Incident Command Structure – a lil Thanksgiving treat

Happy Thanksgiving from the West Central and Central Regional Healthcare Preparedness Coalitions

“Oh my gosh, Ole,” Lena exclaimed. “I flipped the calendar and there it is!  Thanksgiving is this month.  Don’t ya know, it’s our year to host! How are we going to do it?”

“Like everything else. You be the boss,” said Ole.

Lena took the role of the Incident Commander. She thought carefully about who would be best for what role, now that she completed her ICS 700 course online as a MN Responds volunteer. She figured the basics were needed: Operations, Logistics, Finance and Planning.

She would need to add the Safety Officer for sure on the day of the event, in case they do a deep fried turkey.

Lena got on the horn with her daughter, Inga, who would be the planning chief and keep it all straight on that new fancy-pants phone. She’d set the menu with family favorite, decide the timeline for events, and share a list of supplies needed.

Ole got an earful of what was going to happen. He volunteered to be the Finance Section Chief and pay for it all if he was allowed to watch the Vikings in peace.  Lena agreed.

Lena’s friend and neighbor Holda is the best cook at the church supper. She’ll serve as the Operations Section Chief and handle all the tactical work:  dish out cooking assignments, appoint someone to entertain the kids, and make sure the men stay in the garage.  And she’ll make sure both fresh cranberry relish and canned cranberry sauce are available to avoid arguments.

Greta, Lena’s other daughter, was the Logistics Section Chief, meaning she’s in charge of all the stuff and stuffing necessary for the day. Since she lives in the big city, she can find everything and have it there by Wednesday.

All progress reports and items were approved by Lena.

On Thanksgiving Day, Holda’s husband Sven found himself a very comfortable chair next to Ole to watch all the goings-on. He’s monitoring the both the game and the team as the Safety Officer.

The table was easily expanded with those who didn’t RSVP like they were supposed to but there’s always extra pie. Everyone knew what was going on, who was in charge of what, and the jobs to be done.

Lena smiled as she hung up her apron. And her thoughts turned to Christmas Lutefisk.

Received from Ann Gibbs, Otter Tail County Public Health

Will This Happen Again? Will We Be Ready??

The first week of November the Central and the West Central regional hospitals participated in a highly infectious disease exercise. A patient presented to the ER with fever, cough, coughing up blood, nausea, pale skin, and diarrhea. How was this patient received?  Did they walk right through the front door? Did they expose the staff and other patients to their disease?  What type of screening questions were asked? Was isolation used?

This exercise was focused on hospitals using effective patient screening mechanisms and utilizing the appropriate isolation precautions. The hospitals were unable to transfer these patients to alternate facilities and were responsible for caring for the patient for up to 24 hours. Discussions took place regarding the appropriate PPE and the availability of PPE.  Recognizing that this patient is going to be in the hospital for a longer period of time and the recommended PPE was atleast the use of N95 masks – did hospitals need to initiate just in time training for fit testing?  Lab work and radiology tests were recommended….the hospitals needed to brainstorm to identify how to fulfill this request and still maintain isolation precautions.

Staffing was an issue during this exercise. Some staff expressed concern about taking care of a patient with an unknown disease that could be highly infectious. Hospitals needed to review their plans to address how to handle that type of situation.  Hospitals needed to review their policies to identify how they are going to take care of staff that were exposed to the patient and how they would monitor their staff.

Waste management plans were reviewed.  How does housekeeping clean a room and the equipment that the patient was in? Do the hospital plans cover the processes in place on how to deal with Category A waste?

How about transporting this patient?  Can the local ambulance service provide transportation or does the State need to assist in contacting an agency that has agreed to transport a Highly Infectious patient.

Communications were tested. When to contact MDH or the local public health…when to contact the Regional Healthcare Preparedness Coordinator?  What type of resources need to be available for the EOC to adequately assist with the care of the patient, the concerns of the staff, and the responsibility to the general public?  Does the EOC have a Public Information and how do they handle concerns from the public and the media.

This was just an exercise however, all our hospitals did very well. Lessons learned will be incorporated into future planning and exercising.