September 29, 2009

Emergency Communications forLong-Term Care FacilitiesDavid Coursey, Amateur Radio Emergency Service, San Joaquin County

Who Am I?& Why Am I Here?

Emergency Coordinator, Amateur Radio Emergency Service (ARES) of San Joaquin County. National ham radio emergency group.

San Joaquin County EMS Agency.

27 Years as Amateur Radio emergency worker -- Call sign N5FDL.

17 Years in San Mateo County Sheriff’s Communications Unit.

Mentor/Trainer, Amateur Radio Emergency Communications Course.

NREMT, SARTECH II

Volunteer

This presentation will help you understand basic emergency communications.

It seems like after every incident, the most common concern heard at event

critiques is:

We needed better communications!

Today’s Goals

Think about communications.

Plan for communications.

Invest in communications.

Communications Emergencies

Inability to communicate with the outside world (or vice versa) -- Doesn’t require a major disaster, just a backhoe or cable cutters.

Inability to communicate internally -- Phone switch quits.

Sudden need for extra communications (such as during an evacuation).

What is an emergency? If it negatively impacts patient care--it’s an emergency.

Various Kinds of Emergencies

Local emergencies that effect only your facility, but leave the rest of the world OK. (Fire, HVAC issues, phone problems, etc.)

Emergencies that impact all health facilities -- H1N1, disasters elsewhere.

“The Big One”

Each requires a specific communications plan as your needs will be different for each.

Distance Is Our Enemy

Communication is about reducing time/energy to move information from place to place.

In normal times, it may require a phone call. In an emergency, you may have to physically hunt down someone.

Then you have to go back where you started and begin again.

No wonder emergencies are disorganized -- People having to do old things in new ways, in a hurry.

And To Make Matters Worse

Communications emergencies are often part of other emergencies that are already taxing resources.

The situation is bad enough and you can’t communicate on top of your other problem(s).

Emergency Communication Needs

Most important is safety of self, staff, community, patients.

Can your facility operate cut off from outside world? (Standing orders, protocols, etc.) Impact on communications?

If patients need transportation to higher level of care, where does it come from, how will it be summoned and coordinated?

Facility logistics may become crucial.

Stakeholder Communication

Employee communication.

Family/patient communication.

Business/corporate communication.

Allied agencies, regulators, etc.

Many Types of Communication

Person-to-person intra-facility.

One-to-many intra-facility.

Inter-facility communication.

Facility to external stakeholders.

Data communication -- Internet, fax, data lines, etc.

Communications Plans

Does your facility have one?

Most everything we do is communication-driven.

Not having a plan is planning to fail. (Yes, a cliche).

A Good Plan

Improves confidence.

Gives managers the ability to manage.

Employees do less “freelancing.” Less running around looking overwhelmed, more accomplishment.

Has to be exercised. Good plans are “living” plans.

Principles of EMCOMM

Always use the most efficient mode available to you.

Limit unnecessary communication.

Proper use of voice vs. printed communication.

Runner may be the best option.

HIPPA issues.

Ability to interface with other organizations.

Principles of EMCOMM

ICS -- Nursing Home ICS

Communications is a Logistics function (not shown in plan)

Tactical identifiers--replace names with functions.

Teams are important. Teams need to communicate.

Plain language

Standard phonetics.

Log everything and keep the log -- “chart” the incident.

EMCOMM Resources

Telephone -- Landline, cellular, satellite

Radios -- Internal/External Communications

Business

Unlicensed

Amateur

Internet -- E-mail

EMCOMM Resources

Automated calling

Emergency notification

Stakeholder communication

Staff communication/callback

Integration with other modes

CAHAN -- CA Health Alert Network

GETS -- Federal system may be available to you

Buy some radios!

Having radios allows you to easily communicate throughout your facility to many people at once

Important in reducing internal response time to an emergency

Radios can be quite inexpensive, but they must be able to work when you need them

Also useful--maybe more so--at an alternate care location

Many types of radios

Inexpensive Family Radio Service (FRS/GMRS) Radios may be fine (less than $50 each).

More expensive “Commercial” radios -- licensed or unlicensed may be used.

Radios chosen must be able to talk all over your facility and for a reasonable distance outside.

FRS Radios

Family Radio Service radios are sold everywhere.

Do NOT believe the mileage claims. Actual range is less than a mile and varies. Many work very well indoors.

Make sure your radios will operate off AA batteries (most will).

Keep radios packed with a cache of AA batteries (hundreds!)

FRS are NOT life-safety radios.

Commercial Radios

Are more expensive than FRS radios. May be more rugged.

Are probably more difficult to power in an emergency than FRS. Some have AA adapters.

Can be used with commercial radio systems (repeaters, etc.) for wide-area coverage. Check for emergency power, etc.

Train With Your Radios

If you can’t do it on a good day, how will you do it during an emergency?

Check for coverage around your facility in advance

Batteries may be your biggest challenge -- there are many ways to address this

Don’t count on rechargeable batteries

Stock lots of AA batteries (if that’s what your radios use)

An Essential Accessory

People learn this the hard way -- Use an earphone with your radios!

This keeps private information private and reduces unnecessary anxiety among patients, other staff, etc.

Have extra earphones available as they break with use.

Many speaker/mics include an earphone jack.

Amateur “Ham” Radio

In longer-lasting emergencies, typically in larger facilities, volunteer Amateur Radio communicators may be an option

They can provide communications to emergency operations centers, other care facilities, etc., depending to the emergency

They can “shadow” your managers as required

Someday, maybe a ham station and trained operators at every facility--just like at every hospital in San Joaquin County

Satellite Internet

2-way satellite-based Internet is widely available.

Antennas may be repositioning after earthquake.

Can be used with VOIP (telephone over the Internet) systems.

Multiple vendors, mobile versions available.

Needs clear southern horizon (SE, S, or SW depending on system).

Not incredibly fast.

May jam following a major emergency due to overuse.

Situation Awareness

Radios for monitoring the situation

NOAA Weather Radio.

AM/FM (crank-powered, Eton and others).

XM/Sirius (247 Emergency Info channel).

Battery-operated TV.

Internet radio and TV (if available).

Cable may work when broadcast doesn’t.

California Health Alert Network(CAHAN) CAHAN is a state-operated “telephone emergency

notification system” that is available for free use by long-term care facilities.

The feds/state/county use it to talk to you.

You use it to talk to your employees and others.

Delivers messages to web, e-mail, fax, telephone, cellular, SMS.

Government EmergencyTelecommunications System (GETS)

GETS provides emergency access and priority processing in the local and long distance segments of the Public Switched Telephone Network (PSTN). It is intended to be used in an emergency or crisis situation when the PSTN is congested and the probability of completing a call over normal or other alternate telecommunication means has significantly decreased

Dial a special number, enter a code, dial the number you need to reach, get connected. Cost: 7-10-cents-per-minute

Facilities that provide medical care are eligible

http://gets.ncs.gov for more information

CAHAN Demonstration

More information?

David Coursey, N5FDLAmateur Radio Emergency Service (ARES)

david@coursey.com(209) 740-7515

Assistance in developing emergency communications plans.Help selecting radios for your emergency kit.

Amateur Radio operator training -- just one day -- no Morse code!

This presentation: http://www.n5fdl.com/ltc

Thank you!David’s daily technology blog: www.techinciter.com

Twitter: @techinciter Facebook: www.facebook.com/coursey