Norrbotten County Council, Sweden
Landstingsdirektörens stab The County Council's Activities
. Health Care
. Dental Care
. Regional Development • Traffic and Infrastructure • Economic Policy • Education • Culture
Landstingsdirektörens stab Political Organisation
Northern Auditors County Council Assembly Health Board
Democracy Committee Eastern Health Board Electoral Committee Patients' Committee Central Health Board Executive Committee Southern Health Board
Regional Committee
Supervisory Board Programme Committee The Foundation Board
Operational Organisation
Landstingsdirektörens stab County Council Chief Executive
Secretariat Staff
Surgical Medical Diagnostic Primary Adult Psychiatry National Culture & Service County Specialties Specialties Specialties Health Care Department Dentistry Education Department Technology Department Department Department Department Department Department Department
•Emergency •General internal •Radiology •Public health •General psychiatry •General dental •Norrbotten Music. •County •Infrastructure ward and medicine centres within clinics Ins. administrative ambulance •Infection •Laboratory the county's •Specialist services •Medical •Skin medicine municipalities emergency •Specialist dental •Norrbotten's technology •General •Respiratory psychiatry clinics museum •County surgery •Rehabilitation property •Operational medicine •Infectious •Norrbotten systems •Hematology diseases unit in Luleå •General county •Dental County Library administration •Urology •Renal medicine activities technology •Emergency cardiology •The County laboratory •Gran Natural •Food service technical •Orthopedic Division for Resource College support surgery •Neurology special •Joint service •Gastro- assistance/ enterology •Kalix School of •Eyes disability •Rheumatology Renewable •Administrative Resource •Ears •Neuro and pain service rehab Management •Oral surgery •Geriatric/Rehab •Purchasing •Paramedicine •Gynaecology •Paediatric and obstetrics •Paediatric psychiatry •Paediatric rehab
Landstingsdirektörens stab HealthHealth carecare inin NorrbottenNorrbotten
• 5 hospitals
• 37 primary care centers
• 70 dental care clinics
~ 7400 employeed
Landstingsdirektörens stab The Safe Count Council
Landstingsdirektörens stab The purpose of management = Patient benefit!
Bla, bla… Bla, bla…
-”We just want to inform you… all victims has now arrived to the hospital
Landstingsdirektörens stab NATIONAL BOARD OF HEALTH AND WELFARE
OPERATIVE CHIEF AND STAFF National level iB -T oS S r / (Obs! Not always established) ice off uty d D te na sig De Regional level/ ECC/ REGIONAL MANAGEMENT Gold control Designated Duty Offiicer / TiB SL+ MA Dispatch Staff (County Council NLL)
A M B U L A N C E S Local level
Medical command and control HOSPITAL MANAGEMENT HOSPITAL MANAGEMENT SL+MA SL+MA SL+MA ev. stab Stab Stab (On scene)
Figure. Organisation of the Health Care system at a Major Incidents in Sweden
Landstingsdirektörens stab Medical Command and Control
Medical Incident Commander Swe: MEDICINSKT ANSVARIG
Ambulance Incident Commander Swe: SJUKVÅRDSLEDARE
Landstingsdirektörens stab National priority system
• RED / Immediate- Prioritet 1 (= life-threatening)
• YELLOW / Urgent- Prioritet 2 (= can wait)
• GREEN / Delayed- Prioritet 3 (= shall wait )
• Black Lifeless!/Dead?
Landstingsdirektörens stab On scene it starts with the first rescue, police and ambulance commanders
Landstingsdirektörens stab I am!!! I am!!!
I am!!!
WhoWho´´ss inin charge?charge?
Landstingsdirektörens stab TheyThey workwork underunder differentdifferent legislationlegislation butbut inin LIAISON!LIAISON!
Landstingsdirektörens stab COORDINATION
AREA CONTROL COMMAND COMMAND COMMAND/ /RESCUE /POLICE MEDICAL
COORDINATION
Landstingsdirektörens stab Possible Major Incident
Landstingsdirektörens stab 1 ‘st report from the scene…
• “Through the windsceen” report according to METHANE to the ECC
M= Possible Major Incident- YES!
E= Exact location
T= Type of incident
H= Hazards
A= Access routs
N= Number of causalities
E= Extra resources required
Landstingsdirektörens stab Brister katastrofmedicinska utbildningskedjan
Larm till SOS‐alarm
Ambulans 1. SL & MA
Misstänkt allvarlig Allvarlig händelse händelse NEJ JA
Hanteras i ordinarie Rapport organisation med befintliga resurser SOS‐alarm Transportresurser Ambulans ‐ Sjukvårdsgrupp ‐ Akutmottagning berört Helikopter –Flyg –Bårbil‐ Buss ‐ Annat sjukhus Samordningsköterska
Larmplan vid höjd beredskap Berörd Samordningssköterska larmar LKL Bakjour och presumtiva funktioner/ avdelningar inom eget sjukhus enligt gällande riktlinjer.
Höjd beredskapsnivå Höjd beredskapsnivå NEJ JA
Hanteras i ordinarie Berörd bakjour bildar särskild organisation med sjukvårdsledning för sjukhuset. befintliga resurser Ledningsansvaret övergår till LKL när de trätt i funktion.
Landstingsdirektörens stab County Council Chief Executive
Secretariat Staff
Surgical Medical Diagnostic Primary Adult Psychiatry National Culture & Service County Specialties Specialties Specialties Health Care Department Dentistry Education Department Technology Department Department Department Department Department Department Department
•Emergency •General internal •Radiology •Public health •General psychiatry •General dental •Norrbotten Music. •County •Infrastructure ward and medicine centres within clinics Ins. administrative ambulance •Infection •Laboratory the county's •Specialist services •Medical •Skin medicine municipalities emergency •Specialist dental •Norrbotten's technology •General •Respiratory psychiatry clinics museum •County surgery •Rehabilitation property •Operational medicine •Infectious •Norrbotten systems •Hematology diseases unit in Luleå •General county •Dental County Library administration •Urology •Renal medicine activities technology •Emergency cardiology •The County laboratory •Gran Natural •Food service technical •Orthopedic Division for Resource College support surgery •Neurology special •Joint service •Gastro- assistance/ enterology •Kalix School of •Eyes disability •Rheumatology Renewable •Administrative Resource •Ears •Neuro and pain service rehab Management •Oral surgery •Geriatric/Rehab •Purchasing •Paramedicine •Gynaecology •Paediatric and obstetrics •Paediatric psychiatry •Paediatric rehab
Landstingsdirektörens stab Crises Organization
Tsunami RKL with Incident Commander Duty officer Medical Incident Commander
Pandemic
LKL LKL LKL LKL LKL Kalix Kiruna Gällivare Sunderbyn Piteå
Incident Commander Medical Incident Commander
Incident Incident Commander spot Medical Incident Commander
Landstingsdirektörens stab Stafforganization on regional and local level
Funktion Område Uppgift
SL Incident Commander Leder sjukvårdens insatser
MA Medical Incident Commander Medicinska inriktningsbeslut, samverkan med MA Socialstyrelsen och MA LKL
SC Cheif of Staff Leder stabens arbete
S1 Personnel/Debreif support Personalförsörjning, krisstöd
S2 Analysis Planering på lång sikt, omfallsplanering, uppföljning av tagna beslut
S3 Current Samordning, fördelningsnycklar, lägesbild, kontakter med LKL, dokumentation
S4 Logistics Materielförsörjning, transport, drift, stabsstöd, bevakning m m
S5 Liasion Samverkansplanering, samverkan med andra myndigheter, kommuner och landsting
S6 Technology Upprättar kommunikation, tekniksupport m m
S7 Information Producerar intern/extern information, omvärldsbevakning
Landstingsdirektörens stab Similar tasks – speeds up the information flow
SL MA
RKL SC
S1 S2 S3 S4 S5 S6 S7
SL MA LKL SC
S1 S2 S3 S4 S5 S6 S7
Landstingsdirektörens stab Possible Major Incident
1. Alarm to the geographically responsibly hospital.
2. Inform the closest hospital
3. Alarm to the Duty officer
Other types of alarm always direct to the duty officer!
Landstingsdirektörens stab Duty officer in Norrbotten County Council
• Who does he call a Saturday evening in Kemi, Rovaniemi, Oulo and Helse-Nord???
Landstingsdirektörens stab