is used to manage implementation of this plan. The Hospital Safety Officer is the primary liaison with regional disaster planning bodies, including state and local government, and ensures that the UWHC Emergency Management Plans are responsive to regional needs. The UWHC Emergency Management Committee ensures that all hospital departments that might be involved in responding to a disaster have current and integrated departmental plans. The UWHC External Disaster Plan is tested annually either through drill or implementation in response to an actual disaster.

PROCEDURE

Plan Activation

  1. Message Center operator and request to activate the "External Disaster Plan"
  2. The Paging and Message Center Operator will contact the Hospital Administrator On Call (AOC) to confirm activation of the External Disaster Plan.
  3. Once confirmed by the AOC, Paging will activate notification pages and/or phone calls to the Incident Command Team and the External Disaster Event List.
  4. The AOC will provide the Paging operator with an informational message to be recorded on the message line (265-7332).

Incident Command Center (F2/210) 

  1. The Nursing Coordinator will open the Incident Command Center (ICC). The ED Physician On-Duty or Rep will conduct a briefing, relating all relevant information available concerning the incident to those personnel staffing the ICC. The Incident Commander or designee will deliver subsequent briefings after first conferring with the ED Physician On-Duty, and the Situation Status Unit Leader will communicate the information on the projection screen and hard copies will be made available throughout the incident. 

Departmental Response for Social Work Services, Spiritual Care Services and Health Psychology Services 

  1. External Disaster Plan during Business Hours (M-F 8:00-4:30pm)
    1. Upon notification of an External Disaster, all Social Workers, Chaplains, and Health Psychologys taff who are in-house in the hospital and clinics will report to the designated Family Waiting Area (FWA) in F8/170-172. These individuals will work together as the family and Patient Support Team. The hospital inpatient adult triage social worker of the day will assume the role of the Family and Patient Support Team Leader (hereafter referred to as the Team Leader) until the Manager of Social Work Services (or designee) assumes this function.
    2. The Team Leader will call the external disaster message line for a detailed overview of the external disaster event (265-7332). Another call will be placed to hospital security to unlock the closet located in F8/170-172, if not already unlocked, and access the materials and the telephones.
      1. The Team Leader will provide information and assign duties to the staff present in the Family Waiting Area.
      2. A list of social workers, chaplains and health psychologists present, available, and able to assist will be compiled. This list will be faxed to the Planning Chief at the ICC (265-0718).
      3. The team leader will assign three social workers to the Emergency Department. The regularly scheduled Emergency Department social worker will act as the communications person for the flow of information between the ED and the Family Waiting Area. The ED Social Worker will assign the three social workers, sent from the Family Waiting Area to the ED, to the three ED treatment areas.
    3. The Team Leader will request from the Incident Command Center any resources, including water, food, etc., to support family members/primary support and friends of patients.
    4. Within the FWA, the Family and Patient Support Team should
      1. Take the phones out of the closet and connect to the proper jacks
      2. Turn on the shared workstation computers, accessing specific programs (i.e. patient bed board info) to have access to necessary patient data.
      3. Be available to answer telephones, provide support and information to families who may be sent to the Family Area or who may be needing information via telephone.
    5. The FWA may receive a number of screened phone calls through the paging service from individuals who are seeking information about relatives, friends, etc. While the paging service will take ‘factual details’ to attempt to locate the ‘missing’ relative, friend; paging may transfer the phone call the FWA so that additional support can be offered.
    6. Communication and collaboration with the FWA will continue throughout the disaster response. Social Workers, Chaplains and Health Psychologists will escort family to the patients as clearance is given
  2. External Disaster Plan after Business Hours, Weekends, & Holidays
    1. The On-Call Social Worker and On-Call Chaplain will receive the initial pages regarding the disaster. Both of these staff will come to the hospital and check-in with each other. The On-call Social Worker will assume the role of the Family and Patient Support Team Leader (Team Leader) until the Manager of Social Work Services (or designee) arrives at the hospital and assumes this function.
    2. The On-Call Social Worker will contact the Manager of Social Work Services, who in turn will call one other social worker (from the social work on-call list). This second social worker will make 3-4 additional calls requesting social workers, Spiritual Care Services chaplains, and health psychology staff to report to the FWA (F8/170-172) at the hospital for the disaster.
    3. The On-Call Chaplain will contact the Manager of Spiritual Care Services (or designee) and request additional Spiritual Care Services support as needed.
    4. The Team Leader will have the Family Waiting Area (FWA) opened (F8/170/2 + unlocking of the closets) by Hospital Security. He/She will contact the external disaster information line for specific details regarding the external disaster event (5-7332).
      1. The Team Leader will review the disaster plan and orient and assign tasks to social workers, psychologist, and chaplains as they arrive and to the staff present in the Family Waiting Area.
      2. A list of social workers, chaplains and health psychologists present and available and able to assist will be compiled. This list will be faxed to the Planning Chief at the ICC (265-0718).
      3. The team leader will assign three social workers to the Emergency Department. The regularly scheduled Emergency Department social worker will act as the communications person for the flow of information between the ED and the Family Waiting Area. The three social workers sent to the ED from the Family Waiting Area will be assigned by the ED Social worker to the three ED treatment areas.
    5. The Team Leader will request from the Incident Command Center any resources, including water, food, etc., to support family members/primary support and friends of patients.
    6. Within the FWA, the Family and Patient Support Team should:
      1. Take the phones out of the closet and connect to the proper jacks.
      2. Turn on the shared workstation computers, accessing specific programs (i.e. patient bed board info) to have access to necessary patient data.
      3. Review the specifics of the plan and be ready to register family members, friends, etc.
      4. Be available to answer telephones, provide support and information to families who may be sent to the Family Area or who may be needing information via telephone.
    7. The FWA may receive a number of screened phone calls through the paging service from individuals who are seeking information about relatives, friends, etc. While the paging service will take ‘factual details’ to attempt to locate the ‘missing’ relative, friend; paging may transfer the phone call the FWA so that additional support can be offered.
    8. Communication and collaboration with the FWA will continue throughout the disaster response. Social Workers, Chaplains and Health Psychologists will escort family to the patients as clearance is given.
      • Incident Command Center Phone Numbers:
        • Primary Incoming 0-9392
        • Secondary Incoming 0-9088
        • Fax line 5-0718
        • Planning Chief 3-9971
        • Logistics Chief 2-6208
        • Operations Chief 2-4937

Security 

  1. Access control is used to secure the ICC, Critical, and Urgent patient care treatment areas and the Decontamination Suite.
  2. Security Officers will manage access into the Ambulatory patient care treatment area.
  3. All personnel working are required to wear a UWHC staff identification badge
  4. For external Disaster responses between 9 pm and 5:30 am, entry to the building may be gained at any employee entrance using your proximity card/ID, or by identifying yourself to security personnel using the camera/buzzer system.
  5. Entry can be gained at the main entrance by use of your proximity/ID card or by contacting the personnel in the security office at the main entrance. If you do not have your ID card access may be delayed, as security will need to verify your identify.

Treatment Areas 

  1. Treatment areas will be established by the ED Physician On-Duty and ED Care Team Leader as needed. For a major disaster, patients will be triaged to any of the following areas:
    1. Critical patients to the South side of the Emergency Department
    2. Urgent patients to the North side of the Emergency Department
    3. Ambulatory patients to the F4/2 Surgery Clinics
    4. Ambulatory over flow is sent to the VA Hospital X-ray Waiting Area DG279 (*256-1901 #17603)
  2. If it is determined, that a treatment area will not be needed, this must be communicated with the ICC and staff assigned to those areas will be re-assigned or dismissed.

Social Services, Spiritual Care Services, and Health Psychology Departmental Plans 

  1. Departmental plans shall be reviewed after each drill or implementation and be revised as needed. Revisions shall be submitted to the Hospital Safety Officer, H4/853 to ensure integration with the overall plan.
  2. Departmental plans shall be easily accessible within those departments, and personnel should refer to these plans for a description of duties during a disaster.
  3. A copy of the Departmental Disaster Plan along with other resource information is kept in containers inside the locked closet in room F8/170-172. It can also be found on Departmental Web Pages and in the Social Work Services online Resource Manual.
  4. An informational briefing will be provided on the incident message line 5-7332.

Arrival of Patients

  1. The triage area will be located at the Emergency Department entrance, and will be staffed by but not limited to an ED Physician and ED nurse. Following triage to determine severity of injuries, patients will be conveyed to one of the Treatment Areas.
  2. Stable patients with special needs (i.e. non-precipitating obstetrics and violent psychiatric) will be transferred to the appropriate facility.

Other Key Activity Sites

  1. Incident Command Center (F2/210 ED MD Conference Room). The HICS team will staff this area.
  2. Family Waiting Area (F8/170-172). All family/significant others should be directed to this area which will be staffed by Social Workers, Chaplains and Health Psychologists.
  3. Press Room (H6/215). All media should be directed to this area that will be staffed by the Public Affairs Department.
  4. Physician Pool (ER Desk) All physician personnel who are not needed in the Emergency Department should report to this area to sign in and will be notified as needed.
  5. Morgue (VA Hospital) all expired patients will be transported to the VA Hospital Morgue. In the event of large numbers of expired patients, the IC will determine an expandable morgue area to be used.

Plan Deactivation

  1. The ED Physician On-Duty and ED Care Team Leader will advise the ICC when the critical phase of the influx of casualties has subsided such that normal operations can be resumed.
  2. The Incident Commander will notify the paging and message center of an all clear based on the situation status throughout the organization.
  3. At any time, non-essential staff can be reassigned or dismissed. After the all clear is communicated, departments will then proceed to deactivate their departmental plan and replace any resources used during the incident.

Departments represented on the UWHC Emergency Management Committee are expected to complete a written critique of the incident.

Disaster Privileges and Assigning Disaster Responsibilities

Support from community Social Workers, Psychologists and Clergy may be requested during times of extended disaster response. These volunteer practitioners will assist with the Family Waiting Area and with counseling/grief response. These individuals will be granted special privileges as listed below:

A. The following information concerning disaster privileges is inserted here so that it will be available for reference. The following was adopted pursuant to Article VIII, Section 4 of the Medical Staff Bylaws. The Medical Board and hospital CEO have approved the following policies and procedures for granting disaster privileges as authorized by the Bylaws.

  1. In times of a local, state or national disaster emergency situation, it may become necessary to grant temporary privileges to External Physicians to help care for an unusually high number of critically ill patients. Disaster privileges may be granted when the Hospital's emergency management plan has been activated and the Hospital is unable to handle the immediate patient needs. In order to expedite the processing of physicians for temporary disaster emergency clinical privileges, the Hospital CEO or Senior Vice President/Medical Affairs or their designees, has the option to grant disaster privileges. The CEO or Senior Vice President/Medical Affairs or their designees will declare a "state of emergency" requiring disaster privileges.
  2. Mechanism to Review External Physicians Who Receive Disaster Privileges
  3. The President or Senior Vice President/Medical Affairs or his/her designee has the following responsibilities when granting disaster privileges:
    1. Make a decision on a case-by-case basis at his or her discretion.
    2. Grant disaster privileges upon presentation of any of the following:
      1. A current license to practice medicine and a valid picture identification issued by a state, federal, or regulatory agency or by a hospital;
      2. Identification indicating that the External Physician is a member of a Disaster Medicine Assistance Team (DMAT);
      3. Identification indicating that the External Physician has been granted authority to render care, treatment, and services in disaster circumstances (such authority having been granted by a federal, state, or municipal entity).
      4. Presentation by current Hospital or Medical Staff member(s) with personal knowledge regarding the External Physician's identity.
    3. External Physicians will be assigned to clinical departments for appropriate allocation pursuant to the Hospital's Disaster Plan.
    4. Any items such as a parking card and name tag (or other identification) will be disbursed to the External Physician in as expedient a manner as possible. A copy of a photo identification card will be made at the time the External Physician first comes to the hospital.
    5. Medical Staff Office personnel will notify appropriate hospital staff, e.g., Emergency Room, Surgery, Nursing Administration, Medical Records, Admissions, Pharmacy, etc., who have a need to know about External Physicians' privileges.
    6. As soon as the immediate situation is under control, Medical Staff Office personnel will begin the verification process of External Physicians' credentials and privileges in accordance with Section 4 of Article VIII.

B. The following information relates to the assignment of disaster responsibilities to volunteer practitioners. A practitioner for purposes of this section is any individual qualified to practice a health care profession (i.e., nurse) and is engaged in the provision of care and services. Practitioners are often required to be licensed by law.

  1. Disaster responsibilities may be assigned to volunteer practitioners when the Hospital's emergency management plan has been activated and the Hospital is unable to handle the immediate patient needs. The Hospital CEO or Senior Vice President of Patient Care Services has the option to assign disaster responsibilities. The CEO or Senior Vice President of Patient Care Services or their designees will declare a "state of emergency" requiring assignment of disaster responsibilities.
  2. The CEO or Senior Vice President of Patient Care Services or his/her designee may assign disaster responsibilities upon presentation of any of the following:
    1. A current hospital picture identification card that clearly identifies professional designation;
    2. A current license, certification or registration;
    3. Primary source verification of licensure, certification or registration (if required by law and regulation to practice a profession);
    4. Identification indicating that the individual is a member of a Disaster Medicine Assistance Team (DMAT) or other recognized state or federal organization or group;
    5. Identification indicating that the individual has been granted authority to render care, treatment, and services in disaster circumstances (such authority having been granted by a federal, state, or municipal entity)
    6. Identification by current Hospital employee(s) who possess personal knowledge regarding the volunteer practitioner’s qualifications.
  3. Primary source verification of licensure, certification or registration (if required by law) shall begin as soon as the immediate situation is under control, and shall be completed within 72 hours from the time the volunteer practitioner presents at the Hospital. If extraordinary circumstances exist such that primary source verification cannot be completed within 72 hours, then it must be done as soon as possible. In these situations, the Hospital will document why primary source verification could not be completed within 72 hours, a demonstrated ability to continue to provide adequate care, treatment and services, and an attempt to rectify the situation as soon as possible.
  4. Any items such as a parking card and name tag (or other identification to allow the Hospital to identify volunteer practitioners assigned disaster responsibilities) will be disbursed to the practitioner in as expedient a manner as possible. A copy of a photo identification card will be made at the time the practitioner first comes to the hospital.
  5. Practitioners will be assigned to clinical departments for appropriate allocation pursuant to the Hospital's Disaster Plan.
  6. The Hospital shall oversee the professional practice of the volunteer practitioners through any combination of direct observation, mentoring and clinical record review.
  7. The Hospital shall decide within 72 hours related to the continuation of the disaster responsibilities initially assigned.

Coordination

Director of Coordinated Care, Case Management and Social Work Services, Manager of Social Work Services, Manager of Spiritual Care Services, Director of Health Psychology and Pediatric Inpatient Rehabilitation Team

SIGNED BY: Safety and Hazard Control Manager
12.11.2006

Note: F6/5 can be made into a negative isolation unit

Note: the Red Cross (233-9300) is provided with information on which victims are in which facility and are considered the central source of information during a disaster.

 

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