SCWIHERC 11-9-22 Meeting Notes
Passcode: See email sent November 10
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.
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.email@example.com 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 firstname.lastname@example.org
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
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
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
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