2012 Continuity of Operations Plan

Department of Pathology 2012 CONTINUITY OF OPERATIONS PLAN Updated 1/16/13

PURPOSE The Continuity of Operations Plan is meant to guide the development of contingency plans to support the University of Michigan Health System critical operations during a pandemic or major disaster event. All units are expected to prepare and maintain up-to-date plans, covering the areas of critical functions, staffing, supplies, contract services, communications, travel and contingency planning.

INCIDENT MANAGEMENT SYSTEM PRIORITIES 1. Safety of staff, faculty patients, families and visitors 2. Continuation of patient care and research within the concept of the greatest good for the greatest number 3. Conservation and effective use of resources

PLANNING PRINCIPLES 1. Not business as usual: in the event of a pandemic or major disaster event, some services will need to be stopped and others will be provided in a different manner. 2. Plans should leverage existing resources and mechanisms. 3. Redeployment of staff should be done in a tiered manner: a. First redeploy within your own department b. Then redeploy to and from your partner department/unit clusters (See page 3) c. Lastly, pool from other internal/external resources (i.e. Labor Pool). 4. Redeployment of staff will be balanced between the critical needs of your own department and the critical needs of other departments. 5. Staff with clinical skills should be utilized in some clinical capacity. 6. Internal staffing will be approached differently than external/volunteer staffing.

WORKING ASSUMPTIONS 1. A natural or man-made disaster affecting our ability to perform critical functions for an undefined time period (plan for a minimum of 96 hours). For example, utility failure, tornado damage, or terrorism event. 2. Actual presentation of a epidemic/pandemic is not yet known. Two main scenarios are being considered: mass volumes of flu patients coming through clinics and ED, and/or direct transfer of patients with acute respiratory disorders coming into intensive care units. Event is expected to be a protracted with 12-week waves over several years. 3. Staff absenteeism estimated at 30-40% due to sick staff, staff caring for family members, or fear of infection can be expected.

INSTRUCTIONS 1. Understand who is in your partner department/unit cluster. Share your Continuity of Operations plan with them. 2. Complete all sections as accurately and completely as possible. 3. Direct questions and return completed plans to: [email protected] 4. Discuss your plan with your staff so assure they are aware of their roles. 5. Update your plan at least annually.

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Partner Department/Unit Clusters

CLUSTER NAME DEPARTMENTS Ambulatory Care All Health Centers/Clinics and Ambulatory Care Administration Basic Science/Research All Medical School Basic Science Departments and Research Labs Clinical Affairs Office of Clinical Affairs, Graduate Medical Education, CIDSS, Michigan Surgical Quality Initiative Diagnostics/Therapies Pathology (Non-ACU), Physical Medicine and Rehab (Non-ACU), Med Sport Physical Medicine Radiation Oncology (Non-ACU), Radiology, Speech Language Pathology Hospital Administration Office of CEO/COO, Contracting & Planning, Michigan Health Corp, Quality Improvement & Program & Ops Analysis, Public Relations and Marketing Communications, Safety Management Services Medical School Development & Alumni Relations, EVPMA, FGP-Billing, FGP-Quality, Medical Education, MLearning, MICHR, Administration MCRU, MSA departments (Clinical Affairs Office, Communications, Dean’s Office, Diversity & Career Dev., Enabling Technology, Facilities Management & Planning, Faculty Affairs, Global Reach, HR, IRB, Medical Education, MSIS, Office of Student Programs, Office of Research, Program in Biomedical Sciences), Regulatory Affairs Medicine Cardiovascular Center, Cancer Center, Dermatology, Emergency Medicine, Family Medicine, Internal Medicine (all admin, divisions, clinics, and labs), Ophthalmology, Survival Flight, Transplant, Pediatrics, Neurology, Nursing/Patient Care All Nursing Departments, ABCC, Home Care Services, Quality Improvement, Risk Management, Infection Control Social Patient/Family Social Work (Spiritual Care, Palliative Care, Child & Family Life), Multicultural Health, Mott, Women’s and Support Holden Programs, Community Health Services, Interpreter Services, Meals on Wheels, Regional Alliance for Healthy Schools, Volunteer Services, Accommodations, Gender Program and Blood Drives, Psychiatry Support Services Contracts/Procurement, Environmental Services, Facilities Operations, Facilities Planning, Patient Food and Nutritional Services, Laundry, Materiel Services, Pharmacy, Panging and Information Services Surgical/OR Anesthesiology, OR/PACU/Surgical Centers, Cardiac Surgery, Neurosurgery, Orthopedic Surgery, General Surgery, Urology, Otolaryngology, OB/GYN Surgery UMHS Core Compliance, MCIT, Corporate Finance, Utilization Management , Revenue Cycle/Collections, Business Services, Outpatient Registration and Insurance Verification, Health and Well Being Services, MHealthy, Employee Assistance Program, Occupational Health Services, Health Information Management, Security Services, UMHS Human Resources

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TABLE OF CONTENTS

SECTION 1: DEPARTMENT/UNIT INFORMATION

SECTION 2: FUNCTIONS

SECTION 3: STAFFING

SECTION 4: SUPPLIES

SECTION 5: CONTRACT SERVICES

SECTION 6: COMMUNICATIONS

SECTION 7: ESSENTIAL TRAVEL

SECTION 8: UTILITY FAILURES

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SECTION 1: DEPARTMENT/UNIT INFORMATION

DEPARTMENT: Department of Pathology LOCATION: 5240 Med Sci 1, SPC 5602 DIVISION/UNIT/AREA/LAB: Pathology FAX: (734) 763-4782 MAIN PHONE: DEPT-WIDE EMAIL: CENTREX PHONE: DEPT PAGING GROUP: HOURS OF OPERATION: DEPT ON-CALL PAGER:

CHAIR: Jay Hess OFFICE PHONE: 734-763-6384 EMAIL: [email protected] DIRECTOR/MANAGER: Martin Lawlor OFFICE PHONE: 734-615-6371 EMAIL: [email protected]

Department’s Emergency Contact(s) and Alternates (at least 3 deep):

NAME AND TITLE/ROLE BUSINESS CONTACT INFORMATION PERSONAL CONTACT INFORMATION Suzanne Butch Address: UH 2F225 Home Phone: (734) 668-8346 Office Phone: (734) 93606861 Cell Phone: (440) 465-5100 Administrative Coordinator Pager: 37165 Business Cell: N/A Email: [email protected] Martin Lawlor Address: M5240 Med Sci 1 Home Phone: (734) 332-5050 Office Phone: (734) 615-6371 Cell Phone: (310) 936-1066 Administrative Director, Pager: (734) 936-6266 #8142 Healthcare Business Cell: N/A Email: [email protected] Thomas Morrow Address: M5218 Med Sci 1 Home Phone: (734) 761-3356 Office Phone: (734) 936-1878 Cell Phone: (734) 645-7315 Assistant Administrator, Pager: (734) 936-6266 #9382 Healthcare Business Cell: N/A Email: [email protected] David Golden Address: M5231 Med Sci 1 Home Phone: (734) 973-1737 Office Phone: (734) 763-4491 Cell Phone: (734) 476-0195 Administrative Manager, Medical Pager: N/A School Business Cell: N/A Email: [email protected] *designated by the Department as the Lead Emergency Coordinator/Planner for the department – responsible for preparing this plan

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SECTION 2: FUNCTIONS

Identify departmental functions (critical, intermediate, and non-critical). Develop contingency plans for continuity of operations and recovery.

PART 1– CRITICAL FUNCTIONS: These functions are critical for your department and cannot be stopped.

FUNCTION 1 Essential Clinical Laboratory Diagnostic Testing/Services – (Blood Bank, Apheresis, Chemistry, Immunology, Hematology/Coag, Microbiology/Virology, Cytology, Anatomic Pathology, Autopsy, Phlebotomy Services) RESPONSIBLE PERSON Administrative managers, Section Supervisor, Laboratory Directors – fan out list available AND ALTERNATE(S) TRIGGERS/DEPENDENCIES  List the indicators that will trigger the activation of action plans for this function.  Loss of the use of equipment , utilities or space  Supplier failure to deliver essential supplies and reagents  Think of your current business and what might affect your activity.  Examples: census, location of patients, # of ORs running, # of procedure rooms running, # of staffed general care units/beds, # research studies, lab experiments, etc. CURRENT PERFORMANCE  Provide standard laboratory diagnostic testing and services. STANDARDS WORK REDESIGN AND  Provide standard laboratory diagnostic testing and services with reduced staffing -potential for delayed REDEPLOYMENT turn-around time. STRATEGIES  Provide essential laboratory diagnostic testing and services (detailed listing to be developed).  Maintain specimen integrity where possible, store specimens for subsequent testing or send out.  Specific services provided on an emergent basis.  Autopsies, both medical examiner and medical cases, would be dependent upon legal need and will be determined on a case by case basis.  Plans will be developed for each laboratory to determine how essential operations will be maintained.  Plans will be developed for each laboratory to ensure adequate staffing requirements using redeployment strategies.

 Currently evaluating staff for cross training within department.

[Add additional functions as needed by copying the table above.]

PART 2 – INTERMEDIATE FUNCTIONS: These functions are important, but are not critical to department operations in the event of reduced staffing. CONFIDENTIAL 6 2012 CONTINUITY OF OPERATIONS PLAN Updated 1/16/13

FUNCTION 1 Non-Essential Laboratory Diagnostic Testing and Services RESPONSIBLE PERSON Administrative Managers, Section Supervisor, Laboratory Directors AND ALTERNATE(S) TRIGGERS/DEPENDENCIES  Loss of the use of equipment , utilities or space  Pandemic effects (reagents/supplies)  Absenteeism CURRENT PERFORMANCE  Provide standard laboratory diagnostic testing and services. STANDARDS WORK REDESIGN AND  Provide standard laboratory diagnostic testing and services with reduced staffing. Maintain specimen REDEPLOYMENT integrity where possible, store specimens for subsequent testing or send out. STRATEGIES

[Add additional functions as needed by copying the table above.]

PART 3 – NON-CRITICAL FUNCTIONS: These functions are not critical for your department and could be stopped during a pandemic event in order to redeploy staff to critical areas.

FUNCTION 1 Human Subject/Critical Research and Non-Critical Research RESPONSIBLE PERSON Faculty, Primary Investigators AND ALTERNATE(S) TRIGGERS/DEPENDENCIES  Pandemic effects  Absenteeism CURRENT PERFORMANCE  Pathology human subject research involves blood/tissue samples. All human subject research could be STANDARDS canceled or postponed in Pathology research laboratories during a pandemic emergency. WORK REDESIGN AND  Pathology will notify all research laboratories to cancel or postpone collection of human subject samples REDEPLOYMENT until further notice. This will occur in both oral and written communications. Research laboratory contact list on file STRATEGIES with plan coordinator.

FUNCTION 2 General Research RESPONSIBLE PERSON Faculty, Primary Investigators AND ALTERNATE(S) TRIGGERS/DEPENDENCIES  Pandemic effects  Absenteeism

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CURRENT PERFORMANCE  Most research activities could be canceled or postponed in Pathology research laboratories during a STANDARDS pandemic emergency. WORK REDESIGN AND  Research laboratories will be notified by Pathology administration and research leadership to suspend REDEPLOYMENT non-critical research activities during a pandemic emergency. This will occur in both oral and written communications. STRATEGIES Research laboratory contact list on file with plan coordinator.

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SECTION 3: STAFFING

PART 1 – AREAS OF NEED: Identify areas of potential staffing need for Critical Functions ONLY (SECTION 2, Part 1 above)

1. Once you have exhausted your own internal resources (by work redesign or reassignment of staff), then you will need to determine what staffing resources you might need from your partner department cluster. 2. Identify by skill category and job title the resources needed within your department that will be needed from your partner department. CATEGORY CATEGORY DESCRIPTION EXAMPLE JOB TITLES Medical Staff, House Officer, Medical Doctor, Doctor of Osteopathy, Dentists, Psychologists, House Officers, Fellows, A and Mid-level providers Physician Assistants, Advance Practice Nurses (NP, Mid Wives, CRNA) Basic Science & Clinical Laboratory Graduate and Undergraduate Students, Basic Science and Clinical B Research Staff Researchers, Animal Technologists, Laboratory Managers, etc. C Nursing Registered Nurses or Licensed Practical Nurse Respiratory Therapists, Pharmacists, Social Workers, Surgical Technologists, Physical D Other Clinical Staff Therapists, Occupational Therapist, Speech Therapists, Nutritionists, Phlebotomist, Medical Assistants, Nursing Assistants, Radiation Technologists, etc. Administrators/Managers, Administrative Professionals, Clerical, Security Personnel, E Administrative/Ancillary Skilled Professionals (plumbers, electricians, etc.), Facility and Operation Support (housekeeping, maintenance, transport, etc.), etc. 3. If training is required, identify your training needs below (just-in-time, on-line module, SIM Center, etc.). 4. What other internal (UMHS departments) or external partners (UM Schools, vendors, etc.) do you think could provide you with staffing resources to maintain your critical functions? Each department is expected to communicate their staffing plans to any identified partners.

FUNCTION SKILL SPECIFIC JOB TITLE HOW TRAINING INTERNAL / CONTACT NAME, PHONE, # CATEGORY MANY NEEDS EXTERNAL EMAIL (A B C D E) (estimate) PARTNER

PART 2 – REDEPLOYMENT: Identify any staff by skills within your area that could be redeployed to fill critical functions in other areas

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1. Once you have staffed all your critical functions (Part 1A), identify all staff by skills and current job title that could potentially be redeployed to meet the needs of other critical functions within other departments. CATEGORY CATEGORY DESCRIPTION EXAMPLE JOB TITLES Medical Staff, House Officer, Medical Doctor, Doctor of Osteopathy, Dentists, Psychologists, House Officers, Fellows, A and Mid-level providers Physician Assistants, Advance Practice Nurses (NP, Mid Wives, CRNA) Basic Science & Clinical Laboratory Graduate and Undergraduate Students, Basic Science and Clinical B Research Staff Researchers, Animal Technologists, Laboratory Managers, etc. C Nursing Registered Nurses or Licensed Practical Nurse Respiratory Therapists, Pharmacists, Social Workers, Surgical Technologists, Physical D Other Clinical Staff Therapists, Occupational Therapist, Speech Therapists, Nutritionists, Phlebotomist, Medical Assistants, Nursing Assistants, Radiation Technologists, etc. Administrators/Managers, Administrative Professionals, Clerical, Security Personnel, E Administrative/Ancillary Skilled Professionals (plumbers, electricians, etc.), Facility and Operation Support (housekeeping, maintenance, transport, etc.), etc. 2. Identify the potential redeployment skill category and redeployment job title that they could fill. 3. Consider staff who may hold licenses, but no longer practice or staff who may moonlight outside of UMHS.

NAME CURRENT REDEPLOYMENT REDEPLOYMENT EMAIL JOB TITLE SKILL CATEGORY JOB TITLE (A B C D E) See Pathology Faculty re- Medical A Clinician; Direct & Non-Direct Patient allocation worksheet Doctor, Care Fellow, Researcher Roster to be developed Administrative D Administrative Professional, Clerical Professionals, Staff Clerical Staff

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SECTION 4: SUPPLIES

1. List essential resources/supplies required for maintaining department’s critical operations. 2. Identify plan for obtaining supplies or stockpiling if appropriate. 3. Identify current and alternate suppliers.

ESSENTIAL CURRENT SUPPLIER NAME, ALTERNATE SUPPLIER ACTION PLAN RESOURCES/SUPPLIES ADDRESS & PHONE NAME, ADDRESS & PHONE Supplies and equipment for Administrative managers, Section Supervisors, Varied Plans to be developed by essential laboratory diagnostic Laboratory Directors maintain adequate supplies. Administrative Managers, Section testing and services Supervisors Blood products Administrative Manager, Laboratory Director Arrangements outlined with the See Blood Order-Change Process American Red Cross (bl44r21.doc) Mortuary Affairs Autopsy Service Coordinator, Laboratory Director Follow functional plan regarding Prepare for activation of alternate mortuary affairs. means of refrigerated unit(s). Phlebotomy Services Phlebotomy draws Path Stores / Materiel Services None

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SECTION 5: CONTRACT SERVICES

1. List essential contract services required for maintaining department’s critical operations. 2. Identify current and alternate contractor name.

ESSENTIAL CONTRACT SERVICES CURRENT CONTRACTOR NAME, ADDRESS ALTERNATE CONTRACTOR NAME, ADDRESS & PHONE & PHONE Blood Products American Red Cross See Blood Order-Change Process 100 Mack Avenue (bl44r21.doc) Detroit, MI 48201 (888) 849-2860 Reagents and supplies Varied Plans to be developed by Administrative Managers, Section Supervisors

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SECTION 6: COMMUNICATIONS

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SECTION 7: ESSENTIAL TRAVEL

1. Identify essential travel required for maintaining department’s critical operations:

ESSENTIAL TRAVEL – DOMESTIC OR CURRENT MODE OF TRAVEL ALTERNATE MODE OF TRAVEL OR ALTERNATIVE TO INTERNATIONAL TRAVEL Specimen Transportation Metro Delivery Internal transportation 4480 Varsity Drive Ste. East Ann Arbor, MI 48108-5007

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SECTION 8: UTILITY FAILURES

1. Consider critical functions that will not be able to be performed if there was a loss of an essential utility. 2. Identify your contingency plan for maintaining your department’s critical operations. 3. Include locations/room numbers where applicable.

UTILITY FUNCTION/OPERATION AFFECTED CONTINGENCY PLAN FAILURE Electricity Laboratory testing Turn off all unneeded equipment use extensions cords Move essential equipment that is not plugged into generator power outlets; Generator Laboratory testing in the event of an existing Safely shutdown equipment on UPS. electrical failure Natural Gas

Water Loss Unable to maintain temperature in blood bank walk- Move to non-water dependent refrigerators in the blood bank or in other in cooler labs Potable Water Staff and patient comfort Obtain bottled water Loss HVAC/Steam Increased heat in room – equipment failures Turn-off unnecessary equipment/take down computer system

Telephone Communication Use emergency phone system, personal cell phones, text messaging, internet Paging Communication Use emergency phone system, personal cell phones, text messaging, internet Network Result reporting Use phone systems, personal cell phones, text messaging

Clinical Ordering and verification of laboratory results Use paper requisitions, phone systems, personal cell phones, text Information messaging System Other IT LIS: reporting laboratory results Use paper requisitions, phone systems, personal cell phones, text System messaging Facility/Building Laboratory testing Need to define potential contiguous space; Traverwood 2 & 4 Damage

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