November 14, 2023 Membership Meeting

Agenda:

SCWIHERC November 14, 2023 Membership Meeting Notes

Meeting recording: https://us06web.zoom.us/rec/share/LdGrskDvUDukdvjAw55DwJDpqYYfXUGytCwHM3f4DnewaxU7ygSc85xmp6TuWCC2.CzBqgIcoEGIn7bc4n

Passcode: see email from Jennifer November 16

Hospital

The hospital group discussed the warehouse survey and discussed the balance of adequate inventory versus space available.  The DASH Tool https://dashtool.org/  is robust and a bit overwhelming, and likely a starting point.  Note that the DASH Tool does let you export results after entering your data.

Suggested meeting topic: FirstNet communications capabilities.  Will work to bring this topic in for a future meeting.

The Hospital Forum will skip meeting in December, Jennifer will send out a survey to schedule for early January.

Membership

Jennifer gave a few SCWIHERC updates.  The Training Needs Assessment Survey was sent out October 25 and will close November 24.  This is very important and our primary source of information for planning trainings in the region and state, please strive to have at least one response per organization, but multiple people from the same organization are welcome to respond!  The ventilator survey, sent Nov 8 and Due Nov 20, can be used to request no-cost ventilators from WI DHS stockpile.  SCWIHERC applied for carryover funding to support a cybersecurity workshop and conduct a power outage tabletop exercise.  Cyber is #3 on our HVA, and WICTRA https://wictra.org/ hosts a two day workshop wherein the first day is doing a TTX to discover your organizational vulnerabilities, and the second day is used to write a cyber event continuity plan.  Power Outage is # 2 on our HVA, and we are looking to host an in-person tabletop exercise like the good old days where we would be grouped together with our local response partners, and cover response to a substantial power outage which affects health partners but also impacts the community.  Other smaller projects for which SCWIHERC requested carryover money include refreshing our website, and continuing our fundraising efforts as a nonprofit organization.  Don’t forget that SCWIHERC is offering scholarships to support emergency preparedness efforts in the region, see email sent November 3.  Also note the following scheduled spring dates: Feb 6 and May 7 for SCWIHERC meetings, February 21 for Medical Surge and Response Exercise (MRSE).

Jim Oleson, WI DHS Warehouse Supervisor, gave an update on warehouse operations.  The state has a glut of supplies received during the pandemic, and needs to demobilize and return to pre-pandemic operations and par levels.  This is the reason behind the warehouse survey which closed yesterday, November 13.  Refer to recording for more details, questions can be sent to james.oleson@dhs.wisconsin.gov

Ann Zenk, Wisconsin Hospital Association, gave a presentation on workforce development and WHA’s work on this topic to train and retain the healthcare workforce.  azenk@wha.org

Traci Lindsey, South Central Wisconsin Area Health Education Centers, also gave a presentation describing SCWAHEC’s mission and work on this topic.  They are interested in hearing from you if your organization can take interns or mentor students in some capacity! trlindsey@scwahec.org

Refer to the recording for more details.

What are we working on and preparing for?

MCI preparedness, upcoming respiratory season, staffing shortages/hiring/retention, cyber threats, decon, PHEP and other emergency plan updates.

Meeting attendance:

Jeff Brown- Mercyhealth

Dave Kitkowski- St. Clare Baraboo and SCWIHERC

Michael Niles- Rock County HD

Karen Nsiah-Ababio- Rock County HD

Jordon Denfeld and Derrick- Maxim Staffing

Karmen Bryer- Beloit Health System

Nathan Bubenzer- Meriter UPH

Dave Larson- Madison VA

Belle Koch- Sauk Prairie Healthcare

Mary Crowley- Juneau County HD

Steve Haskell- UW Health

Patti Miller- City of Beloit EM

Angie Cohen- Grant Regional

Jodi Moyer- Beloit Health System

Carmen Luther- Reedsburg Area Med Ctr

Ben Thompson- Mercyhealth

Christal Foreyt- Gundersen Boscobel

Mary Tessendorf- Monroe Hospital

Tammy Kingery- Gundersen Moundview

Adam Dahle- Encompass Health Rehab Hospital

Mike Stephens- Fort HealthCare

Leanne Seifert- Watertown Regional Med Ctr

Sally Blackbourn- Memorial Hospital of Lafayette County

Sharon Rateike- ECRI

Page Heinke- SSM Health at Home

Kyle Schaeffer- UW Health

Emily Kosterman- Waupun Memorial

Katie Budack- Grant Regional

Tina Strandlie- Stoughton Health

Sarah Jensen- Marquette Co HD

Debbie Siegenthaler- Iowa Co HD

Sean Madison- NIPARC

Victoria Parker- Watertown HD

Lynn Skatrud- Green Co HD

Jodie Molitor- Sauk Co HD

Erin Hastert- Lafayette Co HD

Kara Takes- Unified Therapy

Kimberley Spurgeon- Family Health La Clinica

Gary Ziegler- Green Co EM

Anthony Rauterberg- Watertown FD

Diana Quinn- SSM Health

Jeff Ethington- UW Health OPO

Jim Oleson- WI DHS

Ann Zenk- WHA

Traci Lindsey- SCWAHEC

Jennifer Behnke- SCWIHERC

September 19, 2023 Membership Meeting

How would you describe the communities we serve?

SCWIHERC 9-19-23 Meeting Notes

Recording:

https://us06web.zoom.us/rec/share/RkZE5-Yn4kbKo0YmbprUKT6Oma22-tvuZ9-PEWL56ojOJeYNDb7FIJHKZ8S4VWo8.RTUAf6dYYceI-eyx

Passcode: see email from Jennifer on September 21                                                                    

Hospital:

-Belle Koch of Sauk Prairie Healthcare gave an overview of a recent incident where a 2” water pipe burst and flooded their OB unit and seeped into several other areas, refer to recording for details.

-Mike Stephens of Fort HealthCare gave an overview of a recent event where severe weather resulted in a power outage causing the hospital to run on generator power for over 3 days including one of the chillers.  Refer to recording for details.

-These events prompted a discussion on eICS (electronic ICS platform) and how hospitals use mass notification software (emergency notifications vs open clinical shifts), and who receives those.

-All HERCs have access to eICS and use it at a regional level to document response.  All partners have the ability to link into SCWIHERC’s eICS for two-way information sharing.  Follow up note: there is no discount for eICS through SCWIHERC.

-We held our hospital representative election after reviewing the nominations and bios of two candidates.  Mike Stephens of Fort HealthCare was elected as the new hospital rep.

-Next hospital forum meeting is October 19 at noon, where we will do an overview and demonstration of RMCC operations.

Membership:

SCWIHERC Updates: This year’s specialty annex theme is chemical hazards surge.  SCWIHERC will be drafting a specialty surge annex on chemical hazards, and then we will conduct a TTX on this hazard at our May meeting.  Additionally, we have a grant requirement of conducting a TTX on our Crisis Standards of Care Concept of Operations, which will be integrated into the chem surge tabletop.  We will also be facilitating another Medical Response and Surge Exercise. 

SCWIHERC Leadership is also working with other HERCs statewide on strategies to support long-term sustainability of the HERCs, and will periodically update at future SCWIHERC meetings.

Some recent updates with our Board of Directors: Aurielle Smith was re-elected to serve as Chair, Dave Kitkowski was elected to serve as Vice Chair, and Mike Stephens was elected as the new hospital representative at this meeting.

We reviewed a presentation and several resources related to whole community planning.  The group came up with the word cloud featured above to describe the communities we serve.

The resources mentioned in this presentation are listed here, please note the addition of the CDC Places resource since the agenda was shared.  Refer to the recording for the discussion and slides.

Whole Community Planning Resource Links:

  1. ACEP PLANNING CONSIDERATIONS FOR PERSONS WITH ACCESS AND FUNCTIONAL NEEDS IN A DISASTER: https://www.acep.org/siteassets/sites/acep/media/disaster-medicine/planning-for-persons-with-functional-needs-in-a-disaster.pdf
  2. ASPR Presentation Reviewing NACCHO Capacity-Building Toolkit: https://www.eventscribe.com/uploads/eventScribe/PDFs/2019/6206/895787.pdf
  3. CDC Access and Functional Needs Toolkit: https://www.cdc.gov/orr/readiness/00_docs/CDC_Access_and_Functional_Needs_Toolkit_March2021.pdf
  4. CDC/ATSDR Social Vulnerability Index: https://www.atsdr.cdc.gov/placeandhealth/svi/index.html
  5. CDC PLACES: Local Data for Better Health: https://www.cdc.gov/places/index.html
  6. CMIST Framework: https://www.phe.gov/emergency/events/COVID19/atrisk/discharge-planning/Pages/CMIST-framework.aspx
  7. CMIST Update: https://disasterstrategies.org/blog-post/defining-functional-needs-updating-cmist-by-june-isaacson-kailes-disability-policy-consultant/
  8. FEMA Inclusion, Diversity, Equity, and Accessibility in Exercises Considerations and Best Practices: https://preptoolkit.fema.gov/documents/d/hseep-resources/idea_guide_final?download=true
  9. FEMA National Risk Index: https://hazards.fema.gov/nri/
  10. NACCHO Capacity-Building Toolkit for including Aging & Disability Networks in Emergency Planning: https://www.naccho.org/uploads/downloadable-resources/NACCHO_Aging-and-Functional-Needs-Planning-FINAL.pdf
  11. Prepared4ALL: https://nationalcenterdph.org/our-focus-areas/emergency-preparedness/prepared4all/online-training/
  12. Prepared Caregivers: https://www.caregiver.va.gov/support/docs/Prepared_Military_Caregivers_Disaster_Relief_Toolkit_Final.pdf
  13. Public Health is for Everyone: https://www.phetoolkit.org/

 

Sharing lessons learned and best practices:

Rock County Health Department has been working on a tool to make better informed decisions on where to set up Points of Dispensing sites, they will keep us posted and also submitted an abstract for the NACCHO Preparedness Summit.

We talked a bit about Air Quality issues over the summer, especially on communications and messaging with the public.  Strategized on sharing these messages through other leaders and offices so that the message wasn’t coming from public health, where we feel like there is messaging fatigue post-COVID.

Public Health Madison and Dane County shared their lessons learned from responding to this hazard.

Refer to recording for more details.

Next meeting will be November 14, 1-4PM

Meeting attendance:

Mike Stephens- Fort HealthCare

Lisa Herritz- Ho-Chunk Nation

Christal Foreyt- Gundersen Boscobel

Victoria Parker- Watertown HD

Michael Niles- Rock County HD

Karen Nsiah-Ababio- Rock County HD

Tom Ellison- UW Health

Nathan Bubenzer- UPH Meriter

Tina Strandlie- Stoughton Health

Dave Kitkowski- St. Clare Baraboo and SCWIHERC

Tammy Kingery- Gundersen Moundview

Carmen Mihlbauer-Luther- Reedsburg AMC

Ben Thompson- Mercyhealth

Emily Kosterman- Waupun Memorial

Angie Cohen- Grant Regional

Geana Shemak- Iowa Co HD

Ian Fisher- Marshfield Health System

Ken Van Horn- PH Madison and Dane County

Belle Koch- Sauk Prairie Healthcare

Steve Haskell- UW Health

Ed Somers- Clearview

Erin Hastert- Lafayette Co HD

Sally Blackborn- Memorial Hospital of Lafayette Co

Mike Hall- SSM Health Monroe/Janesville

Haley Schreiber- St. Mary’s Janesville

Mary Tessendorf- Monroe Hospital

Jason Witte- WI DHS EMS

Jeff Ethington- UW Health OPO

Brooke Fuchs- Rainbow Hospice

Kara Takes- Unified Therapy

Jessie Phalen- Sauk Co HD

Lynn Skatrud- Green Co HD

Paige Heinke- SSM Health Home Care

Sean Madison- NIPARC

Jodie Molitor- Sauk Co HD

Darienne Blair- Columbia Co HD

Carrie Meier- Dane Co EM

Aurielle Smith- PH Madison and Dane Co, SCWIHERC

Leanne Seifert- Watertown RMC

Taylor Fish- Sauk Co PH

Kelly Heysinger- Unified Therapy

Jennifer Behnke- SCWIHERC

May 17, 2023 Membership Meeting


Recording link and passcode: See email from Jennifer on May 20.
Hospital:
We discussed how hospitals should prepare for the Medical Response and Surge Exercise on June 14. The scenario will give each hospital a 20% surge of paper patients based on the bed survey responses. The premise of the exercise is that hospitals will then look at their real census and staffing on exercise day, and move through their paper patient surge to determine how many patients they can make room for, how many current admissions where they can expedite discharge, and whether they have enough supplies to care for the paper patients in this scenario. Please consider inviting your local EMS, interfacility transport, public health department, and emergency management reps to your hospital command center during the exercise. There will be a hotwash immediately after the conclusion of the exercise, and we will also talk more in-depth at our June Hospital Forum meeting (June 20 at noon) about how hospitals responded and overall themes, strengths, and areas for improvement.
Reminder that hospitals are asked to complete the MATCH survey to report their in-kind efforts on exercises and real events. These survey responses help the Hospital Preparedness Program meet our 10% grant matching requirement from the feds. Deadline for survey completion for this grant year is June 30 (we will ask again for activities starting July 1 next year). MATCH survey link: https://www.surveygizmo.com/s3/3321278/WHEPP-Exercise-and-Real-Event-Report-F-02007-06-2022
ABLS continues to be a hassle, without warning we learned ABA changed learning platforms about 6 weeks ago, current course progress was lost if the course wasn’t finished at that time, and users cannot find where to access the course on the new platform. Jennifer sent out an email on May 8 to all users on her master registration list requesting that they attempt to log in and find the course, and if it is not there, to reach out to ABLS (ABLS@ameriburn.org) to put in a support ticket. Users should do this before they attempt to resume the course, to be sure the course is actually there when they need it! Related to the Burn Surge Plan- don’t forget to share/post the burn plan activation one-pager so your staff know when and how to activate the burn plan. Link:
We reviewed the poorer than usual EMResource response rates, especially to mass casualty incident type events. Typically two root causes: training is needed to show staff how to do it correctly, or alerts are not getting to the staff tasked with responding. Remember that notification methods include text message (to personal or pass around phones), email, and voice alerts (robodial that can also go to a landline). Group expressed an interest in continued reminders to keep addressing the problem, Jennifer will also compile response rates and share soon. Remember that the success of the RMCC, and more importantly better patient outcomes, are supported when hospitals respond. This is the only way for the field to understand your current capabilities based on your current staffing and patient loads!
Membership:
Medical Response and Surge Exercise: Two specific injects written into exercise to engage local public health and emergency management. Please join your hospital command center in person so you can learn from each other and learn what you can offer each other in this scenario. Even if you cannot be there in person, your hospitals (or the exercise controllers) will reach out to you during the exercise for support on these injects. Please discuss with your staff how you would respond to these injects and add that to feedback survey or email to Jennifer.

SCWIHERC will be doing annual review of plans, making updates, and requesting documentation that your organization received our plans via DocuSign in Junem completion requested by June 30. This is an annual federal requirement that HERCs must meet to show the feds that we pr ovided these plans to our partners, your completion of the DocuSign is our official documentation for this requirement.

Several opportunities remain from now until June 30: Flyers for all are attached.
Media Relations Workshop June 1, 11 seats remain

Active Shooter Incident Management Basic for First Responders June 6 or 7, 60 seats remain

CMS Virtual Exercise June 21, room for 100 more organizations! Please continue to target and share this with long-term care facilities, hospices, home health agencies, ambulatory surgery centers, outpatient physical/occupational therapy providers, end stage renal disease (dialysis) providers, federally qualified health centers, rural health centers, and intermediate care facilities for individuals with intellectual disabilities. This exercise is customized to these audiences to help test their emergency operations plan, communication plan, and help them satisfy an exercise requirement!

Mark Paulson, WI DHS Radiation Protection Section Manager, joined us to give a presentation on their office and the support and resources offered. Refer to recording and remember that these resources can be reached 24/7 at 608-258-0099 (WI DHS emergency line).

We then proceeded through the tabletop exercise on a radiation injury scenario (SitMan link: ). This is here for your organization if you would like to review this scenario internally with your staff and leadership. https://drive.google.com/file/d/1W4BTeB51-XwBKA8e6L2PPiSjJ7tyoqjg/view?usp=share_link

Other helpful resources:

Radiation Emergency Assistance Center/Training Site: https://orise.orau.gov/reacts/index.html

WI DHS web page that links to a lot of the resources below and some WI specific guides: https://www.dhs.wisconsin.gov/radiation/protection/index.htm
Radiological Dispersal Device (RDD) Response Guidance Planning for the First 100 Minutes: Video and link to guidance https://www.dhs.gov/publication/st-frg-rdd-response-guidance-planning-first-100-minutes
First 100 minute guidance https://www.dhs.gov/sites/default/files/publications/nustl_rdd-responseplanningguidance-public_28oct2021-508-revised.pdf
CDC Population Monitoring and Reception Centers: https://www.cdc.gov/nceh/radiation/emergencies/populationmonitoring.htm?msclkid=79e6b5b7d14411ec9ad290c77bf9f899
Guide to operating shelter during a radiation emergency: https://www.emergency.cdc.gov/radiation/pdf/operating-public-shelters.pdf
Points of Dispensing to Community Rection center planning toolkit: https://www.cdc.gov/nceh/radiation/emergencies/pdf/POD_to_CRC_Planning_Tool-508.pdf
Video and job aid for screening people for external contamination: https://www.cdc.gov/nceh/radiation/emergencies/screeningvideos/index.htm
Just in time training resources and quick reference guides for clinical staff: https://orise.orau.gov/resources/reacts/references.html

Radiation Injury Treatment Network: https://ritn.net/

ASPR TRACIE: https://asprtracie.hhs.gov/technical-resources/32/radiological-and-nuclear/27

Some strengths and areas of improvement from our discussion will be captured and shared in a brief after action report and improvement plan in the next few weeks.

Next meeting in new grant year yet to be scheduled, but likely in September, watch email!
Meeting attendance:
Lisa Herritz- Ho Chunk Nation
Jim Abitz- Southwest Health
Angie Cohen- Grant Regional
Steve Haskell- UW Health
Belle Koch- Sauk Prairie
Jodi Moyer- Beloit Health System
Matt Christian- Marshfield Medical Center Beaver Dam
Nathan Bubenzer- Meriter UPH
Lyle Kratochwill- Richland Hospital
Carmen Luther- Reedsburg AMC
Diana Quinn- SSM Health
Chad Atkinson- Mercyhealth
Christal Foreyt- Gundersen Boscobel
Dave Larson- Madison VA
Paige Heinke- SSM Health
Colleen Wilson- Waupun Memorial
Mike Hall- Monroe Hospital
Carol Quest- Watertown PH
Eric Anderson- Dane County EM/EMS
Dave Kitkowski- St. Clare Baraboo
Joe Meagher- Dodge County EM
Sharon Rateike- St. Mary’s Janesville
Lisa Peters- Gundersen Moundview
Tom Ellison- UW Health
Tammy Kingery- Gundersen Moundview
Leanne Seifert- Watertown RMC
Carmen Carpenter- Iowa County PH
Brent Skiba- Watertown RMC
Mike Stephens- Fort Health Care
Loni Hefner- Access Community Health Centes
Samroz Jakvani- Jefferson County PH
Hannah Sedlacek- Adams County HHS
Victoria Parker- Watertown PH
Matt Bartol- Dodge County EM/PH
Erin Hastert- Lafayette County PH
Kimberley Spurgeon- Family La Clinica
Lynn Skatrud- Green County PH
Michael Niles- Rock County PH
Jeff Kindrai- Grant County PH
Stacy Blakemore- Sauk Co EM
Gary Ziegler- Green County EM
Josh Kowalke- Reedsburg Area Ambulance
Roman Mullen- Dodge County PH
Carol Brown- Rainbow Hospice
Lisa Schweitzer- SSM Health
Sarah Jensen- Marquette County PH
Mark Paulson- WI DHS
Aurielle Smith- Public Health Madison and Dane County, SCWIHERC
Mike Lohmeier- SCWIHERC and UW Health
Dan Williams- SCRTAC
Jennifer Behnke- SCWIHERC

March 22, 2023 Membership Meeting

SCWIHERC 3-22-23 Meeting Notes

Recording: See email from Jennifer on March 24 for link and passcode.

Hospital:

We discussed the end of the Public Health Emergency and how the hospitals are modifying policies in response.  There is quite a bit of variability in policies regarding masking for patients, visitors, clinical and non-clinical staff.  This is an evolving topic and those still requiring masking continue to discuss and prepare for changing those policies soon. 

We discussed the DASH Tool and many had an opportunity to use it since our last meeting.  Consensus is that the tool is straightforward and easy to use. https://dashtool.org/ Related webinar: https://files.asprtracie.hhs.gov/documents/aspr-tracie-disaster-available-supplies-in-hospitals-dash-webinar-ppt.pdf   Many noted that their current inventory management systems also account for certain scenarios and increased burn rates that are also considered by the DASH Tool. 

Next Hospital Forum is April 12 at noon, will resume discussion on TJC New Emergency Management Standards that was started in February.

Membership:

SCWIHERC is planning several activities before June 30:

ActivityTarget AudienceNotesProposed Date(s)
Radiation Injury Annex Review and TTXEveryoneNext Regional MeetingMay 17- scheduled!
Medical Response and Surge Exercise (MRSE)Hospitals, everyoneVirtual functional, about three hoursJune
CMS Partners Virtual ExerciseSNF, Home Health, Hospice, Amb Surgery Ctrs, ESRD providers, PT/OT, FQHC, RHC, ICFIIDVirtual functional, about three hoursJune
Media Relations WorkshopPartners who deal with the mediaIn-person workshop, 6-8 hoursJune
Active Shooter Incident Management Basic (with TtT)First RespondersStudents: 4 hour slots over two days Trainers: both full daysJune
Tech Systems In-service (EMResource, EMTrack, eICS, WEAVR)Anyone who uses any of these systems and wants to learn more/needs a refresher (new staff!)Virtual over Zoom, come and go for each session (60-90 min) as you wishMay

All activities will be promoted by email when the dates are confirmed and registration is available.

Final HVA is available and posted to SCWIHERC shared drive.  Of note: supply chain, staffing shortage, and workplace violence have all moved up in ranking, and are recent additions to the HVA.

We had a lengthy discussion on Supply Chain.  This is our #7 ranking hazard on our regional HVA.  Vulnerabilities exposed or exacerbated by pandemic continue to exist today.  This topic is emphasized by HPP grant and ASPR TRACIE because it is so impactful to response to all hazards!

Refer to the discussion questions in separate attachment, and this resource: https://files.asprtracie.hhs.gov/documents/aspr-tracie-partnering-with-the-healthcare-supply-chain-during-disasters.pdf 

Organizations are encouraged to facilitate internal discussion on this topic.

Refer to the recording for full discussion, some very high level themes and takeaways:

-Supply chain for both pharmacy and other materials is incredibly complex.  We appreciate our materials management partners for everything they do to obtain the supplies we need to care for patients.  Maintaining relationships with vendors is critical.

-Pharmacy shortages are not new but possibly more prevalent now.  Constant state of reaching out to health system motherships, retain pharmacies, other potential sources.  Entire pharmacy roles exist just to modify formularies and communicating changes to clinical staff is constant.

-The task of balancing is constant: just in time delivery and lean principles vs paying and storing a glut of supplies that may never be used.  This is a struggle for all orgs.

-Small wholesalers and creative partnerships and resources have been a lifeline in the past: homemade supplies, partnering with others who can produce items we need (face shields, hand sanitizer, 3D printing)

-Suggested systemic measures to improve situation include government incentives for increased production, onshore/domestic production to significantly cut lead and shipping time could relieve allocation pressure. 

What are we concerned about right now?  ED Boarding, lack of post-acute care discharge beds, lack of transportation for patient transfer, delayed care keeping acute care busy, ED is the primary care of last/only resort so they stay full.  Chronic issues!

  • Meeting attendance:
  • Angie Zastrow- Rainbow Hospice
  • Nathan Bubenzer- UPH Meriter
  • Chad Atkinson- Mercyhealth
  • Belle Koch- Sauk Prairie Healthcare
  • Gary Trulson- UW Health
  • Jessica Palzewics- Marshfield Medical Center Beaver Dam
  • Jodi Moyer- Beloit Health System
  • Karmen Bryer- Beloit Health System
  • Bob Swenarski- St. Mary’s Janesville and SCWIHERC
  • Nikki Ripp- Adams County HHS
  • Casey Farnum- UW Health
  • Loni Hefner- Access Community Health Centers
  • Seaton
  • Chris Brownell- Grant Regional Health Center
  • Dave Larson- Madison VA
  • Lynn Skatrud- Green County HD
  • Mary Crowley- Juneau County HD
  • Lori Mertens Pelliteri- Dean Clinics
  • Christal Foreyt- Gundersen Boscobel
  • Jane Lentz-Gervais- Adams Co EM
  • Colleen Wilson- Waupun Memorial
  • Marie Darling Ellis- Columbia County HHS
  • Diana Quinn- SSM Health
  • Bill Sobaskie- Madison VA
  • Mike Hall- Monroe Hospital
  • Leanne Seifert- Watertown Regional Med Ctr
  • Lisa Herritz- Ho-Chunk Nation
  • Carmen Mihlbauer-Luther- Reedsburg Area Med Ctr and SCWIHERC
  • Tina Strandlie- Stoughton Health
  • Daniel Pease- Town of Beloit Fire
  • Carmen Carpenter- Iowa Co HD
  • Eric Anderson- Dane County EM/EMS
  • Charlie Johnson- St. Mary’s Madison
  • Kimberley Spurgeon- Family Health La Clinica
  • Hannah Sedlacek- Adams Co HHS
  • Jeff Kindrai- Grant Co HD
  • Jason Witte- WI DHS EMS
  • Erin Hastert- Lafayette Co HD
  • Kara Takes
  • Jessie Phalen- Sauk Co HD
  • Paige Heinke
  • Patti Miller- City of Beloit EM
  • Gary Ziegler- Green Co EM
  • Matt Bartol- Dodge Co PH/EM
  • Michael Niles- Rock Co HD
  • Samroz Jakvani- Jefferson Co HD
  • Sarah Jensen- Marquette Co HD
  • Matt Christian- Marshfield Medical Center Beaver Dam
  • Sally Blackbourn- Memorial Hospital of Lafayette Co
  • Dan Williams- SCRTAC
  • Mike Lohmeier- SCWIHERC and UW Health
  • Jennifer Behnke-SCWIHERC

January 25, 2023 Membership Meeting

SCWIHERC 1-25-23 Meeting Notes
Recording: see email from Jennifer on January 26.
Hospital Meeting:
ABLS update: still have seats left, still have hospitals in region that haven’t used their seats. All unused seats that were previously earmarked for a hospital in our region will be given up to the first come, first served pool in the region and state if unclaimed after February 10. Then facilities may request extra seats, and other regions may use them as well. Jennifer will send a separate email on this with a specific breakdown of how many seats remain from initial allocation for each facility.
Burn Plan one page quick reference guide: Identified need for this resource after debriefing from Pulaski bonfire incident, wanted to make a resource available for frontline ED staff to know how to activate the burn plan and where to find more information. Please educate your staff on this resource and post where it will be available to them: (in shared drive)
Med shortages: If a medication shortage has been raised to a level of significance that your EOC/IC within your facility is aware of it, please share with Jennifer to be shared for situational awareness to the region (facility will be de-identified), state, feds. State and feds need significant lead time to act on this info, so earlier is better!
Question on readily available safety references and resources for staff that can be included in newsletters etc? Looking for something that has already been created to minimize recreating the wheel. If you identify any, please share with Jennifer.
Public Health Emergency was extended until April, but how are we getting ready to transition to operations after PHE expires and going back to “new” normal? Please start to discuss with your team and share any checklists or resources you have started in anticipation of this task. Jennifer will also look for resources and discuss with other HERC Coordinators.
Anyone using the DASH Tool? Disaster Available Supplies in Hospitals. https://dashtool.org/ Related webinar: https://files.asprtracie.hhs.gov/documents/aspr-tracie-disaster-available-supplies-in-hospitals-dash-webinar-ppt.pdf Recommend entering your information in these forms to find out what your numbers are to start planning and making the case for carrying this inventory of these supplies. Will revisit with March supply chain meeting to continue discussion.

Will discuss new TJC EM standards at next hospital meeting, please bring your questions and discussion points for the group.

Membership Meeting:
Plug for WEM Governor’s Conference, registration and agenda info: https://wigcot.eventsair.com/2023-wisconsin-governors-conference-on-emergency-management-homeland-security Starts end of February in West Madison/Middleton.
HVA Survey due February 24, see email from Jennifer on January 24 for link.
Exercise update: currently soliciting bids for Medical Response and Surge Exercise (MRSE). Must be completed by June 30, goal of exercise day between May and early June. Exercise info: https://aspr.hhs.gov/HealthCareReadiness/guidance/MRSE/Pages/default.aspx Seeking exercise design team members, please email Jennifer if interested! Also NucRad TTX based on draft surge plan to be held May 17 as part of SCWIHERC meeting. NucRad is topic for this year’s specialty surge.
March 22 meeting will have supply chain integrity theme, please invite your internal and external (vendor) supply chain partners!
Anticipating funding to continue SALT Triage Ribbon and RMCC training project this spring, target audience is EMS providers but we should probably offer at least one more session for hospital audience, only about half participated in May 2022.
SCWIHERC is planning a virtual information sharing systems in-service day in late spring, more hands-on approach for using various systems (EMResource, EMTrack, eICS, others?). More info to come.
Sam Anderson, WI DHS OPEHC Training and Exercise Coordinator Samuel.Anderson@dhs.wisconsin.gov Sam talked about the training needs assessment survey results, statewide results included in email from Jennifer January 25 but regional results will also be compiled later. Looking at optimal and efficient planning with expensive course offerings (CHEC, BDLS, ADLS etc.) in the face of limited funding availability.
Presentations and extensive discussion on using EmPOWER tool, refer to recording. https://empowerprogram.hhs.gov/
Mandi Walsh, Health Preparedness and Response Ops Specialist mandi.walsh@dhs.wisconsin.gov
Ken Van Horn, Emergency Preparedness Coordinator, PHMDC KVanHorn@publichealthmdc.com
ONLY Local Health Officer or their designee can request the data! Recommend pulling practice data set out of PCA Portal and practicing sorting and deleting data to find what you need to take action. Ken will share his notes with LHDs when he has a chance.
While using/requesting the response data, we learned that we can speed up the request and implementation by making sure we knew how exactly we could share the files with only applicable people (easy on most systems, not on ours)and, after scrambling to find some people to help sort data on Dec. 23 right before a holiday, are putting together a list of people who can step in and are comfortable with this data set.
Note that coordination of safety checks should triage patients based on the type of device they are relying on and how emergent it is to life safety (cardiac devices, ventilators). Coordinate with your local EOC and EMS to create your own triage criteria. Pros and cons to using law enforcement officers to conduct safety checks: keeps fire/EMS free for response and other 911, but not all communities feel safe answering the door to law enforcement unannounced. Consider in your response planning!
Other current topics: Feds will not mobilize Tamiflu from SNS until all other local/regional resources have been exhausted. More info in email from Jennifer Friday, January 20. What else are we focusing on? Staff burnout and wellbeing. Remember that “Now What?” modules are available on demand from SCWIHERC shared drive under best practices, resiliency. These are in five units and can be used one at a time at small staff meetings etc.
Next meeting: March 22, 1-4PM.
Meeting attendance:
Jane Lentz-Gervais, Adams Co EM
Josh Kowalke, Reedsburg Area Ambulance Service
Mary Crowley, Juneau Co PH
Lynn Skatrud, Green Co PH
Dave Kitkowski, St. Clare Baraboo,
Gary Ziegler, Green Co EM
Victoria Parker, Watertown PH
Ken Van Horn, PH Madison and Dane Co
Tom Ellison, UW Health
Roman Mullen, Dodge Co PH
Nick Metz, Upland Hills Health
Lori Mertens Pelliteri, Dean Clinics
S Eaton, Community Health Systems
Charlie Johnson, St. Mary’s Madison
Lisa Herritz, Ho Chunk Nation
Colleen Wilson, Waupun Memorial
Marie Ellis, Columbia Co PH
Christal Foreyt, Gundersen Boscobel
Ian Fisher, Marshfield Medical Center Beaver Dam
Carmen Luther, Reedsburg Area Medical Center
LuAnn Reuter, Prairie Ridge Health Columbus,
Chad Atkinson, Mercyhealth Janesville
Mike Stephens, UW Health
Jodi Moyer, Beloit Memorial
Emily Kosterman, Waupun Memorial
Sally Blackbourn, Memorial Hospital of Lafayette County
Sarah Jensen, Marquette Co PH
Steve Haskell, UW Health
Colton Ritchie, PH Madison and Dane Co
Dave Larson, Madison VA
Belle Koch, Sauk Prairie Hospital
Katie Budack, Grant Regional
Jennylynde Packham, UW Health Rehab Hospital
Leanne Seifert, Watertown Regional Medical Center
Kimberley Spurgeon
Carol Brown, Rainbow Hospice
Mike Hall, Monroe Hospital
Nathan Bubenzer, Meriter
Tammy Kingery, Gundersen Moundview
Joe Meagher, Dodge Co EM
Jim Abitz, Southwest Health
Mary B, Jefferson Co HD
Bob Swenarski, St. Mary’s Janesville
Keith Hurlbert, Iowa Co EM
Diana Quinn, SSM Health
Angie Cohen, Grant Regional
Dan Williams, SCRTAC
Aurielle Smith, PH Madison and Dane Co
Jeff Kindrai, Grant Co PH
Carrie Meier, Dane County EM
Samroz Jakvani, Jefferson Co PH
Matt Bartol, Dodge County PH/EM
Madison Dillinger
Jodie Moliter, Sauk Co PH
Annie Fridh, Community Health Systems
Carly Tibbits, Iowa Co PH
Patti Miller
Cara MacKenzie
Karen Greenwald, Dodge Co PH
Alesha Erdenberger
RoAnn Warden, Green Co PH
Mary Tessendorf, Monroe Hospital
Julie Staffin, Mayville EMS
Sam Anderson, WI DHS OPEHC
Mandi Walsh, WI DHS OPEHC
Jennifer Behnke, SCWIHERC

November 9, 2022 Membership Meeting

SCWIHERC 11-9-22 Meeting Notes

Recording: https://us06web.zoom.us/rec/share/PQWEweQMuvett1Y6doMZ2uxAiWsRWIxKJ2e-ShmfTi13VDo0zbQRmaUqARLRCylN.FFBdmVxW9rubyYJ7
Passcode: See email sent November 10

Hospital Meeting:
EMResource reminders- PEDs surge bed count, update at least once daily, not going away as long as surge is an issue. PEDS ED Boarders expected to go up

ABLS- next batch expiring in February, sending periodic updates. Seat allocation: 5 nonphysician seats for each level III, IV and unclassified, 12 nonphysician setas for each level I and II. 2 physician seats for each hospital. Reach out at any time to enroll new students, check assignment, with other questions.

Open discussion: violent patients and patient security screening. Barriers to implementation- staffing. Seeing increase in threats from patients/visitors. Not necessarily weapons, but more physical aggression/assault directed at staff. Is incidence increasing, or reporting increasing? Both. Increasing visitors d/t decreasing COVID restrictions is a factor.
De-escalation options: Crisis Prevention Institute Nonviolent Crisis Intervention, MOAB (management of aggressive behavior), increasing posted signage on patient/visitor behavior expectations, higher security presence in facility, DT4EMS, active threat drills at service level. Safety solution in another state: installed hotel safes in trauma bays to store contraband/weapons while the patient was admitted, have security staff move weapon off patient. Some states have quite intensive security screening procedures compared to us. Shared escalation policy- green, yellow, red, full lockdown, policy shared by email November 10.

HCID discussion: need a review of Ebola state ConOps and how ETCs/Regional Treatment Centers are involved, include transportation plan.

Membership Meeting:

Leadership review SCWIHERC and OPEHC: http://www.scwiherc.org/category/who-are-we/ or first tab of Coalition phone book in SCWIHERC shared drive.

Fiscal and Sustainability Update- The HERCs have been presented with a lot of new policies that impact how we do business. Grant funds are only reimbursable after expenses have been incurred, so how do we solve cash flow to pay for vendors and services up front? Historically have had the benefit of having a fiscal agent, but now that we are an incorporated legal entity, this is not allowed anymore. Current coping mechanism is HERC staff have been putting expenses on personal credit, which is not advisable or sustainable. To better explore options, SCWIHERC will be recruiting a Sustainability Coordinator to explore our options for revenue sources and cash flow issues. Sustainability Coordinator Request for Application emailed and posted to scwiherc.org on November 10. SCWIHERC Board welcomes any and all suggestions and ideas on how to cope with these issues. Additional fiscal policies that have been recently updated include a Net 30 days from submission turnaround time on funding disbursement, we cannot spend grant funds on food, any HERC travel is reimbursed at the state rate (previously was federal rate), must use state procurement guidelines for competitive bids, and all HERC expenses must be explicitly approved by the state ahead of time to be reimbursed.

Training, Exercises, SALT Triage and RMCC Project and Training: Training needs assessment was sent out October 26, sent again November 10, due Nov 30. Your input is requested and valued!

Working on request for application to find a contractor to assist with planning and conducting our Medical Response Surge Exercise (MRSE), which replaced the Coalition Surge Test (CST) from the before COVID times. This exercise will also test our pediatric surge plan to satisfy another grant deliverable. Plan to use a Wisconsin Dells peak tourism season scenario for surge. Other planned TTX is for radiological surge, which is the topic of our specialty surge annex this year.

Still continuing with SALT Triage and Regional Medical Coordination Center project and training. Offered 5 first receiver train the trainer sessions in May, about half of hospitals participated. Still hoping to have other hospitals participate, please reach out to plan a regional training or to request triage ribbon kits or replacement ribbons. Youtube training video for hospitals: https://www.youtube.com/watch?v=N7OG8a7vXnE

Also continuing to offer similar training to EMS agencies in the region, also incorporating training on RMCC resource-activation and coordination. Reach out to schedule these sessions!

Will Koehne, WI DHS OPEHC Epidemiologist, gave an interview of Hospital Dashboards on PCA Portal, review recording, email Jennifer or Will William.koehne@dhs.wisconsin.gov for access. Other systems’ discussion deferred at this time.

RSV surge- Please update bed count (green banner) daily! What will be the issues with PEDs surge? Short on pediatric providers and staff for both ED and inpatient. Some have developed some education for nursing and family practice to augment clinical care- partner with your respiratory therapy! Jennifer will forward clinical resources from the National Pediatric Disaster Coalition/AAP to hospitals.

No reports of diesel fuel shortage in the region at this time, but have seen elsewhere in the state. Be sure you have a priority contract with your vendor and please relay any news of shortages to Jennifer and your county emergency manager for situational awareness.

No reports of albuterol shortage in the region at this time, but have seen elsewhere in the state. Reports of etomidate, fentanyl, and racemic EPI shortages.

Doug Hill gave an update on Crisis Standards of Care. Note that Wisconsin Hospital Mutual Aid MOU will be sunsetting and not renewed, due to a lack of interest from hospital leaders and WHA. Refer to recording and this 2010 WHA document he referenced: https://www.wha.org/WisconsinHospitalAssociation/media/WHACommon/EmergencyPrep/HospitalsGuideforMassCasualtyEvents6-2010.pdf
Doug Hill can be reached at djh1967@gmail.com

Meeting attendance:
Matt Bartol- Dodge County HHS, EM
Tom Ellison- UW Health
Lyle Kratochwill- Richland Hospital
Christal Foreyt- Gundersen Boscobel
Mary Crowley- Juneau Co HD
Amanda Diedrich- Juneau Co HD
Sarah Jensen- Marquette Co HD
Jodi Moyer- Beloit Health System
S Eaton
Donna Haugom- Jefferson Co EM
Tina Strandlie- Stoughton
Belle Koch, Sauk Prairie Hospital
Carmen Luther- Reedsburg Area Med Ctr
Jim Abitz- Southwest Health
Ron Krause- Mercyhealth
Matt Christian- Marshfield Med Ctr Beaver Dam
Jennylynde Packham- UW Health Rehab
Dan Williams- SCRTAC
Adrianne Bonow
Eric Anderson- Dane County EM
Dave Larson- Madison VA
Mike Stephens- UW Health
Steve Haskell- UW Health
Nathan Bubenzer- Meriter UPH
Katie Budack- Grant Regional
Dave Kitkowski- St. Clare Baraboo
Sam LaMuro- Fort HealthCare
Jodie Molitor- Sauk Co HD
Nina Gregerson- PH Madison and Dane County
Leanne Siefert- Watertown Regional Med Ctr
Karen Greenwald- Dodge Co HD
Kimberley Spurgeon- Family Health La Clinica
Heather Poker- St. Mary’s Madison
Tammy Kingery- Gundersen Moundview
Samroz Jakvani- Jefferson Co HD
Laura Kane- UW Health
Sally Blackbourn- Memorial Hospital of Lafayette Co
Carrie Meier- Dane Co EM
Sharone Rateike- St. Mary’s Janesville
Elizabeth Chilsen- Jefferson Co HD
Nick Metz- Upland Hills Health
Victoria Parker- Watertown HD
Lynn Skatrud- Green Co HD
Emily Kosterman- Waupun Memorial
Jane Gervais- Adams Co EM
Jeff Kindrai- Grant Co HD
Colton Ritchie- PH Madison and Dane County
Ken Van Horn- PH Madison and Dane County
Tanna McKeon- Green Co EM
Debbie Siegenthaler- Iowa Co HD
Andrea Murleau
Madison Dillinger
Chad Atkinson- Mercyhealth Janesville
Will Koehne- WI DHS OPEHC
Doug Hill- CSC Project
Aurielle Smith- PHMDC and SCWIHERC
Mike Lohmeier- UW Health and SCWIHERC
Jennifer Behnke- SCWIHERC

June 15, 2022 Membership Meeting

June 15 SCWIHERC Membership Meeting Notes

Recording: https://us06web.zoom.us/rec/share/wYwuz5B6WVGw6soEGLGesQok22HqbqntjDjYXnPow9qNH43d4sWKCVrDmKeEdd9q.uli6SRc1SaAX19OL

Passcode: See email sent June 15

Reminder that DocuSign signatures for annual plan review are due June 30.  Reminder email was sent directly to signer on file for your organization.  Will resend any unsigned plans 7-10 days before deadline.

Upcoming Trainings and Information:

Course Location Date Link if available
MGT-341; Dis. Preparedness Hosp/HC Spooner October (TEEX still determining exact date)
MGT-341; Dis. Preparedness Hosp/HC Fox Valley Tech T.C. July 26-27 https://my.teex.org/TeexPortal/Default.aspx?MO=mCourseCatalog&D=EU&C=MGT341&S=476
CISM – Group Columbia Sheriff Office June 17-18 Contact HERC coordinator
AWR-331; Winter Weather Lincoln County 27-Sep https://ndptc.hawaii.edu/training/delivery/3120/
AWR-232; Mass Fatalities Planning Oneida County Sheriff 29-Jun

 

 

SCWIHERC Exercises

-Medical Response Surge Exercise – Replaces Coalition Surge Test.  Planning to start this summer.  Tie into DARES scenario?

-Pediatric Surge TTX – As part of MRSE exercise/scenario?

Annual Plans Review:

After plans are reviewed and updated, Docusign process, same as last year.  Sent to every core organization except EMS (which will be sent June 16), signatures due by June 30.

Scholarships:

Scholarship opportunities start July 1!  $2,000 aggregate limit per active member (must provide proof of participation in 2 SCWIHERC events in previous 365 day period), must meet other application requirements.  Valid on conference registration fees, travel (mileage/flight/lodging). Scholarship opportunity excludes PHEP recipients, please use PHEP funds!

Burn Surge Plan Review and Tabletop Exercise: SitMan and slides available in Shared Drive, also review recording.

Hospital Meeting:

ABLS:

Is a mess, please continue to send your registered student information, please be patient and standby!  Student will receive an email when successfully enrolled and course is accessible.

SALT Triage First Receiver Train the Trainer

Resuming this project after COVID delay. Three facets of training/maintaining staff proficiency:

  • SALT Triage First Receiver video, which should be viewed by anyone in your organization who might be put to the task of triage in the event that you have an MCI in your community that would result in self-presenting patients. Link: https://youtu.be/N7OG8a7vXnE
  • Train the Trainer sessions for our Champions to review the concepts and receive training on our SALT ribbon bags, see emailed out April 27.  We will distribute the ribbon bags for your facility to your Champion at these trainings.
  • Your Champions bring their training and ribbon bags back to your facility, where they train your other staff on these SALT triage concepts, and how to use the ribbon bags, and maintain a regular competency program for your new hires and as part of annual training for current staff.

About half of hospitals have received their bags and participated in our SCWIHERC trainings in mid-May.  Direct outreach to hospitals that haven’t is forthcoming.  We really encourage all of our regional hospitals to join this project to ensure they have staff that know how to field triage self-presenting patients and their triage methods are consistent with EMS field triage.

CSC Updates: Doug Hill

Wisconsin Hospital Mutual Aid MOU- There is not a strong statewide desire to renew this document as a state.  Opportunity to develop regional MOUs if desired, (what are next steps/follow up?)

CSC Concept of Operations- Doug Hill is developing as part of grant deliverables, but it leans more along the lines of allocation of scarce resources than crisis standards of care.

CSC Article: https://www.tandfonline.com/doi/full/10.1080/15265161.2021.1925778 PDF of article available in Best Practices Folder of shared drive.

GE IV Contrast Shortage- Looks like we’re coming out of it. No current concerns.

TJC EM Standards Update Resources:

From Wakefield Brunswick:

https://8233470.fs1.hubspotusercontent-na1.net/hubfs/8233470/2022%20WB%20TJC%20Standards%20Crosswalk.pdf?utm_medium=email&_hsmi=207521692&_hsenc=p2ANqtz-8dPgjm85QpnPpWdrX8hL1gewNlqdhFXI3TKJ3RQj94aWfzvV35_6ylXflyGk2iBM2kZVTOEAHyqcgKHFbUAe3jItIfTKK5kRgzctEhCiWw3v73pVQ&utm_content=207521692&utm_source=hs_email

https://vimeo.com/678545023/05ccb3f28a?utm_medium=email&_hsmi=213264864&_hsenc=p2ANqtz–YF8DR8UWsCCEpSDw2u7Ia-GOcd8m0JFWlXuLfmKMfQ81o-zjbMvb93-rVgSKR4oMXb_LUZJFofUzC7UnNeuS3NiTG5U6Nr-NUjcoW9bZMxb_yh4M&utm_content=213264864&utm_source=hs_email

AHEPP Webinar June 15 1100 recording will be posted to notes at http://www.scwiherc.org/june-15-2022-membership-meeting/ when available.

Lessons Learned and Best Practices from COVID-19 and other real events:

How are we remaining nimble for future variants/surge/vaccination/testing?

What else are we working on? Mass casualty drills, implementing SALT Triage in ED.

What else are we responding to? Current event in Dane County from June 13 storm, widespread power outages including some persisting into 48+ hours (as of the time of these notes being written).  Compounded by heat advisory.  More widespread severe storms anticipated tonight through whole region and state, be prepared!  Current lessons learned:  cell networks were jammed immediately after power outage, don’t forget basics like Wireless Priority Service, WISCOM radio, GETS cards, FirstNet.  When SCWIHERC Responder has communication issues (Jennifer lost power during event and cell service was spotty for a few hours), that will be posted on EMResource under coalition header at top of page (hover over Jennifer’s name), and as out of office reply on email when possible, with further instruction.

Meeting Attendance:

Jane Lentz-Gervais- Adams County EM

Charlie Johnson- St. Mary’s Madison

Jeff Kindrai- Grant County HD

Brent Skiba- Watertown Regional Medical Center

Mike Tedeschi- NEWHERC

Lisa Herritz- Ho Chunk Nation

Joe Meagher- Dodge County EM

Jennylynde Packham- UW Health Rehab

Dave Kitkowski- St. Clare Baraboo

Katie Budack- Grant Regional Health Center

Matt Christian- Marshfield Medical Center Beaver Dam

Angie Cohen- Grant Regional Health Center

Doug Hill- CSC Coordinator

Tina Strandlie- Stoughton Health

Bill Ritzer- Reedsburg Area Medical Center

Galen Kennedy

Kara Takes- Unified Therapy

Diana Quinn- SSM Health

Lynn Skatrud- Green County HD

Michael Niles- Rock County HD

Nathan Bubenzer- UPH Meriter

Ed Somers Clearview Dodge County

Suzanne Schreiner- Adams County HHS

Rodney Punzel- UW Health

Julie Gorman- Sauk Prairie Healthcare

Jodie Molitor- Sauk County HD

Jen Hankwitz- UW Health

Brian Allen- Southwest Health

Michael Stephens- UW Health

Alice Salli- Mendota Mental Health Institute

Sam LaMuro- Fort HealthCare

Mary Tessendorf- Monroe Hospital

Steve Haskell- UW Health

Jim Abitz- Southwest Health

Carol Brown- Rainbow Hospice

Jennifer Lorenz- Mercyhealth Janesville

Kurt Hoeper- Upland Hills Health

Sarah Jensen- Marquette County HD

Sally Blackbourn- Memorial Hospital of Lafayette County

Lori Mickelson- UW Health Burn Program

Carmen Carpenter

Mike Hall- Monroe Hospital

Dave Larson- Madison VA

Dr. Mike Lohmeier- SCWIHERC

Jennifer Behnke- SCWIHERC

May 3, 2022 Membership Meeting

Join us for our membership meeting May 3: https://us06web.zoom.us/j/83510672818?pwd=eE9HcXBPNVhxVVdHUGJBbUxlRFVEdz09

Agenda:

May 3 SCWIHERC Membership Meeting Notes

Recording:

https://us06web.zoom.us/rec/share/oU9dLWPN8fbFNHiXINbtizeS-LweaQaCs90jb342-SdWhBUhPgcmnIjbkxEqyf_W.A1NakBNlcyg75sjN?startTime=1651599029000

Passcode: refer to email from May 3 or ask Jennifer

Reminder that COVID AAR survey is due May 27, see email sent April 23 for more info and link to survey.

Upcoming Trainings and Information:

CourseLocationDateLink if available
MGT-341; Dis. Preparedness Hosp/HC  Spooner  October (TEEX still determining exact date)   
MGT-341; Dis. Preparedness Hosp/HC  Fox Valley Tech T.C.  July 26-27  https://my.teex.org/TeexPortal/Default.aspx?MO=mCourseCatalog&D=EU&C=MGT341&S=476
CHEC – Basic & Advanced  Wausau  May 17-19  Contact HERC coordinator
CISM – Group  Columbia Sheriff Office  June 17-18  Contact HERC coordinator
AWR-331; Winter Weather  Lincoln County  27-Sep  https://ndptc.hawaii.edu/training/delivery/3120/
AWR-232; Mass Fatalities Planning  Oneida County Sheriff  29-Jun   
AWR-326; Tornado Awareness  Lake Delton  17-May  https://ndptc.hawaii.edu/training/delivery/3119/
MGT-439; Pediatric Disaster ResponseMilwaukeeMay 5 – 6Pediatric Disaster Response and Emergency Preparedness | TEEX.ORG

SCWIHERC Exercises

-Burn Surge TTX Due June 30 – Scheduled for NEXT SCWIHERC MEETING (Date TBD soon)

-Medical Response Surge Exercise – Replaces Coalition Surge Test.  Likely this summer.  Tie into DARES scenario?

-Pediatric Surge TTX – As part of MRSE exercise/scenario?

Annual Plans Review:

After plans are reviewed and updated, Docusign process, same as last year.  Goal to send out at beginning of June, signatures due by June 30.

ABLS:

Is a mess, please continue to send your registered student information, please be patient and standby!  Student will receive an email when successfully enrolled and course is accessible.

SALT Triage First Receiver Train the Trainer

Resuming this project after COVID delay. Three facets of training/maintaining staff proficiency:

  1. SALT Triage First Receiver video, which should be viewed by anyone in your organization who might be put to the task of triage in the event that you have an MCI in your community that would result in self-presenting patients. Link: https://youtu.be/N7OG8a7vXnE
  2. Train the Trainer sessions for our Champions to review the concepts and receive training on our SALT ribbon bags, see emailed out April 27.  We will distribute the ribbon bags for your facility to your Champion at these trainings.
  3. Your Champions bring their training and ribbon bags back to your facility, where they train your other staff on these SALT triage concepts, and how to use the ribbon bags, and maintain a regular competency program for your new hires and as part of annual training for current staff.

Lessons Learned and Best Practices from COVID-19 and other real events:

How are we remaining nimble for future variants/surge/vaccination/testing?

Hospitals: creation of a high consequence infectious disease plan/annex at the hospital level that details information regarding medical countermeasures, Strategic National Stockpile, volunteer management (including WEAVR), ASPR pandemic preparedness checklist (https://files.asprtracie.hhs.gov/documents/aspr-tracie-hcc-pandemic-checklist-508.pdf), PPE burn rate calculator (https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/burn-calculator.html), Acute Hospital Care at Home (see COVID-19 email update sent April 1), other healthcare at home initiatives.  Integrating COVID population back into hospital units (in negative pressure rooms) to free up COVID units but maintain them for additional surge readiness.

Local Health Departments: maintaining capacity for contact tracing, testing, and vaccination, cross training staff on all so they can meet current needs. Maintaining testing capacity with state contracts and private testing vendors.  Continue to meet with healthcare partners to maintain readiness.

Other Healthcare providers: continuing to practice good infection control practices including masking per CDC guidelines (https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html), working with local pharmacies to maintain testing and vaccination capacity

What else are we working on? Workplace violence training/escaping violent encounters, missing persons drills, hospital evacuation training, streamlining plain language alerts (getting away from code colors).  Public health also working on responding to higher rates of other communicable diseases, boosting childhood vaccination rates that have suffered during pandemic by promoting Vaccines for Children providers/enrollment, lead screening, home visits, starting WIC in person again.

We could do better on EMResource response rates, especially for MCI events.  Response to these alerts breaks down based on a number of factors, including staff turnover and not being able to keep up with training, how alerts are received, alert fatigue, being able to tell from an alert if something is informational only or requires action.  Will take back to discuss further at state level. EMResource resources are available in SCWIHERC shared drive -> EMResource.  Additional information and resources: https://www.dhs.wisconsin.gov/preparedness/systems/emresource.htm Reach out to Jennifer to troubleshoot/verify alerts/facilitate training.

Brian Kaczmarski, Statewide HERC Coordinator, gave a presentation on the state and regional High Consequence Infectious Disease Plans.  The current version of these plans as well as the slides from the presentation are available in the shared drive.  A resource mentioned during the presentation is the Dane County EMS Primer on Infectious Disease:  https://em.countyofdane.com/documents/pdfs/ems/Infection-Control-EMS-Primer-on-ID-7.11.19.pdf

We then transitioned into a tabletop exercise/discussion on a High Consequence Infectious Disease scenario.  The Situation Manual for this exercise is available in the SCWIHERC shared drive ->Exercise Templates. 

Meeting Attendance:

Josh Kowalke- Reedsburg Ambulance

Emily Kosterman- Waupun Memorial

Jeff Kindrai- Grant County Health Dept

Jodi Moyer- Beloit Memorial

Lynn Skatrud- Green County Health Dept

Elizabeth Chilsen- Jefferson County Health Dept

Lisa Herritz- Ho Chunk Nation Health

Andy Koehler- Fort Health Care

Angie Cohen- Grant Regional

Sam LaMuro- Fort Health Care

Jodie Molitor- Sauk County Health Dept

Tina Strandlie- Stoughton Health

Lyle Kratochwill- Richland Hospital

Jennylynde Packham- UW Health Rehab

Sarah Jensen- Marquette County Health Dept

Christal Foreyt- Gundersen Boscobel

Sarah Van Hoof- UW Health

Jessie Phalen- Sauk County Health Dept

Dave Kitkowski- SSM Health St. Clare Baraboo

Nikki Ripp- Adams County Health Dept

Tanna McKeon- Green County EM

Kara Takes- Unified Therapy

Michael Guss- Walworth County Health Dept

Dave Larson- Madison VA

Mike Stephens- UW Health

Lori Mertens Pelleteri- SSM Health

Brenda Totzke- Mile Bluff Medical Center

Sally Blackbourn- Memorial Hospital of Lafayette County

Mary Bender

Kelly Mitchell- UW Health

Ken Van Horn- Public Health Madison and Dane County

Carmen Carpenter- Iowa County Health Dept

Steve Haskell- UW Health

Aurielle Smith- SCWIHERC and PHMDC

Victoria Parker- Watertown Health Dept

Katie Budack- Grant Regional

Michael Niles- Rock County Health Dept

Kurt Hoeper- Upland Hills Health

Julie Gorman- Sauk Prairie Healthcare

Karen Sell- Prairie Ridge Health Columbus

Tammy Kingery- Gundersen Moundview

Jane Lentz-Gervais- Adams County EM

Brianna Juszczak- Mile Bluff Medical Center

Heidi Finucan- Mile Bluff Medical Center

Diana Quinn- SSM Health

Donna Haugom- Jefferson County Emergency Management

Julie Leibfried- Lafayette County Health Dept

Samroz Jakvani- Jefferson County Health Dept

Brian Kaczmarski- WI HERCs

Jennifer Behnke- SCWIHERC

December 1, 2021 Membership Meeting

December 1 SCWIHERC Membership Meeting Notes

Meeting Recording Link (will expire November 30, 2022): https://transcripts.gotomeeting.com/#/s/5cf0be5de39db689f4f6e1cb48dd4a53eeef6f86fa0aa3509f3d0de1a9bf5793

We started by reviewing EMResource user info and event notification preferences.  Both of these are found under the “Preferences” tab.  It is recommended that your ED HUC desk landline number be added to the EM Coordinator’s EMResource notification voice section under “Preferences” and “User info.”  Remember to click save when navigating away from this form.  Then go into event notifications and check the voice box for MCI region 5, MCI statewide/bordering regions, Bed Count region 5, Bed Count Statewide/bordering regions, general announcement region 5 and statewide/bordering regions, and any other alerts you want the ED to receive. Click save when navigating away from this form.  Be sure the EM Coordinator and any other appropriate users are receiving other important notifications such as resource request, be on the look out, Amber alert, etc.  Note that we have recently noted serious delays in notifications coming from certain events (seems to be tied to general announcement type events) and an escalated support ticket has been started with Juvare.

Anyone needing help setting up or verifying alerts, or refresher EMResource training with staff, should reach out to Jennifer.

We discussed the Regional Medical Coordination Center concept.  Any time an incident happens within SCWIHERC’s 14 county region, we may activate the RMCC to help the field determine where to transport patients from the field.  The recommended threshold for activation is 5 patients or more.  It is critical for hospitals to respond to the MCI alert within 15 minutes.  This helps the field help your facility by trying not to give you more than you can handle, which is important with high census right now.  If the needs of the field can’t be met with the numbers currently entered, you may be asked to refresh your bed counts accordingly.  Please also be aware that the field may send you at least one patient prior to receiving counts, which is also why your response is important.  If there is an MCI close to your facility, your facility should always expect to receive some patients from that scene.

We reviewed the EmPOWER and Social Vulnerability Index data.  Jennifer sent out the most recent update on October 20.  It is a grant deliverable to send this out twice a year.  There is a summary of numbers of electricity-dependent CMS beneficiaries broken down by county in this update, and there is a new spreadsheet that breaks out those beneficiaries based on categories like ventilators, oxygen tanks or concentrators, dialysis, electric mobility devices etc.  The spreadsheet contains tons of information and definitions.  These numbers are helpful for planning and should be shared with local planning partners.  The limitation to this data is it is all de-identified, so it doesn’t help us find these populations until after an emergency has occurred, therefore we don’t know how to use this list to the greatest benefit of our communities.  There are opportunities for whole community preparedness and collaboration with other providers, such as home health and hospice agencies, dialysis and durable medical equipment providers, to better prepare for caring for these populations.

General EmPOWER data can be found at: https://empowermap.hhs.gov/

The EmPOWER spreadsheet is obtained from HHS and uploaded to the PCA Portal where Health Departments and HERC Coordinators can retrieve it.

Social Vulnerability Index data is at https://www.atsdr.cdc.gov/placeandhealth/svi/index.html

Including county level data: https://svi.cdc.gov/prepared-county-maps.html

We had a discussion on several topics related to COVID-19 response:

Questions on how orgs are adapting their ICS structure to such a long event:  holding meetings virtually, relying on dashboards for info sharing, moving to weekly meetings.

Questions on how orgs are managing their AAR process:  several subsections or versions of AAR to cover different phases of pandemic.

Discussion around current visitor policies:  only allowing one visitor at a time, in some cases only one visitor per day (same person can come and go, but multiple visitors cannot).  Some variation with OB, PEDs, and end of life patients.  Offering or requiring visitors wear masks. No visitors for COVID positives or respiratory patients until COVID ruled out. Meriter shared external link to their policies: https://www.unitypoint.org/madison/coronavirus-updates-closings.aspx

Lots of discussion on how visitor policies have led to an increase in security and behavioral events due to visitors’ unwillingness to comply.

General discussion around coping with surge.  Facility closed urgent care to move staff to ED, but caused an uptick in ED visits.  Biggest barriers are staffing shortage, lack of physical room, extended wait for transfers, lack of transportation options.   Question on using Critical Care Paramedics to augment Respiratory Therapy in hospitals?  Also still asking for another ACF to decompress surge.

Shortage of post-acute care available beds, including noting problems with major variations from one facility to another in admission parameters (COVID history, how many days since COVID negative, patient can’t have visitors for 90 days after COVID (note that prohibiting visitors is not allowed and addressed by CMS here: https://www.cms.gov/files/document/qso-20-39-nh-revised.pdf)

Also don’t forget RAST resource for helping LTCF with outbreaks: https://www.dhs.wisconsin.gov/publications/p02883.pdf

Joe Cordova reviewed the resources for staffing assistance.  This process will be coming down officially in writing, but consists of: 2 attempts at WEAVR outreach (first doesn’t yield much, sometimes second does) WEAVR request procedure: https://content.govdelivery.com/accounts/WIDHS/bulletins/2f696ca. WI DHS staffing resource assistance (Jennifer emailed on Oct 1).  If those resources aren’t sufficient, email Joe (joseph.cordova@wi.gov) to discuss the process of applying for federal staffing assistance (Jennifer emailed the form and additional FEMA information to hospitals on November 20.  Do not submit this form to your local Emergency Manager, email Joe with questions).  Note that federal staffing requests are usually only granted for 2-3 week deployments, and that FEMA will want requestors to provide details both on how staff will be used, and what the facility’s plan for staffing is once the deployment, if granted, ends.

Finally, we shared identified needs and ideas for supporting staff mental health and resiliency.  With staffing being one of our biggest limiting factors, and staff burnout being one of the biggest causes, providing staff support should be an organizational priority.

Ideas shared include giving staff the opportunity to share their stories and know that they are not alone.  Having separate support groups for leadership where they can feel vulnerable.  Manager purchased the book ER Nurses by James Patterson and wrote a message of appreciation and admiration for each of them inside.  Offering support groups to staff.  Deployed a therapist to round on units for staff.  Hospital wellness coordinator shared materials and resources, Jennifer will try to get and share. “Managing the soft side of hard stuff.”  Jennifer shared debriefing that another colleague did for HERC staff, will look at SCWIHERC offering that in an anonymous and virtual environment where staff can just drop in and talk with their peers from outside their organization.  Will look at providing a separate offering for leaders so they have a safe space to feel vulnerable outside their normal management duties.

SCWIHERC Deliverables/Projects Update agenda item was not covered due to lack of time, will be covered at a future meeting.

Meeting attendance:

Chad Atkinson- Mercyhealth

Jeff Ethington- UW Health OPO

Joe Meagher- Dodge County EM

Diana Quinn- SSM Health

Lisa Herritz- Ho Chunk Nation

Steve Haskell- UW Health

Sharon Warden- Mile Bluff Medical Center

Kara T-Unified Therapy

Lori Mertens Pelliteri- SSM Health

Alice Salli- Mendota Mental Health

Mary Tessendorf- Monroe Hospital

Aurielle Smith- SCWIHERC and Public Health Madison Dane County

Jane Gervais- Adams Co EM

Mike Hall- Monroe Hospital

Tom Ellison- UW Health

Dave Larson- Madison VA

Asa Rowan- Beloit Area Community Health Systems

Jodie Molitor- Sauk Co HD

Kurt Hoeper- Upland Hills Health

Gail Scott- Jefferson Co HD

Bob Swenarski- St. Mary’s Janesville

Allison Davey- Green Lake Co HD

Keith Hurlbert- Iowa Co EM

Kathy Johnson- Columbia Co EM

Angie Cohen- Grant Regional Health Center

Tina Strandlie- Stoughton Health

Sarah Jensen- Marquette Co HD

Sam LaMuro- Fort Health Care

Amy Nehls- Dodge Co EM

Jeff Kindrai- Grant Co EM

Matt Byczek- UnityPoint Health

Jessie Phalen- Sauk Co HD

Ron Krause- Mercyhealth

Brenda Koehler-Borchardt- Watertown Regional Medical Center

Amanda Dederich- Juneau Co HD

Angie Zastrow- Rainbow Hospice

Laura Kane- UW Health

Josh Kowalke- Reedsburg Ambulance

Katrina Harwood- Rock Co HD

Christal Foreyt- Gundersen Boscobel

Suzanne Schreiner- Adams Co HD

Nathan Bubenzer- UPH Meriter

Carrie Meier- Dane Co EM

Julie Gorman- Sauk Prairie Healthcare

Brian Allen- Southwest Health

Samroz Jakvani- Jefferson Co HD

Megan Lee- UW Health

Russ Sprecher- St Clare Meadows

Julie Liebfried- Lafayette Co HD

Mike Stephens- UW Health

Michael Niles- Rock Co HD

Joe Cordova- WI DHS

Jennifer Behnke- SCWIHERC

SCWIHERC Hospitals See High Patient Volumes, Limited Resources – News Release

FOR IMMEDIATE RELEASE

September 10, 2021

Hospitals in South Central Wisconsin see high patient volumes, limited resources
Hospitals seek community help to prevent COVID-19 cases putting critical strain on regional healthcare systems

Hospitals and healthcare facilities throughout southcentral Wisconsin are experiencing a high volume of inpatients, limiting hospital beds and putting a strain on resources.

This serious situation is occurring across the 14 counties of the South Central Wisconsin Healthcare Emergency Readiness Coalition, (SCWIHERC). Its member hospitals are asking for our communities’ help.

To better control the situation, the hospitals are urging everyone to continue being vigilant with COVID-19 safety measures, such as receiving any COVID-19 vaccine, masking, and physically distancing where appropriate.

This present high volume of patients spans across critical care areas of the hospitals, like intensive care units (ICU), general medical floors, and emergency departments. With resources stretched, it is becoming more difficult to receive care close to home if you may need it for COVID and non-COVID-related illnesses.

From July 28 to Sept. 1, the total number of COVID-19 hospitalizations increased four-fold in the South Central region. In that same timeframe, there were 5.5 times the number COVID-19 ICU hospitalizations. Many rural hospitals have no or limited ICU capability and are all reliant on the same limited ICU beds in larger cities, including Madison.

While the current high volume in healthcare facilities in the region is a mixture of COVID-19 and non-COVID-19 patients, a rise in preventable COVID-19 admissions is a driving factor. Preventing a further rise in COVID-19 admissions is our focus in this critical time.

In fact, COVID-19 infections requiring hospitalization are increasing at a similar rate to last winter’s surge. With students from pre-K through college returning to classrooms, the Labor Day holiday, and colder weather soon driving people indoors, additional increases are expected which could stretch resources to critical levels.

To receive a COVID-19 vaccine, please contact your local healthcare providers, or visit the state Department of Health Services vaccine webpage.

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The South Central Wisconsin Healthcare Emergency Readiness Coalition (SCWIHERC) is a coalition that collaborates with 29 area hospitals and numerous other healthcare providers over 14 counties to prepare for and respond to emergencies in South Central Wisconsin.

SCWIHERC Members signing this message:

Organization Media Contact Name and Email (if provided)
South Central Wisconsin Healthcare Emergency Readiness Coalition Jennifer Behnke (jennifer.behnke@scwiherc.org)
Aspirus Divine Savior Hospital and Clinics Haley Gilman (haley.gilman@aspirus.org)
Beloit Health System Megan Goggin (mgoggin@beloithealthsystem.org)
Edgerton Hospital and Health Services  
Grant Regional Health Center  
Gundersen Health System Chris Stauffer (cjstauff@gundersenhealth.org)
Marshfield Medical Center – Beaver Dam Dan Baulch (baulch.dan@marshfieldclinic.org)
Memorial Hospital of Lafayette County and Primary Care Clinics  
Mercyhealth Rebecca Rose (rrose@mhemail.org)
Mile Bluff Medical Center, Mauston  
Prairie Ridge Health  
Reedsburg Area Medical Center Robert Van Meeteren (rvanmeeteren@ramchealth.org)
The Richland Hospital Lyle Kratochwill (lyle.kratochwill@richlandhospital.com)
Sauk Prairie Healthcare Amy Ryan (amy.ryan@saukprairiehealthcare.org)
SSM Health Lisa Adams (Lisa.Adams@ssmhealth.com)
Southwest Health Jaime Collins (collinsj@southwesthealth.org)
Stoughton Health Laura Mays  (lmays@stoughtonhealth.com)
UnityPoint Health – Meriter Nicole Aimone (Nicole.Aimone@unitypoint.org)
UW Health Andrew Hellpap (AHellpap@uwhealth.org)
Watertown Regional Medical Center Steve Hunt (Steven.Hunt@watertownregional.com)
William S. Middleton Memorial Veterans Hospital Paul Rickert (paul.rickert@va.gov)