Emergency Operations Plan

I. INTRODUCTION

A. EMERGENCY OPERATIONS PLAN

The Emergency Operations Plan of University Hospital is designed to expand hospital services in coordination with other emergency facilities to provide care to the community and its patients during internal and external disaster situations.

This emergency operations plan includes how the UMDNJ – University Hospital will establish and maintain a program to ensure effective response to disasters or emergencies affecting the environment of care. This plan addresses four phases of emergency management activities: mitigation, preparedness, response and recovery.

A hazard vulnerability analysis is completed to identify hazards and the direct and indirect effect these hazards may have on University Hospital.

Copies of this plan shall be distributed to the Newark Office of Emergency Management and the Essex County Office of Emergency Management to inform them of the scope of the disaster capabilities.

The Chief Executive Officer or designee will be responsible for the initiating and phasing in of the hospital’s Emergency Operations Plan.

The Department of Hospital Support Services will offer additional education and training for Hospital staff including management and emergency responders. All staff must receive annual emergency preparedness training. After completing the training staff will be able to:

 Describe the purpose of the Emergency Operations Plan.  Describe the difference between an internal and external disaster.  Identify locations of areas used for treatment and disaster management.  Identify the resources available to University Hospital in the event of a disaster.  Describe/explain the four phases of an evaluation and evacuation procedures.  Identify the internal and external disaster situation announcements.  Identify who will provide crowd control and information to the media.  Know who to obtain assistance for hearing impaired and non-English speaking customers.  Explain how a disaster situation is terminated.  Identify the primary and secondary administration and nursing command post locations.  Know how to notify essential departments/units during a disaster.

Supplemental training will be provided by Department/Nurse Managers on their department/unit specific emergency preparedness (contingency) plan. Emergency Operations Plan UMDNJ – University Hospital

Revised: August 2, 2004

II. OBJECTIVES

The Emergency Operations Plan identified the following processes to manage disaster and emergencies.

a. Identify specific procedures in response to a variety of disasters based on a hazard vulnerability analysis performed by the hospital;

b. Initiate the plan including a description of how, when, and by whom the plan is activated;

c. Define and when appropriate, integrating the hospital’s role with community wide emergency response agencies (including the identification of who is in charge of what activities and when they are in charge) to promote interoperability between the hospital and the community;

d. Notify external authorities of emergencies;

e. Notify personnel when emergency response measures are initiated;

f. Identify personnel during emergencies;

g. Assign available personnel in emergencies to cover all necessary staff positions;

h. Manage the following during emergencies and disasters:

 Patients activities including scheduling, modifying, or discontinuing services, control of patient information, and patient transportation;  Staff activities (for example, housing, transportation, and incident stress debriefing);  Staff-family support activities;  Logistics of critical supplies (for example, pharmaceuticals, medical supplies food supplies, linen supplies, water supplies);  Security (for example, access, crowd control, traffic control); or  Interaction with the news media

i. Evacuate the entire facility (both horizontally and, when applicable, vertically) when the e environment cannot support adequate patient care and treatment;

j. Establish an alternative care site(s) that has the capabilities to meet the clinical needs of patients when the environment cannot support adequate patient care including processes that address, when appropriate,

 Management of patient necessities (for example, medications, medical records) to and from the alternative care site;  Patient tracking to and from the alternative care site,

2 Emergency Operations Plan UMDNJ – University Hospital

 Interfacility communication between the hospital and the alternative care site, or  Transportation of patient, staff, and equipment to the alternative care site, and

k. Continuing and/or re-establishing operations following a disaster.

In addition, the plan identifies the following resources such as:

l. An alternate means of meeting essential building utility needs (for example, electricity, water, ventilation, fuel sources, medical gas/vacuum systems) when the hospital is designated by its emergency plan to provide continuation service during a disaster or emergency;

m. Backup internal and external communication systems in the event of failure during disasters and emergencies;

n. Facilities for radioactive or chemical isolation and decontamination; and

o. Alternate roles and responsibilities of personnel during emergencies, including who they report to within a command structure that is consistent with that used by the local community.

3 Emergency Operations Plan UMDNJ – University Hospital III. OPERATIONS AND CONTROL

A. COMMAND CONCEPTS OF OPERATIONS

University Hospital will utilize a unified incident command approach to manage emergency operations affecting or impacting University Hospital and its surrounding community. Once the Administrator On- Call has made the decision to implement the emergency operating procedures, the command post will be opened. The Nursing Office Center will receive all nursing issues. The following members of executive management (unified command) or their designees will be responsible for the command and control of resources and operations at the hospital facility until normal operations are resumed:

UNIFIED COMMAND (Executive Management) Chief Executive Officer Vice President Finance Chief of Staff Vice President Ambulatory Care Vice President Operations Vice President Nursing Executive Director Nursing Administrator On-Call

B. CHAIN OF COMMAND FOR EMERGENCY ACTIONS : 1. CHIEF EXECUTIVE OFFICER 2. CHIEF OF STAFF 3. VICE PRESIDENT AMBULATORY CARE 4. VICE PRESIDENT FINANCE 5. VICE PRESIDENT OPERATIONS 6. INTERIM VICE PRESIDENT NURSING 7. EXECUTIVE DIRECTOR NURSING 8. ADMINISTRATOR ON-CALL 9. DIRECTORS OF PATIENT CARE SERVICES 10. PATIENT CARE COORDINATOR

This integrated approach to incident management recognizes the clinical expertise as well as the administrative and operational resources, which are required to adequately manage an emergency situation affecting a major University teaching hospital. Depending on the type of emergency and the need for expert resources, the unified command will request additional members as required. Whenever the Emergency Operations Plan is activated, the responsible command representatives, or their designee, must respond to the hospital command post to assume command and control responsibilities.

4 Emergency Operations Plan UMDNJ – University Hospital The Administrator On-Call is responsible to operationalize decisions made by the Unified Command representatives and is the overall responsible administrative person in charge of command post operations and incident follow-up procedures.

C. DISASTER SITUATION COMMAND POST PERSONNEL

Depending upon the incident the following personnel should be present: Unified Command as listed above Disaster Coordinator Director Marketing and Media Relations Public Safety Representative REMCS/EMS Representative Nursing Operations Center Representative Scribe(s)/Others

D. COMMAND POST OPERATIONS

The primary responsibility of the command post is to assume command and control of all hospital operations during a disaster scenario until the facility is returned to normal operations. Therefore, all decisions regarding the operations of University Hospital and patient management as well as resources will be presented to the command post for determination.

Depending on the nature of the emergency and the status of hospital operation, the following actions should be considered by the unified command:

hold over of current staff; recall of additional staff; discontinue patient visiting privileges; discontinue outpatient clinic visits; discharge eligible patients; transfer appropriate inpatients to other facilities; accept appropriate transfer patients;

authorize the procurement of emergency supplies and resources; authorize emergency expenditures; request Emergency Management resources; notification of status to Central Administration; notification of status to regulatory authorities if required; notification of patient status to family members; conclusion of disaster situation; and any other required actions deemed necessary by the unified command.

E. COMMAND POST LOCATION

The primary Hospital Command Post location is the Administrative Conference Room UH D-215. This command post will be utilized unless affected by the disaster at which point the secondary Command Post located in conference room UH C-455 will be used. The Nursing Operations Center is located in the Nursing Office in room D-202. The alternate location for the Nursing Operations Center is E-406.

Upon notification of a disaster, the command post will set up for operation. Telephone equipment is stored in the credenza on the left side of the conference room and the Emergency Operations Plan Manual is located in cabinet #1. Keys to the conference room D-215 and the cabinets are available in the Nursing Office, Room D-202. Conference Room C-455 has been designated as the alternate command post. Keys to this conference room and credenzas are also located in the Nursing Office, Room D-202 and Hospital Support Services Room A-216.

F. COMMAND POST COMMUNICATIONS

There are six (6) unrestricted telephone lines available and one fax/modem line in the command post. The Public Safety representative and EMS representative assigned to the command post will bring portable radios. If additional communications capabilities are required, a request can be made to the Newark Office of Emergency Management for a mutual aid response of a communications mobile vehicle.

Hospital Command Post Telephone Numbers

In-Coming Calls Only: Out-going Calls Only:

972-5800 972-3640 972-5801 -

IV. EXTERNAL DISASTER

An external disaster is an event which may involve a disaster in the surrounding community that would require University Hospital to provide supplemental emergency medical care at the disaster site or may precipitate an influx of patients. Examples of external disasters are: large fire in the community, plane crash, major snow storm, gas line explosions, building collapse, extensive or prolonged utility failure, major public event (sporting event, arrival of public figure in community or on campus), civil disturbance, strike or labor action.

A. NOTIFICATION PROCESS

1. Phase I: Disaster Alert Notification from external sources regarding a disaster or impending danger may be

6 Emergency Operations Plan UMDNJ – University Hospital received by:

a. Department of Public Safety b. REMCS c. Telephone Operators

If notified from external sources, REMCS and Telephone Operators will notify the department of Public Safety and vice versa.

Upon notification by external source(s) or the Department of Public Safety:

REMCS will notify:

a. Administrator On-Call (AOC) ( 856-719-3963) b. Emergency Department (2-5123) c. Director of Trauma, Surgical/Trauma Attending (In-House) and Trauma Team (2-6000) d. Newark Office of Emergency Management (OEM) (973) 733-3660 and Essex County (OEM) when applicable at (973) 621-4160/4105

Upon notification of a disaster or impending danger, Phase I: Disaster Alert will be activated by the Administrator On-Call (AOC). This will enable the hospital to a state of readiness to respond to any situation prior to knowing the impact of the situation on University Hospital’s resources.

Administrator On-Call (AOC) will notify:

a. Telephone Operators (2-6000) b. Nursing Office (2-5671/5672) c. Disaster Coordinator (2-3337) Beeper (973-421-0676) d. Chief of Staff (2-0440) Beeper (973-312-6310)

Telephone Operators will notify:

a. Department of Physical Plant/Environmental Services 24 HOURS (2-5400) b. Central Supply Services 24 HOURS (2-3438/3437) c. Admitting Department 24 HOURS (2-4045) d. Laboratory 24 HOURS (2-4080) e. Patient Transport 7 AM - 12 MIDNIGHT (2-7433)

2. Phase II: Disaster Situation (External)

Upon notification from Public Safety and/or REMCS, the Administrator On-Call or the Surgical Trauma Attending will activate Phase II Disaster Situation.

Activation of Phase II: Disaster Situation

The following will occur:

1. Administrator On-Call or the Surgical Trauma Attending will notify:

a. The Senior Surgical Trauma Attending/AOC

b. Advise Nursing Office to activate Nursing Operations Center and proceed with their notification list.

c. Notify the Department of Public Safety (2-4491)

d. Advise the Telephone Operators to announce the Disaster Situation over the Public Address System: (2-6000)

“Code Triage in the Emergency Department.” (Repeat three (3) Times)

2. The Telephone Operators will notify the following to advise them that Phase II: Disaster Situation has been activated: (Initiate home phone tree if no response to pager within 5 minutes).

Executive Committee consisting of: - Chief Executive Officer - Vice President for Finance - Chief of Staff - Vice President Ambulatory Care - Vice President Operations - Interim Vice President Nursing - Executive Director Nursing - Administrator On-Call - Physical Plant/Environmental Services - Central Supply Services - Admitting - Pathology & Laboratory Medicine - Telecommunication Operator Services Supervisor

NOTE: AFTER PHASE II NOTIFICATION, OPERATOR(S) MUST HAND DELIVER THE PHASE I DISASTER ALERT NOTIFICATION SHEET/FORM TO THE COMMAND POST.

3. The Disaster Coordinator will notify the following:

8a.m.- 5p.m. 5p.m. - 8a.m.

Physical Plant 2-5400 2-5400

Materials Management 2-3597 2-3438/6515 Pager 973-318-4377

EOC Coordinator 2-3358 Pager 973-421-0208

EOHSS 2-4812 2-4491

4. The Chief of Staff will notify medical staff.

5. The designated departments will provide support to the Emergency/Trauma Department and prepare for additional resources accordingly.

6. The Medical Staff, Nursing Unit and each Department will activate their respective Disaster Plans and recall lists.

B. DESIGNATED DEPARTMENT SUPPORT

THE DESIGNATED DEPARTMENTS WILL PROVIDE SUPPORT TO THE EMERGENCY/TRAUMA DEPARTMENT AND PREPARE FOR ADDITIONAL RESOURCES ACCORDINGLY:

 NURSING OFFICE WILL DISPATCH 3 R.N.’s TO THE EMERGENCY DEPARTMENT

 DEPARTMENT OF PHYSICAL PLANT/ENVIRONMENTAL SERVICES – HOUSEKEEPING SERVICE WORKER

 CENTRAL SERVICES - 1 CENTRAL SERVICES TECHNICIAN TO BRING AND REMAIN WITH EMERGENCY CART

 ADMITTING DEPARTMENT - 1 ADMITTING/REGISTRATION CLERK

 DEPARTMENT OF LABORATORY MEDICINE AND PATHOLOGY - ENSURE THAT ADEQUATE STAFFING IS IN PLACE.

 PATIENT TRANSPORT SHOULD MAKE SURE THAT ADEQUATE WHEEL CHAIRS

9 Emergency Operations Plan UMDNJ – University Hospital AND STRETCHERS ARE AVAILABLE. DISPATCH ONE (1) CUSTOMER SERVICE TECHNICIAN II (LOGISTICS)

10 Emergency Operations Plan University Hospital

V. INTERNAL DISASTER

An internal disaster is an event which impacts University Hospital’s physical plant or ability to provide adequate staffing and which could require patient relocation or evacuation. Examples of internal disasters are fire, chemical release, power outage, bomb explosions, building damage, massive failure of a utility system, severe staff shortage, biological contamination

In the event of an internal disaster, the Department of Public Safety will notify REMCS and if necessary, the Newark Fire Department.

A. DISASTER SITUATION: NOTIFICATION PROCESS

1. Upon notification by the Department of Public Safety, REMCS will notify: a. Administrator On-Call (AOC) (Beeper: 856-719-3963) b. Emergency Department (Direct Line 2-5123) - speak to Charge Nurse. c. Director of Trauma, Surgical/Trauma Attending (In-House) & Trauma Team (972-6000) d. Newark Office of Emergency Management (OEM) (973) 733-3660 e. Essex County (OEM) when applicable (973) 621-4160/4105

2. Administrator On-Call will: a. Advise Nursing Office to activate Nursing Operations Center and if AOC not in-house, activate the Hospital Command Post. b. Advise the Telephone Operators to announce the Disaster Situation over the Public Address System:

“D Code Triage in the Command Post Ext. 5800/5801” (Repeat Three (3) Times)

3. The Telephone Operators will notify the following to advise them of the Internal Disaster:  Disaster Coordinator  Administrator On-Call  Chief Executive Officer  Vice President Finance  Chief of Staff  Vice President Ambulatory Care  Vice President Operations  Interim Vice President Nursing  Executive Director Nursing  Executive Director, Perioperative Services  Physical Plant/Environmental Services

 Central Supply Services  Admitting  Laboratory  Director, Marketing and Media Relations  Telecommunications; Operator Supervisor

NOTE: OPERATOR(S) MUST HAND DELIVER IMMEDIATELY AFTER NOTIFICATION THE “DISASTER ALERT NOTIFICATION” TO COMMAND POST.

4. The Disaster Coordinator will notify the following: a. Physical Plant (2-5400) b. Materials Management (2-3597/6828/3438/6515) c. EOC Coordinator (2-3358) Beeper: 973-421-0208 d. EOHSS (2-4812/4490/4491)

B. LOGISTICAL SUPPORT

SPD has developed a local hospital network of Material Managers who routinely borrow and lend supplies to hospitals in the network. St. Michaels, Beth Israel and East Orange General Hospital are participating Essex County facilities. Hospital Materials Management Managers, Assistant Managers and Supervisors are authorized to execute a loan from an area hospital. The SPD Emergency Operating Procedures Plan outlines the capabilities and resources available to support University Hospital in the event of an incident.

An agreement is in place with Tuscan Dairies to provide potable water to University Hospital in a disaster situation (see Attachment). Lighting will be supplied by power from the emergency generator. Newark Emergency Management will provide lighting upon notification of the type of emergency.

C. TRIAGE: RECEIVING AND SORTING

1. All casualties are to be transported through the Emergency Ambulance Entrance.

2. Admitting staff will provide disaster tag packets prior to casualty arrivals. Disaster tags will be pre- stamped with a unit number. Admitting personnel will complete the disaster tag patient information with a minimum of name, date of birth and sex after the hospital triage team makes patient disposition. All patients will be tagged. Medical Records acts as the first back-up to Admitting.

3. The Emergency Triage Officer, in conjunction with the Emergency Department Nurse Manager, will receive incoming casualties. Based upon the field triage tag, the team will reassess, prioritize and make patient dispositions.

4. The team will use the Universal Disaster Tag Categories. These categories are:

Priority Disposition Symbol Color Interpretation Destination

0 Black Death Morgue

I Rabbit Red Life Threatening- Trauma Rapid Transport

II Turtle Yellow Urgent - Slow C385 (ER)

III Ambulance Green Delayed Ambulatory Care Unit # 6 & 7

5. Emergency Admitting data will be taken from their disaster tag by the admitting clerk. At no time will this cover tag be removed from the patient.

6. Before patients leave the Emergency Department, all basic information concerning the patient will be placed in the Disaster log, including disaster tag# and location of patient assignment for further care. Copies will be sent to the Hospital Command Post, Admitting, Media Relations and Pastoral Care.

7. Upon notification of a disaster situation, Environmental Services personnel will inventory the institution for all available stretchers and wheelchairs and will bring them to the Emergency Department - Holding Area. (Refer to #4 on page 15).

D. TREATMENT AREAS

Priority I Red Surgical or Severe Trauma Cases (Life Threatening)

 Patients requiring surgery or immediate life saving intervention will be given any necessary treatment in the Emergency Department, Shock Trauma or Critical Care areas.

 Patients requiring specialized treatment not available at University Hospital (i.e., burns) will be transferred to the appropriate facilities.

Priority II Yellow Stretcher Cases (Urgent)

 Treatment to stretcher patients will be given in the Emergency Department. (Refer to #4 on page 15)

 Patients then will be transported to C-385 (ER) for further treatment or observation as required.

Priority III Green Minor First Aid - Ambulatory (Delayed)

 Patient from the Triage Area requiring only minor first aid treatment will receive the needed treatment in the Ambulatory Care area (Unit # 6 & 7). (Refer to #4 on page 15).

 Patients will then be escorted to the outpatient waiting area to wait for transportation to their homes.

E. X-Ray

 Patients requiring diagnostic X-Ray procedures will be transported from the ER (C-385) to the X- Ray station. (C-305) extension 2-4907. (Refer to #12 on page 15). In the event that the number of casualties exceeds the capabilities of the Emergency Department, other departments can be opened to support minor and urgent care patients. The opening and staffing of these areas are authorized only by the Administrator On-Call.

a. Ambulatory Care Area will serve as the treatment facility for minor first aid - ambulatory. The Doctors Office complex will serve as the overflow ambulatory care area. (Refer to #4 on page 15).

b. The Holding Area will provide immediate supportive medical care to patients categorized as urgent. (Refer to #4 on page 15).

Priority 0 Black - Death (Morgue)

F. DISASTER STATIONS & LOCATIONS

STATION LOCATION/EXTENSION

1. Admitting: Emergency Reception Area, Admitting Office (2-4045)

2. Discharge: Outpatient Reception Area (2-3331)

3. Employee Entrance: Medical Science Building - Main Entrance

South Orange Avenue

4. Holding: Emergency Department (Urgent care, if needed) (2-5464) Ambulatory Care (minor cases, if needed) (2-5027/4993) Community Mental Health Gym (excess holding)

5. Hospital Command Post: D-215 (5800/5801) C-455

6. Morgue: (Forensic Lab) MSB A-521 (2-5234/4794)

7. Nursing Operations Center: D-202 Extensions (2-5671/5676/5677/8750/8754)

8. Patient Receiving: Emergency Department Ambulance Entrance

9. Receiving: Supply SPD Loading Dock/A-119 (2-4175)

10. Surgery: Operating Room (2-6901)

11. Triage: Emergency Department Triage Area

12. X-Ray: Radiology Department C-305 (2-4907)

G. CENSUS MANAGEMENT

During a major disaster with a large number of in-coming casualties, the Chief of Staff will contact the Chief Resident of the appropriate in-patient services arrange for the discharge of appropriate patients to home or for transfer to another hospital. Transfer arrangements must be established prior to discharge. Approval of the primary physician must be obtained prior to discharge. The Directors of the in-patient Surgical and Medical Service will cancel all elective admissions in order to free appropriate beds. The ICU Director will designate patients for transfer to the Step-Down Units for consolidation on units other than the SICU or the Trauma Step-Down Unit. All elective surgical procedures will be suspended and the appropriate complement of operating rooms and critical care nurses will be called in by the Nursing Director of the O.R.

Upon notification of an emergency condition, the surgical and medical attendings in charge will assign a senior resident with the charge nurse to survey the floors of each service. They will list patients, in order of increasing severity of illness, appropriate for transfer to a general staging area.

Upon completion of the survey, the residents will report back to their respective attendings. The attendings or physician in charge will then order the transfer of these patients as warranted by the number of casualties expected.

Upon notification of an emergency condition, Environmental Services will assign personnel to set-up cots or litters in the designated staging area(s). Simultaneously, nursing personnel will be assigned to the staging area to prepare for the arrival of patients.

H. OPERATIONS AND CONTROL

Dissemination of Emergency Information to Hearing Impaired or Non-English Speaking Persons

The Inpatient Units, Public Safety stations, Emergency Department, Information Desk and Admitting Department will be equipped with signage (bilingual as well as symbols) indicating that the hospital is in the midst of an emergency and that patients and visitors should not panic. The signage will also direct the individuals to the Department/Nurse Manager and await further instruction.

If any evacuation is necessary, the Department/Nurse Manager or designee will accompany hearing-impaired and/or non-English speaking individuals to the appropriate area.

Each In-patient Unit and Department is to report to their respective Command Posts that they require assistance for hearing impaired and/or non-English speaking persons. The information provided must include name(s) and location.

The Command Post is to maintain the list of hearing-impaired and/or non-English speaking individuals and monitor their status.

The Department of Social Work Services at extension (2-5727) will also be responsible for assisting all hearing impaired and non-English speaking persons by identifying any available interpreters (Interpreter’s Roster Attachment 11). The Department will maintain a listing of the names and location of those individuals needing assistance.

I. CONTROL OF MEDIA, FAMILIES, VISITORS AND OTHER

CROWD CONTROL

The University Public Safety Department provides crowd control as specified in the Public Safety policy and procedures. In the event that visitors and/or crowd control presents a problem, and upon notification from a Public Safety Supervisor or designee, the Newark Police Department will be called to assist. Direct police contact phones can be found in the Emergency Room area by the hospital police desk.

MEDIA RECEPTION

The University Hospital Department of Marketing & Media Relations will be responsible for release of all casualty information to the press. Members of the press are not to be admitted into the hospital. The press will be stationed in the Medical School, Medical Science Building Room B-515 (The Rosemary Gellene Room). The Department of Marketing & Media Relations will be in charge of this operation. Internal security will be necessary to maintain and control the media.

FAMILIES OF VICTIMS

The Dental Student Lounge Area B-Level, Dental School will be designated for the families of D.O.A. victims. Family members of all other victims will be directed to Rooms B-721 and/or B-723 located in the Dental School. This area will be controlled by the Chaplain, crisis personnel and Public Safety. The Chaplain will act as a spokesperson to the families. Periodic updates will be provided to the families by Social Work Services or the Chaplain.

HOSPITAL VISITORS

During emergency operating conditions, it is critical for University Hospital to limit access to the facility. The Command Post will determine if it is necessary to cancel visiting hours and clinic sessions and any non-essential activity scheduled at University Hospital.

In any emergency condition, the presence of visitors in the hospital may interfere with care of the injured. Visitors will be asked to leave as rapidly as possible for the areas involved. All visitors will be removed from the Emergency Room, Out-Patient department, etc. UMDNJ Police Officers, with an Administrator, will be responsible for coordinating visitor control.

J. INTERNAL & EXTERNAL DISASTER

TERMINATION DISASTER SITUATION

The Administrator On-Call, upon notification from the appropriate emergency officials and Disaster Coordinator, will terminate the Disaster Situation. Once the decision has been made, the following will occur:

1. Administrator On-Call will:

a. Advise the Nursing Office to terminate Nursing Operations Center. The Nursing Office will proceed with their notification list (2-5671/5676) b. Notify Public Safety (2-4490) c. Close the Command Post and advise the Telephone Operators to announce the termination of the Disaster Situation over the Public Address System:

“Code Triage ALL CLEAR” (Repeat Three (3) Times)

2. Operator will notify:

a. Executive Management

3. The Disaster Coordinator will notify the following:

a. Physical Plant (2-5400) b. Materials Management - Supply, Process and Distribution (2-3437/3597) c. EOC Coordinator (2-3358) EOHSS (2-4812)

K. RECOVERY

Since the type and nature of disasters as well as the size and magnitude of them will vary tremendously, there is no prescriptive recovery procedure that “fits all sizes”. It is therefore the responsibility of the Command Center, and specifically the Incident Commander, to ensure a systematic and organized recovery effort. In much the same way the incident command structure will be used to respond to an incident, the same structure and unified command will be used to re-open services and return the hospital to normal operations. The Incident Command Center will remain open until the Hospital has fully recovered from the disaster.

L. EMERGENCY PREPAREDNESS DRILLS

Emergency Preparedness and/or disaster drills will be conducted at least twice a year; with one drill simulating a natural disaster with an influx of patients from outside of the hospital. Other drills may involve patient evacuation and will include all working shifts. Each drill will be followed by a critique and a report written by the Administrator On-Call and reviewed by the Environment of Car Management Committee. The report will include problems identified during implementation, corrective actions taken staff participation, type of disaster, outside agencies involved, and the time factors will also be included.

APPENDICES

APPENDIX A

EVACUATION PLAN

APPENDIX A EVACUATION PLAN

In the event that an emergency situation occurs in a particular department or nursing unit of the hospital, the Department/Nurse Manager or designee will identify the need to evacuate the affected area. This decision will be based upon the extent of immediate threat to patients, visitors and staff. The Department Nurse Manager or designee will immediately contact the Department of Public Safety and communicate the decision to evacuate.

The Department of Public Safety will be responsible for notifying the following:

 REMCS  Fire Department, if necessary  Operator 111

The Internal Disaster Plan will be activated in accordance with the established procedures.

The AOC, in conjunction with the Department of Public Safety, the Disaster Coordinator and the Hospital Safety Coordinator will oversee the evacuation. Public Safety will assist by directing the evacuation throughout University Hospital.

Each Department and Nursing Unit will follow their respective evacuation plans to manage the safe removal of patients, visitors and staff.

I. Levels of Evacuation

Depending on the nature and extent of the emergency there are four (4) different levels of evacuation that may be utilized.

1. Partial Evacuation

An isolated area, for example, a patient room is the site of the emergency and requires that the individuals in the area be removed to another location.

2. Lateral/Horizontal Evacuation

An entire department or nursing unit is affected by the emergency and requires all individuals in the area to be removed to another location on the same floor.

a. Move patients, visitors and staff beyond the nearest fire doors in the department area/nursing unit.

b. If moving patients from one nursing unit to another, the protocol is as follow:  Blue Unit to Green Unit  Yellow Unit to Green Unit  Green Unit to Blue Unit

c. For those patients that are non-ambulatory patients, the patient’s bed or stretcher is to be pushed to the designated area.

d. The Nurse/Department Manager or designee must ensure that the patient’s Medical Chart is collected and transported with the patient.

e. The Nurse/Department Manager or designee and if appropriate, the Director of Pharmacy, is responsible for securing all medications and drugs prior to evacuation.

3. Vertical Evacuation

An entire floor is affected buy the emergency and requires that all individuals on the floor be removed to another floor. Generally, individuals should be moved downward to the floor below. However, in the event that the emergency situation affects C-level or the floors beneath it, the evacuation may include the use of exit doors to the adjacent building (Medical Science Building and/or University Behavioral HealthCare Center) or outside of the building.

a. Only stairways and the “Link” to the Medical Science Building are to be used to move patients to floors below.

b. Ambulatory patients are to be moved as follows:  Wrap patients in blankets.  Lead patients using a Daisy Chain (single file, each patient maintaining close contact with person in front). A staff member should be at the front end of the line and another staff member is to be at the end of the line.

c. Wheelchair patients are to be transported by Blanket Slide or Carry.

d. Whenever possible, infants and children are to be moved by cribs. Infants can be moved, if necessary, by placing wrapped infants side by side on a blanket and using a Blanket Pull.

e. The Nurse/Department Manager or designee must ensure that the patient’s Medical Chart is collected and transported with the patient.

f. A list of all evacuated patients must be maintained. The listing should identify the following:  Name of Patient  Name of Staff Accompanying Patient  Destination of Patient

g. A list of all employees and their disposition must be maintained to account for all personnel.

4. Facility Evaluation

The entire facility or building is affected by the emergency and necessitates the removal of ALL occupants. This will require an organized approach including a sequence of dismissal based upon immediate threat of danger.

Any facility evacuation will be based on the following priority situation:  Immediate Location of Emergency  Intensive Care Units (From I-Level down to E-Level)  Emergency Department

II. Transporting Evacuated Patients

1. Emergency Medical Services (EMS) will coordinate and direct all transportation of evacuated patients.

If local resources are not readily available, EMS will request assistance form other emergency service entities including the New York City EMS and the Health and Hospitals Corporation. In addition, EMS can activate the Medical Transportation Association of New Jersey for the emergency response of licensed ambulances and invalid coaches to assist the hospital in the event of an evacuation.

2. The Receiving facility or facilities may operationalize their own Disaster Plans in preparation for the incoming patients.

III. Responsibilities

1. The Group Manager for Physical Plant & Executive Director for Hospital Support Services is responsible for ensuring that evacuation routes (including safety and emergency lighting in corridors and stairways) are clearly marked throughout the facility.

2. As part of the orientation process, all staff will participate in training sessions regarding the Hospital Fire Safety and Emergency Evacuation Plan.

3. The Disaster Coordinator is responsible for scheduling and conducting periodic evacuation drills and exercises.

4. In the event of an emergency situation requiring an evacuation, the Unified Command is responsible for notifying the local government and alternate facilities of the evacuation.

APPENDIX B

HOSPITAL SUPPORT STAFF HOURS OF OPERATION

APPENDIX B HOSPITAL SUPPORT STAFF HOURS OF OPERATION

1. University Hospital, 150 Bergen Street, Newark, N.J. is a 890,081 square foot hospital building located on 64 acres of the UMDNJ Campus. The hospital houses approximately 466 in-patients and 553 ambulatory care units. Additional outpatient facilities are located on GA and GB level of the Stanley S. Bergen Jr. Building, 65 Bergen Street, Newark, N.J., utilizing approximately 50,000 square feet of area.

DEPARTMENT HOURS OF OPERATION

Nursing 24 Hour ER 24 Hour Admitting 24 Hour Infection Control 24 Hour Central Supply 24 Hour Material Management – SPD 7:30 a.m. – 5:00 p.m. Pastoral Care 8:00 a.m. – 5:00 p.m. (On-Call) Food & Nutrition 6:30 a.m. - 9:00 p.m. Public Safety 24 Hour Nuclear Medicine 7:30 a.m. – 5:00 p.m. Pharmacy 24 Hour Environmental Services 24 Hour Radiology 24 Hour Radiation Oncology 7:30 a.m. – 4:30 p.m. (On-Call) Quality Assurance 7:30 a.m. – 5:00 p.m. Physical Medicine & Rehabilitation 8:00 a.m. - 5:00 p.m. (On-Call) Cardiorespiratory 7:00 a.m. – 5:00 p.m. (On-Call) Pathology & Laboratory Medicine 24 Hour Medical Records 7:30 a.m. – 5:30 p.m. Social Work Services 8:00 a.m. – 5:00 p.m. (On-Call) Physical Plant 24 Hour HMIS 24 Hour IS&T 24 Hour Clinical Engineering 7:00 a.m. – 6:00 p.m. (On-Call) Volunteer Services 9:00 a.m. – 5:00 p.m. Transport Services 7:00 a.m. – 12:00 midnight

*Nursing staff work twelve hour work shifts - 7am to 7pm and 7pm to 7am

APPENDIX C

RESPONSIBILITIES

APPENDIX C RESPONSIBILITIES

A. By designation of the Chief Executive Officer, the Administrator-On-Call is responsible for directing the Emergency Response.

B. The respective Department Managers and the Executive Director of Nursing will initiate directives to implement call-in of personnel to augment the Personnel Pool.

The designated individual in each department and the Nursing Operations Center will be responsible to recall staff. Each Department and Nursing Division will maintain a telephone tree for recall purposes.

C. The Director of Medical Records will be responsible for safeguarding essential records. The respective Department Managers will be responsible to safeguard the essential records for their department. All medications and essential records are maintained by the Director of Pharmacy.

D. The Department of EOHSS and all Department Managers are responsible for the provision of the necessary information on the emergency operations plan. A copy will be maintained in each department and in all patient care areas. Each department must have developed and established individual emergency plans.

E. These plans are introduced to all new employees with the guidance of the respective department manager. Staff is responsible to direct patients and visitors as to the proper procedures during an emergency situation.

F. Training in safety measures is provided to all employees by the individuals designated in the areas of the Office of Environmental and Occupational Health and Safety Services (EOHSS), the Environment of Care (EOC) Management Committee or designee, and their respective Departments.

It is the Manager’s responsibility to ensure their staff is familiar with their respective department’s Emergency Operation Plan.

G. The Disaster Coordinator is responsible for the development and maintenance of logistical preparations for emergency situations. The Administrator-On-Call is responsible for records, reports and expenditures during an emergency.

APPENDIX D

CONTINUITY

LEADERSHIP

APPENDIX D CONTINUITY OF LEADERSHIP

A. The line of succession to assure continuous leadership is as follows CHIEF EXECUTIVE OFFICER; In the absence of the CEO, the CHIEF OF STAFF; In the absence of the COS, the VICE PRESIDENT FOR AMBULATORY CARE; In the absence of the Assistant Vice President, the VICE PRESIDENT FOR FINANCE; In the absence of the Vice President of Finance, the INTERIM VICE PRESIDENT OF NURSING; In the absence of the Interim Vice President of Nursing, the EXECUTIVE DIRECTOR NURSING; In the absence of the Executive Director, the . ADMINISTRATOR ON-CALL; In the absence of the Administrator On-Call, the DIRECTORS OF PATIENT CARE SERVICES; In the absence of the Director of Patient Care Services, the PATIENT CARE COORDINATOR

B. Resources and information are requested from Operations Departments through contact between the respective Department Managers and the Command Post. Nursing Managers communicate directly with the Nursing Operations Center.

C. Medical Records are essential and are kept with the patient during all transport operations.

APPENDIX E

ADMINISTRATION

LOGISTICS

APPENDIX E ADMINISTRATION AND LOGISTICS

A. The Hospital Administrator On Call (AOC) directing the activities of the command post will review and approve requests for extraordinary expenses incurred during an emergency. The department requesting the approval will include a record of the expenses incurred as well as a justification of necessity in the evaluation report due to the AOC within one week of the event. The finance department will assist the AOC in preparing financial reports regarding total incident expenses.

B. If the resources of University Hospital are not sufficient enough to mitigate the emergency, the Command Post can request the Newark Office of Emergency Management (OEM) to facilitate support from voluntary agencies or government agencies. If local resources are not available, Newark OEM can forward the request to Essex County OEM for assistance. If Essex County OEM is unable to provide assistance from within the county, the State Police Office of Emergency Management Region I, will be activated upon request of the Essex County OEM Coordinator.

1. University Hospital Emergency Medical Service (EMS) will coordinate the mutual aid response of ambulances and mobile intensive care units (MICU) in accordance with the Department of Health (DOH) statewide emergency operating procedures and the New Jersey State First Aid Council Mobilization Plan. If local resources are not readily available, EMS can request assistance from New York City EMS and the Health and Hospitals Corporation.

2. University EMS can also activate the Medical Transportation Association of New Jersey for emergency response of licensed ambulances and invalid coaches to assist the hospital in the event of an evacuation. Private ambulance companies will activate their staff recall rosters and divert resources from nonessential assignments to provide emergency support to health care facilities. Each private provider has an established emergency rate which will be charged to the hospital.

3. UMDNJ and University Hospital are members of the National Disaster Medical System (NDMS) which upon activation by the President of the United States or upon request of the Governor of New Jersey, can mobilize national resources from both the military and private sector.

C. Medical/surgical supplies, laboratory supplies, and linen will be provided by the department of Materials Management. Materials Management has agreements for emergency delivery of critical supplies in the event of an emergency within four hours of notification.

APPENDIX F

PLAN DEVELOPMENT

MAINTENANCE

APPENDIX F PLAN DEVELOPMENT AND MAINTENANCE

University Hospital participates in all emergency management exercises sponsored by the City of Newark as well as actively providing support and receiving patients from the Annual Newark International Airport Exercises.

Additionally, as the designated Level I Trauma Center servicing Northern New Jersey, University Hospital participates in several local and regional disaster exercises, accepting the specialty care patients transported by ground or medevac helicopter.

University Hospital will annually submit copies of the emergency plan to the Newark Office of Emergency Management and the Essex County Office of Emergency Management.

University Hospital Disaster Committee and the Environment of Care Management Committee will ensure the emergency plan is reviewed and deficiencies are corrected each time the emergency plan is activated for an actual event or simulated exercise. University Hospital’s Environment of Care Management Committee will actively participate in reviewing and modifying the Emergency Operations Plan.

APPENDIX G

UNIVERSITY HOSPITAL CONTINGENCY PLAN & GUIDE FOR UTILITY INTERRUPTIONS

APPENDIX H

NUCLEAR BIOLOGICAL CHEMICAL (NBC) ANNEX

ATTACHMENTS

#1 Map of the Greater Newark Area will identify major roadways, railways, Newark International Airport, Seaports of Newark and Elizabeth. (Located in the Command Post)

#2 Map of the Newark UMDNJ Campus will identify the facilities roads, parking areas and main access points. (Located in the Command Post)

#3 Map of Greater Newark Area Hospitals and their locations. Brief summary of hospital specialty care capability or service. (Located in the Command Post)

#4 Map of University Hospital facility floor plan will be supplied indicating the buildings, heat plants, boilers, generators flammable liquid storage and hazardous material storage. (Located in the Command Post)

#5 Map of the fire fighting equipment and stations in Appendix A

#6 Command Post Response List and the Administrative Notification Response List

#7 External Disaster Phase I: Alert Notification Response List

#8 External Disaster Phase II: Disaster Notification Response List

#9 Internal Disaster Notification

#10 Medical Staff Disaster Plan

#11 Interpreter’s Roster

#12 Tuscan Dairy Agreement

S1 PERSONNEL

MANNED BY: THE COMMAND POST

1. OBTAIN INFORMATION CONCERNING INCIDENT FROM S2 AND IMPLEMENT PERSONNEL SUPPORT. THIS INFORMATION MUST INCLUDE AT A MINIMUM THE FOLLOWING:

A. CURRENT AVAILABLE STAFF AT UNIVERSITY HOSPITAL IN THE CRITICAL AREAS. I.E., (ER, TRAUMA, OR) AND OTHER PATIENT CARE AREAS IF NEEDED.

B. DETERMINE THE NUMBER OF BEDS AND THEIR LOCATIONS AVAILABLE AND CONSISTENTLY UPDATE THIS INFORMATION. FAX FROM ADMITTING EVERY HOUR AFTER INCIDENT. THIS INFORMATION WILL BE POSTED ON THE INCIDENT BOARD LOCATED IN THE COMMAND POST.

C. IDENTIFY THE NUMBER AND TYPE OF STAFF THAT WILL BE AVAILABLE TO REPORT TO DUTY. IDENTIFY APPROXIMATE ETA AFTER NOTIFICATION.

D. AT COMPLETION OF INCIDENT, OBTAIN ACCOUNT NUMBER TO RECORD LABOR HOURS FROM EACH DEPARTMENT INVOLVED WITH THE INCIDENT.

E. PREPARE AFTER ACTION REPORT AND SUBMIT TO HOSPITAL DISASTER COORDINATOR WITHIN 72 HOURS AFTER INCIDENT.

F. ENSURE PROPER COMPLETION OF COMMAND POST CHECKLIST.

S2 INTELLIGENCE

MANNED BY: PUBLIC SAFETY OR EMS

1. GATHER INFORMATION AND MAKE SAID INFORMATION AVAILABLE AS NEEDED TO COMMAND POST (CP) . THIS INFORMATION MUST INCLUDE AT A MINIMUM THE FOLLOWING:

A. LOCATION OF INCIDENT

B. TYPE OF INCIDENT - I.E., AIRPLANE CRASH, FIRE, BOMB THREAT

C. NUMBER AND TYPE OF CASUALTIES EXPECTED

D. ANTICIPATED ETA TO UNIVERSITY HOSPITAL

E. PREPARE AFTER ACTION REPORT AND SUBMIT TO HOSPITAL DISASTER COORDINATOR WITHIN 72 HOURS AFTER THE INCIDENT.

S3 OPERATIONS

MANNED BY: NURSE MANAGER/DEPARTMENT MANAGER

1. COORDINATE THE ACTIVITIES OF ALL THE SUPPORT SERVICES TO ENSURE SUCCESSFUL COMPLETION OF THE MISSION. THIS FUNCTION WILL DIRECT THE RESOURCES TO THE AREA WITH THE MOST IMMEDIATE NEED INCLUDING: 8:00 am - 5:00 pm 5:00 pm - 8:00 am NEWARK OFFICE OF EMERGENCY MANAGEMENT (OEM) 733-3660 973-578-3906

HOSPITAL FINANCE 2-3721 973-421-0748

FOOD SERVICES - (PATIENT FAMILY SUPPORT) 2-4026/4021 2-4021

ENV. SVCS.(CONF. RMS/WAITING AREAS) 2-5400 2-5400

MEDIA – PUBLIC RELATIONS 2-8007 973-318-4866

MEDICAL/CLINICAL REQUIREMENT 2-0440 973-312-6310 (CHIF OF STAFF OFFICE)

MEDICAL EQUIPMENT (CLINICAL ENGINEERING) 2-6661 2-6661 973-312-6394 973-312-6394

MEDICAL GAS (RESPIRATORY) 973-421-0893 973-421-0893

NURSING ADMINISTRATION 2-5676 2-5677

PASTORAL CARE 2-5668 973-312-3966

PATIENT/FAMILY ASSISTANCE (ADMITTING) 2-4050/4051 2-4050/4051

PATIENT TRANSPORT 2-5803 2-7433

PHARMACY 2-5118/5121 2-5118/5121

PHYSICAL PLANT (EMERGENCY POWER/HVAC) 2-5400 2-5400 UTILITIES/ELEVATOR OPERATIONS

RADIOLOGY 2-4907 2-4907 41 Emergency Operations Plan University Hospital

S3 OPERATIONS (CONT’D)

1. COORDINATE THE ACTIVITIES OF ALL THE SUPPORT SERVICES TO ENSURE SUCCESSFUL COMPLETION OF THE MISSION. THIS FUNCTION WILL DIRECT THE RESOURCES TO THE AREA WITH THE MOST IMMEDIATE NEED INCLUDING

8:00 am - 5:00 pm 5:00 pm - 8:00 am

QUALITY ASSURANCE 2-7623/7059 See Attachment 11

HEARING IMPAIRED/BILINGUAL 2-5727 800-643-2255/210019 800-523-1786-911

EOC COORDINATOR 2-3358 973-421-0208

EOHSS 2-4812 2-4490

SECURITY (PUBLIC SAFETY) 2-4491 2-4491/4492

SPACE ALLOCATION 2-5400 2-5400 (CP/PHYSICAL PLANT)

CITY/COMMUNITY LIAISON (REMCS) 2-7000 (24 Hrs) 2-7000 (24 Hrs)

VEHICLE TRANSPORTATION 2-4315 973-421-0664

WASTE REMOVAL 2-7019 2-5400

WATER (PHYSICAL PLANT) 2-5400 2-5400

S4 SUPPORT SERVICES

PHONE NUMBER: 972-3597 (973-318-4377)

UPON NOTIFICATION, GATHER INFORMATION REGARDING THE AVAILABILITY OF ESSENTIAL SUPPLIES REQUIRED TO SUPPORT THE INCIDENT.

A. MEDICAL - PATIENT

B. NON-MEDICAL - PATIENT

C. SHIPPING/RECEIVING

D. LAUNDRY

E. VENDOR SERVICES

1. WATER 2. FOOD 3. EQUIPMENT 4. GENERAL SUPPLIES

F. OTHER SUPPORT (HOSPITALS, CITY, STATE)

S5 PUBLIC RELATIONS

PHONE NUMBER: 972-8007 (973-318-4866)

DIRECT AND CONTROL THE FLOW OF INFORMATION REGARDING THE INCIDENT AND THE ACTIVITIES OF UNIVERSITY HOSPITAL AS IT RELATES TO THE INCIDENT.

1. PROVIDE INFORMATION TO THE PUBLIC VIA VARIOUS

MEDIA FORMS.

2. PROVIDE INFORMATION TO HOSPITAL COMMAND POST

3. COMMUNITY ISSUES/CONCERNS

4. INFORMATION FOR PATIENT FAMILIES

44 Emergency Operations Plan University Hospital ATTACHMENT 7 TELEPHONE OPERATORS/TELECOMMUNICATIONS EXTERNAL DISASTER PHASE I: ALERT NOTIFICATION RESPONSE CHECKLIST

CALL METROCALL 1 866-208-6365 COMMAND POST # 972-5800/5801

Date ______Time

EXTENSION BEEPER NUMBER RESPONSE COMMENTS TIME Environmental Services 2-5400 (24 Hours) Central Supply Services 2-3438/6515 (24 Hours) Admitting Department 2-4045 (24 Hours) Laboratory 2-4080 (24 Hours) Infection Control 2-5790 (24 Hours) Patient Transport 2-7433 973-312-5654 (7 am - 12 am) 973-421-0339

Name of person completing form:______

45 Emergency Operations Plan University Hospital ATTACHMENT 8

EXTERNAL DISASTER PHASE II: DISASTER NOTIFICATION RESPONSE CHECKLIST CALL METROCALL 1- 866-208-6365 COMMAND POST # 972-5800/5801 Date______Time ______Date ______Time ______EXTENSION BEEPER NUMBER RESPONSE HOME # RESPONSE COMMENTS TIME TIME Administrator On-Call (AOC) N/A 856-719-3963 N/A Chief of Staff, - Suresh Raina, MD 2-0440 973-699-4721 973-535-2660

Disaster Coordinator - Steven L. Mosser 2-3337 973-421-0676 973-886-4192 Surgical Attending/Trauma Team SEE DOCTOR ON CALL SCHEDULE Public Safety – Glen E. Crawford 2-4491 609-481-8345 (C) 757-382-9232 Chief Executive Officer- Sidney Mitchell 2-5658 973-566-8752 201-239-1861 Vice President Ambulatory Care - 2-4968 973-566-4949 973-477-6296(C) Adam Henick/Ed Jimenez 2-3109 973-281-9353 201-785-9660 Vice President Finance – James Lawler 2-3721 973-421-0748 908-604-4918 Vice President Operations – 2-0874 973-281-4389 201-363-0124 Derrick Johnson/Steven Mosser 2-3337 973-421-0676 973-886-4192 Interim Vice President Nursing - Patricia Wrobbel 2-1787 973-318-4392 973-838-3577 Marketing & Media Relations Director, Robin Preisler 2-6273 973-318-4866 908-233-8529 Assistant, Roger Ramsey 2-6273 973-318-4978 973-673-2481

46 Emergency Operations Plan University Hospital Patient Care Services

Executive Director, Nursing Patricia Wrobbel 2-1787 973-318-4392 973-838-3577

Executive Director, Perioperative Svcs 2-5730 Nancy Berger 973-312-4945 908-276-7269

Family Health Services 2-5837 Ferne Bell-Woodley 973-312-5286 732-827-0250

Division Psychiatry 2-6127 Chris McCallion 973-312-6193 732-842-9118

Division of Critical Care 2-7012 Linda McGinnis 973-566-7483 973-471-4416

Cardiac Services & Education & 2-6824 Professional Development 973-566-2766 845-365-2818 Fabienne Ryan

Emergency Department 2-1624 James Henry 973-566-7508 908-531-6735

Medical/Surgical 2-6652 Judy Colorado 973-566-8111 908-832-6641

Telecommunications - Lois Gibbs-Reid 2-4052 973-421-0305 973-371-1842

Name of person completing form:______

ATTACHMENT 9

INTERNAL DISASTER NOTIFICATION RESPONSE CHECKLIST

CALL METROCALL 1- 866-208-6365 COMMAND POST # 972-5800-1 Date______Time ______Date ______Time ______

EXTENSION BEEPER NUMBER RESPONSE HOME # RESPONSE COMMENTS TIME TIME Administrator On-Call AOC 856-719-3963 N/A Chief of Staff, - Suresh Raina, MD 2-0440 973-699-4721 973-535-2660 Disaster Coordinator - Steven L. Mosser 2-3337 973-421-0676 973-886-4192 Surgical Attending/Trauma Team SEE DOCTOR ON CALL SCHEDULE Public Safety – Glen E. Crawford 2-4491 609-481-8345 (C) Chief Executive Officer – Sidney Mitchell 2-5658 973-566-8752 201-239-1861 Vice President Ambulatory Care- 2-4968 973-566-4949 973-467-3468 Adam Henick/Ed Jimenez 2-3109 973-281-9353 201-785-9660 Vice President Finance – James Lawler 2-3721 973-421-0748 908-604-4918 Vice President Operations - 2-0874 973-281-4389 201-363-0124 Derrick Johnson/Steven Mosser 2-3337 973-412-0676 973-886-4192 Interim Vice President Nursing Patricia Wrobbel 2-1787 973-318-4392 973-838-3577 Marketing & Media Relations Director, Robin Preisler 2-6273 973-318-4866 908-233-8529 Assistant, Rogers Ramsey 2-6273 973-318-4978 973-673-2481

48 Emergency Operations Plan University Hospital Directors of Patient Care Services

Executive Director, Nursing Patricia Wrobbel 2-1787 973-318-4392 973-838-3577 Executive Director, Perioperative Svcs Nancy Berger 2-5730 973-312-4945 908-276-7269 Family Health Services Ferne Bell-Woodley 2-5837 973-312-5286 732-827-0250 Division of Psychiatry Chris McCallion 2-6127 973-312-6193 732-842-9118 Division of Critical Care Linda McGinnis 2-7012 973-566-7483 973-471-4416 Cardiac Services/Education & Professional Development 2-6824 973-566-2766 845-365-2818 Fabienne Ryan

Telecommunications - Lois Gibbs-Reid 2-4052 973-421-0259 Physical Plant Frank Watts 2-3413 973-865-2288 James Campoli 2-5175/7770 973-214-8797 Paul Crawford 2-4858 973-202-9258

Environmental Services 2-5400 Central Supply Services 2-3438/6515 Admitting Department 2-4045 Laboratory 2-4080 Patient Transport 2-7433 973-312-5654 (7am -12 am) 973-421-0339

Name of person completing form: ______

COMMAND POST CHECK LIST

Name of person completing form: Activation Date: Time: TASK TIME S1 (Personnel) conducted by: S2 (Intelligence) conducted by: S3 (Operations) conducted by: S4 (Support Services) conducted by: S5 (Public Relations) conducted by: AOC called command post “Code Triage ” announced Public Safety arrived to command post PCC arrived to command post AOC arrived to command post AOC terminates disaster mode “Code Triage ALL CLEAR” announced Command post closed Operator report received in command post

PATIENT INFORMATION TASK TIME Command post notified that patients are being transferred to UH ER notified command post that all patients have been received Patients arrive to UH – ER Stretchers transported to ER Patient tag types/number of patients RED YELLOW GREEN BLACK

MEDICAL STAFF DISASTER PLAN

Disasters are events which would quickly overwhelm the routine staffing patterns and supplies of the hospital. The Emergency Operating Plan will be activated depending on: 1.) magnitude of event 2.) the number or the acuity of the victims 3.) type of disaster.

The following are the mechanisms by which physicians will be recruited to assist in a disaster:

DISPATCH OF PHYSICIANS TO THE SCENE

It is the first priority of the University Hospital medical staff to provide service within the hospital. Therefore, the Trauma Center Director will determine whether or not the EMS Medical Director or his designee will be sent to the scene, after ascertaining that there are sufficient medical staff in the hospital to care for the expected number of emergency admissions and provide care for patients already in-house. Assuming that the in-house demands are at least minimally covered, it is the responsibility of the EMS Medical Director to dispatch at least one physician to the scene if requested. If medical staff personnel are dispatched to the scene, radio communication will be maintained with them through the Emergency Medical Service and they will be recalled to the hospital at the discretion of the Surgical/Trauma Attending in charge.

The Senior Surgical Attending will proceed to the Hospital Triage Area and will direct the Triage Function.

KEY PERSONNEL WILL ASSUME DUTIES AS INDICATED

Upon notification that the Emergency Operations Plan has been activated, the following medical staff will report to the designated areas:

SURGERY/TRIAGE

UH Medical Director or designee Director, NorthStar Air Medical Program Section Chief, Trauma Surgery ER Attending

SURGICAL ICU

Director of Surgical ICU

TRAUMA

Chief of Trauma Surgery

MEDICAL STAFF DISASTER PLAN (Cont’d)

NEURO ICU

Chief of Neuro ICU

OPERATING ROOM

Chairman, Department of Surgery Medical Director, Operating Room Chairman, Department of Orthopedics Chief, Section of Neurosurgery Chairman, Department of OB/GYN

All other Attending Surgical personnel will report to the Chief of General Surgery on E-Yellow (Rm E- 349) for assignments.

MEDICAL EMERGENCY AREA (ER)

Medical Director, Emergency Room Nurse Manager, Emergency Medical Director

All other Medical Attending personnel will report to the Medical Critical Care Unit for assignment - I- Yellow 1 & I-Yellow 2

PEDIATRIC EMERGENCY AREA

Director, Emergency Room Nurse Manager, Pediatrics If the Emergency Alert predicates, the following areas will be named:

OUTPATIENT DEPARTMENT

Chairman, Oral Maxillofacial Surgery Nursing Director Ambulatory Care Chief, Section of ENT Designated ENT Attending Director of Medical Clinics

52 Emergency Operations Plan University Hospital ESSENTIAL PHONE NUMBERS

Command Post Phone Lines: 972-5800/5801 & 972-3640/3641 Fax Line: 972-7609

Emergency - 222 Medical Emergency - 111 Census 4050/4051 Central/General Stores/Linen 3437/6515 Clinical Engineering 6661 EMS 4850 Emergency Room 5123/5124 Food & Nutrition 4021/4025/4026 Nursing Operations Center 5671/5672 Operating Room 6901 Page Operator 6000 Patient Transport Services 7433 PCC (after 3 PM) 5676/5677 Pharmacy 5118/5121 Physical Plant/Environmental Services 5400 Public Relations (Marketing & Media) 8007 Public Safety 4491 Radiology 6907 REMCS 7000 Same Day Surgery 2929 Vehicle Transportation 4573

NURSING UNITS Level Yellow Green Blue D 0543 5617/5618 N/A E 5622 5754 2364 F 5626 5624/5625 5633 G 6128 5882 6476 H 5636 5638 5634 I #1 6072 N/A N/A I #2 6068 N/A N/A I N/A N/A 5640 Renal 6080 Labor & Delivery 5813/5814/5815 FICN 5610 PICU 3784 SICU 5755 NICU 5882