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 ECC/ Designated Duty officer / SoS-TiB Dispatch AND HEALTHWELFARE OPERATIVE CHIEF A Designated Duty Offiicer / TiB AND STAFF M B U L A N C E S REGIONAL MANAGEMENT National level (Obs! Not always established) Medical command and control SL+ MA (County Council NLL) Staff SL+MA Regional level/ Figure. Organisation ofev. the stab Health Care system at a Major Incidents in Gold control Sweden (On scene) Landstingsdirektörens stab HOSPITAL MANAGEMENT SL+MA Local level Stab HOSPITAL MANAGEMENT SL+MA 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.