Medical Surge Capacity And Capability-Books Pdf

Medical Surge Capacity and Capability
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This page left intentionally blank, Medical Surge Capacity and Capability. A Management System for Integrating, Medical and Health Resources. During Large Scale Emergencies, Second Edition, September 2007. This document was prepared under Contract Number 233 03 0028 for the. U S Department of Health and Human Services, Medical Surge Capacity and Capability. This page left intentionally blank, Overall Contents.
Introduction, iv Acknowledgments, vii Forward, ix Executive Summary. xiii Introduction, 1 1 Chapter 1 Overview of MSCC Emergency Management. and the Incident Command System, 2 1 Chapter 2 Management of Individual Healthcare. Assets Tier 1, 3 1 Chapter 3 Management of the Healthcare Coalition. 4 1 Chapter 4 Jurisdiction Incident Management Tier 3. 5 1 Chapter 5 Management of State Response and, Coordination of Intrastate Jurisdictions.
6 1 Chapter 6 Interstate Regional Management, Coordination Tier 5. 7 1 Chapter 7 Federal Support to State Tribal and Jurisdiction. Management Tier 6, 8 1 Chapter 8 Implementation Training and System. Evaluation, A 1 Appendix A MSCC Management System Assumptions. B 1 Appendix B Incident Command System Primer for Public. Health and Medical Professionals, C 1 Appendix C What Is an Incident Action Plan. D 1 Appendix D Glossary, E 1 Appendix E List of Acronyms.
F 1 Appendix F Additional Readings, Medical Surge Capacity and Capability. This page left intentionally blank, Introduction, Acknowledgments. In preparing this handbook a panel of nationally recognized subject. matter experts was convened representing the Federal State local and. private sectors HHS gratefully acknowledges and thanks the panel for. lending their expertise and experience to the development and review of. this handbook, Prepared for, U S Department of Health and Human Services. 200 Independence Avenue S W Washington D C 20201, Contract No 233 03 0028. Prepared by, The CNA Corporation, Institute for Public Research.
Ann Knebel R N D N Sc FAAN, Office of Preparedness and Emergency Operations. Office of the Assistant Secretary for Preparedness and Response. Eric Trabert M P H, The CNA Corporation Institute for Public Research. Joseph A Barbera M D Co Director of the Institute for Crisis Disaster. and Risk Management The George Washington University. Anthony G Macintyre M D Associate Professor of Emergency. Medicine The George Washington University, Medical Surge Capacity and Capability. This page left intentionally blank, Introduction, The Medical Surge Capacity and Capability MSCC handbook was. published in August 2004 to describe a systematic approach for managing the. medical and public health response to an emergency or disaster Shortly after. its publication the Department of Homeland Security released the National. Response Plan NRP In accordance with Homeland Security Presidential. Directive HSPD 5 the NRP established the structure and process for a. coordinated multidisciplinary and all hazards approach to domestic incident. management based on a National Incident Management System NIMS. The NRP was put to its first real world test during Hurricane Katrina. Although incident response is a State and local responsibility after action. reviews from Katrina indicate the need to strengthen Federal support of. State and local efforts and improve preparedness for the Federal response. to a catastrophic event Katrina was a stark reminder of the devastating. consequences especially among the medically fragile segments of society. when the local healthcare infrastructure fails It also revealed that collaborative. planning information sharing and incident management coordination. hallmarks of the MSCC handbook apply not only to surge events but also to. maintaining normal healthcare operations and services a concept known as. medical system resiliency The lessons learned from Katrina spurred changes. to the NRP 1, The impetus for updating the MSCC handbook was to describe recent.
changes to the Federal emergency response structure particularly the Federal. public health and medical response The revision also expands on several. concepts described in the first edition of the MSCC handbook to facilitate. their implementation While the tiered approach described in this handbook is. consistent with NIMS and the NRP this revision addresses terminology and. concept descriptions to assure consistency with Federal guidance. A subject matter expert panel was convened in August 2006 to identify. areas of the MSCC handbook that should be expanded or updated The panel. was drawn primarily from the pool of experts that participated in the development. of the original MSCC Based on the panel s insights HHS worked with the CNA. Corporation and Drs Joseph Barbera and Anthony Macintyre to prioritize areas. for revision and complete the necessary changes, In addition to promoting consistent terminology with the NRP and. NIMS the following is a list of key updates or revisions contained in this. second edition of the MSCC handbook, U S Department of Homeland Security Notice of Change to the National Response. Plan May 25 2006 Available at http www dhs gov dhspublic interapp editorial. editorial 0566 xml, Medical Surge Capacity and Capability. Tier 6 Federal Support to State Tribal and Jurisdiction. Management has been rewritten to highlight changes to the Federal. emergency response structure The chapter focuses on the information. that medical and public health planners need to know regarding the. request receipt and integration of Federal public health and medical. support under Emergency Support Function 8 of the NRP 2. The handbook now emphasizes how MSCC concepts can be applied. not only to medical surge but also to maintain normal healthcare. services and operations during a crisis i e medical system. resiliency, Newly added section 1 4 1 clarifies the role of Incident Command. versus the regular administration of an organization during response. and recovery operations Included in this section is a description of the. Agency Executive role in ICS, In accordance with NIMS the handbook describes the role of.
a Multiagency Coordination System MACS Multiagency. Coordination Center MACC and Multiagency Coordination. Group MAC Group in providing emergency operations support to. incident command The application of these concepts at Tiers 2 and 3. is particularly important 3, Section 1 3 1 draws distinctions between the processes and structures. that are used in preparedness planning and those used during. incident response and recovery, An important lesson learned from Hurricane Katrina and included. in this update is the need at all levels of government to plan for the. health services support needs of medically fragile populations. The structure of the Emergency Operations Plan EOP has become. increasingly standardized Section 2 3 of the handbook provides a. more detailed description of the requirements of an effective EOP for. healthcare organizations, The term healthcare organization has been substituted for. healthcare facility to reflect the fact that many medical assets. that may be brought to bear in an emergency or disaster are not. facility based, At the time of this writing the NRP is undergoing revision and may soon be known as the. National Response Framework However the Emergency Support Function ESF structure. as described in this handbook is not expected to change Additional information on the. National Response Framework is available at http www fema gov emergency nrf. As NIMS is updated the terminology used to describe components of multiagency coordi. nation systems may change however the general concepts remain the same. Introduction, Executive Summary, Medical and public health systems in the United States must prepare for.
major emergencies or disasters involving human casualties Such events. will severely challenge the ability of healthcare systems to adequately care. for large numbers of patients surge capacity and or victims with unusual. or highly specialized medical needs surge capability In addition medical. and public health systems can expect incidents that significantly impact their. usual operations as occurred with Hurricane Katrina These so called mass. effect events can have devastating consequences for medically fragile. segments of society and those living with chronic health conditions Limited. or no access to routine healthcare services can cause these populations. to rapidly decompensate producing a downstream surge of demand for. acute care that can overwhelm local capabilities The first step in addressing. medical surge and medical system resiliency is to implement systems. that can effectively manage medical and health response as well as the. development and maintenance of preparedness programs. The Medical Surge Capacity and Capability MSCC Management. System describes a management methodology based on valid principles. of emergency management and the Incident Command System ICS. Medical and public health disciplines may apply these principles to. coordinate effectively with one another and to integrate with other response. organizations that have established ICS and emergency management. systems fire service law enforcement etc This promotes a common. management system for all response entities public and private that may. be brought to bear in an emergency In addition the MSCC Management. System guides the development of public health and medical response that. is consistent with the National Incident Management System NIMS. The MSCC Management System emphasizes responsibility rather than. authority alone for assigning key response functions and advocates a. management by objectives approach In this way the MSCC Management. System describes a framework of coordination and integration across six. tiers of response, Management of Individual Healthcare Assets Tier 1 A well defined. ICS to collect and process information to develop incident plans and. to manage decisions is essential to maximize MSCC Robust processes. must be applicable both to traditional hospital participants and to. other healthcare organizations HCOs that may provide hands on. patient care in an emergency e g outpatient clinics community. Medical Surge Capacity and Capability, health centers private physician offices and others as noted on. page 2 2 Thus each healthcare asset must have information. management processes to enable integration among HCOs. at Tier 2 and with higher management tiers, Management of a Healthcare Coalition Tier 2 Coordination among. local healthcare assets is critical to provide adequate and consistent. care across an affected jurisdiction 4 The healthcare coalition. provides a central integration mechanism for information sharing and. management coordination among healthcare assets and also establishes. an effective and balanced approach to integrating medical assets into. the jurisdiction s ICS, Jurisdiction Incident Management Tier 3 A jurisdiction s ICS. integrates healthcare assets with other response disciplines to provide. the structure and support needed to maximize MSCC In certain events. the jurisdictional ICS promotes a unified incident command approach. that allows multiple response entities including public health and. medicine to assume significant management responsibility. Management of State Response Tier 4 State Government participates. in medical incident response across a range of capacities depending. on the specific event The State may be the lead incident command. authority it may provide support to incidents managed at the. jurisdictional Tier 3 level or it may coordinate multijurisdictional. incident response Important concepts are delineated to accomplish. all of these missions ensuring that the full range of State public health. and medical resources is brought to bear to maximize MSCC. Interstate Regional Management Coordination Tier 5 Effective. mechanisms must be implemented to promote incident management. coordination between affected States This ensures consistency in. regional response through coordinated incident planning enhances. information exchange between interstate jurisdictions and maximizes. MSCC through interstate mutual aid and other support Tier 5. incorporates existing instruments such as the Emergency Management. Assistance Compact EMAC and describes established incident. command and mutual aid concepts to address these critical needs. Federal Support to State Tribal and Jurisdiction Management Tier 6. Effective management processes at the State Tier 4 and jurisdiction. The term jurisdiction in this context refers to a geographic area s local government which. commonly has the primary role in emergency or disaster response. Executive Summary, Introduction, Tier 3 levels facilitate the request receipt and integration of Federal.
public health and medical resources to maximize MSCC The Federal. public health and medical response is described emphasizing the. management aspects that are important for State and local managers. to understand, The tiers of the MSCC Management System do not operate in a. vacuum They must be fully coordinated with each other and with the. non medical incident response for medical and public health resources to. provide maximum MSCC The processes that promote this coordination. Medical Surge Capacity and Capability Executive Summary health centers private physician offices and others as noted on page 2 2 Thus each healthcare asset must have information management processes to enable integration among HCOs at Tier 2 and with higher management tiers Management of a Healthcare Coalition Tier 2 Coordination among local healthcare assets is critical to

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