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Umpqua Community College Shooting – Integrating long term needs into response

Umpqua Community College Shooting – Integrating long term needs into response

Roseburg, OR

October 2015

On October 1, 2015, in Roseburg, Oregon at Umpqua Community College, students gathered for their Intro to Creative Writing class. Moments later, tragedy struck. A 26-year-old male student fatally shot his professor and eight fellow students in the classroom. Nine other students were also injured before the incident ended. The mass shooting was the deadliest in Oregon's modern history, and left a profound and lasting effect on the local community.

As the community, the Oregon Health Authority (OHA), and the Region 3 Coalition addressed immediate needs, including collaborating with the FBI Victims Assistance and the local District Attorney's Office, the Red Cross, and grappling with family reunification, the longer term behavioral health needs became apparent. The Region 3 Health Care Coalition (HCC), a diverse coalition of health care, public health and emergency management members funded through the Hospital Preparedness Program (HPP) and OHA responded to a request from the community to create a safe outlet to discuss the incident in a judgment free space. These groups working together stood up the Umpqua Wellness Center to provide grief and behavioral health counseling and support for those navigating the tragic shooting.

In order to staff the community center, the OHA utilized Oregon's Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP) to recruit, staff, and hire community health support. ESAR-VHP is a federal program run by the National Healthcare Preparedness Programs (NHPP) that supports states and territories in establishing standardized volunteer registration programs for disasters and public health and medical emergencies. With ESAR-VHP and HPP support, OHA recruited 10 volunteers who generously served for 16 weeks. Akiko Saito, Operations Chief for the OHA Public Health Division-Health Security Preparedness and Response Program, said, "Because of previous ESAR-VHP and HPP funding, we were able to build our ESAR-VHP program-State Emergency Registry of Volunteers in Oregon (SERV-OR) and staff the community wellness center appropriately. We built SERV-OR from the ground up, and truly wouldn't be where we are today without HPP."

The Umpqua Wellness Center strengthened the resilience of a community. Throughout the life of the wellness center, SERV-OR volunteers saw 56 clients and provided more than 1,700 hours of clinical support. Additionally, the Umpqua Wellness Center was able to meet a unique need by assisting an unexpected number of first responders who came to the center seeking support to cope with the aftermath of the incident. The Umpqua Wellness Center and HPP helped its community through the spectrum of needs after the shooting, from immediate family reunification to longer term behavioral health support and assisted a grieving community as it processed the tragedy it had endured.

Papal Visit Preparations

Papal Visit Preparations

Southeastern Pennsylvania

September 2015

For any major event in a city, it's always important to be prepared for a range of outcomes. The papal visit to the U.S. in September of 2015 was no exception. Preparations and planning began long before the pope actually stepped foot inside the U.S.; preparing cities and states for large crowds and ensuring that plans and protocols were in place should anything go wrong. Philadelphia, as one of the three cities visited by the pope on his trip, prepared the medical community in the region for any events that might pose a risk of overwhelming the health care system.

The Hospital Preparedness Program (HPP) enables the health care system to save lives during emergencies that exceed the day-to-day capacity of the health and emergency response systems. This is accomplished through the development of regional health care coalitions (HCCs) that incentivize diverse and often competitive health care organizations with differing priorities and objectives to work together. HCCs collaborate to ensure that each member has the necessary medical equipment and the supplies, real-time information, communication systems, and trained healthcare personnel to respond to an emergency.

The Southeast Pennsylvania Health Care Coalition, a coalition of health care facilities formed as a result of HPP's efforts in the region, held two meetings with all of the region's hospital CEOs and preparedness staff concerning papal activities. The HCC discussed responsibilities and resources at the city, state, and federal level, ensuring all hospitals were informed, prepared, and aligned. Mark Ross, the Healthcare Emergency Preparedness Manager for Hospital and Health System Association of Pennsylvania and emergency coordinator during the papal visit, lauded the regional preparedness planning that HPP funded. "HPP's regional funding allowed for 17 transplants from across the New Jersey, Delaware and Pennsylvania area to occur even during a high profile event such as the papal visit. Regional coordination, communication, and planning allowed us to conduct life-saving efforts across state lines without any interruption."

In addition to bringing together the medical community to prepare for any disruption or large scale event, the HCC participated in the U.S. Secret Service's planning committee for health and medical issues. The HCC leader, along with several other members, serve on the committee and help share critical information and align response efforts between disparate, but important groups.

"The planning and execution for the papal visit by our staff and volunteers at a local, regional, and state level allowed us to ensure the safety of residents throughout Philadelphia," said Martin Raniowski, Deputy Secretary for Health Planning and Assessment for the Pennsylvania Department of Health. "The planning for the pope's visit highlighted the importance of taking a regional focus on preparedness. HPP's funding and guidance helped with both planning and training, ensuring that our team's efforts to maintain a healthy environment for Philadelphians and visitors to our state during the entire weekend of the pope's visit were successful."

Overall, the Southeast Pennsylvania HCC planned and prepared for an emergency well in advance of the pope's visit. Hospital facilities, the Secret Service and nearby states all coordinated to ensure that the health care system was trained, coordinated and prepared for an event, ensuring the people that came to Philadelphia visited a truly prepared community.

The Story You Haven’t Heard: How the Northwest Healthcare Response Network Saved Lives After a Tragic Tour Vehicle Crash

The Story You Haven’t Heard: How the Northwest Healthcare Response Network Saved Lives After a Tragic Tour Vehicle Crash

Seattle, WA.

September 2015

You likely have not heard of the tragic September 2015 Ride the Ducks tour vehicle crash that killed five students and injured 71 individuals on Seattle's Aurora Bridge. With almost all of the fatalities and injuries affecting foreign national students and tourists from 14 different countries and nearly 60 people requiring critical hospital care, it is easy to see how this could have been a widespread, national story. Thanks to Seattle's Northwest Healthcare Response Network health care coalition (HCC) and its members, it was not. All of the injured were triaged and transferred from the bridge to seven area hospitals within an hour of the incident. The incident made local newscasts, but the HCC's coordinated, lifesaving response meant that the tragedy did not develop into a magnitude that made national news headlines.

The Northwest Healthcare Response Network is a non-profit organization with diverse membership, including hospitals, emergency medical services, emergency management organizations, blood centers, public health agencies, and others. The HCC works to ensure that each member has the necessary medical equipment and supplies, real-time information, communication systems, and trained health care personnel to respond to emergencies, such as the Aurora Bridge crash, to save lives.

Immediately following the crash, area hospitals were notified to update their bed availability in WATrac, the HPP-funded statewide communication, patient tracking, and incident management system. Armed with real-time WATrac information and years of practice through HPP-funded mass casualty incident and medical surge exercises, Network members were able to efficiently distribute patients and resources between hospitals, enabling all of the injured to receive lifesaving care within an hour of the crash and preventing any one facility from becoming overwhelmed. Throughout the response, the Network served as the command center for coordination and information sharing between HCC members and other critical stakeholders, such as local government officials and national investigators; for example, the Network coordinated patient tracking information through WATrac to support family reunification efforts. The HCC's response coordination was instrumental to preventing the crash from becoming an even greater tragedy and warranting headlines around the country.

The Network's crash response clearly demonstrated the HCC's lifesaving role in coordinating health care organizations in the Seattle community during disasters and emergencies. The incident helped the Network identify capabilities that could be enhanced even further for future responses, such as refined protocols to prevent hospitals from being burdened by requests for information. The crash response also highlighted the need to continually engage regional emergency preparedness partners so that they are familiar with patient tracking operations and legal limitations on information sharing.

To build on and share these lessons learned with the Seattle community, the Network worked with partners and stakeholders during the year after the crash on strategies for improving coordination and information sharing. This effort culminated in an emergency planning session led by the Seattle Office of Emergency Management to educate Seattle's regional foreign consular community on disaster response operations in case another incident with so many foreign national victims should arise. The Network also worked with ASPR's Technical Resources, Assistance Center, and Information Exchange (TRACIE) to develop guidance on protecting patient privacy during disasters so that other health care coalitions around the country can benefit from the Network's lessons learned. As a result of the Network's efforts, Seattle and communities around the country are better equipped to save lives during disasters and emergencies, preventing tragedies from growing to a degree that makes them nationally known.

"HPP impacted every aspect of our response," reflected Onora Lien, the Network's Executive Director. "Without years of HPP support, we would not have had the plans, personnel, equipment, systems, or relationships to respond as effectively as we did and prevent this from becoming a greater tragedy. HPP funding and guidance have been instrumental in preparing our community across a number of variables – I can't imagine how we would have coordinated our response to the crash without HPP."

Tennessee Chemical Spill

Tennessee Chemical Spill

Blount, TN 

July 2015

On a rainy July night in rural Blount County, Tennessee, a cargo train carrying hazardous materials passed through a residential area. During that trip, a wheel on the train had rubbed a hole into one of the tankers carrying the flammable and toxic chemical acrylonitrile. The acrylonitrile began leaking from the tanker, hitting the ground and sinking into the soil. Initially, the train operator did not even know that there was a leak.

Emergency calls were quickly made as the train came to a swift halt and within 20 minutes of the incident, emergency personnel were alerted to the problem. First responders arrived on site, cordoning off the area and notifying residents of the spill.

Long before the incident unfolded, the Hospital Preparedness Program (HPP), a federal program that works with health care entities across the nation to ensure local, state, and regional health care systems are coordinated, trained, and prepared, helped to train and equip Blount Memorial Hospital emergency and health care personnel so that they were ready to respond to this type of emergency.

HPP had funded decontamination and preparedness trainings and part of their training included detailed knowledge of chemical hazards and the proper decontamination steps. In addition, HPP supported the construction of decontamination showers at the hospital, as well as the radios and state-wide notification system, which form the backbone of a prepared community. The training and communication systems ensured that health care emergency preparedness personnel at multiple hospitals and across county lines were coordinated to save lives.

As a direct result of their participation in this HPP-funded training, Blount Memorial Hospital emergency and health care personnel immediately noted that acrylonitrile, when exposed to water, becomes the toxic gas cyanide. Suddenly, the rain that night turned from inconvenient to life-threatening.

With nearly 30 of the 57 cars on the train carrying hazardous materials and volatile natural gas, first responders had to act quickly and effectively. Over 5,000 residents were evacuated and within hours, the Knoxville/East Tennessee (KET) Healthcare Coalition (HCC) worked with Blount County Hospital to aggregate cyanide treatment kits across 15 counties. Funded by HPP, HCCs coordinate at the local, regional, and state levels to bring together local hospitals, other health care facilities, and emergency personnel to plan for and coordinate responses to health care emergencies that exceed the day-to-day capacity of the health and emergency response systems.

Over the course of three days, 157 patients were decontaminated, monitored, and/or treated for cyanide exposure at Blount Memorial Hospital, most of whom were first responders.

"Due to our training, we were synchronized in our response. During the peak of this emergency, we were able to reduce the intake time - from the door to the doctor - for patients with chemical exposure entering the busy emergency department from 28 minutes to 13 minutes. On top of the more routine emergency patients with heart attacks, strokes, and traumas we receive on a daily basis – that's extremely impressive." noted Carole Chambers, Director of Safety and Emergency Management. She credits the success of the disaster response to the "collaborative efforts of the community, the dedicated and well-trained hospital staff and the partnership between HPP, the Tennessee Department of Health, and local coalition members."

The partnership between HPP, the Tennessee Department of Health, and local HCC members ensured that the situation was properly identified as a serious threat that required swift and coordinated action.

"Midnight on the night of a chemical spill with potential cyanide exposure is not the time to be creating relationships," said Wanda Roberts, Regional Hospital Coordinator and liaison for the local HCC. "Thanks to HPP-funded exercises and trainings, I knew exactly who to call and I knew they were knowledgeable and prepared. I wouldn't have it any other way. HPP funding saves lives."

Amtrak Train Derailment, Philadelphia, PA

Amtrak Train Derailment, Philadelphia, PA

 

Philadelphia, PA

May 2015

In May 2015, en route from Washington DC to NYC, an Amtrak train carrying 238 passengers derailed. Over 200 were injured and eight killed. The large volume of patients highlighted the need for a coordinated and regional approach to preparedness. The Amtrak derailment caused a ripple of shock throughout the country, especially considering over 86,000 passengers rely on Amtrak every day.

Fortunately, the Hospital Preparedness Program (HPP), the Pennsylvania Department of Health (DoH), and the regional health care coalition (HCC) had long been working together to prepare local health care systems for disasters that could cause a surge in patients. HPP-funded systems helped distribute notifications of emergency room capacity; facilitated communication; enhanced patient tracking and triaging to help people get the care that they needed. Because these systems were in place before the train derailed, they were ready to protect health and save lives when seconds counted.

Martin Raniowski, Deputy Secretary for Health Planning and Assessment for the Pennsylvania Department of Health stated, "The expedient and effective response to this terrible tragedy shows that the system works, thanks largely to the funding provided by the Hospital Preparedness Program".

Even as emergency crews were still on the ground searching for survivors and victims, local health care facilities, EMS, and emergency management agencies, all members of HPP-supported HCCs, were already in action, working together to facilitate a swift, coordinated response. HCCs are an integral part of HPP. They incentivize diverse and often competitive health care organizations with differing priorities and objectives to work together. The HCC members in Pennsylvania collaborated to ensure that each member of their coalition had the necessary medical equipment and supplies, real-time information, communication systems, and trained health care personnel to respond to public health emergencies, including large scale accidents like the Amtrak train derailment.

Mark Ross, emergency coordinator on the ground during the Amtrak derailment and an HCC leader in Pennsylvania, praised HPP for their regional focus on preparedness and emphasis on the vital systems that help operationalize HCCs. "Through HPP funding, our HCC created an effective incident management structure that was critical to our health care system response to the Amtrak train derailment," Mr. Ross said. "Within a half hour window, HPP-funded systems were able to send out notifications of emergency room capacity to HCC members a full 30 minutes prior to the official city alerts. This enhanced information sharing provided responders real-time communications on vital resources throughout the region." HCC members immediately activated another HPP-funded response platform to track and triage patients, facilitating the proper distribution of patients preventing any single hospital from being overburdened. The operational response of HCC members, along with their systems and training, allowed for an effective response within an organized incident command structure, saving lives, improving care, and increasing accountability.

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