The purpose of the Hospital Surge Plan Checklist and Resources is to assist hospitals in developing and/or updating their plans for response to a significant surge event, as well as to provide tools, examples and guides to assist with plan development and implementation.
The purpose of the Family Information Center (FIC) Planning Guide for Healthcare Entities is to support healthcare partners in the development of a detailed plan to provide information, support services and reunification assistance to family members of disaster patients.
Development of the Family Information Center Planning Guide for Healthcare Entities was led by the Los Angeles County Emergency Medical Services Agency and developed in coordination with a multi-disciplinary Project Oversight Group. Project Oversight Group members provided strategic guidance regarding guide development, validation, and implementation.
Hospitals may release individually-identifiable patient information to another hospital or health facility for the purpose of diagnosis or treatment of a patient.
A hospital may release individually-identifiable patient information to a public or private entity authorized by law or by its charter to assist in disaster relief efforts, to notify, or assist in the notification of (including identifying or locating), a family member, a personal representative of the patient, or another person responsible for the care of the patient, of the patient’s location, general condition or death.However, unless the following steps interfere with the ability to respond to the emergency, the hospital must follow the following steps before disclosing information if the patient is present and has the capacity to make health care decisions:
Obtain the patient’s agreement to the disclosure;
Provide the patient with the opportunity to object to the disclosure (if the patient objects, no disclosure may be made); or,
The hospital may reasonably infer from the circumstances based on the exercise of professional judgment that the patient does not object to the disclosure. If the patient is not present or is unable to agree or object, then the hospital may determine whether the disclosure is in the best interests of the patient and, if so, disclose only the information that is directly relevant to the disaster relief organization’s involvement with the patient’s health care.
Note: a “public or private entity authorized by law or by its charter to assist in disaster relief efforts” could include Red Cross, other hospitals, first responders, etc.
Unless the patient has requested that information be withheld (“no information” or “John Doe” patients, information about the general condition (undetermined, good, fair, serious, critical, deceased) and location of an inpatient, outpatient or emergency patient may be released to other third parties only if the inquiry specifically contains the patient’s name. This is the maximum information that may be released under this provision of the law (this provision is meant to allow visitors, clergy, florists, etc. to find patients) – however, CHA recommends that hospitals use their discretion when exercising this authority. For example, it is reasonable to give a room number to a florist who asks, “Which room is Bernice Hathaway in?” However, disclosing this information to the media would likely not comply with the HIPAA “minimum necessary” standard. And of course, a hospital should not notify other third parties of a patient’s death before the next-of-kin is notified.
If there are mass casualties, the spokesperson may release basic patient information such as the aggregate number of victims, their sex and their general conditions. However, individually-identifiable patient information may not be released without the patient’s consent.
Reference: California Civil Code Sections 56.10(c)(15), 56.1007, and 56.16; 45 C.F.R. Section 164.510 (a) and (b)(4).
Primarily developed for use by hospitals, but also beneficial for use by other providers and health plans, this manual contains information on general emergency response planning and related integration activities for hospitals.
This manual also includes guidance for hospitals related to increasing capacity and expanding existing workforce during a surge, augmenting both clinical and nonclinical staff to address specific healthcare demands, addressing challenges related to patient privacy and other relevant operational and staffing issues during surge conditions.
This manual addresses the assets under a hospital’s control that can be used to expand capacity and respond to a healthcare surge.
Pediatric surge planning involves identifying knowledge gaps and insufficiency of pediatric specific supplies. The purpose of this Pediatric Surge Training Course is to help prepare general acute care facilities to the challenges of pediatrics. The course is designed for a target audience that has knowledge of disaster planning.
The Emergency Preparedness Team at Rady Children’s Hospital prepared this manual. This team includes physicians, nursing, behavioral health, surgeon, safety supervisor, trauma, pharmacy, security and disaster planning experts. The curriculum development team conducted in-depth research of best practices and other existing curricula to bring best practice.
The goal of this curriculum is to prepare hospitals and clinics have the tools to respond more effectively in a disaster which involves a surge of child victims.
Flu season is here and some hospitals are experiencing an influx of patients in their emergency departments. This may require the need to set up a tent for triage. CHA would like to remind hospitals that the California Department of Public Health (CDPHi) has provided guidance on preparing for tent use. On January 20, 2010, CDPH issued the Approval for Health Care Facility Use of Surge Tents. This document is in addition to the provisions for written approval of tent use described in AFL 09-39 issued October 30, 2009. CHA also released a related memo on November 22, 2011. These documents are intended to expedite the approval of the operation of surge tents and they remain in effect for the 2015 flu season.
Due to the recent increase in influenza patients, hospitals should review requirements for tent use. According to a new State Fire Marshal (SMF) policy, tents with labels do not have to be annually recertified. Other current requirements are detailed in the attached California Department of Public Health (CDPHi) guidance. Hospitals should note that the CDPH Licensing and Certification (L&C) district office must provide written approval for tent use as explained in All Facility Letter 09-39. In the absence of any specific suspension of statute or regulation by Governor’s Executive Order, tents will be approved for use only as waiting rooms; to conduct triage and medical screening exams; and to provide basic first-aid and outpatient treatment that meets all applicable rules and regulations. Any other use may require a program flex. The SFM approves the nonflammable material used in tents, and requires each section of the top and sidewalls of tents designed to hold 10 or more occupants to have an SFM-approval label. Hospitals should only use tents with an SFM label. If no labels are affixed to tents, hospitals should contact their local fire jurisdiction.
Local fire marshals, depending on their jurisdiction, may have a variety of requirements as prerequisites for tent use. Hospital owners should be in contact with their local fire marshals now to learn the requirements prior to the use of a tent.
OSHPD will review utility connections for tents that originate in, pass through or pass under buildings regulated by OSHPD. OSHPD will also require that tents do not obstruct the required means of egress from the hospital. OSHPD is willing to pre-approve the use of a tent when a hospital can specifically designate where it will be located on the hospital grounds. Hospitals are encouraged to receive this preapproval. This can be scheduled through a field review by area compliance staff.
All SNF, NF and SNF/NF are required by Federal regulations to “have detailed written plans and procedures to meet all potential emergencies and disasters, such as fire, severe weather, and missing residents” [ CFR 483.75 (m) F Tag 517 ].
California’s Health and Safety Code (H&S) and California’s Code of Regulations – Title 22, (T22) specify the “details” that are required in the facility emergency plan. To help you prepare for the external disaster plan review during the annual survey process, DHS has prepared the following optional self assessment tool for your use.