NC Emergency Management Association Conference
Greg Shuping- Haywood County Emergency Management
Marty Stamey- Hospital Operations & Emergency Management
Hospital Demographics
Main Structure- 7 Story, 190,000sf
 169 Bed Facility
 17 Bed Emergency Department
 16 Bed Behavioral Health Unit
 County Population 60,000

Hospital Census Prior to the FIRE
TOTAL- 75
 PCU- 16
 ICU- 3
 Women’s Care- 4
○ Active Labor- 2
 Med Surg.- 18
 BHU- 16
 ED- 16
○ IVC- 4
June 19, 2014

18:28
 Pull Station Fire Alarm received at the 911
Center.
 Upgraded to a full alarm assignment based
on multiple callers reporting heavy smoke
from the electrical room.

18:33
 First units arrive, smoke showing from rear
loading dock area.
June 19th, 2014
Incident Command established by Fire
Department
• Hospital, EM, EMS, Law Enforcement
leadership at the command post to ensure
effective decision-making.
• Accountability an issue with such a large
building.
• High stress and chaotic environment for the
first 15-30 minutes.
June 19, 2014

18:53
 Fire Under Control
 Small Fire confined to the Electrical Room area, but
with HUGE consequences to Hospital Operations.
 Additional Hospital administration arriving.
 Hospital Command Post established in another
building behind the main structure.

19:30
 H.I.C.S. established and initial briefing given by
Hospital CEO.
 Fire Department returns control of the building back
to Hospital Administration.
Initial Response Highlights

Initial Response Command Post already
identified in response plans and exercises.
 We had recently conducted a disaster drill at the
hospital!

Immediate notification of County Emergency
Management & EMS performed upon
notification of “smoke showing”.
 Allowed a good transition from first responders to
hospital administration control.

Incident occurred after most scheduled
surgeries and other outpatient services were
complete.

19:40
 Emergency Department Diversion

20:25
 Code Black- Power Failure

20:33
 Code Silver- Patient Evacuation Decision

21:45
 EMS resources on scene
○ 11 units
 Buncombe County Mass Casualty Bus on
Standby.
Hospital Evacuation

Immediate Evacuation vs. Phased Evacuation
 Decision to completely evacuate at 20:45

Evacuation Numbers/Destinations
 Harris- 18 adults, 2 newborns, 4 BHU
 Mission- 2 acute adults & 7 from ED
 Homestead- 1
 13 Remaining BHU patients to Rutherfordton, Balsam
Center and Kings Mountain
 25 patients discharged
Hospital Evacuation

Notification to area hospitals of a FULL
DIVERSION

Public and Family Notifications (perception
issues)

EMS resource management- All patients & staff
moved by 03:10 hours the following morning.

Final BHU patient evacuations complete at
08:00 hours.
1 meg generator to power 500 ton chiller
2- 2 meg generators on scene to power the hospital
The NEXT MORNING

Establishing a mobile Emergency Department
in the parking lot.
 Resources needed to make this happen?
○ Mobile Tractor Trailer units (SMAT, MED 1, etc.)
○ Additional supporting tents (SMAT, DPR cache, etc.)
○ Restrooms, medical supplies, pharmacy, X-ray, labs,
etc.
○ SIGNS
○ Public Information
○ Emergency Lighting
○ Staffing

06:10- Decision to deploy MED-1
Relationships Prior to the
Incident

Local Emergency Planning Committee

Monthly Emergency Services team
meetings with hospital administration

Multiple Exercises and consolidated
training throughout the years.

Attrition at Hospitals, especially in key
positions.
Completely out of main hospital for 3 weeks.
• June 19- July 8- 12 hour operational periods at the command post.
• August 17- Final electrical testing and return of primary hospital power.
External support demobilized.
• August 22- Hospital ICS terminated.
Internal
I. Communications
YES
NO
N/A
Was the appropriate staff notified when emergency measures initiated? (Code announced or
paged)
8
2
2
Were emergency communications set up?
11
1
Were community emergency response agencies efforts incorporated/ coordinated?
10
2
Did the hospital communicate with patients and families during the emergency?
9
3
Did the hospital communicate to the media during the emergency?
11
1
Comments: Extensive effort and emphasis was placed on up-to-date information
Communications
(Circle One)
1x1
Poor
2x2
Fair
3x2
Good
4x3
Very Good
Communications Score of 3.58
5x4
Excellent
Score
3.58
Internal
II. Resources/Assets
YES
NO
N/A
Did hospital have enough supplies on hand? (medical, pharmaceutical, emergency)
10
1
2
Did hospital manage support activities appropriately? (housing, transportation,
communication, stress debriefing)
10
1
1
Did hospital obtain additional resources from another entity? (Corporate, another
hospital, health department, etc.)
12
Resources/Assets
(Circle One)
1
Poor
2
Fair
3x2
Good
4 x7
Very Good
Resources/Assets Score of 4.0
5 x2
Excellent
Score
4.0
Internal
III. Safety/Security
YES
NO
Was adequate security provided?
12
Were emergency vehicles and personnel able to have access to all areas, equipment,
and supplies required?
12
Were unauthorized personnel kept away from the areas?
11
1
Did facility take steps to identify and address hazards created by this event?
11
1
Safety/Security
(Circle One)
1
Poor
2x2
Fair
3x1
Good
4 x4
Very Good
Safety/Security Score of 3.91
5 x4
Excellent
N/A
Score
3.91
Internal
IV. Staff Management
YES
NO
Were provisions for the management of staff, including distribution and assignment of
responsibilities and functions, adequate?
11
1
Was there adequate staffing and call-in response?
10
2
Was staff competent to perform assigned duties?
11
1
Was staff support needed, provided and adequate?
10
2
Staff Management
(Circle One)
1
Poor
2x2
Fair
3x2
Good
4x4
Very Good
Staff Management Score of 3.78
5 x2
Excellent
N/A
Score
3.78
Internal
V. Utilities Management
YES
Were any of the following disrupted?
12






12
Electricity ( or Emergency Generator)
Water
Fuel
HVAC
Medical Gas/Vacuum Systems
Other (Specify):
NO
12
8
4
12
5
7
If any of the above were disrupted, were the appropriate actions taken? Describe:
Numerous generators brought on site and wired in, outside support from CHS and DLP, periodic
downtimes during testing and repairs Details in HICS documentation
Utilities Management
(Circle One)
1x1
Poor
2x2
Fair
3x1
Good
4x4
Very Good
Utilities Management Score of 3.25
X
5 x1
Excellent
Score
3.25
N/A
Internal
VI. Patient Clinical & Support Activities
YES
NO
N/A
Were provisions for the management of patient including scheduling of services, control of
patient information, admission, transfer, and discharge adequate?
10
2
Were all patients accounted for, triaged, and prioritized?
10
2
Was all necessary medical treatment readily available and adequate?
10
2
Was patient transfer plan effective?
10
2
Was temporary shelter needed?
5
5
2
If temporary shelter was needed but inadequate, please describe:
Was alternate care site needed?
10
2
If alternate care site was needed, was site identified and was it available, accessible and
adequate?
10
2
If alternate care site was not identified, available, accessible or adequate, please describe: Local Hospitals
Patient Clinical &
Support Activities
(Circle One)
1x1
Poor
2x1
Fair
3x1
Good
4 x4
Very Good
5 x4
Excellent
Patient Clinical & Support Activities Score of 3.82
Score
3.82
Overall Score for Incident from Internal Responses
3.74
External
I. Communications
YES
Was the appropriate staff notified when emergency measures initiated? (Code
announced or paged)
5
Were emergency communications set up?
5
Were community emergency response agencies efforts incorporated/ coordinated?
5
Did the hospital communicate with patients and families during the emergency?
1
Did the hospital communicate to the media during the emergency?
5
Communications
(Circle One)
1
Poor
2
Fair
3
Good
4x1
Very Good
Communications Score of 4.80
NO
5x4
Excellent
N/A
4
Score
4.80
External
II. Resources/Assets
YES
NO
N/A
Did hospital have enough supplies on hand? (medical, pharmaceutical, emergency)
2
3
Did hospital manage support activities appropriately? (housing, transportation,
communication, stress debriefing)
4
1
Did hospital obtain additional resources from another entity? (Corporate, another hospital,
health department, etc.)
5
Resources/Assets
(Circle One)
1
Poor
2
Fair
3
Good
4 x3
Very Good
Resources/Assets Score of 4.4
5 x2
Excellent
Score
4.4
External
III. Safety/Security
YES
Was adequate security provided?
5
Were emergency vehicles and personnel able to have access to all areas, equipment, and supplies
required?
5
Were unauthorized personnel kept away from the areas?
5
Did facility take steps to identify and address hazards created by this event?
5
Safety/Security
(Circle One)
1
Poor
2
Fair
3
Good
4 x2
Very Good
Safety/Security Score of 5.0
5 x3
Excellent
NO
Score
4.6
N/A
External
IV. Staff Management
YES
NO
N/A
Were provisions for the management of staff, including distribution and assignment of
responsibilities and functions, adequate?
3
2
Was there adequate staffing and call-in response?
3
2
Was staff competent to perform assigned duties?
3
2
Was staff support needed, provided and adequate?
3
2
Staff Management
(Circle One)
1
Poor
2
Fair
3
Good
4x1
Very Good
Staff Management Score of 4.67
5 x2
Excellent
Score
4.67
External
V. Utilities Management
YES
NO
5
1
5
1
1
4
N/A
Were any of the following disrupted?






Electricity ( or Emergency Generator)
Water
Fuel
HVAC
Medical Gas/Vacuum Systems
Other (Specify):
4
4
4
1
If any of the above were disrupted, were the appropriate actions taken? Describe:
(1)
(2)
5
The disruption only occurred due to the actual incident.
Temporary generators and security lighting was in place
Utilities Management
(Circle One)
1
Poor
2
Fair
3
Good
4x1
Very Good
Utilities Management Score of 4.67
5 x2
Excellent
Score
4.67
External
VI. Patient Clinical & Support Activities
YES
NO
N/A
Were provisions for the management of patient including scheduling of services, control of
patient information, admission, transfer, and discharge adequate?
2
3
Were all patients accounted for, triaged, and prioritized?
2
3
Was all necessary medical treatment readily available and adequate?
2
3
Was patient transfer plan effective?
1
Was temporary shelter needed?
1
3
3
2
If temporary shelter was needed but inadequate, please describe:
Was alternate care site needed?
If alternate care site was needed, was site identified and was it available, accessible and
adequate?
If alternate care site was not identified, available, accessible or adequate, please describe:
3
2
3
2
The establishment of an alternative site was based upon the decision to divert patients to Harris Regional Hospital and
Mission Hospital in Asheville.
Patient Clinical &
Support Activities
(Circle One)
1
2
Poor
Fair
3x1
Good
4 x2
Very Good
5
Excellent
Patient Clinical & Support Activities Score of 3.67
Score
3.67
Overall Score for Incident from External Responses
4.47
Questions
marty.stamey@haymed.org 828-400-4812
gshuping@haywoodnc.net 828-508-8387
Thank You!