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Code Green - Evacuation Plan

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PURPOSE:
To communicate an effective procedure to be utilized for the evacuation of part or all of Chatham Hospital in the event of a fire, hurricane, tornado, toxic spill or other types of severe emergencies.

This is a guide. Circumstances evaluated may require changes to ensure the safety of patients, visitors and hospital staff.

Any staff person who has knowledge of an emergency situation in which evacuation may be required, will remove patients, visitors, hospital staff and themselves from immediate danger and notify their Director. After hours, weekends and holidays, they are to notify the nursing supervisor or the Administrator on-call.

The staff person will provide information concerning the situation to the Director or Administrator.

The Administrator (or Incident Commander) will assess the situation and be responsible for deciding if an evacuation is necessary.

The Administrator (or Incident Commander) will initiate the evacuation plan by paging over the intercom “CODE GREEN” three times.

The Administrator (Incident Commander) will log on to Fast Command for appropriate instructions and notify outside agencies for assistance as indicated.

The Administrator, if possible, will set up a Command Center in the Small Conference Room; (if Incident Command has not previously been established; will become the Incident Commander) and obtain two way radios located in the Emergency Department.

Order of Evacuation Due to a Fire:
The order in which patients are evacuated is based on the patient's physical and medical condition. The priorities for patient evacuation are as follows:

Ambulatory Patients: Form a group of ambulatory patients and appoint a helper to lead them to safety and to remain with them until the all-clear signal.

Wheelchair Patients: Move these patients to safety. Take chairs back for additional patients.

Stretcher and Helpless Patients: Move these patients to safety. If the patient cannot walk with support or sit upright in a wheelchair, they should be transported using a stretcher, rolled in their beds, dragged on the floor on mattresses or blankets, or carried.

Order of Evacuation Due to Infrastructure Failure

Ambulatory Patients: Ambulatory patients should be evacuated last since they have little reliance upon infrastructure and can often be easily discharged or referred to other providers.

Life-Support or Machine Assisted Patients: Patients who are highly reliable upon any life support equipment or other power operated medical device should be stabilized as much as possible and evacuated first while the infrastructure is still intact.

Wheelchair, Stretcher, or Otherwise Helpless Patients: Patients who cannot walk or who are confined to a bed or stretcher should be evacuated immediately after the first group to utilize any infrastructure that remains intact such as lights.

Coordination for the transfer of patients should take place in accordance with statewide MEMORANDUM OF UNDERSTANDING signed by all of the Hospitals in North Carolina.

EVACUATION of Hospital

Horizontal and External Evacuation Instructions

Each director or designee of each area will perform as necessary in the event of an evacuation.

The Director or designee will inform staff of the evacuation destination(s).

The Director or designee will account for all persons once the evacuation point is reached.

The Director or designee will report missing person(s) to Incident Command.

Each staff person is authorized to take immediate action to remove all persons from the danger zone. The danger zone is defined as the location of the fire, hazardous gas leak, toxic chemical spill, etc.

Horizontal evacuation can be determined by the following person(s):

Area Director or designee

Hospital Administrator

Maintenance Director

Security or designee

Fire Department personnel

Other Emergency Agency personnel

The type of emergency determines a horizontal evacuation.
Staff will evacuate to areas that are considered “safe” and are located on the same floor.

Internal evacuation should be to a destination that is at least two smoke zones away from the emergency location.

Staff will move non-ambulatory patients in beds or wheelchairs when possible.

Staff will move ambulatory patients in a group.

The area director or designee will assign staff person(s) to an ambulatory group.

Appointed staff will escort patients, customers, and visitors to the designated evacuation location and remain with the individuals until an “All Clear” is announced.

The administrator on call or the Incident Commander will determine external evacuation.

Staff will utilize the following evacuation procedures:

Staff will proceed to the nearest available exit.

The Director or designee will appoint staff person(s) to an ambulatory group. Appointed staff will escort patients, customers, and visitors to the designated evacuation location and remain with individuals until an “All Clear” is announced.

If the evacuation requires vertical movement, staff will use the proper carrying method to move the person.

The director or designee will be responsible for assisting the impaired staff with evacuation.
Staff will be aware of all exit routes for the evacuation.

The best evacuation route will be determined at the time evacuation is deemed necessary.

Staff will make certain that patient charts accompany the patient in the event of an evacuation.

TOTAL EVAUCATION OF Chatham Hospital

Should it be necessary to evacuate Chatham Hospital, the following will occur:

If the hospital must be evacuated, patients will be evacuated to UNC Hospitals if at all possible. Discharging all patients who can be safely discharged, canceling all elective surgeries and diverting new patient arrivals to other area hospitals will accomplish this.

When evacuation to the outside is required, departments should meet in the outside area designated on their departmental site specific fire/emergency response plan to conduct a count of patients and personnel in order to notify the Siler City Fire Department should they believe any persons were not successfully evacuated or who may be trapped in the building.

Should total evacuation be required, patients will be transferred to:

UNC Hospitals

Wake Med

Duke University Hospital

Randolph Hospital

Central Carolina Hospital

Coordination for the transfer of patients should take place in accordance with statewide MEMORANDUM OF UNDERSTANDING signed by all of the Hospitals in North Carolina.

PROCEDURE:

I. Responsibilities:

The Director or designee of each department will perform as necessary in the event of an evacuation.

The Director or designee will coordinate the emergency evacuation plan for each specific area.

The Director or designee will coordinate instructions given by the emergency response personnel; such as, the hospital Administrator, Incident Commander, and the fire department or other emergency response personnel.

The Director or designee will assign staff to specific evacuation duties as needed.

The Director or designee will instruct staff to track movement of patients, customers, and visitors.

The Director or designee will account for all persons after the evacuation.

Each Director or designee will conduct annual training programs concerning the evacuation plan.

The Director or designee will facilitate active staff participation in drills.

The Director or designee will orient each staff person concerning the location of the fire exits and where the exits lead.

The Director or designee will facilitate the posting of updated evacuation maps for the site. The evacuation maps should always be available and reviewed with new staff.

If physically impaired staff members are present, the director or designee will be responsible for facilitating the safe evacuation of each impaired staff person.

The hospital Administrator or Incident Commander will determine if additional emergency plans will be implemented.

All staff will perform as necessary in the event of an evacuation.

Staff will care for non-ambulatory patients, customers, and visitors.

Staff will close or open doors and windows as required.

Staff will collect medical records and client cards.

Staff will assist the director or designee as assigned.

Staff will remain calm.

Staff will attempt to calm patients, customers, and visitors.

Other staff will be contacted if assistance is needed.

All staff, once evacuated, will report to the area director or designee for accountability of all persons evacuated.

II. General Evacuation Instructions:

Staff will take safety precautions as indicated in the event of an evacuation.

Each staff person will be familiar with evacuation procedures and be prepared to implement the evacuation plan as required.

Staff will become familiar with the evacuation routes.

Staff will attempt to calm patients, customers, and visitors during the evacuation process.

Staff will remove patients, customers, and visitors from the immediate danger zone first.

Staff will check exit routes for smoke, fire, or overcrowding before leading patients, customers, and visitors into an exit path.

Staff will look for exit route markers and signs during evacuation.

Staff will escort patients and visitors from the building to the evacuation assembly area. Patients and visitors will be led out of the building or patients and visitors will be directed to follow another staff person.

Staff will know the number of people in the evacuation group and perform a count of the group once evacuation is completed. All missing person(s) will be reported to the director or designee.

The Director will designate the assembly location.

Should the assembly location be an inappropriate location to evacuate due to the condition at the time, the director or designee will relocate all individuals to a more appropriate location.

III. Evacuation Incident Command Center
When a total evacuation is required due to a major disaster inside the building, an incident Command Center will be established at the site. Refer to Chatham Hospital Emergency Operations Plan for Command Center establishment.

The Command Center will be used to communicate and coordinate with the following entities:

Law enforcement, public safety, and emergency agencies

Surrounding healthcare facilities

Medical and hospital staff

News media

Local government units, local establishments, and organizations for temporary care of patients and/or support assistance

IV. Building Re-entry

The hospital Administrator, Incident Commander, law enforcement, or fire department relative to the nature of the disaster will determine re-entry to the building.

In cases where “Code D Internal” is implemented, the hospital Administrator or Incident Commander will be the authority who determines when reentry will be accomplished. This decision will be made after consultation with local authorities at the scene.

“All Clear” will be announced when it is safe to enter the building.

EVACUATION SITES (SAFE AREAS) INTERIOR:
TO BE DETERMINED BASED ON SITUATION

EVACUATION SITES (SAFE AREAS) EXTERIOR:
TO BE DETERMINED BASED ON SITUATION

TRANSPORTATION RESOURSES FOR PATIENT TRANSER:
To be determined by the Incident Commander in consultation with Chatham County Emergency Management and Medical Personnel.

First Health

Randolph EMS

UNC Aircare

Duke Lifeflight

UNC Ground Mobile Intensive Care

Care Link

DEPARTMENTAL RESPONSIBILITIES:
This section covers individual departmental responsibilities in addition to those mentioned in the basic plan. These are expected initial duties and will be further determined through Incident Command. Any department or any non-specified personnel will report to the Command Center for direction.

BUSINESS OFFICE

Department Director or designee reports to the Command Center for instructions.

Primary responsibilities may be to remove and secure cash boxes, certificates and bonds in a pre-designated location or the Command Center.

CARDIOPULMONARY

Department Director or designee reports to the Command Center.

Primary responsibilities are airway management of patients who will be moved to other areas of the hospital or transported to outside locations.

EMERGENCY PERSONNEL