Who Moved My Hospital?A Controlled Patient

Evacuation

Carolyn Wells, RN, MSN,CEN, MEPTrauma/Emergency Preparedness Coordinator

Liberty Hospital, Liberty, MO

Background

Two community hospitals merged

One Level II Trauma Center

One busy OB serviceTwo very old

buildings needing lots of maintenance

The Solution: Build one brand new hospital

Background

Planning began one year aheadIntense planning began 6 months from date

of move (which was a moving target)Decision made to use regional electronic

patient tracking system (EMTrack)Decision also made to use WebEOC

Patient Tracking

Patient Tracking System

EMTrack

Similar Technology as FedEx/UPS

Patients Are Issued Bar-coded Triage Tags

Barcode on Tag is Unique Identifier

Additional Info is Added at Any Time

Process Starts by Scanning Tag

A Patient’s Location is Updated at Hospital

Hospitals Track Both Transports and Walk-Ins

Data Flows from Portables……to Local Laptop or PC …

…to a secure, Central Database

EMTrackEMSWare

Patient Tracking Equipment

Handheld ScannerRugged Device

Will take multiple drops to concrete, IP64 standard

Long Battery Life 12-15 hours Constant

UseAll-In-One Integrated Device

Barcode Scanner12 information categoriesCamera for Patient PhotosWireless 802.xxx Internal Memory for Batch Mode

Tag# • Auto Loaded from Scan• Can be manually entered• Required Field• Number must be unique

Alt# • Hospital Admit #• Decon Property Kit Barcode

or Drivers License

Portable User Input

Patient Tracking Activity Flow

Incoming DataFrom Field

Incoming Patient Alert: Trauma

Data Updated in Systemat Hospital

Patient Tag Scannedat Hospital to Update

Location

Hospitals are notified with an audible alarm and flashing “Incoming Patient Alert.”

EMTrack allows them to see pertinent info.Data viewed anywhere with Internet access.

Access based on permissions and log-in

WebEOC

Web-Based Emergency Management System Local Jurisdictional Boards Hospital Boards County Boards Regional Boards

WebEOC

A Board is created for each event

WebEOC

Jurisdictional Boards Can be kept as

local communication

Can be pushed up to the county board

WebEOC

County Boards Can be kept

within the county

Can be pushed up to the regional boards

WebEOC

Many other options with WebEOC FEMA Forms ICS Forms NWS Weather Alerts Map Tac

WebEOC

Centerpoint Medical Center

Our Partners for the Move

Independence/EJC Emergency ManagementMARC (Mid-America Regional Council)Primary Ambulance Agency

AMR (American Medical Response, Inc.)Mutual Aid Agencies

Independence Fire Department Lee’s Summit Fire Department Central Jackson County Fire Protection District Harrisonville EMS MAST (Metropolitan Ambulance Service Trust)

Moving Day Timeline

0400 – Incident Command Center opens at Independence Regional and Centerpoint

0430 – Briefing of all participants0500 – Patient ID scanned into EMTrack0530 – First patient left IRHC en route to

Centerpoint0535 - Rain started (inches per hour) and

quickly became a deluge

Patients Leaving IRHC

Patient ID band scanned with handheld scanner at ambulance entrance

Destination entered Ambulance info entered Triage category chosen Final check that chart,

meds, belongings, etc. with patient

Call to IC informing them of patient time out

Receiving Patients at CMC

Receiving Patients at CMC

ID Band checked upon arrival

Patient name pulled up in EMTrack

Patient accepted at CMC

Room number put into system

Patient Move

49 patients transported from IRHC by 1130 4 ventilator patients moved

Incident Command moved to MCI at 1200Resumed patient transfer at 130036 patients moved from MCI by 1540

5 mother/baby couplets 6 NICU babies (separate Neonatal Transport Unit)

Support from the Community

MARC (Mid-America Regional Council) Staff support on day of move

Independence EOC stood up for this event Provided radios to both hospitals Communications person ran WebEOC Amateur radio supported communications in 3

locationsJackson County EOC

County EM Manager was in the Independence EOC Facilitated communication with MODOT

Patient Move

Challenges Torrential

Rains Road Closings Staging of

Ambulances Blue Hospital

Signs “Closed” signs

had to be redone

Rainfall Amounts

Flooding in Kansas City Area

Complaint First Provider Last Provider Status

T:Red - Gastroenterology IRHC- TC Centerpoint Medical Center Receive to Room 263@0605

T:Green - Pulmonary IRHC - TC Centerpoint Medical Center Receive to Room 617@0605

T:Yellow - Hematology IRHC - TC Centerpoint Medical Center Receive to Room 601@0611

T:Red - Gastroenterology IRHC - TC Centerpoint Medical Center Receive to Room 260@620

T:Yellow - Trauma - head and facial IRHC - TC Centerpoint Medical Center Receive to Room 212@635

T:Green - Trauma - abdominal IRHC - TC Centerpoint Medical Center Receive to Room 608

T:Green - Gastroenterology IRHC - TC Centerpoint Medical Center Receive to Room 610

T:Red - Cardiology IRHC - TC Centerpoint Medical Center Receive to Room 259

T:Yellow - Trauma - head and facial IRHC - TC Centerpoint Medical Center Receive to Room 605

T:Yellow - Cardiology IRHC - TC Centerpoint Medical Center Receive to Room 209

T:Red - Renal/urology IRHC - TC Centerpoint Medical Center Receive to Room 255

T:Red - Cardiology IRHC - TC Centerpoint Medical Center Receive to Room 201

T:Yellow - Endocrinology IRHC - TC Centerpoint Medical Center Receive to Room 612

T:Yellow - Cardiology IRHC - TC Centerpoint Medical Center Receive to Room 210

T:Yellow - Cardiology IRHC - TC Centerpoint Medical Center Receive to Room 208

T:Yellow - Cardiology IRHC - TC Centerpoint Medical Center Receive to Room 204

T:Yellow - Gastroenterology IRHC - TC Centerpoint Medical Center Receive to Room 607

T:Green - Pulmonary IRHC - TC Centerpoint Medical Center Receive to Room 603

T:Green - Trauma - musculoskeletal IRHC - TC Centerpoint Medical Center Receive to Room 619

T:Green - Trauma - musculoskeletal IRHC - TC Centerpoint Medical Center Receive to Room 613

T:Green - Trauma - musculoskeletal IRHC - TC Centerpoint Medical Center Receive to Room 616

T:Yellow - Trauma - musculoskeletal IRHC - TC Centerpoint Medical Center Receive to Room 611

Successful Patient Move/Evacuation

First time EMTrack used to track a large number of patients

Multi-agency coordination to move a large number of patients

No patients were harmed or deteriorated during the transfers

Lessons Learned

There are never enough ambulances or transport vehicles

Electronic tracking of patients very helpful

Emergency Management support is essential

Pre-planning of staging areas (and backups)

Practice, practice, practice!

Questions?