Salvage Considerations – Salvage Considerations – who's responsible? who's responsible?

Paul Bishop

Healthcare Guidance - HTM 05-01 (Revised 2013) Healthcare Guidance - HTM 05-01 (Revised 2013) GuidanceGuidance

Managing Healthcare Fire Safety…Managing Healthcare Fire Safety…

8.3 - Fire Safety Protocols - refers to salvage & continuity planning8.3 - Fire Safety Protocols - refers to salvage & continuity planning

9.3 - Fire Safety Information Manuals refers:9.3 - Fire Safety Information Manuals refers:

Local fire salvage plan (where applicable). Local fire salvage plan (where applicable). A plan that provides details of A plan that provides details of items and their locations specific to the area that will assist the fire and items and their locations specific to the area that will assist the fire and rescue service to plan their fire-fighting, and where possible recovery rescue service to plan their fire-fighting, and where possible recovery activities to best protect the continuity of care, delivery of service and activities to best protect the continuity of care, delivery of service and high value property. The local salvage plan may include details ofhigh value property. The local salvage plan may include details of: :

items required to support the continuation of care such as patient items required to support the continuation of care such as patient notes, specialist drugs or equipment; notes, specialist drugs or equipment;

high value equipmenthigh value equipment

service-critical itemsservice-critical items

HTM Guidance 05-01 HTM Guidance 05-01 Cont…Cont… Managing Healthcare Fire Safety…Managing Healthcare Fire Safety…

10.4 – Planning and Responding to a Fire Emergency refers:10.4 – Planning and Responding to a Fire Emergency refers:

Recovery: Recovery: Salvage planning; Salvage planning;

Appendix E – Establishing Fire Safety protocols refers:Appendix E – Establishing Fire Safety protocols refers:

Salvage and Continuity PlanningSalvage and Continuity Planning• Who is responsible for developing the salvage plans and Who is responsible for developing the salvage plans and

continuity plan? continuity plan? • How are salvage and continuity plans coordinated How are salvage and continuity plans coordinated

between different departments and different between different departments and different organisational levels? organisational levels?

• How is the salvage and continuity plan made available to How is the salvage and continuity plan made available to the fire and rescue service when they attend? the fire and rescue service when they attend?

• Who initiates a review of the salvage plan and continuity Who initiates a review of the salvage plan and continuity plan? plan?

Are reviews undertaken periodically? If so, at what period? Are reviews undertaken periodically? If so, at what period? Are reviews undertaken in response to material changes? If so, how are Are reviews undertaken in response to material changes? If so, how are

these initiated? these initiated?

Other Healthcare Guidance?...Other Healthcare Guidance?...

No specific NHS guidance for Emergency Planning Officers/ Risk & Resilience managers

ISO 22301 – Business Continuity Management:

1. 8.3.3 Protection & Mitigation2. 8.4.4 Business Continuity Plans

No mention of salvage however 8.4.4 C3 refers to “prevention of further loss or unavailability of prioritized activities”

Emergency Emergency AAssistancessistance

It It maymay be possible to direct emergency assistance to be possible to direct emergency assistance to items of great clinical, service delivery, or economic items of great clinical, service delivery, or economic value.value.

Therefore Therefore inin support of the emergency response, support of the emergency response, recovery, and business continuity initiatives, recovery, and business continuity initiatives, wards/depts shouldwards/depts should consider the need to pre-plan for consider the need to pre-plan for salvage operations as part of our fire/emergency salvage operations as part of our fire/emergency planning.planning.

Priorities & Pre-Priorities & Pre-pplanninglanningPrPrioritiesiorities

Concentrate yourConcentrate your resources towards materials/equipment of ‘value’, resources towards materials/equipment of ‘value’, not just financial valuenot just financial value. Items . Items of little value should be placed to one of little value should be placed to one side until irreplaceable material has been dealt with. Items/Areas may side until irreplaceable material has been dealt with. Items/Areas may include:include:

Patient notes/care plansPatient notes/care plans, m, medical recordsedical records Pharmacy dept’s – drug administration - medicinesPharmacy dept’s – drug administration - medicines MRIMRI PET/CTPET/CT Linac’sLinac’s Theatres – AnaestheticTheatres – Anaesthetic machines machines etc etc ITU’s - life support equipmentITU’s - life support equipment Labs – Stem Cell – survival a cancer patientsLabs – Stem Cell – survival a cancer patients Radiology/Radiotherapy – mobile X-Ray machinesRadiology/Radiotherapy – mobile X-Ray machines

Priorities contPriorities cont……

MRIMRI: 3T = £1.8M - 1.5T = £1M: 3T = £1.8M - 1.5T = £1M

PET/CT: Definition Edge = £PET/CT: Definition Edge = £00.8M - Edge = £1.2M.8M - Edge = £1.2M

Anaesthetics machines = £30K+Anaesthetics machines = £30K+

ITU’s - life support monitors ITU’s - life support monitors = £30K+ = £30K+

Radiology/Radiotherapy – mobile X-Ray machines £250K+ Ultrasound equipment Radiology/Radiotherapy – mobile X-Ray machines £250K+ Ultrasound equipment £50-£250K£50-£250K

Distraction TV’s (3D V Pod) – £9k - Children deptsDistraction TV’s (3D V Pod) – £9k - Children depts

Patient notes/care plans Patient notes/care plans – will impact triage and immediate/continual care – will impact triage and immediate/continual care requirements and mrequirements and medical records – loss oedical records – loss or damage may renderr damage may render non-complia non-compliantnt

Pharmacy departments – patient care service delivery – internal/external Pharmacy departments – patient care service delivery – internal/external provision - delayed delivery timesprovision - delayed delivery times

Radiotherapy masks (Shells) - Unable to treat patients without - service criticalRadiotherapy masks (Shells) - Unable to treat patients without - service critical

Vaci-Bags – Immobilise patients for scanning – again service criticalVaci-Bags – Immobilise patients for scanning – again service critical

Pre-Pre-pplanninglanning

Pre-planningPre-planning - might include: - might include:

The priority risks (permanent or moveable objects)The priority risks (permanent or moveable objects) The best methods of removing and/or protecting The best methods of removing and/or protecting priority riskspriority risks Identification of salvage teamsIdentification of salvage teams External assistance – Dormant contractsExternal assistance – Dormant contracts Formulate information packsFormulate information packs Salvage cards – Medical equipment library manager Salvage cards – Medical equipment library manager Identification of a safe areaIdentification of a safe area Security requirementsSecurity requirements Well practiced – include in simulated evacuationsWell practiced – include in simulated evacuations

Information packs Information packs Information packs should be kept securely in the wards/depts and at main reception and/or in premises information boxesInformation packs should be kept securely in the wards/depts and at main reception and/or in premises information boxes

Information packs should contain:Information packs should contain:

List of persons to contact in an emergencyList of persons to contact in an emergency Detail the roles of personDetail the roles of persons involved s involved A description of risk itemsA description of risk items Advance identification of and arrangements with salvage companies/building contractors etcAdvance identification of and arrangements with salvage companies/building contractors etc Aftercare details Aftercare details

These These

Salvage Salvage CCardsards Salvage cards should include:Salvage cards should include:

A plan of the room/area or exact locationA plan of the room/area or exact location of the item of the item A full description of the item using identifiable features such as item A full description of the item using identifiable features such as item serial numbers etcserial numbers etc A photo of the item with short descriptionA photo of the item with short description Details of the method of salvage highlighting special removal Details of the method of salvage highlighting special removal instructions e.g. secured to wall or item comes apart into several pieces instructions e.g. secured to wall or item comes apart into several pieces Information on specialist tools for the above pointInformation on specialist tools for the above point Diagrams for deconstruction Diagrams for deconstruction where where applicableapplicable Kept in ward/department – electronic copy for command & controlKept in ward/department – electronic copy for command & control

NBNB: All cards should be laminated for durability: All cards should be laminated for durability

Damage toDamage to expect following fire expect following fire

Several types you may encounter, including items/equipment that are:Several types you may encounter, including items/equipment that are:

• Completely burned and beyond salvageCompletely burned and beyond salvage

• Partially burnedPartially burned, but dry, but dry

• Partially burned, but wetPartially burned, but wet

• Smoke or soot damagedSmoke or soot damaged

• Unburned, but wetUnburned, but wet

• Physically damaged from salvage or fire-fighting effortsPhysically damaged from salvage or fire-fighting efforts

• Heat affected Heat affected

Trust ImplementationTrust Implementation

Prioritise a selection of departments with items of high valuePrioritise a selection of departments with items of high value

Departmental survey – to identify high value itemsDepartmental survey – to identify high value items

Meet with Service Managers to explain the initiativeMeet with Service Managers to explain the initiative

Confirm agreed actions Confirm agreed actions

Undertake a trial to determine best practice on how to collate and Undertake a trial to determine best practice on how to collate and present the informationpresent the information

Review outcomes, amend where necessary, and then implement Review outcomes, amend where necessary, and then implement across all deptsacross all depts

Monitor and review Monitor and review

SummarySummary

Who’s responsible?...Responsible Person (RP) Who’s responsible?...Responsible Person (RP) Management Executive, Service Managers, Matrons, SSN’s, Management Executive, Service Managers, Matrons, SSN’s, EPLO’s, Risk & Resilience Managers, Fire EPLO’s, Risk & Resilience Managers, Fire AAdvisors/dvisors/MManagersanagers

Who should lead?...EPLO’s - R & R managers Who should lead?...EPLO’s - R & R managers

Why?...Business continuity planning matterWhy?...Business continuity planning matter

Periodic review/amendments?... EPLO’sPeriodic review/amendments?... EPLO’s/R & R Managers /R & R Managers

Thank you and Questions?