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<p><strong>You Are Here:</strong> <span class="crumb_link"><a href="/" class="crumb_link">AHRQ Archive Home</a> > <a href="/prep/" class="crumb_link">Public Health Preparedness Archive</a> > <a href="index.html" class="crumb_link">Disaster Alternate Care Facility Selection Tool</a> > <a href="dacfrep.htm" class="crumb_link">Disaster Alternate Care Facilities: Selection and Operation</a> > Appendix D (continued)</span></p>
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<td height="30px"><span class="title"><a name="h1" id="h1"></a>Disaster Alternate Care Facility Selection Tool </span></td>
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<td><div id="centerContent"><p><strong>Public Health Emergency Preparedness</strong></p> <div class="headnote">
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<p>This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.</p>
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<p>This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: <a href="https://info.ahrq.gov/">https://info.ahrq.gov</a>. Let us know the nature of the problem, the Web address of what you want, and your contact information. </p>
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<p>Please go to <a href="https://www.ahrq.gov/">www.ahrq.gov</a> for current information.</p></div>
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<h2>Appendix D: Alternate Care Facility Questionnaire—Summary of Results (continued) </h2>
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<p><em>Notes</em>: Remarks in brackets [example] have been edited by the reviewing investigator to preserve confidentiality. No other changes have been made to survey data. The use of a period (.) in any field indicates no data was received from the survey respondent for that item. </p>
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<table border="1" cellspacing="0" cellpadding="2">
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<tr valign="top">
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<th scope="col">Survey Question/Topic</th>
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<th scope="col">Site 1</th>
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<th scope="col">Site 1'</th>
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<th scope="col">Site 2</th>
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<th scope="col">Site 3</th>
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<th scope="col">Site 4</th>
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<th scope="col">Site 5</th>
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<th scope="col">Site 6</th>
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<th scope="col">Site 7</th>
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<th scope="col">Site 8</th>
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<th scope="col">Site 9</th>
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</tr>
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<tr valign="top">
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<td scope="row">Visitor Limit?</td>
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<td>[name] Question - in the [clinic] we did not limit</td>
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<td>No</td>
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<td>Not applicable</td>
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<td>No - family were also evacuees, though they were provided different space</td>
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<td>Unknown</td>
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<td>No</td>
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<td>No</td>
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<td>No</td>
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<td>No</td>
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<td>Yes</td>
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</tr>
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<tr valign="top">
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<td scope="row">Auxiliary Care?</td>
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<td>.</td>
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<td>N/A</td>
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<td>Not applicable</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>No</td>
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</tr>
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<tr valign="top">
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<td scope="row">Outside Integration?</td>
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<td>[name] question</td>
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<td>Yes</td>
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<td>Yes—[State] State guard (medical branch) provided security and lab technicians and logistical support</td>
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<td>Yes</td>
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<td>We were a DMAT but other ACS did use DMATS</td>
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<td>No</td>
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<td>No</td>
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<td>Yes</td>
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<td>Yes—[State] medical rangers</td>
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<td>Yes</td>
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</tr>
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<tr valign="top">
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<td scope="row">Integration Lessons?</td>
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<td>.</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>N/A</td>
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<td>.</td>
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<td>.</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>.</td>
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</tr>
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<tr valign="top">
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<td scope="row">Integration Detail</td>
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<td>.</td>
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<td>Federal response agencies worked best when they integrated into the already set-up local incident command structure.</td>
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<td>Assisted us in understanding their capabilities</td>
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<td>We split up teams/ integrated shifts with folks from all groups which resulted in a wonderful collaborative consciousness. Included student leaders as well.</td>
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<td>.</td>
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<td>N/A</td>
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<td>.</td>
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<td>Be flexible. Learn. Respect, adapt</td>
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<td>Need strong incident command to manage multiple levels of outside input.</td>
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<td>.</td>
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</tr>
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<tr valign="top">
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<td scope="row">Pets Allowed?</td>
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<td>[name] question</td>
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<td>No - pets were housed outside the facility in a separate shelter</td>
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<td>No</td>
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<td>No - but there was a place on campus for them</td>
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<td>Yes</td>
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<td>Yes - limited</td>
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<td>Yes</td>
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<td>No</td>
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<td>No</td>
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<td>No</td>
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</tr>
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<tr valign="top">
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<td scope="row">Facility Issues?</td>
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<td>Yes—[name] question</td>
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<td>Yes</td>
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<td>No</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>No</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>No</td>
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<td>.</td>
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</tr>
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<tr valign="top">
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<td scope="row">Issue Detail</td>
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<td>lack of ample plumbing</td>
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<td>Environmental issues related to exhaust fumes, noise, etc. due to vehicular traffic and leaving vehicles on.</td>
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<td>.</td>
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<td>Gymnasiums are large and noisy - it really never was quiet. Other treatment areas as well were loud & light.</td>
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<td>Lighting (not NO but other shelters) and noise control - also bathroom access</td>
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<td>Cell communications at first. Then satellite delivered with phones.</td>
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<td>Drinking water, meds preparation, lack of phones</td>
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<td>No toilets, inadequate electrical support, no air condition</td>
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<td>(Used a gymnasium - required reassurance to college administrators that we would not damage floors)</td>
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<td>.</td>
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</tr>
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<tr valign="top">
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<td scope="row">Any Other Issues?</td>
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<td>See attached file. [redacted]</td>
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<td>.</td>
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<td>.</td>
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<td>.</td>
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<td>There needs to be a troubleshooting expert group who can be called to come in and help with problems esp. when the operations people become overwhelmed and unable to make good decisions</td>
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<td>.</td>
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<td>The nearby VA support was a major reason for our success.</td>
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<td>.</td>
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<td>Bed triage & labeling helpful. Use dieticians/ licensed diabetic educators to arrange diabetic management teams. Needlesticks are hazardous.</td>
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<td>.</td>
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</tr>
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<tr valign="top">
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<td scope="row">Self-Presenting?</td>
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<td>Yes - But [name] tried to prevent this</td>
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<td>No</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>No</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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</tr>
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<tr valign="top">
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<td scope="row">Ambulance Route?</td>
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<td>Directly to ACF</td>
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<td>N/A</td>
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<td>Hospital first</td>
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<td>Hospital first - not possible in this circumstance, though EMS did manage to take true criticals to hospitals</td>
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<td>Directly to ACF</td>
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<td>Directly to ACF</td>
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<td>.</td>
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<td>Depends on patient acuity</td>
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<td>Hospital first</td>
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<td>Directly to ACF</td>
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</tr>
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<tr valign="top">
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<td scope="row">Mental Health?</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>No</td>
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<td>Yes</td>
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</tr>
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<tr valign="top">
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<td scope="row">Futility of Care?</td>
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<td>[name] question</td>
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<td>.</td>
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<td>No</td>
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<td>No</td>
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<td>Yes</td>
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<td>No</td>
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<td>.</td>
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<td>No</td>
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<td>No</td>
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<td>.</td>
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</tr>
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<tr valign="top">
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<td scope="row">Futility of Care Details</td>
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<td>.</td>
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<td>Do not understand question.</td>
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<td>Not applicable to our operation since we performed no in-patient or ICU care</td>
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<td>It didn't come up</td>
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<td>0 guidelines it had to do with logistics and transportation and staffing</td>
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<td>.</td>
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<td>.</td>
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<td>.</td>
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<td>.</td>
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<td>.</td>
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</tr>
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<tr valign="top">
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<td scope="row">Pediatrics Care: ED Nurses?</td>
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<td>Yes</td>
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<td>.</td>
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<td>.</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>.</td>
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<td>.</td>
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<td>Yes</td>
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<td>.</td>
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</tr>
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<tr valign="top">
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<td scope="row">Pediatrics Care: ED Docs?</td>
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<td>Yes</td>
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<td>.</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>.</td>
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<td>.</td>
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<td>Yes</td>
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<td>Yes</td>
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</tr>
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<tr valign="top">
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<td scope="row">Pediatrics Care: Family Docs?</td>
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<td>Yes</td>
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<td>.</td>
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<td>.</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>.</td>
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<td>.</td>
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<td>.</td>
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<td>Yes</td>
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<td>.</td>
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</tr>
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<tr valign="top">
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<td scope="row">Pediatrics Care: Pediatrics ED Docs?</td>
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<td>Yes</td>
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<td>.</td>
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<td>.</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes - limited</td>
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<td>.</td>
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<td>.</td>
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<td>.</td>
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<td>.</td>
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</tr>
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<tr valign="top">
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<td scope="row">Pediatrics Care: Pediatrics Midlevel?</td>
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<td>Yes</td>
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<td>.</td>
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<td>.</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>.</td>
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<td>Yes</td>
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<td>.</td>
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<td>.</td>
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<td>.</td>
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</tr>
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<tr valign="top">
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<td scope="row">Pediatrics Care: Pediatrics Nurses?</td>
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<td>Yes</td>
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<td>.</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>.</td>
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<td>.</td>
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<td>Yes</td>
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<td>.</td>
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<td>.</td>
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</tr>
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<tr valign="top">
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<td scope="row">Pediatrics Care: Pediatricians?</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>.</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>Yes</td>
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<td>.</td>
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</tr>
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<tr valign="top">
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<td scope="row">Pediatrics Care: Other?</td>
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<td>Yes</td>
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<td>Yes - handled by another agency so cannot speak fully to this question</td>
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<td>.</td>
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<td>.</td>
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<td>Yes</td>
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<td>.</td>
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<td>.</td>
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<td>.</td>
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<td>.</td>
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<td>.</td>
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</tr>
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<tr valign="top">
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<td scope="row">Pediatrics Care Other Detail</td>
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<td>Answer pertains to the [clinic] only - almost every combination</td>
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<td>Via coordination with community (private) provider for pediatrics services.</td>
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<td>.</td>
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<td>.</td>
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<td>Paramedics</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Immunizations?</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes - but only for fire service and law enforcement coming from various parts of the country on the way to [location]</td>
|
|
<td>Yes - tetanus</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes - tetanus</td>
|
|
<td>No</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Infectious Disease Surveillance?</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>No</td>
|
|
<td>Yes</td>
|
|
<td>No</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Infectious Disease Surveillance Detail</td>
|
|
<td>Both the [name] public health and [name] provided this surveillance - in fact [name] was the first to identify and DNA type the organism responsible for the GE outbreak</td>
|
|
<td>Cot-to-cot surveys in shelter areas by Epidemiology Task Force was conducted nightly to assess for symptoms that may correlate with certain disease patterns.</td>
|
|
<td>County public health epidemiologist reviewed cases</td>
|
|
<td>Monitored trends</td>
|
|
<td>Walk rounds. & informal look arounds. Other facilities I know had a stronger PH component.</td>
|
|
<td>[State] Public Health rotated teams that interacted with [State] Epidemiology.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>Minimal disease surveillance - diarrhea, respiratory tract infections were monitored</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Hospital Transfer System?</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes - only 2-3% of ACF patients were transferred to hospital ED's (out of >10,000 patient encounters)</td>
|
|
<td>Yes</td>
|
|
<td>Initially no! After a while yes but limited. In other ACFs I have had an ambulance on standby for transfer</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Surge: Early Discharge?</td>
|
|
<td>Yes</td>
|
|
<td>.</td>
|
|
<td>No local hospitals used these strategies</td>
|
|
<td>Yes</td>
|
|
<td>Unknown</td>
|
|
<td>Yes</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Surge: Hospital Transfer?</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>No local hospitals used these strategies</td>
|
|
<td>.</td>
|
|
<td>Unknown</td>
|
|
<td>Yes</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Surge: ICU to Ward?</td>
|
|
<td>Yes</td>
|
|
<td>.</td>
|
|
<td>No local hospitals used these strategies</td>
|
|
<td>.</td>
|
|
<td>Unknown</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Surge: Interhospital Transfer?</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>No local hospitals used these strategies</td>
|
|
<td>Yes</td>
|
|
<td>Unknown</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>Yes</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Surge Criteria Detail</td>
|
|
<td>.</td>
|
|
<td>Unknown</td>
|
|
<td>None of these strategies were employed</td>
|
|
<td>We were informed by local health that beds were becoming available especially after NDMS kicked in</td>
|
|
<td>Unknown</td>
|
|
<td>Guesstimations only</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>If patients met minimal criteria for discharge they were discharged home or back to the shelter.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Special Medical Needs (SMN)?</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>In NO all comers</td>
|
|
<td>Yes</td>
|
|
<td>No</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>No</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">SMN: Dialysis?</td>
|
|
<td>Yes</td>
|
|
<td>.</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>Yes</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">SMN: Mental Health?</td>
|
|
<td>Yes</td>
|
|
<td>.</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>.</td>
|
|
<td>Yes</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">SMN: Ventilator?</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">SMN: Other?</td>
|
|
<td>Yes</td>
|
|
<td>Expanded definition for what was considered MSN population - so a diabetic without insulin for few days with need to store insulin, dispose of sharps, ADA diet, etc. became a patient with MSN.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>Yes</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>Yes</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">SMN Other Detail</td>
|
|
<td>hemonc/ transplant/<br />
|
|
CF/<br />
|
|
shunts/<br />
|
|
etc</td>
|
|
<td>Other such patients included those morbidly obese, mental health needs, patients on chronic dialysis, etc.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>Chronic health prob.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>COPD, diabetes patients, Alzheimer/ geriatric patients</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Special ACF Group?</td>
|
|
<td>Yes</td>
|
|
<td>No</td>
|
|
<td>No</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>No</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>Yes</td>
|
|
<td>No</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Special ACF Group Detail</td>
|
|
<td>Ventilator dependent</td>
|
|
<td>In operation such as ours, integrated services worked best esp. due to fact that patient characteristics were unknown in advance of operation initiation.</td>
|
|
<td>.</td>
|
|
<td>Infectious - it wasn't an issue for us, but if we were dealing with flu etc, should have separate ACF. Also hospice/palliative care</td>
|
|
<td>Chronic ventilator patients with respiratory therapists</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>Ventilator patients</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Multiple Ventilators?</td>
|
|
<td>Yes</td>
|
|
<td>No</td>
|
|
<td>No</td>
|
|
<td>No - not without extraordinary resources - which are better left in the hospital</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>No</td>
|
|
<td>Depends on staffing and resources</td>
|
|
<td>No - unless the personnel (nurses/ respiratory technicians) are available.</td>
|
|
<td>No</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Other SMN/Patient Care Issues</td>
|
|
<td>With Hurricane RITA which came at the heels of Katrina we had appx 30 ventilator dependent children arrive at our EC - we had to open a floor just for these patients - as a result, we are working with the [State] to create a regional location [redacted]</td>
|
|
<td>.</td>
|
|
<td>Avoid segmenting patients according to medical diagnoses</td>
|
|
<td>We did not have many deaths - but hospice/ palliative care patients that were evacuated did come through and sent to a different facility</td>
|
|
<td>Morbidly obese/mobility issues are huge problems for hygiene and skin breakdown</td>
|
|
<td>Dialysis was not an issue, but could have been. Also we had 8 obstetric patients that we transferred out (luckily).</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Patients In ACF?</td>
|
|
<td>[name] question</td>
|
|
<td>Very limited information known.</td>
|
|
<td>Visual head count only</td>
|
|
<td>We counted every 2 hours / kept track on a grease board</td>
|
|
<td>Walking around</td>
|
|
<td>Electronic system tracking tool</td>
|
|
<td>paper process</td>
|
|
<td>Database</td>
|
|
<td>Daily patient census recorded on Excel program. All patients signed in & out of facility.</td>
|
|
<td>Patient recording and tracking.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Patient Location?</td>
|
|
<td>[name] question</td>
|
|
<td>Very limited information known. </td>
|
|
<td>Medical record form indicated the location within the ACF where care was rendered (adult, ped, mental lhth, dental, OB, ... etc.)</td>
|
|
<td>Had charge nurses & team leads at each treatment area keeping track</td>
|
|
<td>Walking around</td>
|
|
<td>Computer board</td>
|
|
<td>a room roster started when they admit.</td>
|
|
<td>Generally</td>
|
|
<td>XY grid coordinates for bed placement.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Patient Disposition?</td>
|
|
<td>[name] question</td>
|
|
<td>Discharge/ transfer information was limited except for perhaps those who were transferred via the regional medical operations center</td>
|
|
<td>Handwritten medical record</td>
|
|
<td>Local EMS & social workers took care of this</td>
|
|
<td>Initially too many patients to too few staff</td>
|
|
<td>Same computer tracking system</td>
|
|
<td>daily count and discharge process include informing patient administration</td>
|
|
<td>Database</td>
|
|
<td>Developed an Excel program. College students assisted.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Patient Tracking System?</td>
|
|
<td>[name] question</td>
|
|
<td>No</td>
|
|
<td>No</td>
|
|
<td>No—[college] students went bedside to bedside with laptops to develop database</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>No</td>
|
|
<td>No</td>
|
|
<td>No</td>
|
|
<td>Yes</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Medical Records?</td>
|
|
<td>EMR - took 2 days to perfect but it was quite good once it overcame the sudden rush of patients - [name] question</td>
|
|
<td>Not handled by our agency.</td>
|
|
<td>Developed de-novo a paper medical record - all completed records were scanned and stored. Data entry clerk created database (name and chief complaint) which was searchable.</td>
|
|
<td>Initially - just one sheet of paper taped to the cot</td>
|
|
<td>Couldn't initially then ran out of supplies</td>
|
|
<td>Paper/file cabinets</td>
|
|
<td>Electronic VA record</td>
|
|
<td>Paper</td>
|
|
<td>(Electronic for monitoring patient status.) In clinic & shelter used a paper record. Patient chart created & attached to bed.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Records Ownership?</td>
|
|
<td>[name] question</td>
|
|
<td>Not handled by our agency.</td>
|
|
<td>County public health dept.</td>
|
|
<td>Records were sent with the patient when transferred and/or given to them with a discharge summary. Local EMS kept copies of discharge/transfers</td>
|
|
<td>Feds</td>
|
|
<td>[State] Public Health</td>
|
|
<td>VA?</td>
|
|
<td>State</td>
|
|
<td>Public health department.</td>
|
|
<td>Have not given thought to this issue. Good point.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Adult/Peds Together?</td>
|
|
<td>Families kept together<br />
|
|
Adult/peds separated</td>
|
|
<td>Families kept together</td>
|
|
<td>Adult/peds separated - moms typically took children needing care to the pediatric section</td>
|
|
<td>Families kept together - as much as possible</td>
|
|
<td>Families kept together</td>
|
|
<td>Families kept together</td>
|
|
<td>Families kept together</td>
|
|
<td>Families kept together</td>
|
|
<td>Families kept together</td>
|
|
<td>Families kept together</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Spouses Separated?</td>
|
|
<td>[name] question</td>
|
|
<td>No</td>
|
|
<td>No</td>
|
|
<td>No</td>
|
|
<td>No</td>
|
|
<td>No</td>
|
|
<td>No</td>
|
|
<td>No</td>
|
|
<td>No</td>
|
|
<td>Yes</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Families Together?</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>No</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Patient Privacy?</td>
|
|
<td>.</td>
|
|
<td>Depends on emergency scenario but in general the preference due to the high anxiety of such scenarios is to keep families together as much as possible.</td>
|
|
<td>.</td>
|
|
<td>Tough to do in a gymnasium. We used sheets & other barriers when possible. Far more important to allow access to patients as most families were also evacuees and separating families at the time would have just made things worse.</td>
|
|
<td>Family takes precedence over privacy in a disaster</td>
|
|
<td>Limited</td>
|
|
<td>Each family unit had private room</td>
|
|
<td>Did not</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Active Finance Section?</td>
|
|
<td>Yes—[name] financed its own efforts in the hope that it would be reimbursed - I don't think it was reimbursed</td>
|
|
<td>Yes - handled through overall County Government, not our agency specifically.</td>
|
|
<td>No</td>
|
|
<td>No - all done by locals/I do not have the info</td>
|
|
<td>No</td>
|
|
<td>Yes</td>
|
|
<td>No</td>
|
|
<td>No</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Volunteer %?</td>
|
|
<td>not sure</td>
|
|
<td>Unknown</td>
|
|
<td>20</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>25</td>
|
|
<td>Not sure.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Charitable Donation %?</td>
|
|
<td>not sure</td>
|
|
<td>Unknown</td>
|
|
<td>10</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>15</td>
|
|
<td>Not sure.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Institution/System %?</td>
|
|
<td>not sure</td>
|
|
<td>Unknown</td>
|
|
<td>40</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>10</td>
|
|
<td>Not sure.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Private Corporation %?</td>
|
|
<td>not sure</td>
|
|
<td>Unknown</td>
|
|
<td>10</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>Not sure.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Local Gov %?</td>
|
|
<td>not sure</td>
|
|
<td>Unknown</td>
|
|
<td>10</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>Not sure.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">State %?</td>
|
|
<td>not sure</td>
|
|
<td>Unknown</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>25</td>
|
|
<td>Not sure.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Federal %?</td>
|
|
<td>not sure</td>
|
|
<td>Unknown</td>
|
|
<td>10</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>100</td>
|
|
<td>.</td>
|
|
<td>25</td>
|
|
<td>Not sure.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td>Other %?</td>
|
|
<td>not sure</td>
|
|
<td>Unknown</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>Not sure.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td>Other % Detail</td>
|
|
<td>not sure</td>
|
|
<td>Unknown</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>Not sure.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
|
|
<tr valign="top">
|
|
<td>Federal Invoice?</td>
|
|
<td>Yes</td>
|
|
<td>Yes - County Government did.</td>
|
|
<td>No</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>Yes</td>
|
|
<td>.</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Federal Reimbursement?</td>
|
|
<td>No</td>
|
|
<td>Yes</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>Yes</td>
|
|
<td>.</td>
|
|
<td>Yes</td>
|
|
<td>No - uncertain</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Reimbursement Secrets?</td>
|
|
<td>yes - create an agreement before the response</td>
|
|
<td>.</td>
|
|
<td>Not applicable</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>None</td>
|
|
<td>.</td>
|
|
<td>No</td>
|
|
<td>No</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Worker Illness/Injury?</td>
|
|
<td>Yes</td>
|
|
<td>Unable to quantify.</td>
|
|
<td>No - not that we were aware of</td>
|
|
<td>No</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>No</td>
|
|
<td>No</td>
|
|
<td>Yes - 1 needlestick injury</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">Workers' Comp Issues?</td>
|
|
<td>[name] question</td>
|
|
<td>N/A</td>
|
|
<td>No - not that we were aware of</td>
|
|
<td>No</td>
|
|
<td>Yes</td>
|
|
<td>Yes</td>
|
|
<td>No</td>
|
|
<td>No</td>
|
|
<td>No</td>
|
|
<td>.</td>
|
|
</tr>
|
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<tr valign="top">
|
|
<td scope="row">Workers' Comp Detail</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>Their commander dealt with it through the Federal Government</td>
|
|
<td>Handled by parent hospital</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
</tr>
|
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<tr valign="top">
|
|
<td scope="row">Other Finance Issues?</td>
|
|
<td>Pay the resource if you want them to return</td>
|
|
<td>.</td>
|
|
<td>ACF financing will now go through the finance section of the city entity which has requested a medical support function.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>.</td>
|
|
<td>Buy on credit, keep receipts, if it is reasonable, it will eventually be reimbursed</td>
|
|
<td>Health Department was not reimbursed at the State or local level. Most work was voluntary. [Name] State Guard was paid a daily stipend.</td>
|
|
<td>.</td>
|
|
</tr>
|
|
<tr valign="top">
|
|
<td scope="row">General Comments</td>
|
|
<td> </td>
|
|
<td>Advanced planning and development of relationships with partners in advance is critical to the success of any large-scale operation.</td>
|
|
<td>See two documents [attached] describing our ACF operations</td>
|
|
<td>[From included cover letter] ... I am an advocate of college campuses as ACF for many reasons. This is a short list: 1. handicapped accessible; 2. large crowds can generally be accommodated; 3. there is already a security presence, and a perimeter can be </td>
|
|
<td>Can not be rigid - flexibility important. Red Cross volunteers. Family together. Palliative care areas. Animals need to be considered. Uniforms very helpful. Understand limitations in your mission.</td>
|
|
<td>.</td>
|
|
<td>Any plan that developed needs to be flexible. A cook book approach would not work well in a disaster situation. VA being a national system has enough resources to sustain a shelter for a "period" of time (no more than 3 months).</td>
|
|
<td>Have good leadership. Tap into churches for volunteers. Help others and they will accommodate/assist you.</td>
|
|
<td>Plan in advance of disaster. We have subsequently identified a university campus with a nursing school to be a ACF for 240 people. We have run [illegible] exercises & call down events to ensure that we can stand up the facility.</td>
|
|
<td>We have had to approach planning from a couple of different angles. Our most likely scenario would be a situation whereby the ACF is used for a short fused- short duration event. On the other hand, we are also approaching the issue with the thought in mind</td>
|
|
</tr>
|
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</table>
|
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<p class="size2"><a href="dacfrep.htm#contents">Return to Contents</a><br /><a href="dacfrepappd5.htm">Proceed to Next Section</a>
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<div class="footnote">
|
|
<p> The information on this page is archived and provided for reference purposes only.</p></div>
|
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