Pandemic Influenza
Response: Ketchikan's
Alternate Care Site Exercise
Learner Objectives
1. Discuss the planning process required to
supply and staff an Alternate Care Site
(ACS).
2. List the staffing
challenges of
operating an
Alternate Care
Site.
3. Discuss lessons
learned.
Polling Question #1
Participants, have you ever participated in
setting up an Alternate Care Site, either in a
drill or as a real event?
A. Yes
B. No
Where is Ketchikan Alaska?
Ketchikan is on an island in Southeast Alaska
Primary Community Partners
in the Exercise
Ketchikan Fire Department
(KFD)
Ketchikan Indian Community
(KIC)
Ketchikan General Hospital
(KGH)
Ketchikan Public Health Nursing
Additional Community Partners in
the Exercise

City of Ketchikan
 Law Enforcement
 Public Works
 Ketchikan Public Utilities

GuardianFlight, Inc.

Ketchikan Gateway Borough

Ketchikan Gateway Borough School District

Ketchikan Pastoral Association

Laidlaw Transit Inc.
Additional Community Partners in
the Exercise

North Tongass Volunteer
Fire Department

State of Alaska
Behavioral Health

South Tongass
Volunteer Fire
Department

Temsco
Helicopters, Inc.

University of Alaska at Anchorage (UAA),
Certified Nursing Assistant (CNA) Program
Community Goal
Our goal is to create an “All Hazards” plan—an
Emergency Operations Plan (EOP) that will allow
our managers to perform their duties with confidence
and efficiency.
This exercise will help guide our responders and
managers and will provide us, the authors of the
“New EOP,” a means to create a document that is
useful for all types of events and for all
departments or agencies involved.
City of Ketchikan Objective

To exercise evacuation policies and procedures

To test mutual aid agreements

To simulate an actual Emergency Operations
Center (EOC) activation that will include a training
session

To exercise large-scale incident management
procedures

To assist any associated agency for the duration
for the exercise
This will help us in the completion of the “re-write of
the emergency operations plan.”
Ketchikan Indian Community
Tribal Health Clinic Objective
To exercise and evaluate its
ability to set up, staff, supply, and operate an
Alternate Care Site for overflow of triaged
“walking wounded” patients from the
Ketchikan General Hospital ER.
Ketchikan General
Hospital Objective
To work with community partners to exercise
and evaluate the:

Establishment and set up of the ACS

Supply and transport of resources to the
ACS

Communication at the ACS

Record keeping of care/services rendered
at the ACS
Ketchikan Public Health
Nursing Objective
For Alternative Care
Sites, public health officials will take the
lead in:

Establishment (identifying a site)

Set-up

Staffing

Operations
Funding

Funding was provided by The City
of Ketchikan through the United States
2005 Homeland Security Grant and the Alaska
Division of Homeland Security and Emergency
Management. Grant # 2005-GE-T5-0031.

Disposable supplies, sleeping bags, and pillows
were provided by the Alaska State Hospital and
Nursing Home Association grant.
Planning Timeline
12/05 to 10/06
6/06 site visit to the proposed site at Fawn Mountain School
Mobile command post
The dam
Evacuation
area (red)
Ketchikan
Creek
Bridges
destroyed
KGH & KIC
are located 3
miles north.
Scenario
South Tongass Hwy:
Fawn Mountain School
is 4 miles south
Exercise:
KPD
Mobile
Command Center
Exercise: Set Up
Tent & Security
Exercise: Tent & Patients
A nurse was assigned to monitor
patients awaiting transfer to Fawn
Mountain Alternate Care Site (FM ACS).
Ten influenza patients are taken to the
isolation tent outside of the ER to await
transportation to FM ACS.
Exercise: Materials

Materials Management readies supplies according
to the pre-determined lists.
Description

Quantity Needed Per Day UOM
Order Quantity
Dispensed
Categories include: CS Disposables, Equipment,
Pharmacy-Meds
Set Up
Hospital maintenance staff

Transfers equipment and
supplies to Fawn Mountain school

Sets up the beds, privacy curtains
Set Up: Signage
Bus Loading
Bus Leaves KGH
Bus arrives at Fawn Mountain ACS
The influenza
patients arrive.
The cots are ready!
FM ACS Care:
Registration
Charts
FM ACS Care: Triage
FM ACS Care: Bed Board
FM ACS Care
Discharge Station
Pastoral Care
The Group Photo
KGH Command Center
KGH: Patients Arrive
KIC ACS
KIC ACS: Pharmacy
Helicopter: Fawn Mountain to KGH
Depart FM ACS
Arrive KGH
Road blocks




Funding sources through KGH were not
available; Home Land Security Grant money
withdrawn
Volunteer patients: age, family, rules
Timing of the exercise was shorter than
planned
Other community events: Health Fair, Mass
Immunization Clinic, Auction
Lessons Learned
Lessons Learned

Staffing



Hospital
Community
Supplies


Transport
Trial

Registration Process

Equipment List

KIC


Activate, communicate, transport
Medical Reserve Corp
Lessons Learned:
Nutrition/Hydration

For the volunteer
patients and staff

KGH, DEC, sack
lunches
Lessons Learned:
Participant Responses
Actors in Fawn Mountain ACS Exercise (10 responses)

It's nice to know that we are preparing for a disaster
before one appears. Thank you.

You did a great job practicing your job and taking
care of us and fulfilling our needs, and I would enjoy
doing this again.

They took really good care of me and made me feel
comfortable.

I felt like I was well cared for and would definitely go
to this hospital if I really did get sick. Everyone was
nice.

You did a great job taking care of your patients.
Lessons Learned:
Participant Responses
Actors in Hospital Exercise: KGH & KIC (7 responses)

KIC staff were more thorough than KGH staff.

Great staff.
Lessons Learned: Dolls
Blow up dolls before
buying them outfits!
Lessons Learned

Emergency
Operations
Plan



Completed
Approved locally
Currently pending
State of Alaska
“OK”
Ketchikan Healthcare Community
Comes Together
Clinics
Primary Care
Providers
Public Health
Ketchikan General Hospital
EMS