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Overview September 12, 2014
Western Region Healthcare Emergency Preparedness Coalition ( WR HEPC)
WNY Hospital Pediatric Disaster
PreparednessPresentation 2014-15
PDP2
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What is the Goal of PDP2?• A separate WG opportunity from our Core
Pediatric WG. – Hospitals who chose PDP2 on their Contract
Work Plan will participate in the quarterly conference call/ webex.
• PDP2 will discuss strategies and progress towards implementing the Hospital Planning Steps – Hospital input & discussion on calls is required
• Goal: aid WNY in developing sustainable Pediatric Surge Capability. 2
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Assumptions
• All hospitals, even hospitals that do not routinely provide pediatric services, need to plan for the possibility that pediatric patients arriving at their hospital during a disaster might require emergency evaluation, critical care, surgical services, inpatient care, and psychosocial support and should be prepared to offer these services accordingly.
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2013-15 Core Pediatric WG Goals• Involve Women and Children’s Hospital of
Buffalo and pediatric service hospitals as resources for WNY planning.
• Develop hospital “Tiers” based on capacity and capability to guide:–Planning recommendations–Development of pediatric training priority
areas, and course recommendations
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2013-15 Core Pediatric WG Goals• Develop priority steps for surge planning.
– Use “Planning Steps” from the Pediatric Toolkit, and other resources
– Develop a strategy and timeline for hospitals to implement the steps.
• Support trainings availability• Develop a recommended pediatric supply
and equipment list.• 2015-16: Hospitals develop internal
Pediatric Surge Plans.5
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Key Hospital “Planning Steps” for 2014-15• Identify and implement a Pediatric Clinical
Coordinator• Identify and add a Pediatric Medical Technical
Specialist to the HICS chart• Develop and maintain a list of admitting physicians
and mid-level practitioners with pediatric expertise• Identify and discuss planning with community
physician resources for emergency staffing, and pediatric supplies and equipment availability
• Identify and Establish Transfer Agreements with hospitals that accept pediatric patients beyond traditional networks, & in geographic proximity.
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Training• Increase medical and nursing staff trained in
PALS, APLS, NALS, PEARS*, ENPC, and Disaster Mental Health techniques specific to children. – Explore the extension of the *Pediatric Emergency
Assessment and Respiratory Stabilization (PEARS) to WNY Hospitals (currently only at WCHOB/ Kaleida System)
– Obtain financial & local clinician trainer support to sponsor Pediatric Fundamental Critical Care Support (PFCCS) Course
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Supply and Equipment List
• Agree on a recommended pediatric supply and equipment list– Maintenance of Broselow Carts– Supply levels to maintain – Just-in-Time Supplemental Resources
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Develop hospital “Tiers”
• Survey Monkey launched for hospitals to self-report service levels & planning status:
• Types and levels of pediatric services • Pediatric Trainings offered• Pediatric Supplies and Equipment• Access to a database of physicians/ mid-levels/
nurses credentialed/ verified for pediatric competency
• Hospital transfer agreements outside WNY• Safe Areas identified • Procedure for Unaccompanied Minors
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Conclusions from Survey…• More PALS training could be conducted;
there is interest in PEARS• WNY hospitals see a need to develop an
internal plan for pediatric surge. – WNY can work with other NYS Regions who
are developing a template plan.
• Some Planning Steps may already be covered by a percentage of hospitals, putting WNY PDP2 ahead as a region.
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Women and Children’s Initiatives • Provide Core Work Group Leadership• Plan for WCHOB to expand phone
consultation capacity in a surge disaster • Expand Pediatric Emergency Assessment,
Recognition, and Stabilization (PEARS) course to regional hospitals
• Provide expertise on planning priorities
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WNY Hospital Planning Steps Implementation 2014
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Identify a Pediatric Clinical Coordinator
• Description of role: “Champion” appointed to:– Advocate for this population. – Serve as a liaison between internal hospital
committees that address emergency prep. – Assist with the development and use of peds
protocols and procedures; planning implementation.
• Time frame for identifying: December 2014.• Target- 100% of hospitals will identify and
appoint the positions.13
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Clinical Coordinator for Pediatric Emergency Care
• See Role Description• A credentialed member of the medical and/
or nursing staff with an interest in disaster preparedness who is accepted by the Emergency Preparedness Committee to assume the following responsibilities:– Attend at least two meetings per year of the EP
Committee.14
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Pediatric Medical Technical Specialist• Add a Pediatric Medical Technical Specialist
to the HICS chart: – Discussion:
• Role description• Who? ED Physician?• What competencies?
• CEMP Revision to include Job Action Sheet• Time frame for completion: December 2014• Target- 100% of hospitals.
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Physician/ Clinician Resource List• Develop and maintain a list of admitting
physicians (ED-MDs, otolaryngologists, anesthesiologists) and mid-level practitioners with pediatric expertise
• How developed and maintained?– Medical Staff Office assistance– Other:
• Time frame: December 2014• Target- 100% of hospitals.
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Action Step Suggestions • Put initiative on your next EP Committee
Agenda• Seek suggestions for the Peds Clinical Coordinator from
EP Committee; Nursing Administration; Medical Leadership
• Discuss your existing credentialing databases for physicians and specialists
• Consider CEMP amendment to include Tech Specialist and other JAS
● A presentation by Dr. Young to the CEOs at the WNYHA is planned for October 6th
●Consider other internal meetings or clinician groups in your area to inform. 17
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Next Webinar• Next Webinar Meeting,
– Thursday November 6th, 2014, 10:00 – 11:00 AM
– Be prepared to report on progress and challenges to implementing these steps\
– Focus reporting on: specific strategies used to identify and engage a Clinical Coordinator; Physician/ Clinician Resource List identification.
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WNY Hospital Planning Steps for Implementation 2015
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Community Resource Identification• Identify and discuss planning with community
physician resources (i.e., Immediate Care Centers, Pediatrician offices) for emergency staffing, and pediatric supplies and equipment availability
• Discussion: How to approach? Venues?– Invite Immediate Care Centers to a meeting?
• Time frame: June 2015• Target- 100% of hospitals.
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Transfer Agreements
• Establish Transfer Agreements with hospitals that accept pediatric patients beyond traditional networks, & in geographic proximity– Identify existing agreements.– What hospitals are located outside WNY and
NYS?
• Time frame: 2015• Target- 100% of hospitals. 21
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Training• Increase medical and nursing staff trained in
PALS, APLS, NALS, PEARS, ENPC, and Disaster Mental Health techniques specific to children
• Discussion: What staff? What hospitals? What % increase are we aiming for – Obtain financial & local clinician trainer support to
sponsor Pediatric Fundamental Critical Care Support (PFCCS) Course
• Use of Survey Data and Tiers to develop recommendations
• 10% regional increase in staff trained outside the ED for PALS/ PEARS/ ENPC? 22
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Supply and Equipment List• Regional adoption of a recommended
pediatric supply and equipment list
• What hospitals need what equipment? – Use Tiers system to develop recommendations?
• Time frame for hospital implementation?
• Percent improvement expected?23
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Other Planning Steps for 2015• Procedure for documenting an
Unaccompanied Minor– Included in the NYS Pediatric Toolkit
• Identification of A Pediatric Safe Area– Checklist for the Area is in the NYS Pediatric
Toolkit– Staffing – To be included in the Pediatric Surge Annex
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Future Work Group Goals• Continue the Pediatric Work Group in
WNY; explore regional expansion.• Increase the involvement and commitment
from regional hospital pediatric clinical leadership.
• Increase the involvement and commitment from regional partners.
• Continue to work with statewide Region WGs to share Best Practices…..
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Future……..• Envision a 3-year plan (2013 – 2016)
• Complete tasks identified in BY 2014-15
• Hospitals develop/ enhance internal Pediatric Surge Plans in 2015-16
• Include ongoing testing of current plans in facility and regional exercises 26