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Evacuation

Overview

Hospital Evacuation

Photo provided courtesy of Robert A. Eplett/OES/CA
March 27, 2009

Hospital plans for full or partial evacuation should incorporate pre-planning and address the incident command and management structure established for its operational area (community). In advance of an event, Hospitals should understand and incorporate local plans and protocols that are in place to support evacuation and should establish Memoranda of Understanding (MOUs) with other hospitals, as necessary, for transfer and mutual aid during an emergency.(See CHA Hospital Evacuation Plan Checklist)

When potential or actual evacuation is first contemplated, the hospital should alert the local emergency medical services agency (LEMSA), Emergency Operations Center (EOC), and/or Medical Health Operational Area Coordinator (MHOAC) in accordance with the protocols established for emergency notification in the area.

The LEMSA or EOC may assist the hospital with identifying and coordinating placement and transport of patients and other support while the hospital is preparing and staging for evacuation of patients in accordance with local plans and protocols. If the LEMSA or EOC are unable to provide assistance, the hospital is responsible for identification of receiving facilities and securing the consent of those facilities for transfer. The hospital should have established protocols for evacuation, including medications, supplies, equipment, medical records summaries and patient tracking.

Because attending physicians may not be available for all patients involved in an immediate evacuation, it is anticipated that hospital-based physicians (for example, emergency, hospitalists, medical director) will coordinate with the sending and receiving hospitals. Medical record summaries should accompany each patient and the patients attending physician should be notified of the location of the patient.

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California Patient Movement Plan
EMSA/CDPH Collaboration

April 17, 2019

The California Patient Movement Plan provides statewide guidance for large-scale patient movement and serves as framework for local planning efforts. Emergency Medical Services Authority (EMSA) and California Department of Public Health (CDPHi) will conduct training and exercises based on the plan.

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Disaster Shelter PIO Toolkit

December 14, 2018

This Care and Shelter Planning Toolkit was developed with guidance by the UASI Care and Shelter Subcommittee to the Emergency Management Work Group. Included in the toolkit are workshop summaries, shelter planning guidance, a resource gap identification tool, best practices, and other resources.

  • Download the Disaster Shelter PIO Toolkit
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Hospital Evacuation Checklist

May 22, 2009

This checklist provides guidance in the development or update of a hospital evacuation plan containing detailed information, instructions, and procedures that can be engaged in any emergency situation necessitating either full or partial hospital evacuation, as well as sheltering in place.

The expectation will be that staff may need to accompany patients and work in staging areas, in local government Alternative Care Sites (ACS) and/or at receiving facilities, subject to receiving proper emergency credentials. Drills, training and reviews must be conducted to ensure that staff have a working knowledge of the plan and to ensure that the plan is workable. 

The hospital evacuation plan should be consistent with federal NIMS and The Joint Commission requirements.

  • Download the Hosptial Evacuation Checklist developed by CHA
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Shelter-in-Place Checklist

May 21, 2009

Attached is the Shelter-In-Place (SIP) Planning Checklist developed by CHA. The tool includes a decision-making algorithm for SIP and evacuation activation.

The Checklist and decision tree may be used to assist hospitals with developing, reviewing or updating their plans. Updated hospital evacuation plans and shelter in place protocols that document a hospital’s critical decision making processes are a Hospital Preparedness Program (HPP) Year 7 requirement.

The document was developed as a tool to help hospitals ensure that  elements listed have been addressed in their plans, policies and procedures.

The “Reference” column is to allow each hospital to note where in their documentation each item is addressed. The decision tree is to allow you to consider the critical decision making factors. This is a Tool for the hospital, and is not for submission to the County.

It is important to note that there are a number of situations or events that may require or lead a hospital to decide to shelter in place and, therefore, to plan in advance for those situations. Please also note that your plan should include what happens to those “locked out” when you are “locked down” (identify a sheltering site(s) outside of locked-down facilities). Also note that SIP differs depending on the type of event.

  • Download the Shelter In Place Checklist developed by CHA (PDF)
  • Download the Shelter In Place Checklist developed by CHA (DOC)

Updated November 30, 2019

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Hospital Repopulation After Evacuation: Guidelines and Checklist

October 28, 2010

Attached is an updated tool for hospitals, Hospital Repopulation after Evacuation Guidelines and Checklist. The purpose of the document is to identify hospital operational and safety best practices, as well as regulatory agency requirements, which must be considered when repopulating after full or partial evacuation of general acute care hospital inpatient building(s) (GACHB). The association sought consultation from a number of State agencies prior to publishing this document.

  • Hospital Repopulation After Evacuation: Guidelines and Checklist
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Evacuation and Shelter-in-Place Guidelines for Healthcare Entities
LA County EMS Agency

September 27, 2013

Evacuation of a healthcare facility may be necessary following an emergency such as a facility fire or damage from a natural disaster such as an earthquake or flooding. The decision to evacuate a healthcare facility will be based on the ability of the facility to meet the medical needs of the patients. Immediate threats to life, such as internal fires or unstable structures, will require emergent evacuation, while other situations may allow for a planned and phased evacuation.

The Evacuation and Shelter in Place Guidance for Healthcare Facilities is composed of three parts:

  • Part I provides general guidance on the differences between evacuation and shelter in place including the roles and responsibilities of healthcare facilities and the healthcare system. Download Part I
  • Part II is an Evacuation and Shelter in Place Plan Template that healthcare facilities may use to create their own plan, or to review when updating their plan. Download Part II
  • Part III is a set of two Tabletop Exercises (shelter in place and evacuation) that facilities may use in the planning phase as they develop their plans to brainstorm about needs, gaps, or solutions, and/or may use to educate personnel on the components of their existing plan. Download Part III
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Neonatal Intensive Care Unit Evacuation Guide

January 18, 2011

This guide was prepared through a collaborative effort to assist healthcare providers assess pre-event vulnerabilities and plan for the evacuation of medically fragile Level III NICU patients while addressing core components of incident management, in conjunction with the promotion of patient safety and evacuation procedures based on lessons learned from past disasters and experiences.

  • Download the Neonatal Intensive Care Unit (NICU) Evacuation Guide
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Hospital Evacuation Decision Guide

June 17, 2010

This Hospital Evacuation Decision Guide was developed by AHRQ, the lead Federal agency charged with supporting research designed to improve the quality of health care, reduce its cost, address patient safety and medical errors, and broaden access to essential services.

This guide is designed to provide hospital evacuation decision teams with organized and systematic guidance on how to consider the many factors that bear on the decision to order an evacuation, and to assist decision teams in identifying some of the special situations, often overlooked, that may exist in their facility or geographic area that could affect the decision to evacuate.

This guide is intended to supplement hospital emergency plans, which frequently lack specific guidance on how to make the critical decision to evacuate (including what factors to consider and for how long the decision may be safely deferred).

  • Download the AHRQ Hospital Evacuation Decision Guide
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Hospital Assessment and Recovery Guide

June 25, 2010

This guide is designed to help organize the initial assessment of a hospital upon return after an evacuation/closure due to an emergency event. The specific assessments are meant to be conducted by hospital staff to assess the level and locations of damage sustained by the hospital, and provide information that will be needed to create the full recovery plan. This guide will be particularly useful for assessing a hospital that has sustained significant or widespread damage.

Each hospital—and every emergency event causing an evacuation—will have unique circumstances. The purpose of this guide is to help organize the initial assessment of the hospital; it is not intended to be a complete “reoccupation” or recovery plan.

  • Download the AHRQ Hospital Assessment and Recovery Guide
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AHRQ Web-based Mass Evacuation Transportation Planning Model

March 30, 2009

AHRQ has released a model to help federal, state, and local emergency planners estimate the vehicles, drivers, road capacity and other resources they will need to evacuate patients and others from health care facilities in disaster areas.

  • Read more
  • Web-based Mass Evacuation Transportation Planning Model

Planning Topics

  • Active Shooter
  • CBRNE
  • Climate Change
  • Continuity Planning
  • Communications
  • Crisis Care
  • Cybersecurity
  • Decontamination
  • Emergency Food Planning
  • Evacuation
  • Healthcare Surge
  • Healthcare Worker Safety & Protection
  • Infectious Diseases
  • Loss of Utilities / Services
  • Natural Disasters
  • Mass Fatality Planning
  • Mental / Behavioral Health
  • Pediatrics / NICU
  • Personal Preparedness
  • Prescription Dispensing
  • Radiological Emergencies
  • Release of Patient Information
  • Security
  • Recovery
  • Terrorism
  • Vulnerable Populations
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