PS1070 SARASOTA MEMORIAL HOSPITAL POLICY TITLE: PERSONS WITH SPECIAL NEEDS (PSN) OPERATIONS DURING A EFFECTIVE DATE: REVIEWED/REVISED DATE: POLICY TYPE: Job Title of Responsible Owner: Director, Integrated Case Management 06/15/99 01/09/15 Clinical Non-Clinical 1 of 9 PURPOSE: POLICY STATEMENT: EXCEPTIONS: DEFINITIONS: To provide for necessary medical shelter for Persons with Special Needs (PSNs) in the event of a hurricane or other community disaster. Sarasota Memorial Hospital (SMH) will work closely with the Sarasota County Emergency Operations Center (EOC) to provide medical shelter for selected subgroups of PSNs in the event of a hurricane or other community disaster. At the time of evacuation, persons presenting to SMH who were not previously registered as PSNs will be triaged by Sarasota County Public Health Department staff in the EOC according to EOC criteria. These persons may obtain PSN classification for sheltering at SMH or may be assigned other shelter accommodations. The EOC will facilitate transport if the person is not capable of transporting him or herself to the assigned shelter. PSNs - Persons with Special Needs directed by the EOC to seek medical shelter in the event of a hurricane or other community disaster. PSN Intake Area area designated for arrival and departure of PSNs located at the Courtyard Tower main entrance. Pre-team - Pre-Team will consist of two Integrated Case Management (ICM) psychosocial case managers (PSCM) who will assist with PSN intake or placement to an alternate setting. Pre-team members leave the facility prior to lockdown of the hospital and arrival of Team A members. Team A - personnel needed to perform critical functions during a hurricane/disaster.they prepare their homes, families and pets prior to reporting to work and remain at the facility during the hurricane/ disaster emergency and while the hospital is under lockdown. After the All Clear announcement and Team B arrives, they will leave. Team B - personnel needed to work in the ICM department or the
2 of 9 PROCEDURE: 1. INTAKE OF PSNs Labor Pool immediately following the All Clear announcement. The primary purpose of Team B is to provide recovery for Team A and to assist in whatever efforts are needed to return the hospital to normal operations. WEBEOC a database that stores information on Sarasota County residents who have signed up for the PSN program. This system captures their medical, demographic and personal information as well as what type of home they live in and in which evacuation zone. a. When it is known that an evacuation (mandatory or voluntary) will be initiated by the EOC: 1) The PSN coordinator (director of ICM) or designee will: a) Contact the labor pool coordinator to notify of activation of PSN intake process. b) Labor pool will supply two triage RNs and two transporters (refer to ICM department policy #138.024, Integrated Case Management Operations During a Hurricane/Disaster for ICM process). c) Contact Information Systems to obtain three mobile laptop computers to be set up in the PSN Intake Area: one in the intake registration area, one for the Triage nurses and one in the Labor Pool. The laptops, with generic sign-ons, will be set up to access WEBEOC through the internet. d) Contact Telecommunications to set up an emergency red phone for the Triage Nurses. e) Contact the director of Nursing Resources or designee and executive director of Hospitality Services or designee to identify available space in pre-designated areas. f) Contact Environmental Services to begin setting up designated conference rooms (cots, chairs, remove tables etc). g) A master list of PSNs will be accessed through the internet website WebEOC,, which is a database of persons who have signed up for the PSN program in Sarasota County. b. After the Sarasota County EOC announces when the
3 of 9 evacuations will begin, the PSN pre-team staff will assemble in the PSN Intake Area at least one hour prior to the time the expected arrivals are to begin. The PSN coordinator or designee (may be Team A at this time) will organize the intake process, coordinating with the hospital Command Center and Sarasota County EOC representatives on-site. c. The PSN will be given an ID bracelet with name and location. The caregiver, if one is present, will be given an ID bracelet with PSN name and alpha identifier for each accompanying caregiver. The PSN will proceed to the triage nurse. d. Triage nurse will complete the assessment and fill out a transport slip with name and location; PSN and caregiver will be transported to their designated location by a transporter. e. PSNs arriving by self-transport will be directed to the PSN Intake Area for registration and location assignment. f. PSNs arriving for shelter who have not previously registered or who are not registered to SMH will be directed to contact the Sarasota County EOC for assignment. The PSN coordinator may determine that, based on volume of PSNs and available space, the PSN presenting may stay at SMH. g. Assistance for PSNs: 1) PSNs are expected to be independent or have assistance from a caregiver for their needs. SMH labor pool staff will be assigned as guides to assist PSNs in way-finding for meals, obtaining linen, etc. No clinical services will be provided. 2) Respiratory Therapy staff will round regularly to assure that all PSNs with oxygen needs are set up and have functional access to oxygen as needed. h. PSNs requiring medical attention - in the event a PSN develops symptoms requiring a physician s assessment; on-call physicians will be notified. If the symptoms are serious enough, the PSN will be sent to the Emergency Care Center (ECC) for evaluation and possible admission. i. Attendants in the PSN locations will notify the PSN registration staff of any room changes made and the registration staff will update the master list. j. Every 1 to 2 hours, the PSN coordinator will provide a count of PSNs to the Command Center and to the EOC representative on-site. k. When it appears that the majority of the expected PSNs have arrived, the PSN coordinator will print lists of PSNs
4 of 9 by location and alphabetically and copies will be provided to the telephone operators, the Command Center and to ICM staff on the A Team. 2. PSN MANAGEMENT DURING THE LOCKDOWN a. ICM staff on the A team will round on all PSNs to confirm transportation and plans for return after the all-clear is called. They may identify other issues to consider at departure (e.g. car in one location, PSN here at hospital). b. When the brunt of the storm appears to have passed but prior to all-clear, ICM A Team will again round on PSNs to provide information about the departure process. 3. DEPARTURE OF PSNs a. Discharge of PSNs: ICM B Team staff or designee will be aware of all PSN locations and will have current listings of PSNs by location including transportation mode, whether transported by self/caregiver or by EOC bus transport. 1) Once the All-Clear is called, the PSN registration site will reopen. Labor pool will supply two transporters. The ICM B Team will be responsible for updating the PSN Census/Disposition spreadsheet during the departure process. 2) Transporters will bring all self parked PSN s to the Patient Intake Area. ICM B Team or designee will call with valet numbers (if valets are present) so that cars can be brought down to loading area. If no valets present, caregivers will be sent to retrieve vehicles and PSNs will depart from loading area. 3) PSNs needing county transportation and based on information received from the Sarasota County EOC, the PSN coordinator will then begin to have PSNs transported to the Patient Intake Area. They will be organized by zip code for transport. Sarasota County will be responsible for their return transportation. 4) If PSNs in certain zip codes have concerns about returning to their homes due to utility failures etc., their concerns, departure and continued shelter needs will be addressed by the Sarasota County EOC. SMH shelter operations conclude at the announcement of the All-Clear. RESPONSIBILITY: It is the responsibility of the director of Integrated Case Management with acting PSN coordinator(s) and labor pool coordinator(s) to
5 of 9 coordinate the arrival, care and departure of PSNs during a hurricane or other community disaster. REFERENCE(S): ICM Department Policy #138.024, Integrated Case Management Operations During a Hurricane/ Disaster SMHCS Policy 00.SAF.48 Hurricane Response Plan ICM department policy #138.024, Integrated Case Management Operations During a Hurricane/Disaster AUTHOR(S): ATTACHMENTS: Colleen Ryan, BS, RN, Manager, ICM Kathleen McDonald, MBA, BSN, RN, QI specialist Deborah Duff, Emergency Management Coordinator Susan Curran, Manager, Employee Relations Attachment A: Patient Intake Area Set-up for PSN Intake Diagram Attachment B: SMH PSN Shelter Guide Attachment C: PSN Locations List
6 of 9 APPROVALS: Signatures indicate approval of the new or reviewed/revised policy. Committees/Sections/Departments: Date Director/Responsible Owner: Vice President/Executive Director: Chief of Medical Operations: (if clinical policy or appropriate) Chief of Staff: (if clinical policy or appropriate) Medical Executive Committee: (if clinical and review requested by CMO and COS) Colleen Ryan, Manager, ICM 12/10/14 Jan Mauck, CNO 12/18/14 R. Stephen Taylor, MD, CMO 12/19/14 James Fiorica, MD 12/20/14 NA Chief Executive Officer: David Verinder, CEO 12/24/14
7 of 9 ATTACHMENT A: PATIENT INTAKE AREA SET UP FOR PSN INTAKE PSNs enter through Surgery Center door Waiting area chairs PSN Registration Desks Labor Pool Waiting area chairs Triage Nurse Triage Nurse
8 of 9 ATTACHMENT B: Sarasota Memorial Hospital PSN Shelter Guide 1. We are a non-smoking facility. Smoking is permitted outside in designated areas (off of hospital property). 2. No firearms, weapons, drugs or alcohol are allowed on premises. 3. No pets are allowed. 4. You may use public phones or your cell phones to make calls. 5. Quiet hours are from 8 PM to 8 AM. 6. Food available: Cafeteria, 4 th floor; vending machines are located throughout the facility.. You and your caregiver(s) will be provided with a cot and appropriate linen. Please bring your own pillows. We apologize in advance, however, we will not be able to provide private rooms for everyone. It is stressful and difficult to live in common quarters; please be considerate and keep your areas and common spaces neat and clean. We are a shelter only facility. Should you require any medical care during your stay with us you will be brought to the Emergency Care Center for evaluation for possible treatment and admission. Thank you for your care and consideration. It is our goal that everyone is as safe and comfortable as possible. Your assistance and patience are greatly appreciated. If you should have any concerns during your stay, you may contact the Hospital Operator from any house phone. DIAL O for the operator.
9 of 9 ATTACHMENT C: PSN LOCATIONS With medical related needs/impairments o 3NW o 4NW o MAC o 5D-ICU o ENDOSCOPY o CABANA (pre-op 2 nd floor critical care tower) Without medical related needs o 3D Conference Room (6) o 3C Conference Room (25-30) o 3C Ortho Gym (6-8) o 4C Conference Room (5-7) o 4D Conference Room (5-7) o 2D Conference Room (5-7)