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 (firstname.lastname@example.org) 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.
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