Healthcare Emergency Manager Core Competencies Assignment

Healthcare Emergency Manager Core Competencies Assignment

Appendix C – Healthcare Emergency Management Competencies Appendix C Healthcare Emergency Management Competencies: Competency Framework Final Report 1 Joseph A. Barbera, MD, Anthony G. Macintyre, MD, Greg Shaw, DSc, Valerie Seefried, MPH, Lissa Westerman, RN, Sergio de Cosmo, MS Institute for Crisis, Disaster, and Risk Management The George Washington University October 11, 2007 Introduction In December 2004, the Veterans

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Health Administration (VHA) Emergency Management Strategic Healthcare Group awarded the Institute for Crisis Disaster & Risk Management (ICDRM) a contract to participate in establishing innovative training and personal development curricula for the VHA Emergency Management Academy (VHA-EMA). The objective of the project was to develop a nationally peer-reviewed, National Incident Management System (NIMS) compliant, competency-based instructional outline and curriculum content upon which to base education and training courses. The curriculum is intended to educate VHA personnel for response and recovery in healthcare emergencies and disasters, to provide a resource for future VHA training programs, and to be placed in the public domain for use by other healthcare personnel. The initial phase of the EMA project consisted of developing a competency framework (competency definition, structure and format, and critical elements) followed by development of peer-reviewed emergency response and recovery competencies for VHAselected healthcare system job groups. The competencies describe knowledge, skills, and abilities essential for adequate job performance during the emergency response and recovery phases of an incident. Peer review was accomplished through a web-based survey of the proposed competencies, which was distributed to a select, nationwide sampling of emergency management personnel who were identified as having extensive experience or advanced expertise in healthcare emergency response. The survey process was designed to obtain a balanced expert opinion as to whether the project team’s written competencies were valid, and to assess the appropriate level of proficiency for each primary competency (i.e., awareness, operations, or expert). The competencies developed during this initial phase were then used to guide the development of learning objectives for the instructional curriculum. 1 This report was supported by Department of Veterans Affairs, Veterans Health Administration contract “Emergency Management Academy Development,” CCN20350A. The report is the work of the authors and does not represent the views of the Department of Veterans Affairs or any of its employees. Institute for Crisis, Disaster and Risk Management The George Washington University 33 Appendix C – Healthcare Emergency Management Competencies An extensive research effort was conducted to understand the historical use of competencies, and to establish objective criteria for competency development. Historical development of competencies Competency modeling originated in business management research, and has evolved extensively over the past 25 years as other disciplines began adopting the practice. 2 The original intent of competency development was to enhance the then common “job analysis” by relating a position’s requisite knowledge, skills and abilities to the overall objectives of the organization in which the position existed. This approach aligns the objectives (i.e., desired outputs) of individual jobs with the overall objectives of the organization, such that organizational objectives are achieved through effective individual job performance. While this was the original intent of competencies, their definition varied widely as time progressed. Competency definitions range from emphasizing underlying characteristics of an employee (e.g., a motive, trait, skill, aspects of one’s self-image, social role, or a body of knowledge) that produce effective and/or superior performance 3 to performance characteristics (i.e., how an employee conducted their job in relation to the organization’s objectives). 4 The application of competencies across the many organizations that use them has also varied widely. The private sector has commonly employed competencies to define “superior performers” 5 and therefore, as a selection tool for hiring, promotion, and/or salary enhancement. In other organizations, competencies have been used for job-specific performance feedback and improvement. Still others have used competencies to guide future program training and development. Because of this variation in definition and application, it becomes critically important to address these vagaries at the outset of any competency development project. This concept was well-described by one competency research team: “The first step in the implementation of any competency-based management framework must be the organizational consensus on how to define ‘competency.’ This agreed upon definition will drive the methodology used to identify and assess the competencies within the organization.” 6 The GWU-ICDRM project team strongly agreed with this concept, and started the project by defining how the competencies within this initiative would be applied: 2 Newsome, Shaun, Victor M Catano, and Arla L. Day. Leader Competencies: Proposing a Research Framework. 2003. available at http://www.cleleadership.ca/paper/leader_competenciesproposing_a_research_framework.pdf 3 Boyatzis, Richard. The Competent Manager: A Model for Effective Performance New York: Wiley, 1982. 4 US Office of Personnel Management. Executive Core Qualifications (ECQ’s), accessed at http://www.opm.gov/ses/ecq.asp 5 Klein AL. Validity and Reliability for Competency-based Systems: Reducing Litigation Risks. Compensation Benefits and Review, 28, 31-37, 1996. cited in “Newsome, Shaun, Victor M Catano, and Arla L. Day. Leader Competencies: Proposing a Research Framework. 2003. 6 Newsome, Shaun, Victor M Catano, and Arla L. Day. Leader Competencies: Proposing a Research Framework. 2003. available at http://www.cleleadership.ca/paper/leader_competenciesproposing_a_research_framework.pdf Institute for Crisis, Disaster and Risk Management The George Washington University 34 Appendix C – Healthcare Emergency Management Competencies The project competencies are intended to serve as formative tools to guide healthcare system personnel in developing knowledge, skills and abilities for effective performance during emergency response and recovery. These competencies are also intended to serve as a guide for developing preparedness education and training, and therefore, to serve as a basis for the healthcare emergency management curriculum. Finally, the competencies may be employed as a tool for assessing the performance of individual healthcare personnel performance during emergency response and recovery operations. Defining a competency framework Despite an extensive search of published articles related to competencies, the GWUICDRM project team determined that no single authoritative source presented a consistent competency definition and competency framework to adequately support the VHA-EMA project needs. A framework was therefore developed, analyzed through pilot competency development, refined and completed before establishing the individual emergency response and recovery competencies for this project. The competency framework was therefore used to impose a strict methodological consistency when developing and defining all competencies developed in this program. Central to this framework is the critical importance of competencies being objective and measurable, internally and externally consistent, and tightly described within the context of the organization’s specific objectives. Within this framework, the project team defined a “competency” as a specific knowledge element, skill, and/or ability that is objective and measurable (i.e., demonstrable) on the job. It is required for effective performance within the context of a job’s responsibilities, and leads to achieving the objectives of the organization. Competencies are ideally qualified by an accompanying proficiency level. 7 The GWU-ICDRM project team recognized the need to adapt the methods for competency development, since the usual business approach to establishing competencies is problematic for emergency management. Business management models establish competencies by observing performance and relating it to individual and organizational outputs. Because emergencies are rare events, and therefore emergency response and recovery outputs occur very infrequently, the related competency framework and definitions for this project are based less upon observed outputs. Instead, the basis is a healthcare system’s emergency response and recovery objectives, together with the NIMS-consistent incident command system 8 structure and processes mandated for use by all emergency response organizations in the U.S. 9,10 7 GWU Institute for Crisis, Disaster and Risk Management. Emergency Management Glossary of Terms (October 2007) available at www.gwu.edu/~icdrm/ 8 Fedral Emergency Management Agency. National Incident Management System (NIMS) (March 1, 2004), available at: http://www.fema.gov/emergency/nims/index.shtm. 9 Bush GW. Homeland Security Presidential Directive (HSPD) -5: Management of Domestic Incidents (February 28, 2003) accessed at http://www.whitehouse.gov/news/releases/2003/02/20030228-9.html Institute for Crisis, Disaster and Risk Management The George Washington University 35 Appendix C – Healthcare Emergency Management Competencies Response competencies in systems using the Incident Command System (ICS), therefore, should be based upon the general incident objectives an organization has during incident response, and upon the organizational structures, processes, and relationships with other organizations that are used during response rather than those used during everyday experience. Emergency competencies are commonly developed without this relationship to a defined response system, 11 making it difficult to define how scientific or medical knowledge is to be implemented in an emergency response. In contrast, the GWUICDRM project team specifically incorporated the NIMS mandate to use ICS by including reference to the NIMS/Incident Command System structure and processes throughout the project’s emergency response and recovery project competencies. Because of the anticipated large number of competencies, the project team also established a “primary versus supporting competency” hierarchy to categorize the individual competencies as they were developed. Designating “primary” and “supporting” competencies helps to maintain a priority in the framework when listing a large number of individual competencies. Supporting competencies are also a means to more fully define and clarify the primary competencies. Preparedness versus response and recovery competencies Published articles describing emergency management competencies commonly do not differentiate between preparedness and response competencies, and list them in an intermixed fashion. 12,13 The GWU-ICDRM project team sought to maintain a separation between these categories. Preparedness competencies are commonly based upon everyday organizational objectives, structure, processes, and relationships to other organizations. Preparedness is unquestionably important, but for it to be accurate, comprehensive and successful in establishing an effective emergency response capability, a thorough understanding of the response system must be established first, and preparedness guided by this. It was therefore reasoned by the project team that specific competencies for emergency response should be established and validated first, and then used as the “end state” to guide the development of valid preparedness competencies. 10 Barbera JA, Macintyre AG, et al. Emergency Management Principles and Practices for Healthcare Systems, Unit 3, Lesson 3.1.1, accessed at http://www1.va.gov/emshg/page.cfm?pg=122 11 ATPM (Association of Teachers of Preventive Medicine) in collaboration with Center for Health policy, Columbia University School of Nursing. Emergency Response Clinician Competencies in Initial Assessment and Management, 2003, accessed at http://www.atpm.org/education/Clinical_Compt.html 12 INCMCE (International Nursing Coalition for Mass Casualty Education). Educational Competencies for Registered Nurses Responding to Mass Casualty Incidents, 2003. Available at: http://www.nursing.hs.columbia.edu/institutes-centers/chphsr/hospcomps.pdf 13 ACEP (American College of Emergency Physicians) and the U.S Department of Health & Human Services, Office of Emergency Preparedness. Developing Objectives, Content, and Competencies for the Training of Emergency Medical Technicians, Emergency Physicians, and Emergency Nurses to Care for Casualties Resulting From Nuclear, Biological, or Chemical (NBC) Incidents, Final Report April 23, 2001. American College of Emergency Physicians, Irving, Texas. Institute for Crisis, Disaster and Risk Management The George Washington University 36 Appendix C – Healthcare Emergency Management Competencies Because of these considerations, the initial project focus was response and recovery competencies. Emergency management program competencies related to mitigation and preparedness were developed later for the two job groups that are the initial focus of the certification project. Establishing appropriate levels of proficiency Concurring with other authors that “competency” is not an all-or-none phenomenon, the GWU-ICDRM project team established “proficiency levels” to address this issue in a graduated fashion. Proficiency levels delineate the “The degree of understanding of the subject matter and its practical application through training and performance…” 14 In emergency management, proficiency indicates the level of mastery of knowledge, skills and abilities (i.e., competencies) that are demonstrable on the job and lead to the organization achieving its objectives. Levels of proficiency may therefore also be used to describe the level of mastery that is the objective of and specific training or education program. The final proficiency levels defined for this project are presented in Table 1. Table 1. Definition of the Levels of Proficiency Represents an understanding of the knowledge/skills/abilities Awareness encompassed by the competency, but not to a level of capability to adequately perform the competency actions within the organization’s system. Operations Expert Represents the knowledge/skills/abilities to safely and effectively perform the assigned tasks and activities, including equipment use as necessary Represents operations-level proficiency plus the additional knowledge/skills/abilities to apply expert judgment to solve problems and make complex decisions. As core and job group competencies were developed, the project team qualified each primary competency with an indicated level of proficiency (awareness, operations, expert). 14 EMA. Urban Search & Rescue Incident Support Team Training: Student Manual. Module 1, Unit 4, Page 6: Planning Process Overview. n/a:40. 4/16/2004, accessed at: http://www.fema.gov/emergency/usr/usrist2.shtm Institute for Crisis, Disaster and Risk Management The George Washington University 37 Appendix C – Healthcare Emergency Management Competencies Developing emergency response and recovery competencies Using the competency framework established in this project, response and recovery “core” competencies were developed for all personnel within a healthcare system that may have a role in the emergency response, regardless of their specific emergency response and recovery function. Additional competencies were then established for three functionally based job groups within a healthcare. The original designation for these job groups were (1) healthcare facility leaders, (2) patient care providers, and (3) emergency management program managers. The titles and definitions evolved with outside input as the project tasks were accomplished (see Table 2 for final titles and descriptions). Initial competency identification and development was accomplished through an analysis of ICS as presented in NIMS, an extensive literature review, and an evaluation of the VHA system and processes for emergency response. 15 Additionally, the GWU-ICDRM project team relied upon their extensive emergency management and disaster response experience, and upon related previous research efforts. 16,17,18 The emergency response and recovery competencies for the initially designated three job groups were then fully developed, studied through a web-based survey, revised based upon input and completed. 19 Identification of additional job groups and their associated competencies Early in the competency development process, it became apparent that there were additional important healthcare emergency management job groups beyond the three that were initially described. These groups have distinct response and recovery responsibilities (and therefore associated competencies) for the healthcare organization’s resiliency and medical surge. After extensive research during the latest phase of the project, the additional groups were identified as: Facilities and Engineering Services (FES), Police and Security Services (PSS), and Clinical Support Services (CSS). Their descriptions are presented in Table 2. Using the previously defined methodology (including web-based peer review), the follow-on project allowed for the development of emergency response and recovery competencies for these remaining job groups. 15 Veterans Health Administration. VHA Emergency Management Program Guidebook, 2005, accessed at: http://www1.va.gov/emshg/page.cfm?pg=114 16 Barbera, Joseph A and Anthony G. Macintyre. Medical and Health Incident Management System: A Comprehensive Functional Description for Mass Casualty Medical and Health Incident Management. Institute for Crisis, Disaster & Risk Management. The George Washington University, Washington DC, October 2002, accessed at www.gwu.edu/~icdrm/ 17 Barbera, Joseph A and Anthony G. Macintyre. Mass Casualty Handbook: Hospital Emergency Preparedness and Response, First Edition. Jane’s Information Group, 2003. 18 CNA Corporation. Medical Surge Capacity & Capability: The Management System for Integrating Medical and Health Resources During large-Scale Emergencies. August 2004, accessed at: http://www.hhs.gov/ophep/mscc_handbook.html 19 Barbera JA, Macintyre AG, et al. VHA-EMA Emergency Response and Recovery Competencies: Competency Survey, Analysis, and Report (June 16, 2005), available at www.gwu.edu/~icdrm/ Institute for Crisis, Disaster and Risk Management The George Washington University 38 Appendix C – Healthcare Emergency Management Competencies Development of preparedness and mitigation (program) competencies for Emergency Management Program Managers and Healthcare System Leaders The methodology utilized in this project focused first on the development and validation of response and recovery competencies as an “end state” for healthcare system personnel in their emergency management activities. The second phase of the project allowed for the development of program competencies for Emergency Program Managers and Healthcare System Leaders, which focused upon preparedness and mitigation activities necessary to reach this “end state.” These two job groups maintain primary responsibility for the emergency management program within a healthcare system, and thus have extensive primary competencies that relate to program development and maintenance required for successful response to emergencies and disasters. The program competencies were developed using the earlier methods, with identical criteria that the competencies be objective and measurable, maintain internal and external consistency, and be described within the context of an organization’s specific emergency management program objectives. Program competencies may more closely align with business management models during day-to-to day operations. Hence, organizational and individual outputs for these groups can be expected to be more frequent. This concept was included in the development of the program competencies. While no formal survey was conducted following the development of these program competencies, peer review was accomplished by providing draft competencies to experts for comment. Only minor changes resulted. The final job group titles and their descriptions are listed below. The competencies follow. Table 2. Healthcare System Job Group Definitions All Personnel (AP) All personnel are defined as any healthcare system administrator, employee, professional staff, licensed independent practitioners or others with a specified role in the healthcare systems emergency operations plan (EOP). Patient Care Providers (PCP) Physicians, physician assistants, registered nurses, licensed practical nurses, nurses working within expanded roles (CRNA, RNP, and others), emergency medical technicians, paramedics, and respiratory therapists and others who provide direct clinical patient care. Not included are clinical support staff that provide patient care services under the direct supervision of patient care providers: e.g., nurse’s aides, procedure technicians, orderlies, and others. Institute for Crisis, Disaster and Risk Management The George Washington University 39 Appendix C – Healthcare Emergency Management Competencies Hospital and/or healthcare system-wide senior executives (CEO, COO, CFO), hospital-wide managers, department heads, nursing executives, chief of the medical staff, and/or senior managers in Healthcare System Leaders large departments or key operating units. It is assumed that members of this job group, due to their everyday organizational (HSL) positions, would be assigned to serve in the command and general staff positions of an ICS structure during a healthcare system’s emergency response. Emergency Management Program Managers (EPM) Personnel primarily responsible for developing, implementing and maintaining healthcare facility and system-wide emergency management (EM) programs that include the Emergency Operations Plan (EOP). System level emergency program managers, above the level of individual facilities, (such as VHA Area Emergency Managers or program managers at the level of the VA Emergency Management Strategic Healthcare Group) are also included in this job group. It is assumed that the individuals in this job group will be assigned to a command & general staff ICS position (usually planning section chief) during response, and so are expected to possess the response and recovery competencies listed under Healthcare System Leaders as well. In some healthcare systems, an EM Program Manager may oversee a more limited position (e.g. program coordinator) with a narrower range of competencies. Clinical Support Services (CSS) Personnel that perform tasks related to the medical care of patients without direct patient interface (e.g. pharmacists, lab technicians, etc.) or provide patient services that aren’t primarily medical care (social services, physical and occupational therapy, pastoral care, patient educators, and others) or provide patient care services under the direct supervision of patient care providers (such as nurse’s aides, procedure technicians, orderlies, transporters). Police & Security Services (PSS) Personnel whose day to day job in the healthcare system involves security and the full range of law enforcement activities. Day-today duties may or may not put these individuals into direct contact with patients. Institute for Crisis, Disaster and Risk Management The George Washington University 40 Appendix C – Healthcare Emergency Management Competencies Facilities and Engineering Services (FES) Personnel whose day to day job involves maintaining the physical plant and its various systems. Included in this group are facilities and physical plant personnel, engineers, grounds personnel, biomedical engineers, food services, communications and IT personnel. It also usually includes administrative safety positions below the level of the healthcare system leaders. Day to day duties rarely put these personnel in direct patient contact. Institute for Crisis, Disaster and Risk Management The George Washington University 41 Appendix C – Healthcare Emergency Management Competencies Emergency Response and Recovery Competencies All Personnel (AP) All personnel are defined as any healthcare system administrator, employee, professional staff, licensed independent practitioners or others with a specified role in the healthcare systems emergency operations plan (EOP). x AP-R1: Utilize general Incident Command System (ICS) principles during incident response and recovery. Recommended proficiency for Primary Competency: operations level Knowledge o AP-R1.1: Describe ICS as an emergency response and recovery operating system and its application to healthcare system incident response and recovery, management structure, concept of operations, and planning cycle. o AP-R1.2: Describe your potential role(s) and responsibilities within the healthcare system response and recovery in terms of ICS principles. o AP-R1.3: Describe the ICS-delineated expectations of individual responders in relation to the healthcare system response and recovery to include: attendance at briefings, reporting requirements, and use of rolerelated documents such as Operational Checklists (Job Action Sheets). Skills o AP-R1.4: Demonstrate an operations level of proficiency in ICS principles by utilizing appropriate forms, attending indicated meetings, and adhering to appropriate reporting requirements. x AP-R2: Recognize situations that suggest indications for full or partial activation of the healthcare system’s Emergency Operations Plan (EOP), and report them appropriately and promptly. Recommended proficiency for Primary Competency: operations level Knowledge o AP-R2.1: Describe the general characteristics of emergency situations that may indicate the need for full or partial EOP activation. o AP-R2.2: Describe the reporting requirements and methodology for situations that may require full or partial EOP activation. Skills o AP-R2.3: Identify situations within your areas of regular duty that should be reported for consideration for full or partial activation of the healthcare system’s EOP. Institute for Crisis, Disaster and Risk Management The George Washington University 42 Appendix C – Healthcare Emergency Management Competencies o AP-R2.4: Report situations within your areas of regular duty by following EOP notification procedures and contacting the appropriate person as indicated by your specific role and by the situation at hand (e.g., page operator, supervisor, etc.). x AP-R3: Participate in healthcare system mobilization to rapidly transition from day-to-day operations to incident response organization and processes Recommended proficiency for Primary Competency: operations level Knowledge o AP-R3.1: Describe the procedures necessary to receive notification of EOP activation and to prepare your work area, as indicated, for EOP response and recovery. o AP-R3.2: Describe the initial reporting requirements for your expected role or position. o AP-R3.3: Describe the location and format of the system EOP. Skills o AP-R3.4: Follow your functional areas mobilization plan as outlined in the EOP to prepare your work area for EOP response and recovery. o AP-R3.5: Confirm notification receipt and report to the appropriate EOP position your initial situation, resource status, and any special problems encountered for your specific role or functional area. o AP-R3.6: Locate the facility EOP and access portions applicable to your role and responsibilities. x AP-R4: Apply the healthcare system’s core mission statement to your actions during emergency response and recovery. Recommended proficiency for Primary Competency: operations level Knowledge o AP-R4.1: Describe how your emergency operations role and responsibilities support the healthcare system mission during emergency response and recovery. Skills o AP-R4.2: Demonstrate your understanding of the healthcare system’s mission during emergency response and recovery by ensuring your actions continually contribute to 1) continuity of patient care operations, 2) the safety of patients, families, and staff, 3) the conservation of property, and 4) the healthcare system support to the community to ensure the nation’s safety. x AP-R5: Apply the healthcare system code of ethics to your actions during emergency operations. Institute for Crisis, Disaster and Risk Management The George Washington University 43 Appendix C – Healthcare Emergency Management Competencies Recommended proficiency for Primary Competency: operations level Knowledge o AP-R5.1: Describe how the healthcare system’s and other codes of ethics (such as Federal codes of ethics for Federal facilities), as applicable, apply to your role and responsibilities during emergency response and recovery. Skills o AP-R5.2: Demonstrate your understanding of the healthcare system’s and Federal codes (as applicable) of ethics by applying them to your individual response actions during emergency response and recovery. x AP-R6: Execute your personal/family preparedness plans to maximize your availability to participate in the healthcare system’s emergency response and recovery. Recommended proficiency for Primary Competency: expert level Knowledge o AP-R6.1: Describe the importance of both a personal and a family preparedness plan to allow you to perform your healthcare system emergency response and recovery role. o AP-R6.2: Describe your responsibility as an employee to maintain a personal and family preparedness plan. o AP-R6.3: Describe your responsibility as a supervisor (if applicable) to promote employee maintenance of a personal and family preparedness plan. o AP-R6-4: Identify the personal/family specific requirements and details that must be addressed in your personal/family preparedness plan that allow you to perform your healthcare system response role in a potentially changed work schedule and environment. Skills o AP-R6.5: Demonstrate your availability to work in your assigned role during healthcare system response and recovery by executing your personal/family preparedness plan. o AP-R6.6: Demonstrate an expert level of proficiency in personal and family preparedness planning by executing your personal/family preparedness plan and meeting your personal and family needs across any circumstances. x AP-R7: Respond with your previously prepared and maintained personal “go-kit” to maximize your ability to perform your assigned role during healthcare system response and recovery. Recommended proficiency for Primary Competency: expert level Knowledge Institute for Crisis, Disaster and Risk Management The George Washington University 44 Appendix C – Healthcare Emergency Management Competencies o AP-R7.1: Describe the importance of your personal “go kit” for selfprotection and to allow you to perform your healthcare system response and recovery role and responsibilities (A “go kit” contains personal supplies that an employee would need to work their emergency response and recovery role beyond a usual work shift, potentially not returning home for 72 hours). o AP-R7.2: Describe your responsibility as an employee to maintain a personal “go-kit.” o AP-R7.3: Describe your responsibility (if applicable) as a supervisor to promote employee maintenance of a personal “go kit.” o AP-R7.4: Describe how the EOP components and related policies and procedures, (evacuation, shelter in place, lock down, etc.) of the healthcare system Emergency Operations Plans impact your decisions on what should be included in your personal “go kit.” o AP-R7.5: Identify your personal situation (physical ability/constraints, medical needs, personal/family preparedness plan, etc.) and how it impacts on your decisions on what should be included in your personal “go kit.” Skills o APC-7.6: Demonstrate your availability to work in your assigned role and operational periods during response and recovery through the use of your personal “go kit.” x AP-R8: Follow the general response procedures for all personnel in the Occupant Emergency Procedures (OEP) and assist others (healthcare system personnel, patients, and visitors) as necessary to accomplish the OEP directives. [Footnote: More specific response procedures are addressed under respective job groups.] Recommended proficiency for Primary Competency: operations level Knowledge o AP-R8.1: Describe the component parts of the OEP and your responsibilities and actions under each. o AP-R8.2: Describe circumstances that could lead to OEP activation and your responsibilities during OEP activation. o AP-R8.3: Describe the reporting procedures for your job position that would activate the OEP. Skills o AP-R8.4: Execute your roles and responsibilities for the facility OEP by conducting the OEP directives for your job position in evacuation, shelter in place, or other actions during emergency operations. x AP-R9: Perform your specific roles and responsibilities as assigned in the healthcare system’s Emergency Operations Plan (EOP) and the appropriate Incident Action Plan (IAP) in order to support the system’s objectives. Institute for Crisis, Disaster and Risk Management The George Washington University 45 Appendix C – Healthcare Emergency Management Competencies Recommended proficiency for Primary Competency: operations level Knowledge o AP-R9.1: Describe the ICS framework as applied specifically to the healthcare system emergency response and recovery. o AP-R9.2: Describe your role and responsibility as assigned in the healthcare system’s EOP. o AP-R9.3: Describe how potential changes in event parameters may necessitate changes in the facility IAP objectives and strategies, and hence changes in your job area’s tactics and assignments (Management by objectives). o AE-R9.4: Describe the urgent issues that could potentially require a change in your job or job area’s response strategies and tactics. o AP-R9.5: Describe your personal accountability requirements during emergency response and recovery. o AP-R9.6: Describe the equipment and technologies for your specific role and responsibilities within the healthcare facility EOP. o AP-R9.7: Describe the facility policy applicable to your role for engaging the media. Skills o AP-R9.8: Demonstrate appropriate EOP-designated reactive actions in response to potential/actual events that have activated the EOP. o AP-R9.9: Demonstrate your specific role and responsibilities as assigned in the healthcare facility’s EOP by following your operational checklist (job action sheet), completing assignments, filling out appropriate forms, and fulfilling reporting requirements. o AP-R9.10: Ensure organizational objectives are met by formulating and/or implementing specific tactics consistent with the objectives and strategies delineated in the controlling IAP for the current operational period. o AP-R9.11: Report data to supervisors, as indicated, to contribute to measuring effectiveness of your EOP functional area and its contributions to achieving the organization’s designated incident objectives. o AP-R9.12: Operate all equipment and technologies for your specific role and responsibilities within the healthcare system’s EOP. x AP-R10: Follow the Communication Plan and reporting requirements as outlined in the healthcare system’s EOP and the specific Incident Action Plan for an emergency event. Recommended proficiency for Primary Competency: operations level Knowledge o AP-R10.1: Describe the policy and methods for communication and reporting during emergency response and recovery. Institute for Crisis, Disaster and Risk Management The George Washington University 46 Appendix C – Healthcare Emergency Management Competencies o AP-R10.2: Describe the process for rapidly communicating urgent issues that could require a change in response strategies or tactics for your job area, and the appropriate party to receive your communication. o AP-R10.3: Describe the process for reporting significant hazard or response impacts that you or your job area encounter to the appropriate party as indicated by the EOP. o AP-R10.4: Describe the general content of the communication plan component of the Incident Action Plan as it relates to your emergency response and recovery role. o AP-R10.5: Describe the procedures applicable to your role for interaction with the media. Skills o AP-R10.6: Demonstrate the reporting requirements within your functional area as delineated in the healthcare system EOP. o AP-R10.7: Maintain communications with appropriate parties for your role/functional area despite changing requirements and event parameters. o AP-R10.8: Demonstrate an understanding of media interactions by referring requests to appropriate personnel (as applicable), and when interacting with the media, follow designated interview procedures and protocols. x AP-R11: Follow and enforce healthcare system’s safety rules, regulations, and policies during emergency response and recovery. Recommended proficiency for Primary Competency: operations level Knowledge o AP-R11.1: Describe the healthcare system’s safety rules, regulations, and policies during emergency response and recovery that maintain personal safety and a safe work environment. o AP-R11.2: Describe how to apply the Safety Plan component of the facility Incident Action Plan. o AP-R11.3: Describe the safety specific actions and procedures to be followed when unsafe situations/events are encountered. o AP-R11.4: Describe incident parameters that may serve as stressors for response personnel, how stress may be manifested, and appropriate interventions for your specific role. Skills o AP-R11.5: Demonstrate your adherence to and enforcement of healthcare system safety rules, regulations, and policies during emergency response and recovery by wearing appropriate PPE, following pre-defined safety procedures, identifying and addressing unsafe practices, and following the IAP Safety Plan as briefed by your immediate supervisor. o AP-R11.6: Recognize and address incident stress for yourself and others in your functional area by identifying manifestations of stress and, in a fashion appropriate to your specific role, decreasing the stressors, limiting Institute for Crisis, Disaster and Risk Management The George Washington University 47 Appendix C – Healthcare Emergency Management Competencies the negative impact of the stressors, or ensuring appropriate assistance in recovering from negative stressors. x AP-R12: Follow and enforce police and security measures consistent with the nature of the incident that has prompted the EOP activation. Recommended proficiency for Primary Competency: operations level Knowledge o AP-R12.1: Describe healthcare system security rules, regulations, and policies that apply to your assigned role and responsibilities in the EOP. o AP-R12.2: Describe the security specific actions and procedures to be followed when a suspicious event or security breach is detected. Skills o AP-R12.3: Demonstrate your adherence to and enforcement of security measures during emergency response and recovery by following security briefings, instruction from individual security personnel, and badge procedures. x AP-R13: Utilize or request (as appropriate) and integrate equipment, supplies, and personnel for your specific role or functional area during emergency response and recovery. Recommended proficiency for Primary Competency: operations level Knowledge o AP-R13.1: Describe procedures for requesting equipment, supplies, and personnel for your functional area and the integration of these resources during emergency response and recovery. Skills o AP-R13.2: Demonstrate your ability to request and integrate additional resources by following EOP procedures outlined for these activities. o AP-R13.3: Demonstrate the ability to assess the adequacy of equipment, supplies and personnel to carry out your job assignments during each operational period. x AP-R14: Follow demobilization procedures that facilitate rapid and efficient incident disengagement and out-processing of individual resources and/or the overall healthcare organization. Recommended proficiency for Primary Competency: operations level Knowledge o AP-R14.1: Describe demobilization policies and procedures for your work area, including procedures to “catch up” on regular staffing and other activities that were suspended or revised during emergency operations. Institute for Crisis, Disaster and Risk Management The George Washington University 48 Appendix C – Healthcare Emergency Management Competencies o AP-R14.2: Describe the policy and procedures for out-processing of personnel during demobilization. o AP-R14.3: Describe the policy and procedures for conducting an initial Incident Review (commonly known as a “hot wash”) for your work area. o AP-R14.4: Describe the policy and procedures for documenting and reporting incident-related issues for inclusion in After Action Report process, analysis, and corrective measures. Skills o AP-R14.5: Demonstrate demobilization procedures for the incident by following the demobilization plan specific to your functional area. o AP-R14.6: Prioritize, initiate or participate in delayed activities (relevant to your position) that were suspended or revised during emergency response. o AP-R14.7: Participate in out-processing, to include a performance evaluation and any indicated physical exam. o AP-R14.8: Provide input into the Incident Review as appropriate for your position during emergency response. x AP-R15: Follow recovery procedures that ensure facility return to baseline activity. Recommended proficiency for Primary Competency: operations level Knowledge o AP-R15.1: Describe policies and procedures for rehabilitation of personnel. o AP-R15.2: Describe policies and procedures for rehabilitation of equipment (including recertification for use), reordering of supplies specific to your functional area, and rehabilitating your workspace. o AP-R15.3: Describe policies and procedures specific to your role and responsibilities for rehabilitation of the facility. o AP-R15.4: Describe the policies and procedures for a formal After-Action Report. Skills o AP-R15.5: Demonstrate an understanding of the importance of personnel rehabilitation activities by participating in personnel rehabilitation as instructed. o AP-R15.6: Demonstrate an understanding of facility and equipment rehabilitation by participating in these procedures to ensure your functional area readiness for day-to-day activities and future EOP activations. o AP-R15.7: Demonstrate an understanding of After Action-Reports by submitting items in the required format. Institute for Crisis, Disaster and Risk Management The George Washington University 49 Appendix C – Healthcare Emergency Management Competencies Emergency Management Program Manager (EPM) Personnel primarily responsible for developing, implementing and maintaining healthcare facility and system-wide emergency management (EM) programs that include the Emergency Operations Plan (EOP). System level emergency program managers, above the level of individual facilities, (such as VHA Area Emergency Managers or program managers at the level of the VA Emergency Management Strategic Healthcare Group) are also included in this job group. It is assumed that the individuals in this job group will be assigned to a command & general staff ICS position (usually planning section chief) during response, and so are expected to possess the response and recovery competencies listed under Healthcare System Leaders as well. 20 x EPM-R1: Recognize circumstances and/or actions, across the program manager’s jurisdiction if appropriate, that indicate a potential incident and report the situation to facility leadership and appropriate authorities. Recommended proficiency for Primary Competency: expert level Knowledge o EPM-R1.1: Describe the conditions across representative hazard types that indicate a potential incident requiring healthcare system response and recovery capabilities. o EPM-R1.2: List the healthcare system leadership positions that should be notified in the event of a potential incident and describe the formal notification process. o EPM-R1.3: List the outside authorities and resources that can be queried to rapidly obtain information about an evolving event, and describe the communication methods for this purpose. Skills o EPM-R1.4: Identify and obtain information from all non-healthcare system sources that could indicate the occurrence of an incident and need for healthcare system response. o EPM-R1.5: Report the circumstances of the potential incident to the relevant facility leader(s) and notify outside authorities as appropriate. x EPM-R2: Provide assistance and guidance to healthcare system Incident Managers, and other authorities as requested, on the decision to fully or partially activate Emergency Operations Plans (EOP). Recommended proficiency for Primary Competency: expert level Knowledge 20 In some healthcare systems, an EM Program Manager may oversee a more limited position (e.g. program coordinator) with a narrower range of competencies. Institute for Crisis, Disaster and Risk Management The George Washington University 50 Appendix C – Healthcare Emergency Management Competencies o EPM-R2.1: Describe the criteria that indicate the need for a partial or full healthcare system EOP activation. o EPM-R2.2: Describe the impact of EOP activation (full or partial) upon day-to-day facility operations. o EPM-R2.3: Describe the process for healthcare system EOP activation. Skills o EPM-R2.4: Assist facility leaders with the decision to activate emergency medical response plans and procedures by communicating relevant information about the nature and consequences of an incident and by explaining the benefits of activating the EOP. o EPM-R2.5: Provide Incident Managers with a list of all facility personnel positions with the authority to activate the EOP, as requested, and outline the methods for activation. x EPM-R3: Assist in the rapid mobilization of activated healthcare systems to transition from day-to-day activities to response and recovery operations. Recommended proficiency for Primary Competency: operations level Knowledge o EPM-R3.1: Describe processes and procedures used to mobilize the healthcare system and/or its individual facilities for emergency response and recovery. o EPM-R3.2: List all the external agencies relevant to your position that should be notified of the healthcare system’s EOP activation and determine their level of response. o EPM-R3.3: List all the internal healthcare system resources and facilities (ICP/EOC and others) that must be mobilized as the EOP is activated. Skills o EPM-R3.4: As requested by facility or healthcare system leadership, assist in facility mobilization by ensuring appropriate external liaisons are established and ensuring the facility management structure for response is clearly communicated externally. o EPM-R3.5: Provide the Healthcare System Incident Manager with briefings on the mobilization status of healthcare system facilities and/or internal resources (such as the EOC or the Decontamination Area) as indicated by the type and scope of the incident activation. x EPM-R4: Ensure full and proper execution of the appropriate emergency operations plan (EOP) for your healthcare system or designated healthcare system facilities during emergency response and recovery. Recommended proficiency for Primary Competency: expert level Knowledge Institute for Crisis, Disaster and Risk Management The George Washington University 51 Appendix C – Healthcare Emergency Management Competencies o EPM-R4.1: Describe the facility-specific as well as the larger, overarching healthcare system incident management organizational structure and response roles of all functional areas and key positions and how the incident management team (IMT) functions in parallel with continued enterprise management and operations.. o EPM-R4.2: Describe the healthcare enterprise’s organizational requirements as well as the relevant laws, regulations, policies and precedents that affect emergency operations and principles of emergency management. Skills o EPM-R4.3: Provide the healthcare system Incident Command Post with an initial projection of the supplies and resources needed for response and recovery as requested and as appropriate. o EPM-R4.4: At the outset of the incident, provide a briefing to the healthcare system incident manager on the response actions undertaken by external incident response agencies, or assure this is accomplished by the healthcare system senior liaison. o EPM-R4.5: Verify that the healthcare system’s personnel have adopted incident management roles and responsibilities according to the response structure and functional roles delineated in the relevant EOPs. o EPM-R4.6: Verify compliance of EOP response actions with applicable rules and regulations, and advise the facility Incident Commander as indicated. o EPM-R4.7: Provide assistance by monitoring the emergency response system assessing the adequacy and effectiveness of the incident management system in place at activated facilities within the healthcare system, as appropriate for the Program Manager’s jurisdiction. o EPM-R4.8: Address any apparent deficiencies noted in the incident management system during response and recovery by notifying the Incident Commander of the facility within the healthcare system and recommending solutions. x EPM-R5: Demonstrate the ability to function as a healthcare system’s Plans Chief within the ICS structure as indicated by the Emergency Operations Plan (EOP). Recommended proficiency for Primary Competency: expert level Knowledge o EPM-R5.1: Describe the healthcare system response roles and responsibilities ascribed to the chief of the Planning Section in the EOP. o EPM-R5.2: Describe the facility Incident Planning Cycle and the key components for which the Plans Chief is responsible. o EPM-R5.3: Describe the methods for functional area reporting and for the collation, processing, and dissemination of this information. Institute for Crisis, Disaster and Risk Management The George Washington University 52 Appendix C – Healthcare Emergency Management Competencies o EPM-R5.4: Describe methods for monitoring response and recovery actions in order to assist the Incident Commander in determining progress towards achieving the incident objectives. Skills o EPM-R5.5: Establish an effective Incident Planning Cycle by defining operational periods (approved by the system Incident Commander), coordinating the Planning Cycle timing with non-healthcare system response agencies, and disseminating the schedule for essential planning activities (management and planning meetings, operational briefings, and others). o EPM-R5.6: Ensure adequate functional area reporting by establishing the time schedule for reporting and verifying reports are received, to include situation, resource status, specific tactics utilized, progress accomplished, and unusual problems encountered; include patient tracking as necessary. o EPM-R5.7: Include information originating internal and external to the system in the planning process by monitoring internal and external sources for information, including the level of response by external organizations, and considering the information in the planning process. o EPM-R5.8: Ensure awareness of event parameters within the healthcare system by providing continual updates to the leader of functional areas and external agencies as appropriate. o EPM-R5.9: Provide rapid contingency response by monitoring for sudden changes in event parameters that necessitate revision of response strategies and tactics, and disseminate appropriate notification to relevant internal and external parties. o EPM-R5.10: Manage orderly and concise planning activities (management and planning meetings, operational briefings) by limiting distractions, providing agendas, and ensuring documentation of all relevant information discussed in the meetings. x EPM-R6: Perform or assist with the senior healthcare system liaison function and ensure that relevant response and recovery information is exchanged with senior healthcare system management levels beyond the immediate agency executive, if indicated. Recommended proficiency for Primary Competency: operations level Knowledge o EPM-R6.1: Describe the purpose and structure of the enterprise’s overarching healthcare system administrative hierarchy (such as the Veterans Integrated Service Network and Headquarters for the VHA) and its potential role during facility emergency response and recovery. o EPM-R6.2: Describe essential components of facility planning that should be disseminated to senior healthcare system management levels. o EPM-R6.3: Describe any assigned healthcare enterprise responsibilities to the community, State, or Federal governments or other entities established Institute for Crisis, Disaster and Risk Management The George Washington University 53 Appendix C – Healthcare Emergency Management Competencies through contracts, statutes or other authorities (for example, the VHADoD Contingency Plan) where the healthcare organization should establish a formal liaison function. Skills o EPM-R6.4: If part of a larger healthcare system (such as a VA Medical Center within a Veterans Integrated Service Network (VISN)), fulfill the region-wide emergency operations (response) plan and liaison function if it is activated. o EPM-R6.5: Ensure that senior healthcare system officials are receiving accurate information from the facility (usually through the facility’s agency executive) by providing the current facility IAP and/or situation reports in formats that are understandable to them. o EPM-R6.6: Ensure that the facility Agency Executive and Incident Manager receive appropriate communications from senior healthcare system officials above the level of the incident management structure. o EPM-R6.7: Assure that established responsibilities to the community, State, or Federal governments or other entities addressed and required actions communicated to appropriate Agency Executives and Incident Management Teams. x EPM-R7: If Program Manager of a larger healthcare system (such as a VA Medical Center within a Veterans Integrated Service Network (VISN)) with activated IMTs within individual healthcare facilities within your network, establish senior liaison with appropriate external healthcare organizations within the healthcare system in your area, conduct information exchange, and coordinate incident response strategies and tactics. Recommended proficiency for Primary Competency: operations level Knowledge o EPM-R7.1: List relevant external healthcare organizations that exist within the emergency response network in your area and methods for contacting them. o EPM-R7.2: Describe how the emergency response and recovery actions of healthcare facilities within your network and in your area impact one another. o EPM-R7.3: Describe how healthcare facilities within your network and external agencies in the same impact area may support one another during emergency response and recovery. Skills o EPM-R7.4: Ensure the IMT contact information for activated IMTs in your network is disseminated to appropriate external emergency response agencies. o EPM-R7.5: Facilitate the process for healthcare facilities within your network to gain access to appropriate external emergency response Institute for Crisis, Disaster and Risk Management The George Washington University 54 Appendix C – Healthcare Emergency Management Competencies agencies by establishing liaison or providing contact methods (as indicated). o EPM-R7.6: Facilitate coordination of response strategies and tactics by ensuring regular exchange of Incident Action Plans (or summaries contained in Situation Reports) between IMTs in your network and the appropriate external emergency response agencies. EPM-R7.7: Facilitate the use of mutual aid agreements between facilities within your network, and with external organizations when indicated. x EPM-R8: Participate in demobilization processes within the activated healthcare organization (such as a VHA Medical Center and/or within its overarching Veterans Integrated Service Network) to disengage resources from incident response and allow return to normal operations or back to stand-by status. Recommended proficiency for Primary Competency: operations level Knowledge o EPM-R8.1: Describe both the general objectives of the demobilization process and the specific management issues associated with demobilization, rehabilitation of response elements, and preparation to return to routine professional roles. Skills o EPM-R8.2: Assist in the demobilization of the healthcare organization and its resources by verifying that operational objectives have been met (or are reassigned to continuing units) and that appropriate internal and external notification is made regarding demobilization. o EPM-R8.3: Participate in any initial incident review (commonly known as a “hot wash”) and assist organizational leadership with ensuring appropriate procedures are followed for maintaining/preserving information for the After Action Report process. o EPM-R8.4: Assist with the debriefing and performance assessments of response personnel under your supervision, and others as requested by the organization’s incident manager. x EPM-R9: Assist, as indicated by assigned position in recovery management, with healthcare organization recovery to full pre-incident function, including return to routine facility management and medical care activities. Recommended proficiency for Primary Competency: operations level Knowledge o EPM-R9.1: Describe the incident planning and management processes for transitioning from response to recovery. Institute for Crisis, Disaster and Risk Management The George Washington University 55 Appendix C – Healthcare Emergency Management Competencies o EPM-R9.2: Describe the procedures and priorities for returning response resources and the overall organization to pre-incident operations and management. o EPM-R9.3: Describe the process required to re-evaluate the healthcare organization’s patient population and post-incident patient care activities, which includes addressing the backlog of regular work. Skills o EPM-R9.4: Assist, as requested, with personnel rehabilitation by providing advice on procedures for addressing physical or psychological concerns. o EPM-R9.5: Assist, as requested, with facility and equipment rehabilitation by establishing priority of recovery activities and identifying additional resources that may be required. o EPM-R9.6: Assist, as requested, with addressing backlogs of regular work by providing advice to facility leaders on surge capacity methods and the prioritization of backlogged services. x EPM-R10: Fulfill emergency management program requirements for a formal incident After-Action Report (AAR) process that captures and processes recommended changes to achieve organizational learning. Recommended proficiency for Primary Competency: expert level Knowledge o EPM-R10.1: Describe the policies and procedures as well as other considerations for completing the formal After Action Report on healthcare system response. o EPM-R10.2: Describe procedures for capturing information, analysis and acceptance or recommendations, and implementation of changes to a healthcare system EOP and overarching emergency management program. Skills o EPM-R10.3: Conduct efficient After Action Reports by utilizing incident response procedures for conducting a meeting and by ensuring After Action Report items are documented in the required format (i.e., issue, background, recommended action, responsible party and recommended timeframe). o EPM-R10.4: Ensure organizational learning by conducting appropriate analysis of recommendations, obtaining formal administration approval of accepted recommendations, and incorporating the recommended changes into the healthcare system EOP and other components of the emergency management program. Institute for Crisis, Disaster and Risk Management The George Washington University 56 Appendix C – Healthcare Emergency Management Competencies Healthcare System Leaders (HSL) Hospital and/or healthcare system-wide senior executives (CEO, COO, CFO), hospitalwide managers, department heads, nursing executives, chief of the medical staff, and/or senior managers in large departments or key operating units. It is assumed that members of this job group, due to their everyday organizational positions, would be assigned to serve in the command and general staff positions of an ICS structure during a healthcare system’s emergency response. x HSL-R1: Identify specific criteria of potential events that require the full or partial activation of the system’s Emergency Operations Plan (EOP). Recommended proficiency for Primary Competency: expert level Knowledge o HSL-R1.1: Describe the specific characteristics of potential events that would require EOP full or partial activation. o HSL-R1.2: Describe the impact of EOP activation (full or partial) upon day-to-day facility operations. o HSL-R1.3: Describe potential sources of information that may assist with incident recognition. Skills o HSL-R1.4: Demonstrate understanding of criteria for EOP full or partial activation by initiating appropriate levels of EOP activation rapidly during specific events. o HSL-R1.5: Ensure appropriate decisions are made about EOP activation by considering the impact of EOP activation (full or partial) upon day-today facility operations including the provision of essential services to existing patient populations. o HSL-R1.6: Ensure appropriate information is included in the decision to activate the EOP (as necessary) by coordinating with facility personnel who have relevant information or who have expertise relevant to the incident type. o HSL-R1.7: Ensure appropriate information from external sources is considered in the decision to activate the EOP by coordinating with external agencies that may provide incident-related information. x HSL-R2: Activate or support activation of the Emergency Operations Plan (EOP) to manage emergency response. Recommended proficiency for Primary Competency: operations level Knowledge o HSL-R2.1: Describe the EOP activation and notification process. Institute for Crisis, Disaster and Risk Management The George Washington University 57 Appendix C – Healthcare Emergency Management Competencies o HSL-R2.2: List the types of notification for the facility and specific functional areas. o HSL-R2.3: List relevant external agencies that should be notified of the system’s EOP activation (full or partial); e.g. VHA/VISN administrators, local public health, local public safety, etc. o HSL-R2.4: Describe the initial reporting process from the notified functional areas in order to determine receipt of the notification message and initial resource availability. Skills o HSL-R2.5: Ensure appropriate EOP activation by identifying personnel with authority to activate the EOP and using the established methods for activation. o HSL-R2.6: Ensure awareness of EOP activation by determining and conducting the appropriate level of notification (update, alert, advisory, activation) for the system, specific functional areas, and external agencies as applicable. o HSL-R2.7: Confirm the activation of functional areas (management, operations, logistics, plans/information, finance/administration) by receiving and processing confirmation of notifications. x HSL-R3: Ensure rapid system mobilization that transitions response personnel and resources from day-to-day activities to their designated incident response status. Recommended proficiency for Primary Competency: operations level Knowledge o HSL-R3.1: Describe the management positions responsible for assuring mobilization of all key resources and personnel in the healthcare system’s EOP, and the reporting process for determining mobilization status. o HSL-R3.2: Describe the layout, location of supplies, and set-up of the facility Incident Command Post (ICP) or alternatively (according to the organization’s EOP), the healthcare facility’s Emergency Operations Center (EOC) with a smaller ICP at the site of primary response activity. Skills o HSL-R3.3: Confirm the mobilization of functional areas (management, operations, logistics, plans/information, finance/administration) by receiving and processing confirmation of mobilization and full readiness for response. o HSL-R3.4: Ensure adequate resources and facilities are available for the healthcare system including assisting with or supervising (as indicated by leader position) establishment of the Emergency Operations Center (EOC) and Incident Command Post (ICP) for the organization. o HSL-R3.5: Review the mobilized command and general staff area of the ICP or EOC to confirm that those positions can fully operate in their positions. Institute for Crisis, Disaster and Risk Management The George Washington University 58 Appendix C – Healthcare Emergency Management Competencies x HSL-R4: Ensure appropriate execution of the healthcare system Occupant Emergency Procedures (OEP) by assuring appropriate protective actions for patients, staff and visitors, and for the integrity of the healthcare system. Recommended proficiency for Primary Competency: operations level Knowledge o HSL-R4.1: Describe the decision process for activating the OEP and how the OEP functions within the Emergency Operations Plan (EOP) for the organization. o HSL-R4.2: Describe the accountability processes for staff, patients, visitors, vital records, and critical equipment and how the overall and final accountability is confirmed. o HSL-R4.3: List critical external resources required to support OEP activation. Skills o HSL-R4.4: Make decisions during OEP implementation that reflect the prioritized system objectives of life safety, incident stabilization, and protection of mission critical property and operating systems. o HSL-R4.5: Demonstrate oversight of accountability for staff, patients, visitors and mission critical systems. x HSL-R5: Ensure that the system’s incident management is effective, utilizes Emergency Operations Plan (EOP) procedures and processes, and uses a pro-active ‘management by objective’ approach. Recommended proficiency for Primary Competency: expert level Knowledge o HSL-R5.1: Describe the functional organization of the healthcare system’s incident management during emergency response and recovery and how the activated incident management team (IMT) interacts through the agency executive with the enterprise’s ongoing management and operating systems. o HSL-R5.2: Describe the initial reactive phase of the healthcare system’s incident response and the important transition to pro-active ‘management by objectives.’ o HSL-R5.3: Describe the healthcare system’s code of ethics and how it is considered/applied during incident planning and management decisionmaking procedures during emergency response and recovery. Skills o HSL-R5.4: Ensure the healthcare system’s incident management structure is well delineated by formally assigning facility incident management positions and providing the organizational structure with assignments Institute for Crisis, Disaster and Risk Management The George Washington University 59 Appendix C – Healthcare Emergency Management Competencies o o o o x (System ICS diagram) to relevant parties both internal and external to the system. HSL-R5.5: Provide pro-active incident management by developing, analyzing, and revising, as necessary, facility response objectives during management meetings in the Planning Cycle (management by objectives). HSL-R5.6: Ensure that healthcare system response objectives are efficiently and adequately met by performing continual monitoring of the system’s incident response system and outcomes. HSL-R5.7: Ensure the healthcare system’s code of ethics is applied, as appropriate, by considering it during response planning and decisionmaking. HSL-R5.8: Address limitations of the healthcare system’s EOP capacity and capability by identifying limitations and developing responseappropriate options to address unmet needs. HSL-R6: Manage continuous incident action planning through iterative planning cycle procedures that provide strategic and general tactical guidance to healthcare system personnel in order to achieve surge capacity, surge capability, and organizational resiliency. Recommended proficiency for Primary Competency: expert level Knowledge o HSL-R6.1: Describe the purpose of management meetings, planning meetings, and operations briefings for emergency response and recovery. o HSL-R6.2: Describe the key components of the healthcare system’s response Incident Action Plan and methods of dissemination, both internally and externally. o HSL-R6.3: Describe the purpose and the components of long term, alternative, contingency, and demobilization planning. Skills o HSL-R6.4: Ensure the clear delineation of the healthcare system’s operations cycle by establishing and disseminating the timing of planning meetings and operational periods. o HSL-R6.5: Ensure facility objectives are met by supervising the development, analysis, and revision of facility response strategies and general tactics. o HSL-R6.6: Ensure healthcare system personnel safety by identifying, minimizing, or preventing threats/hazards, and by responding to all real or potential safety issues for healthcare system response (Safety Plan) throughout the emergency response and recovery. o HSL-R6.7: Ensure efficient incident planning, as indicated by your incident management position, by participating in or conducting structured planning and management meetings, and operations briefings. o HSL-R6.8: Ensure appropriate dissemination of incident planning decisions by documenting and disseminating the healthcare system’s Institute for Crisis, Disaster and Risk Management The George Washington University 60 Appendix C – Healthcare Emergency Management Competencies Incident Action Plans to relevant persons internal and external to the facility. o HSL-R6.9: Demonstrate comprehensive incident planning by performing or assigning analysis of long term, alternative, contingency, and demobilization plans during response and recovery. o HSL-R6.10: Manage efficient exchange of information by participating in shift change briefings. x HSL-R7: Manage efficient information processing regarding response activities Recommended proficiency for Primary Competency: operations level Knowledge o HSL-R7.1: Describe the components and timing of functional area reporting and how the results can be processed and analyzed to identify progress or problems in meeting the facility’s incident objectives. o HSL-R7.2: Describe critical sources of incident information external to the healthcare system. o HSL-R7.3: Describe procedures for reporting back to functional areas, including dissemination of the healthcare system’s Incident Action Plan. o HSL-R7.4: Describe types of event parameters that would require sudden changes in response strategies or tactics. Skills o HSL-R7.5: Ensure adequate functional area reporting by establishing the timing of the reporting and verifying that reports include a situation description, resource status, specific tactics utilized, progress accomplished, and unusual problems encountered (include patient tracking as necessary). o HSL-R7.6: Include information originating external to the healthcare system in the planning process by monitoring external sources for information (including the level of response by external organizations) and considering them in the planning process. o HSL-R7.7: Ensure awareness of event parameters within the healthcare system by providing continual updates to the leaders of functional areas and to external agencies as appropriate. o HSL-R7.8: Provide early response to contingencies by monitoring sudden changes in event parameters that necessitate immediate revision of response strategies and tactics and by disseminating appropriate notification to relevant parties (internal and external). x HSL-R8: Provide information on the facility’s emergency response and recovery activities to patients, patients’ families, facility personnel’s families, the media, and the general public, as appropriate. Recommended proficiency for Primary Competency: operations level Institute for Crisis, Disaster and Risk Management The George Washington University 61 Appendix C – Healthcare Emergency Management Competencies Knowledge o HSL-R8.1: Describe the methods of delivering information to the media and the important components of the message. o HSL-R8.2: Describe procedures used to ensure patients, patients’ families, and facility personnel’s families are kept apprised of response operations. o HSL-R8.3: Describe coordination techniques that ensure the facility’s media message is consistent with other organizations’ messages to the public. o HSL-R8.4: Describe HIPAA and its application to emergency response and recovery as well as other patient confidentiality measures. Skills o HSL-R8.5: Ensure the continuous update of relevant parties by providing, or assigning the task of providing, incident updates and the timing of subsequent update reports. o HSL-R8.6: Ensure media messages are appropriate and consistent with that of other organizations by coordinating with the external community incident managers and public information personnel. o HSL-R8.7: Identify public perceptions of the facility’s response and false information relating to the facility’s response by performing monitoring of media reports (address falsehoods as indicated). o HSL-R8.8: Ensure confidentiality of patient information by monitoring response and recovery actions for adherence to these standards where applicable. x HSL-R9: Monitor the response and recovery needs of the facility’s functional areas, and, if needed, provide support with additional facilities, equipment, communications, personnel or other assistance. Recommended proficiency for Primary Competency: operations level Knowledge o HSL-R9.1: Describe resource-tracking processes for the facility. o HSL-R9.2: Describe the resource request processes for functional areas in the facility to request both internal and external resources. o HSL-R9.3: List the critical elements of a Communications Plan. o HSL-R9.4: List potential sources of technical assistance. o HSL-R9.5: Describe procedures for ensuring the health and well-being of facility personnel. o HSL-R9.6: Describe integration methods of outside donated resources (personnel, equipment, supplies). Skills o HSL-R9.7: Demonstrate the ability to anticipate functional area requests by conducting an adequate incident planning process. Institute for Crisis, Disaster and Risk Management The George Washington University 62 Appendix C – Healthcare Emergency Management Competencies o HSL-R9.8: Provide logistical support to functional areas, first by identifying functional area needs and then appropriate resources to meet those needs. o HSL-R9.9: Provide communication support to functional areas by assisting with the development and approval of the facility Communications Plan, which should document and disseminate contact methods for relevant parties internal and external to the facility. o HSL-R9.10: Provide technical assistance to functional areas, as indicated, by identifying outside subject matter experts or other appropriate information resources. o HSL-R9.11: Ensure the health and well-being of facility personnel by participating in/approving the Medical Plan for the IAP (as indicated by your management position). o HSL-R9.12: Assist with the integration of external assistance and supplies, solicited and unsolicited, by managing them until they are assigned to specific functional areas. x HSL-R10: Establish appropriate measures to document, track, or reimburse financial costs associated with facility response and recovery. Recommended proficiency for Primary Competency: operations level Knowledge o HSL-R10.1: Describe processes for tracking personnel and resources utilized during response. o HSL-R10.2: Describe processes for compensating personnel utilized during response and for claims made by these personnel. o HSL-R10.3: Describe processes for reimbursement of external assistance provided during response. o HSL-R10.4: Describe processes for tracking other costs of response (e.g. delayed elective procedures, equipment and supplies consumed, etc). Skills o HSL-R10.5: Provide for personnel compensation by maintaining lists of personnel utilized during response and time worked. o HSL-R10.6: Provide for incident expense claims by ensuring appropriate documentation is completed and submitted within the required time periods. o HSL-R10.7: Provide for equipment and supply reimbursement by tracking lists of supplies and equipment utilized during response and recovery. o HSL-R10.8: Provide for compensation of external assistance (contract or cooperative assistance) by tracking utilization of these resources and ensuring prompt payment as indicated. o HSL-R10.9: Provide a summary of response and recovery impact on facility finances by documenting and analyzing the direct and indirect costs of EOP activation, including lost revenue. Institute for Crisis, Disaster and Risk Management The George Washington University 63 Appendix C – Healthcare Emergency Management Competencies x HSL-R11: Manage facility response so that it adheres to appropriate regulations and standards or seek relief as required. Recommended proficiency for Primary Competency: operations level Knowledge o HSL-R11.1: Describe permissible emergency response and recovery deviations from the normal standard of medical care provided under normal facility conditions, and the processes for seeking temporary suspension or relaxation of regulations during emergencies. o HSL-R11.2: Describe, in general, the applicable public health laws and their impact on the facility’s emergency response and recovery. o HSL-R11.3: Describe the process for verifying the credentials of healthcare and other professionals, from resources external to the facility, who offer assistance to the healthcare facility. o HSL-R11.4: Describe potential liability exposures that could occur for the facility and its patient care staff during emergency response and recovery. Skills o HSL-R11.5: Address appropriate healthcare regulatory issues during response and recovery by monitoring response activities for regulatory compliance and correcting deviations or appropriately justifying and explaining them. o HSL-R11.6: Request and obtain appropriate regulatory relief by contacting appropriate authorities and providing explanations of, and justifications for, the requests. o HSL-R11.7: Ensure appropriate credentialing and privileging of response personnel (from internal or external sources) to perform healthcare tasks, within the facility’s operations, by monitoring personnel activities for conformance to their specific expertise. o HSL-R11.8: Provide facility and personnel liability protection by documenting incident details surrounding occurrences with potential legal liability. x HSL-R12: Ensure that the Business Continuity Program considerations are incorporated into the facility’s Incident Action Planning (IAP) process. Recommended proficiency for Primary Competency: operations level Knowledge o HSL-R12.1: Describe the purpose and importance of a Business Continuity Program that is fully integrated into the facility EOP. o HSL-R12.2: Describe the elements and supporting functions of a Business Continuity Program as outlined in the NFPA 1600 Standard on Disaster/Emergency Management and Business Continuity Programs, 2004 Edition. Institute for Crisis, Disaster and Risk Management The George Washington University 64 Appendix C – Healthcare Emergency Management Competencies o HSL-R12.3: Describe how the Business Continuity Program aligns with overall Incident Command System (ICS) organization and procedures. Skills o HSL-R12.4: Include business continuity specific objectives in the Incident Action Planning process in order to address the recovery, resumption, and restoration of facility-specific services. o HSL-R12.5: Use (as appropriate) the Business Continuity support annex forms and guidance during emergency response and recovery. x HSL-R13: Assure that incident-specific safety guidance, in the form of an Incident Safety Plan and/or IAP safety message, is developed by the Safety Officer position through action planning and appropriately disseminated to responders. Recommended proficiency for Primary Competency: operations level Knowledge o HSL-R13.1: Describe the importance of empowering the safety office position to stop or alter incident operations that present immediate safety risks to responders, staff, patients, visitors or the integrity of the healthcare system. Skills o HSL-R13.2: Provide technical advice and other input into the safety plan and safety message development as indicated by technical background and the assigned position in Command and General Staff of the Incident Management Team (IMT). x HSL-R14: Ensure rapid and effective demobilization of the healthcare organization’s response resources, and eventually the emergency response itself, as the organization transitions to recovery operations. Recommended proficiency for Primary Competency: operations level Knowledge o HSL-R14.1: Describe the management of demobilization and the important processes that must occur during the demobilization process. o HSL-R14.2: Describe methods used to formally announce full or partial demobilization. o HSL-R14.3: Describe procedures for out-processing of personnel. o HSL-R14.4: Describe the procedures for conducting an initial incident review. Skills o HSL-R14.5: Guide the orderly demobilization of functional areas by ensuring that demobilization occurs as soon as the facility and/or resources are no longer needed for response (i.e. their specific response objectives have been met or otherwise resolved). Institute for Crisis, Disaster and Risk Management The George Washington University 65 Appendix C – Healthcare Emergency Management Competencies o HSL-R14.6: Provide clear explanation and notification of demobilization to relevant parties (internal and external), usually by demonstrating that response objectives have been met. o HSL-R14.7: Provide adequate out-processing of response personnel by ensuring adequate debriefings and assessments of performance as appropriate. o HSL-R14.8: Provide for an orderly initial incident review process (commonly known as a “hot wash”) by utilizing response procedures to conduct the meeting. x HSL-R15: Ensure recovery is accomplished to restore the healthcare organization to baseline operations and to capture important lessons for organizational improvement. Recommended proficiency for Primary Competency: operations level Knowledge o HSL-R15.1: Describe the overall process for managing the return of the organization to baseline operations and all activities to regular management oversight, including addressing the backlog of regular workload that accumulated during emergency operations. o HSL-R15.2: List critical equipment, priorities for rehabilitation, and the methods for re-certifying the equipment for future use. o HSL-R15.3: Describe the process for facility re-certification (if applicable). o HSL-R15.4: Describe the personnel rehabilitation process. o HSL-R15.5: Describe the After-Action Report process and methods utilized to keep the process orderly and constructive. Skills o HSL-R15.6: Manage the initial recovery operations by employing the same incident management structure and processes as used for the emergency response phase, with new objectives, personnel, and departmental assignments as needed; transition the management of residual recovery operations to everyday administrative functions as recovery management is terminated. o HSL-R15.7: Manage rehabilitation and re-certification for use of equipment and incident facilities by prioritizing areas for initial attention. o HSL-R15.8: Provide for personnel rehabilitation by disseminating the methods for response personnel to address psychological and/or physical concerns. o HSL-R15.9: Oversee the After-Action Report process by using facility procedures and processes that capture response deficiencies and best practices, and that incorporate accepted changes as EOP and emergency management program revisions (i.e., organizational learning). Institute for Crisis, Disaster and Risk Management The George Washington University 66 Appendix C – Healthcare Emergency Management Competencies Patient Care Provider (PCP) Physicians, physician assistants, registered nurses, licensed practical nurses, nurses working within expanded roles (CRNA, RNP, and others), emergency medical technicians, paramedics, and respiratory therapists and others who provide direct clinical patient care. Not included are clinical support staff that provide patient care services under the direct supervision of patient care providers: e.g., nurse’s aides, procedure technicians, orderlies, and others. x PCP-R1: Recognize situations related to patient care that indicate the need for full or partial activation of the healthcare system’s Emergency Operations Plan (EOP), and report them appropriately and promptly. Recommended proficiency for Primary Competency: operations level Knowledge o PCP-R1.1: Describe patient presentation criteria (unusual signs and symptoms indicative of deliberate illness/injury, indications of potentially epidemic illness/injury, unexpected rapid patient deterioration, difficult patient interventions such as decontamination, etc.) that indicate the possible need for EOP activation. o PCP-R1.2: Describe patient population profiles and other situation-based criteria (unusual numbers, very unusual contagiousness and other indications of increased risk to response personnel or current patients, etc.) that indicate the possible need for EOP activation. o PCP-R1.3 Describe resources available to Patient Care Providers in obtaining additional patient or situational information related to determining the need for activating the EOP. o PCP-R1.4: Describe the reporting requirements and the contact methods when events are recognized that may indicate the need for possible EOP activation (full or partial). Skills o PCP-R1.5: Identify situations within the regular clinical care area that should be reported for consideration of full or partial activation of the healthcare facility’s EOP. o PCP-R1.6: Report situations within the regular clinical care area by following EOP notification procedures and contacting the appropriate person (e.g., page operator, supervisor, etc.) as indicated by your specific role and by the situation at hand. o PCP-R1.7: Assist decision-makers with incident recognition by responding rapidly and adequately to their inquiries and requests for additional pertinent clinical and patient population information. Institute for Crisis, Disaster and Risk Management The George Washington University 67 Appendix C – Healthcare Emergency Management Competencies x PCP-R2: Participate in the mobilization of the your clinical area to transition from day-to day operations to the incident response organization and process. Recommended proficiency for Primary Competency: operations level Knowledge o PCP-R2.1: Describe the procedures necessary to prepare your clinical area, as indicated, for EOP response and recovery. Skills o PCP-R2.2: Ensure maximum patient surge capacity and capability and organizational resiliency by assisting in the mobilization of your clinical care area as described in the EOP. o PCP-R2.3: Establish and implement triage criteria based on actual and anticipated patient needs, disease parameters, and anticipated resources. o PCP-R2.4: Establish a decontamination area and other functions that are inactive during baseline operations, as indicated and per your individual assignment. o PCP-R2.5: Provide surge bed capacity for incident victims by accomplishing rapid disposition of existing patients in the emergency department, outpatient procedures area, and inpatient units as indicated by the EOP. o PCP-R2.6: Conduct actions as described in the EOP that are indicated for the specific incident parameters, including resource management and situation reporting. o PCP-R2.7: Ensure that external notifications (as relevant to your position) are coordinated through command and general staff x PCP-R3: Follow the healthcare Occupant Emergency Procedures (OEP) for your specific clinical care areas by assuring protective actions for patients and staff and by assisting others as necessary to accomplish the OEP directives. Recommended proficiency for Primary Competency: operations level Knowledge o PCP-R3.1: Describe the component parts of the OEP and your responsibilities to protect patients and, as indicated by your position, maintain accountability for patients, patient care information (charts, etc.) and clinical staff. o PCP-R3.2: Describe the methods to be used to maintain patient care during OEP activity, including during shelter-in-place, evacuation, or emergency events in the clinical unit. Skills o PCP-R3.3: Execute your roles and responsibilities in the facility OEP for protecting patients, patient information and others (as indicated) by Institute for Crisis, Disaster and Risk Management The George Washington University 68 Appendix C – Healthcare Emergency Management Competencies assisting with evacuating patients, establishing shelter-in-place, or other actions during OEP operations. o PCP-R3.4: Ensure continuous patient care by prioritizing and performing essential clinical interventions during OEP operations. x PCP-R4: Provide Surge Capacity by managing/treating increased numbers of patients (compared with day-to-day activities), regardless of etiology. Recommended proficiency for Primary Competency: operations level Knowledge o PCP-R4.1: Describe strategies and tactics appropriate to your clinical area that provide surge capacity for a significantly increased number of patients. o PCP-R4.2: Describe the triage processes necessary to match need with available resources in your clinical area. Skills o PCP-R4.3: Provide patient surge capacity by instituting and adhering to the EOP measures designated for your clinical area. o PCP-R4.4: Maximize the ability of patients to help themselves (when appropriate) by providing clear instructions and by enhancing their ability to help themselves (e.g., by controlling pain or other interventions). o PCP-R4.6: Manage or participate in degradation of overall services by prioritizing critical tasks and activities over less critical ones. o PCP-R4.7: Perform ongoing triage (matching resources to needs) to manage patient load by assigning priorities for services including diagnostic testing, pharmaceutical administration, operative intervention, blood infusion, and others. o PCP-R4.8: Provide continuous input into management decision-making by projecting resource needs for your clinical area as appropriate. x PCP-R5: Provide Surge Capability by managing/treating all incoming patients with specialty needs that vary significantly from day-to-day healthcare system activities. Recommended proficiency for Primary Competency: operations level Knowledge o PCP-R5.1: Describe special etiologies that may tax the facility response, even with limited numbers of patients. o PCP-R5.2: Describe the pathophysiology of injuries and illnesses associated with mass casualties and the indicated interventions for your clinical discipline. o PCP-R5.3: Describe threats or hazards posed by these types of patients. o PCP-R5.4: Describe methods for hazard/threat containment for these types of patients (as applicable). Institute for Crisis, Disaster and Risk Management The George Washington University 69 Appendix C – Healthcare Emergency Management Competencies o PCP-R5.5: List resources where technical information may be found that may assist with caring for patients with these needs. Skills o PCP-R5.6: Demonstrate understanding of injury and illness associated with these specialty-needs patients by providing the appropriate interventions to minimize further injury/illness and to maximize patient recovery. o PCP-R5.7: Provide evidence-based care for these patients by accessing technical expertise as appropriate. o PCP-R5.8: Perform special situation procedures per the EOP annexes and as indicated by event circumstances (e.g., decontamination, isolation, etc.) o PCP-R5.9: Contain hazards/threats posed by patients (as applicable) by removing the hazards from the patients, the use of PPE, appropriately locating patients or other measures. o PCP-R5.10: Adhere to appropriate chain custody procedures as applicable to the particular situation at hand. x PCP-R6: Provide for efficient information processing for your clinical area through both reporting and receiving information according to established time schedules. Recommended proficiency for Primary Competency: operations level Knowledge o PCP-R6.1: Describe the types of relevant information that are required for reporting from your clinical area. o PCP-R6.2: Describe the format and timing of reporting information from your clinical area. o PCP-R6.3: Describe the methods in which your clinical area should receive incident information during emergency response and recovery. Skills o PCP-R6.4: Provide input into the healthcare system’s incident planning through updates (as requested) on situation (patient care, continued or recovered function of patient care systems, etc.), resources (pharmaceuticals, equipment and medical supplies, etc.), special problems encountered, and tasks completed in your clinical area. o PCP-R6.5: Ensure tracking of incident patients by providing updates (as requested) on numbers, types, and locations of patients as well as interventions required. o PCP-R6.6: Ensure appropriate designations are used for patient tracking (‘meets case definition for incident’, ‘suspicious for case definition,’ etc.) as applicable. o PCP-R6.7: Provide prompt notification when patient care activities reveal information that dictates major or sudden changes in response strategies. o PCP-R6.8: Deliver or participate in briefings conducted for your clinical area. Institute for Crisis, Disaster and Risk Management The George Washington University 70 Appendix C – Healthcare Emergency Management Competencies x PCP-R7: Manage the psychological impact on victims, victims’ families, and staff through both preventative and therapeutic measures. Recommended proficiency for Primary Competency: operations level Knowledge o PCP-R7.1: Describe the potential psychological effects on incident victims and their families and the indicated interventions for your clinical discipline. o PCP-R7.2: List the potential psychological effects on responding personnel and the indicated interventions for your work area. o PCP-R7.3: Describe preventative methods that may lessen the psychological impact on victims, victims’ families, and staff. Skills o PCP-R7.4: Provide psychological and emotional support to patients and their families as indicated by your clinical discipline. o PCP-R7.5: Provide information on the event, its etiology, and facility interventions to patients and family members in your clinical area (written if possible). o PCP-R7.6: Provide frequent updates on expected interventions for individual victims to the family members in your clinical area. o PCP-R7.7: Assist with the identification of specific stressors for staff in your work area and report them to your supervisor. o PCP-R7.8: Assist with assigned measures designed to reduce staff stress during response and recovery (e.g. facilitating information dissemination amongst staff). x PCP-R8: Incorporate relevant safety practices and procedures in all incident operations for your clinical area. Recommended proficiency for Primary Competency: operations level Knowledge o PCP-R8.1: Describe categories of hazards that may pose a risk to clinical staff during emergency response and recovery. o PCP-R8.2: Describe interventions for clinical staff and others to reduce the potential risk created by incident parameters. Skills o PCP-R8.3: Participate in or conduct safety briefings (based upon the incident Safety Plan) during each work cycle. o PCP-R8.4: Adhere to universal precautions and infection control procedures (whether day-to-day or specific to the incident) as indicated. o PCP-R8.5: Adhere to appropriate work cycles for your clinical area. o PCP-R8.6: Select and use appropriate PPE when applicable. Institute for Crisis, Disaster and Risk Management The George Washington University 71 Appendix C – Healthcare Emergency Management Competencies o PCP-R8.7: Provide for safe use of PPE by monitoring those individuals utilizing PPE. o PCP-R8.8: Minimize security-safety risk to clinical personnel by coordinating with facility security personnel. x PCP-R9: Integrate outside resources into your clinical area as required to meet response objectives. Recommended proficiency for Primary Competency: operations level Knowledge o PCP-R9.1: Describe procedures for requesting, receiving, briefing, assigning and supervising clinical personnel from other clinical units or from other facilities. o PCP-R9.2: Describe procedures for requesting, receiving, rapid inservicing and using equipment and supplies (especially items that aren’t normally used in your clinical area). Skills o PCP-R9.3: Initiate requests for outside resources by delineating specific needs in the required format. o PCP-R9.4: Assist in the integration of personnel from outside your work area by ensuring they participate in briefings on operations in your area and monitoring their response actions o PCP-R9.5: Integrate equipment and supplies from outside your clinical area by ensuring familiarity with their use and by tracking their use. o PCP-R9.6: Provide appropriate utilization of technical expertise by assessing the source and incorporating applicable recommendations. x PCP-R10: Follow recovery procedures for your clinical area that promote rapid return of the facility to baseline activity. Recommended proficiency for Primary Competency: operations level Knowledge o PCP-R10.1: Describe policies and procedures for rehabilitation of patient care and clinical support personnel. o PCP-R10.2: Describe procedures for reassessing your clinical area’s patient population and planning for resolving surge needs. o PCP-R10.3: Describe the responsibilities, specific to your role, for rehabilitation of your clinical area. o PCP-R10.4: Describe the policies and procedures for formal After Action Report of patient care in your clinical area. Skills o PCP-R10.5: Demonstrate an understanding of the importance of personnel rehabilitation activities by participating in personnel rehabilitation as instructed. Institute f…
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