COVID-19 2020 Incident Action Plan Planning Schedule 1000 Command and General Staff: for the Incident Commander (IC), IC assistant, Medical Specialist, Public Information Officer (PIO), Safety Officer, Section Chiefs and Public Liaison Officer -- solve problems within the current OP and begin planning for the next Operational Period 1100 Operations: Section Chief, Unit Leaders and Physician Liaison: within each section, discuss current the current Operational Period and begin planning for next Operational Period 1200 Planning and Logistics: Section Chief and Unit Leaders: within each section, discuss current the current Operational Period and begin planning for next Operational Period 1300 Finance Section: Section Chief and Unit Leaders: within each section, discuss current the current Operational Period and begin planning for next Operational Period 1400 Tactics and Pre-Plan Meeting: for the Section Chiefs and Liaison Offer to determine how to meet goals and objectives for the next Operational Period 1600 Due: Statistics, Forms 203, 204, 213, 214 Safety and Human Resource Reports 1700 Planning Meeting: for the Section Chiefs, Safety Officers, Unit Leaders and Public Information Officer to finalize the plan for the next Operational Period 2100 Incident Action Plan (IAP) Disseminated MRH Overall Goal: Objectives:
Transcript
COVID-19 2020 Incident Action Plan
Planning Schedule 1000 Command and General Staff: for the Incident Commander (IC), IC assistant, Medical Specialist, Public
Information Officer (PIO), Safety Officer, Section Chiefs and Public Liaison Officer -- solve problems within the current OP and begin planning for the next Operational Period
1100 Operations: Section Chief, Unit Leaders and Physician Liaison: within each section, discuss current the current Operational Period and begin planning for next Operational Period
1200 Planning and Logistics: Section Chief and Unit Leaders: within each section, discuss current the current Operational Period and begin planning for next Operational Period
1300 Finance Section: Section Chief and Unit Leaders: within each section, discuss current the current Operational Period and begin planning for next Operational Period
1400 Tactics and Pre-Plan Meeting: for the Section Chiefs and Liaison Offer to determine how to meet goals and objectives for the next Operational Period
1600 Due: Statistics, Forms 203, 204, 213, 214 Safety and Human Resource Reports 1700 Planning Meeting: for the Section Chiefs, Safety Officers, Unit Leaders and Public Information Officer to finalize
the plan for the next Operational Period 2100 Incident Action Plan (IAP) Disseminated MRH Overall Goal: Objectives:
MRH Situation to Date as of
COVID tests Pending Positive Acute Care ICU Ventilator
PPE Inventory and Five Day Consumption Rate as of
PPE Inventory as of Start of Operational Period
(units)
MRH Consumption Rate (units per day based on
the last 5 days)
Masks - N95
Masks - Adult
Masks - Pediatric
Goggles
Gowns Priorities for today as of 0900
ZachW
Sticky Note
Marked set by ZachW
Daily Briefing Updates
MEDICAL TECHNICAL BRIEF
OPERATIONS
PLANNING
LOGISTICS
FINANCE
COMMUNICATIONS/MEDIA
OTHER
ORGANI Z AT I ON AS S I GNM EN T L I ST ( I C S 2 0 3 )
Chief
Chief
Chief
Chief
Unit Leader(s) Physician Liaison(s)
Medical Branch
Hotline/RET/Clinic
Emergency Dept
CACU
Med Surg
OB
Hospice
Surgery
Ancillary Services
Imaging
Lab
Cardio
EVS
Security/Building
Business
Registration
Billing
Chief
Chief
Time Unit
Procurement Unit
Comp/Claims Unit
Cost Unit
IC/UCs
IC Assistant
1. Incident Name: 2. Operational Period: Date From: Date To:
3. Incident Commander(s) and Command Staff: 7. Operations Section:
IC/UCs
Medical Specialist
Safety Officer
Public Info. Officer
Liaison Officer
4. Agency/Organization Representatives:
Agency/Organization Name
Documentation Unit
5. Planning Section:
Chief
Chief
Resources Unit
Situation Unit
Service Branch
Demobilization Unit
6. Logistics Section:
Chief
Chief
Supply
Food and Water Services
IT Unit
Support Branch 8. Finance/Administration Section:
Family Services
Medication
9. Prepared by: Name: Position/Title: Signature:
ICS 203 IAP Page Date/Time:
Labor
Credentialing
ZachW
Cross-Out
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
Coronavirus 5/5/20 5/7/20
0900 0900
Annie Relph, Darci Miller,
Anna Curtis, RN 5/5/20
Anna Curtis 435-851-9894, Tammy Tucker 435-469-1504
Operations
Medical
Respiratory Tent
Tammy Tucker RN Anna Curtis
Alice Friend LPN Anna Curtis
09-14 435-469-1504 RN wear full PPE
11-20 951-203-2428 LPN wear full PPE
Chris Canning Anna Curtis 09-20 860-597-1188 MA wear full PPE
1 RN staffed all day. 1 MA on call for busier times. Please obtain Covid-19 nasopharyngeal swab while wearing goggles, N95 mask, face shield andgloves in any person with fever, cough or shortness of breath. Face shields should be cleaned after each patient and re-used.2- see green book for standing orders and operating set up/take down
-Tent staff need to escort patients to ER for transfer or have ER nurse meet them at the door, make sure patient does not enter ER without a mask.- Text Ronnie ((916) 807-8218, Anna Curtis (435) 851-9894 and Tracie Carroll (435) 260-9614 the numbers at the end of the shift.-Get updates from Green binder-Staff need to clock in under COVID and not your regular department- Please also keep track of # PPE used through out shift
ER RN
MRH
MRH ext 3570
Lab ext 3409
Radiology ext 3412
ext 3997
MRH
COVID line
Tammy Tucker RN RN
5/5/20 1500
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
Coronavirus 5/5/20 5/7/20
0900 0900
Annie Relph, Darci Miller,
Anna Curtis, 5/6/20
Anna Curtis 435-851-9894, Tammy Tucker 435-469-1504
Operations
Medical
Respiratory Tent
Alice Friend LPN Anna Curtis
Angie Herrera Anna Curtis
09-20 951-203-2428 RN wear full PPE
09-20 239-470-5215 MA on call. wear full PPE
1 RN staffed all day. 1 MA on call for busier times. Please obtain Covid-19 nasopharyngeal swab while wearing goggles, N95 mask, face shield andgloves in any person with fever, cough or shortness of breath. Face shields should be cleaned after each patient and re-used.2- see green book for standing orders and operating set up/take down
-Tent staff need to escort patients to ER for transfer or have ER nurse meet them at the door, make sure patient does not enter ER without a mask.- Text Ronnie ((916) 807-8218, Anna Curtis (435) 851-9894 and Tracie Carroll (435) 260-9614 the numbers at the end of the shift.-Get updates from Green binder-Staff need to clock in under COVID and not your regular department- Please also keep track of # PPE used through out shift
ER RN
MRH
MRH ext 3570
Lab ext 3409
Radiology ext 3412
ext 3997
MRH
COVID line
Tammy Tucker RN
5/4/20 1500
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
Coronavirus 5/5/20 5/7/20
0900 0900
Annie Relph, Darci Miller,
Anna Curtis, RN 5/7/20
Anna Curtis 435-851-9894, Tammy Tucker 435-469-1504
Operations
Medical
Respiratory Tent
Mary Frothingham Anna Curtis
Anna Curtis
09-20 435-259-1570 RN wear full PPE
09-20 MA on call. wear full PPE
1 RN staffed all day. 1 MA on call for busier times. Please obtain Covid-19 nasopharyngeal swab while wearing goggles, N95 mask, face shield andgloves in any person with fever, cough or shortness of breath. Face shields should be cleaned after each patient and re-used.2- see green book for standing orders and operating set up/take down
-Tent staff need to escort patients to ER for transfer or have ER nurse meet them at the door, make sure patient does not enter ER without a mask.- Text Ronnie ((916) 807-8218, Anna Curtis (435) 851-9894 and Tracie Carroll (435) 260-9614 the numbers at the end of the shift.-Get updates from Green binder-Staff need to clock in under COVID and not your regular department- Please also keep track of # PPE used through out shift
ER RN
MRH
MRH ext 3570
Lab ext 3409
Radiology ext 3412
ext 3997
MRH
COVID line
Tammy Tucker RN
5/4/20 1500
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
Coronavirus 5/5/20 5/7/20
0900 0900
Annie Relph, Darci Miller, Jimmy Walling, Michelle Peterson
Anna Curtis, Tammy Tucker 5/5/20
Anna Curtis, RN 435-851-9894
Medical
Operations
Green
GREEN- Clinics
Mel Sakrison Ken Clinic
Paula Kelley Jonas Clinic
08-17 435-259-5532 MRHC
08-17 435-260-1626 MRHC
Abbie Sitton Mack Clinic 08-17 970-712-6266 MRHC
Janet Gay Float 08-17 918-510-5804 MRHC
Beata W Eve Clinic 12-20 847-691-4419 MRHC
Angie Hererra Des/Keely 08-17 239-470-5215 MRHC
Courtney Williams Quinn Clinic 08-17 435-210-4001 MRHC
Hannah Bodenhamer Urgent Care 13-20 720-383-0989 UC
Mark Weissinger Urgent Care 13-20 928-380-0882 UCSayge Anderson Urgent Care 13-20 727-543-9685 UCFront Table-0530-1300: Lindsey Shurtleff - 435-260-08291300-2000: Becca Dennis 831-600-6145
Continue to practice MRHC COVID Protocol.Ensure that at least one clinical staff member stays in the Clinic until 1700 to support provider for Urgent Care patient visits.
ManagerAnna Curtis 435-851-9894
Tammy Tucker RN MRHC Case Manager
5/4/20 1400
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
Coronavirus 5/5/20 5/7/20
0900 0900
Annie Relph, Darci Miller, Jimmy Walling, Michelle Peterson
Anna Curtis, Tammy Tucker 5/6/20
Anna Curtis, RN 435-851-9894
Medical
Operations
Green
GREEN- Clinics
Mel Sakrison Ken Williams
Paula Kelley Munger Clinic
08-13 435-259-5532 MRHC
08-17 435-260-1626 MRHC
Abbie Sitton Mack Clinic 08-17 970-712-6266 MRHC
Janet Gay Float 08-17 918-510-5804 MRHC
Beata W Eve Clinic 12-20 847-691-4419 MRHC
Angie Hererra Des/Keely 08-17 239-470-5215 MRHC
Courtney Williams Franke Clinic 08-17 435-210-4001 MRHC
Mark Weissinger Urgent Care 13-20 928-380-0882 UC
Ken Williams Urgent Care 13-20 UC
Lindsey Shurtleff Urgent Care 13-20 435-260-0829 UC
Front Table-0530-1300: Mary Frothingham 435-259-15701300-2000: Chris Mathe - 603-667-8209
Continue to practice MRHC COVID Protocol.Ensure that at least one clinical staff member stays in the Clinic until 1700 to support provider for Urgent Care patient visits.
ManagerAnna Curtis 435-851-9894
Tammy Tucker RN MRHC Case Manager
5/4/2020 1400
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
Coronavirus 5/5/20 5/7/20
0900 0900
Annie Relph, Darci Miller, Jimmy Walling, Michelle Peterson
Courtney Williams Quinn Clinic 08-17 435-210-4001 MRHC
Whitney Mack Urgent Care 13-20 UC
Daysha Talbert Urgent Care 13-20 801-702-7971 UC
Sayge Anderson Urgent Care 13-20 727-543-9685 UC
Front Table-0530-1300:1300-2000: Misty Kovacs 716-445-3046
Continue to practice MRHC COVID Protocol.Ensure that at least one clinical staff member stays in the Clinic until 1700 to support provider for Urgent Care patient visits.
ManagerAnna Curtis 435-851-9894
Anna Curtis MRHC Manager
4/23/2020 1200
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
5/5/20 5/7/20
0900 0900
Annie Relph RN, Darci Miller
Tammy Tucker RN 5/5/20
Anna Curtis RN, 435-851-9894 Tammy Tucker RN 435-469-1504
MEDICAL
OPERATIONS
RED
Hotline
Margie Swenson Hotline
Traci Jones Hotline
0700-070 435-260-1662 Home-cell
0700-070 435-260-8690 Home-cell
Scott Brockmeir Hotline 09-1700 919-260-0532 Home-cell
Nurses and MA's to answer hotlines. Take questions regarding the COVID-19 and screen for signs and symptoms. Refer to respiratory tent or stayhome and isolate and monitor. Help patients navigate appointments, call ins for medications, payments and answer general health questions. Callahead to the ER and let them know who you are sending. Have patient self register prior to arriving.
Remember to text call numbers to Tammy and Anna by 7:30am following your shift.
Tammy Tucker RN, BSN Unit Leader
1 5/4/20 1400
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
5/5/20 5/7/20
0900 0900
Annie Relph RN, Darci Miller RN
Tammy Tucker RN 5/6/20
Anna Curtis RN, 435-851-9894 Tammy Tucker RN 435-469-1504
MEDICAL
OPERATIONS
RED
Hotline
Michele Lesoine Hotline
Kelly Lindsey Hotline
0700-070 385-404-0118 Home-cell
0700-070 801-735-9720 Home-cell
Scott Brockmeir Hotline 09-17 919-260-0532
Nurses and MA's to answer hotlines. Take questions regarding the COVID-19 and screen for signs and symptoms. Refer to respiratory tent or stayhome and isolate and monitor. Help patients navigate appointments, call ins for medications, payments and answer general health questions. Callahead to the tent and ER and let them know who you are sending. Have patient self register prior to arriving.
Remember to text call numbers to Tammy and Anna by 7:30am following your shift.
Tammy Tucker RN, BSN MRHC Case Manager
1 5/4/20 1400
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
5/5/20 5/7/20
0900 0900
Annie Relph RN,
Tammy Tucker RN 5/7/20
Anna Curtis RN, 435-851-9894 Tammy Tucker RN 435-469-1504
MEDICAL
OPERATIONS
RED
Hotline
Michele Lesoine Hotline
Tiffanie Tabberer Hotline
0700-070 385-404-0118 Home-cell
0700-070 435-260-0602 Home-cell
Paula Kelly Hotline 09-17 435-260-1626 Home-cell
Nurses and MA's to answer hotlines. Take questions regarding the COVID-19 and screen for signs and symptoms. Refer to respiratory tent or stayhome and isolate and monitor. Help patients navigate appointments, call ins for medications, payments and answer general health questions. Callahead to the tent and ER and let them know who you are sending. Have patient self register prior to arriving.
Remember to text call numbers to Tammy and Anna by 7:30am following your shift.
Tammy Tucker RN, BSN MRHC Case Manger
1 5/4/20 1400
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
Coronavirus/COVID 19 5 May 2020 6 May 2020
0900 0900
Annie Relph, RN Darci Miller, RN
Dr. Paul Reay
Joe Christman, RN 435.773.1003 Georgia Russell APRN 435.260.6008
MEDICAL
OPERATIONS
RED
EMERGENCY DEPT.
Mike K,RN Joe Christman
Craig C,, RN Joe Christman
06-18 Ext. 3570 ED
06-18 Ext. 3570 ED - Dirty
Scott C, RN Joe Christman 18-06 Ext. 3570 ED - Dirty
Matt B,RN Joe Christman 18-06 Ext. 3570 ED
Dr.Alexander AM Ext 3572 ED
Dr. Scherer PM Ext 3572 ED
Angela Mercier APRN 12-22 Ext 3588 ED
Kelley L. RN Joe Christman 06-18 Ext. 3570 Orientation
Enter Front Desk for temp check at start of shift Two RN's staffing Emergency Department 24/7. One RN designated each shift as "dirty" nurse to takeHigh Risk patients and when Respiratory Evaluation tent not staffed. COVID virus binder to be reviewed and signed by all staff at beginning of shift.Face mask issued to staff beginning work week. Frequent hand washing and NO face touching reminders. One ER physician for 24 hour shift and oneAPRN for a 12 hour shift No Visitor policy to be strictly enforced in Emergency Department GOGGLES AND MASKS REQUIRED . Clean all hard, flatsurfaces and door handles hourly with "pink" spray. Stock Rooms, PPE carts and put away laundered scrubs. One RN orienting
Prepare PPE and Temp plan for ER point of Entry. Prepare for RE Tent closure. Continue PACU conversion to COVID use.
0600-1800
Scott C, RN
Mike K, RN 650-5049
1800-0600 801.556.6969
Unit Leader 435.773.1003
435.260.600
Joe Christman
Georgia Russell APRN 1200 -2200
Joe Christman RN ER Manager
1 5.4.. 2020 1310
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
Coronavirus/COVID 19 6 May 2020 7 May 2020
0900 0900
Annie Relph, RN Darci Miller, RN
Dr. Paul Reay
Joe Christman, RN 435.773.1003 Georgia Russell APRN 435.260.6008
MEDICAL
OPERATIONS
RED
EMERGENCY DEPT.
Mike K, RN Joe Christman
Rochelle S, RN Joe Christman
06-18 Ext. 3570 ED
06-18 Ext. 3570 ED
Karen F RN Joe Christman 18-06 Ext. 3570 ED - Dirty
Scott C RN Joe Christman 18-06 Ext. 3570 ED
Dr.Alexander AM Ext 3572 ED
Dr. Scherer PM Ext 3572 ED
Georgia Russell APRN 12-22 Ext 3588 ED
Kelley L. RN Joe Christman 06-18 Ext. 3570 Orientation - Dirty
Enter Front Desk for temp check at start of shift Two RN's staffing Emergency Department 24/7. One RN designated each shift as "dirty" nurse to takeHigh Risk patients and when Respiratory Evaluation tent not staffed. COVID virus binder to be reviewed and signed by all staff at beginning of shift.Face mask issued to staff beginning work week. Frequent hand washing and NO face touching reminders. One ER physician for 24 hour shift and oneAPRN for a 12 hour shift No Visitor policy to be strictly enforced in Emergency Department GOGGLES AND MASKS REQUIRED . Clean all hard, flatsurfaces and door handles hourly with "pink" spray. Stock Rooms, PPE carts and put away laundered scrubs. One RN orienting
Prepare PPE and Temp plan for ER point of Entry. Prepare for RE Tent closure. Continue PACU conversion to COVID use.
0600-1800
Karen F
Mike K, RN 650-5049
1800-0600 801.556.6969
Unit Leader 435.773.1003
435.260.600
Joe Christman
Georgia Russell APRN 1200 -2200
Joe Christman RN ER Manager
1 4.30. 2020 1310
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
Coronavirus/COVID 19 7 May 2020 8 May 2020
0900 0900
Annie Relph, RN Darci Miller, RN
Dr. Paul Reay
Joe Christman, RN 435.773.1003 Georgia Russell APRN 435.260.6008
MEDICAL
OPERATIONS
RED
EMERGENCY DEPT.
Rochelle S RN Joe Christman
Jess E,, RN Joe Christman
06-18 Ext. 3570 ED
06-18 Ext. 3570 ED - Dirty
Karen F RN Joe Christman 18-06 Ext. 3570 ED
Brandi PRN Joe Christman 18-06 Ext. 3570 ED- Dirty
Dr.Alexander AM Ext 3572 ED
Dr. Scherer PM Ext 3572 ED
Angela Mercier APRN 12-22 Ext 3588 ED
Enter Front Desk for temp check at start of shift Two RN's staffing Emergency Department 24/7. One RN designated each shift as "dirty" nurse to takeHigh Risk patients and when Respiratory Evaluation tent not staffed. COVID virus binder to be reviewed and signed by all staff at beginning of shift.Face mask issued to staff beginning work week. Frequent hand washing and NO face touching reminders. One ER physician for 24 hour shift and oneAPRN for a 12 hour shift No Visitor policy to be strictly enforced in Emergency Department GOGGLES AND MASKS REQUIRED . Clean all hard, flatsurfaces and door handles hourly with "pink" spray. Stock Rooms, PPE carts and put away laundered scrubs. One RN orienting
Submit PPE and Temp plan for ER point of Entry. Prepare for RE Tent closure. Continue PACU conversion to COVID use.
0600-1800
Brandi PRN
Rochelle S RN 650-5049
1800-0600 801.556.6969
Unit Leader 435.773.1003
435.260.600
Joe Christman
Georgia Russell APRN 1200 -2200
Joe Christman RN ER Manager
1 4.30. 2020 1310
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
Daysha Talbert, RN (O) Dirty 06-18 801-702-7971 MS
Mark Weisinger, RN (O) Clean 06-18 928-380-0882 MS
All staff will wear proper PPE according to patient diagnosisPatients with respiratory symptoms will go to rooms 112-117All admissions will continue to be screened with PCR for Covid-19.
Main Phone
MS
MS 435-719-3670
Charge Portable 435-719-3672
Gayle Audenried RN co-leader CACU
5-4-20
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
Jessica Bohannan RN NRP, Clean 18-06 435-260-0134 MS
Traci Jones RN Charge, dirty 18-06 435-260-8690 MS
Sami Coylar, CNA clean 18-06 435-260-2212 MS
All staff will wear proper PPE according to patient diagnosisPatients with respiratory symptoms will go to rooms 112-117All admissions will continue to be screened with PCR for Covid-19.
Main Phone
MS
MS 435-719-3670
Charge Portable 435-719-3672
Gayle Audenried RN co-leader CACU
5-4-20 1600
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
Scott Brockmeier, RN Charge, dirty 18-06 919-260-0532 MS
Ryan Huels, RN Clean, NRP 18-06 303-829-9764 MS
Sami Coylar, CNA Clean 18-06 435-260-2212 MS
All staff will wear proper PPE according to patient diagnosisPatients with respiratory symptoms will go to rooms 112-117All admissions will continue to be screened with PCR for Covid-19.
Main Phone
MS
MS 435-719-3670
Charge Portable 435-719-3672
Gayle Audenried RN co-leader CACU
5-4-20 1600
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
Covid 19 5/5/20 5/6/20
0900 0900
Operations Chiefs
Naomi Helquist (435) 210-0895 or Connie Wilson (435)260-0153
L&D
MRH
Avery Black Naomi Helquist 06-18 801-318-6714 OB call for OB pts >20 weeks with
OB/labor concerns (day orient)
Kathy Standifird Naomi Helquist 06-18 970-640-6985 Same as above 9day)
Tiffany Butler Naome Helquist 18-24 435-650-3054 OB call for OB patients >20 weeks
and OB covid line calls nights
Naomi Helquist Naomi Helquist 06-18 (435) 210-0895 Retur OB related Covid hotline calls
OB RN care and return of OB related calls coming into Covid hotline for patients > 20 weeks gestation. Design department specific entry point,temperature recording procedure, and PPE storage for entering/exiting MRH. Clarify where Newborns that have Discharged early will be seen forCCHD follow up in collaboration with Med-Surg and safety.
Use of aerosolizing precautions during appropriate times as listed in L&D protocol. Limit extra staff in L&D rooms during periods of aerosolization asmuch as possible to reduce PPE use and potential exposure of staff to Covid 19. Use iPad as much as possible to facilitate virtual support from familyand/or doula once available.
cell phones as above
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
Covid 19 5/6/20 5/7/20
0900 0900
Operations Chiefs
Naomi Helquist (435) 210-0895 or Connie Wilson (435)260-0153
L&D
MRH
Kathy Standifird Naomi Helquist 06-18 970-640-6985 OB call for pts > 20 weeks gest
with OB/labor concerns. (day)
Tiffany Butler Naome Helquist 18-24 435-650-3054 OB call for OB patients >20 weeks
and OB covid line calls nights
Naomi Helquist Naomi Helquist 06-18 (435) 210-0895 Retur OB related Covid hotline calls
OB RN care and return of OB related calls coming into Covid hotline for patients > 20 weeks gestation. Design department specific entry point,temperature recording procedure, and PPE storage for entering/exiting MRH. Clarify where Newborns that have Discharged early will be seen forCCHD follow up in collaboration with Med-Surg and safety. Work with ER to clarify OB triage during Covid.
Use of aerosolizing precautions during appropriate times as listed in L&D protocol. Limit extra staff in L&D rooms during periods of aerosolization asmuch as possible to reduce PPE use and potential exposure of staff to Covid 19. Use iPad as much as possible to facilitate virtual support from familyand/or doula once available.
cell phones as above
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
Covid 19 5/7/20 5/8/20
0900 0900
Operations Chiefs
Naomi Helquist (435) 210-0895 or Connie Wilson (435)260-0153
L&D
MRH
Avery Black Naomi Helquist 06-18 801-318-6714 OB call for OB pts >20 weeks with
OB/labor concerns (day orient)
Kathy Standifird Naomi Helquist 06-18 970-640-6985 Same as above 9day)
Tiffany Butler Naomi Helquist 18-24 435-650-3054 OB call for OB patients >20 weeks
and OB covid line calls nights
Naomi Helquist Naomi Helquist 06-18 (435) 210-0895 Retur OB related Covid hotline calls
Rachel Parker Connie Wilson 06-09 (435) 210-4309 OB call starts friday at 0600 for
the weekend
OB RN care and return of OB related calls coming into Covid hotline for patients > 20 weeks gestation. Design department specific entry point,temperature recording procedure, and PPE storage for entering/exiting MRH. Clarify where Newborns that have Discharged early will be seen forCCHD follow up in collaboration with Med-Surg and safety.
Use of aerosolizing precautions during appropriate times as listed in L&D protocol. Limit extra staff in L&D rooms during periods of aerosolization asmuch as possible to reduce PPE use and potential exposure of staff to Covid 19. Use iPad as much as possible to facilitate virtual support from familyand/or doula once available.
cell phones as above
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
Coronavirus/COVID-19 5/5/2020 5/0582020
0900 0900
Michelle Peterson (435) 260-1485
Dr. Katherine Williams, MD (435)260-8543
Margy Swenson, RN/Jessica Walsh, RN
Margy Swenson, RN
Nina Ross, RN
09-17* (435) 260-1662 Unit Leader
09-17* (435) 210-4168 Hospice patient care and on call
Barb Crossan, RN 09-17* (435) 209-7576 Hospice patient care
Jessica Walsh, RN 09-17* (435) 210-0522 Hospice admin, Unit Leader
Nina has 2 hospice patients. 1 in the community, 1 at the CCC. Nina has experience at MRH in Urgent Care, MS and in the OR. She will need to stayclean through out the entire incident. Nina is responsible for keeping the temperature log for hospice. During this period, Nina will be working onassigned projects, visiting patients and taking call. Barb has 3 hospice patients, 2 in the community and one at CCC. One of Barb's communitypatients is living at Rock Ridge. Barb also works for Rocky Mountain Care. Barb will need to stay clean through out the entire incident. During thisperiod Barb has scheduled patient visits.Margy is one of the Unit Leaders for hospice. She has ER and MS experience as well as EMS, Search and Rescue and Incident Commandexperience. Margy will be acting Unit Leader 5/8.Jessica has administrative responsibilities, communication. Working remotely when appropriate. Jess and Margy will practice donning/doffing.Jessica will be acting Unit Leader 5/5-5/7. Staffing will adjust to needs as they present. Prepared to move RNs where appropriate.
*Our hours are flexible and do not always follow the 09-17 schedule. The nurses are salaried and work when necessary and have breaks when theycan. Please feel free to contact the acting Unit Leader with any needs.
Staff will be working remotely as much as possible. Implementing necessary and appropriate infection control precautions. Will enter admissions whenentering the hospital for temperature screen. Will self-monitor temp and report to Nina Ross, when doing pt visits. Will wear goggles and masks inhospital. Will eat only in hospice private offices. Will screen (via telephone) patients for respiratory symptoms prior to in person visits.
Main Phone
Hospice
Hospice (435)719-3772
Basement Office (435)719-3778
24 On Call RN (435)260-7070
(435)260-0522
Hospice
Hospice Jessie's Cell
Margy Swenson GCH Case Manager Margy SwensonDigitally signed by Margy Swenson DN: cn=Margy Swenson, o=Grand County Hospice, ou=Hospice, [email protected], c=US Date: 2020.04.11 11:58:23 -06'00'
5/04/2020 1355
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
5/5/20 5/6/200700 0700
ANNIE- DARCI- MICHELLE- JIMMY
WHITNEY MACK
MICHELLE PETERSON
O.R.
O.R.
O.R.
O.R.
MICHELLE PETERSON SUPERVISOR
BRITTANY CANTWELL CIRCULATOR
830-1300 435-260-1373 O.R. OFFICE
830-1530 406-590-8216 O.R. NURSE ON CALL
NOEL SMITH SCRUB TECH 830-1530 480-285-4120 O.R. SCRUB ON CALL
MICHELLE PETERSON 435-260-1373
Michelle Peterson O.R. Manager
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
5/6/20 5/7/200700 0700
ANNIE- DARCI- MICHELLE- JIMMY
WHITNEY MACK
MICHELLE PETERSON
O.R.
O.R.
O.R.
O.R.
MICHELLE PETERSON SUPERVISOR
TAMMY TENTLER CIRCULATOR
435-260-1373 O.R. OFFICE
435-210-0513 O.R. NURSE ON CALL
SARAH JENSEN SCRUB TECH 801-725-3263 O.R. SCRUB ON CALL
MICHELLE PETERSON 435-260-1373
Michelle Peterson O.R. Manager
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
5/7/20 5/8/200700 0700
ANNIE- DARCI- MICHELLE- JIMMY
WHITNEY MACK
MICHELLE PETERSON
O.R.
O.R.
O.R.
O.R.
MICHELLE PETERSON SUPERVISOR
KAREN TAYLOR CIRCULATOR
830-1300 435-260-1373 O.R. OFFICE
830-1530 435-260-1247 O.R. NURSE ON CALL
NOEL SMITH SCRUB TECH 830-1530 480-285-4120 O.R. SCRUB ON CALL
MICHELLE PETERSON 435-260-1373
Michelle Peterson O.R. Manager
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
COVID-19 05/05/2020 05/6/20200900 0900
Annie R./ Darci M./Jimmy W./ Michelle P.
Cindy H. Imaging Services
Cindy H.
Heidi E. Cindy H.
07-1730
07-2030
Beth R. Cindy H. 0900-21
Jordan J. Cindy H. 0730-20
Jessica E. Cindy H. 08-2030
Ivy M. Cindy H. 2030-07
Create plan for department point of entry.
Cindy Hirschfeld
05/04/2020 14:00
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
COVID-19 05/06/2020 05/07/20200900 0900
Annie R./ Darci M./Jimmy W./ Michelle P.
Cindy H. Imaging Services
Cindy H.
Mindy B Cindy H.
07-1730
07-2030
Rachel M. Cindy H. 07-2030
Beth R. Cindy H. 0830-21
Heidi E. Cindy H. 08-2030
Ivy M. Cindy H. 2030-07
Create plan for department point of entry.
Cindy Hirschfeld
05/05/2020 14:00
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
COVID-19 05/07/2020 05/08/20200900 0900
Annie R./ Darci M./Jimmy W./ Michelle P.
Cindy H. Imaging Services
Courtney R. Cindy H.
Mindy B. Cindy H.
08-1800
07-2030
Rachel M. Cindy H. 0700-21
Jordan J. Cindy H. 0730-20
Ivy M. Cindy H. 2030-07
Create plan for department point of entry.
Cindy Hirschfeld
05/04/2020 14:00
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
Coronavirus 5/5/2020 5/6/2020
0900 0859
Darci Miller, Annie Relph, Jimmy Walling, Michelle Peterson
Start testing high risk areas asymptomatic patients for covid PCR and Ab.
All Personnel to wear masks, goggles, and gloves.
Carrie McCune 435-260-2435
Carrie McCune Med Tech
5/4/2020 @0822
AASSIGNMENT LIST (ICS 204)
1. Incident Name:
2. Operational Period: Date From: Date To:
Time From: Time To:
4. Operations Personnel: Name Contact Number(s)
Operations Section Chief:
Branch Director:
Division/Group Supervisor:
3.
Branch: 1
Division: 1
Group: 1
Staging Area: 1
5. Resources Assigned:
Resource Identifier Leader # o
f
Pe
rso
ns
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
COVID-19 05/05/2020 05/06/2020
0900 0900
Annie R./ Darci M./Jimmy W./ Michelle P.
DR. WHITNEY MACK
JIMMY WALLING CARDIOPULMON
Richens, Raymond STAFF THERAPIST
Mays, JeChelle CP Manager
07-1930 435-650-1885(cell) 719.3550 CP portable N95 fit testing, ER, MS
08-1700 435-260-0469(cell) 719-3552 CP desktop ER, OP, MED Surge, ordering,
meetings, equipment
Med surge in-pts we round and chart on, including charges and administering orders. EKG's in ED and OP. Restock pyxis for RT supplies used byMed Surge. Edit EKG's in ED and SDS machines, transmit EKG's uploaded to charts and charged for procedures. Received conf EKG's back from St.Mary's Hospital, RT uploaded and put copies in providers boxes, faxed to out side entities and filed in patient charts. RT to set up and train staff onrespiratory equipment, and researching alternitive ventilation ideas and equipment needed.RT will continue to cover the ED, Med surge and out patients as the providers will allocate which out patient orders will be scheduled and which oneswill wait until further notice. RT will be available 24 hours with call in the evenings.ER states that they will limit calls to RT for EKG's, etc for ER patients in the De-con room and room 4.
CONSERVE PPE; WEAR MASK AND GOGGLES AT ALL TIMES, AND MAINTAIN A COMFORTABLE DISTANCE BETWEEN COWORKES. SEEJECHELLE FOR MASK AND EYE PROTECTION. MEAL REQUESTS SLIPS AVAILABLE, TEMP UPON ENTERING MRH AT START OF SHIFT. RTTO WEAR STREET CLOTHES TO WORK, CHANGE INTO SCRUBS AT WORK, WEAR GOGGLES AND MASK AT ALL TIMES. CHANGE OUT OFSCRUBS UPON END OF SHIFT.
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
COVID-19 05/06/2020 05/07/2020
0900 0900
Annie R./ Darci M./Jimmy W./ Michelle P.
DR. WHITNEY MACK
JIMMY WALLING CARDIOPULMON
Richens, Raymond STAFF THERAPIST
Mays, JeChelle CP Manager
07-1930 435-650-1885(cell) 719.3550 CP portable N95 fit testing, ER, MS
08-1700 435-260-0469(cell) 719-3552 CP desktop ER, OP, MED Surge, ordering,
meetings, equipment
Med surge in-pts we round and chart on, including charges and administering orders. EKG's in ED and OP. Restock pyxis for RT supplies used byMed Surge. Edit EKG's in ED and SDS machines, transmit EKG's uploaded to charts and charged for procedures. Received conf EKG's back from St.Mary's Hospital, RT uploaded and put copies in providers boxes, faxed to out side entities and filed in patient charts. RT to set up and train staff onrespiratory equipment, and researching alternitive ventilation ideas and equipment needed.RT will continue to cover the ED, Med surge and out patients as the providers will allocate which out patient orders will be scheduled and which oneswill wait until further notice. RT will be available 24 hours with call in the evenings.ER states that they will limit calls to RT for EKG's, etc for ER patients in the De-con room and room 4.
CONSERVE PPE; WEAR MASK AND GOGGLES AT ALL TIMES, AND MAINTAIN A COMFORTABLE DISTANCE BETWEEN COWORKES. SEEJECHELLE FOR MASK AND EYE PROTECTION. MEAL REQUESTS SLIPS AVAILABLE, TEMP UPON ENTERING MRH AT START OF SHIFT. RTTO WEAR STREET CLOTHES TO WORK, CHANGE INTO SCRUBS AT WORK, WEAR GOGGLES AND MASK AT ALL TIMES. CHANGE OUT OFSCRUBS UPON END OF SHIFT.
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information
6. Work Assignments:
7. Special Instructions:
8. Communications (radio and/or phone contact numbers needed for this assignment):
Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
/
/
/
/
9. Prepared by: Name: Position/Title: Signature:
ICS 204 IAP Page _____ Date/Time:
COVID-19 05/07/2020 05/08/2020
0900 0900
Annie R./ Darci M./Jimmy W./ Michelle P.
DR. WHITNEY MACK
JIMMY WALLING CARDIOPULMON
Richens, Raymond STAFF THERAPIST
Mays, JeChelle CP Manager
07-1930 435-650-1885(cell) 719.3550 CP portable N95 fit testing, ER, MS
08-1700 435-260-0469(cell) 719-3552 CP desktop ER, OP, MED Surge, ordering,
meetings, equipment
Med surge in-pts we round and chart on, including charges and administering orders. EKG's in ED and OP. Restock pyxis for RT supplies used byMed Surge. Edit EKG's in ED and SDS machines, transmit EKG's uploaded to charts and charged for procedures. Received conf EKG's back from St.Mary's Hospital, RT uploaded and put copies in providers boxes, faxed to out side entities and filed in patient charts. RT to set up and train staff onrespiratory equipment, and researching alternitive ventilation ideas and equipment needed.RT will continue to cover the ED, Med surge and out patients as the providers will allocate which out patient orders will be scheduled and which oneswill wait until further notice. RT will be available 24 hours with call in the evenings.ER states that they will limit calls to RT for EKG's, etc for ER patients in the De-con room and room 4.
CONSERVE PPE; WEAR MASK AND GOGGLES AT ALL TIMES, AND MAINTAIN A COMFORTABLE DISTANCE BETWEEN COWORKES. SEEJECHELLE FOR MASK AND EYE PROTECTION. MEAL REQUESTS SLIPS AVAILABLE, TEMP UPON ENTERING MRH AT START OF SHIFT. RTTO WEAR STREET CLOTHES TO WORK, CHANGE INTO SCRUBS AT WORK, WEAR GOGGLES AND MASK AT ALL TIMES. CHANGE OUT OFSCRUBS UPON END OF SHIFT.
Division/Group Supervisor: Justin Usery (970) 312-7931 or (435) 719-3590
5. Resources Assigned:
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information Resource Identifier Leader
Cathy Somerville
Justin Usery 8 (435) 220-0081 06:00-14:00
Jeneane Coesens
Justin Usery 8 (801) 824-9347 06:00-14:00
Yesenia Flores
Justin Usery 8 (928) 660-3235 06:00-14:00
Jonathan Escobar
Justin Usery 8 (435) 220-0938 06:00-14:00
Willy Bridenbaker
Justin Usery 8 (435) 260-2578 06:00-14:00
Andy Kelley
Justin Usery 8 (970) 260-0501 15:00-23:00
Anita Del Val
Justin Usery 8 (720) 595-6049 18:00-02:00
Kyha Gritts
Justin Usery 8 (435) 210-4895 19:00-03:00
Steven Mason
Justin Usery 8 (435) 210-8709 19:00-03:00
6. Work Assignments: Cathy Somerville: Laundry Room. Jeneane Coesens: Laundry Room/Float. Yesenia Flores: MED/SURG. Jonathan Escobar: ED. Willy Bridenbaker: Laundry Room. Andy Kelley: Ancillary Services. Anita Del Val: Laundry Room. Kyha Gritts: Clinics/Urgent Care. Steven Mason: Public Areas. If requested to clean a covid/possible covid room, ensure that you are wearing the n95 mask that you have been fit tested for along with the other appropriate PPE unless the room has sat undisturbed for bare minimum of one hour, then enter with all PPE, but regular mask. Adhere to the Donning/Doffing procedures set in place in each area. If you are unsure what these procedures are, ask nursing staff. Wear PPE in all areas of the hospital at all times unless at a predetermined eating area. You will DON your mask and goggles at Main Admissions, and DOFF your mask and googles at Main Admissions as you leave.
7. Special Instructions: ALL STAFF: LOG INTO RELIAS AND MAKE SURE YOU ARE CAUGHT UP ON ALL OF YOUR TRAININGS. As of now Antonia, Matthew, Anita, Laurie, Yesenia, and Steven all have units due. Day Crew: Please bring all gowns from your respective areas to the laundry room at 1:00 PM so that they can be washed. Day laundry employees will need to ensure that these items are thrown in the washing machines before they leave. Night Crew: Gather the dirty rags from your respective areas and replace with a few new ones (Public Areas: Main Admissions and Med/Surg. Clinics/Urgent Care: Admissions desks and nurses stations. Ancillary/Infusion: ED Admissions and ED Nurses Station. Public Areas Employee: Remove the red bags from the old recycle bins located in main admissions at 8:00 PM and take directly to the laundry room. Ancillary Services: Remove the red bags from the old recycle bins located in the ED and take directly to the laundry room. These bags contain reusable masks that are given to our patients, and will need to be laundered every night at 8 PM, and then delivered back to each area. All night Employees: Make sure that you are delivering the dirty homemade gowns that are in your areas to the laundry room by 23:00 (11:00 PM) every night so that the laundry room employees will have time to get them washed and put in the dryers. Night Laundry Employees: Upon arriving on shift, please move the gowns from the washer to the dryer if they have not already been moved. Then fold and deliver the gowns as dictated on the chart in the laundry room immediately. At the end of your shift, please throw another load of the gowns in the washer/dryer if there is enough for a load. These gowns must be washed every night, as they need to be delivered to their respective areas the following morning by 7:00 AM. .
8. Communications (radio and/or phone contact numbers needed for this assignment): Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
ICS 204 Assignment List Purpose. The Assignment List(s) (ICS 204) informs Division and Group supervisors of incident assignments. Once the Command and General Staffs agree to the assignments, the assignment information is given to the appropriate Divisions and Groups. Preparation. The ICS 204 is normally prepared by the Resources Unit, using guidance from the Incident Objectives (ICS 202), Operational Planning Worksheet (ICS 215), and the Operations Section Chief. It must be approved by the Incident Commander, but may be reviewed and initialed by the Planning Section Chief and Operations Section Chief as well. Distribution. The ICS 204 is duplicated and attached to the ICS 202 and given to all recipients as part of the Incident Action Plan (IAP). In some cases, assignments may be communicated via radio/telephone/fax. All completed original forms must be given to the Documentation Unit. Notes: • The ICS 204 details assignments at Division and Group levels and is part of the IAP.
• Multiple pages/copies can be used if needed.
• If additional pages are needed, use a blank ICS 204 and repaginate as needed.
ASSIGNMENT LIST (ICS 204) 1. Incident Name:
COVID-19
2. Operational Period: Date From: 05/05/2020 Date To: 05/08/2020 Time From: 08:00 Time To: 08:00
Division/Group Supervisor: Justin Usery (970) 312-7931 or (435) 719-3590
5. Resources Assigned:
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information Resource Identifier Leader
Cathy Somerville
Justin Usery 8 (435) 220-0081 06:00-14:00
Jeneane Coesens
Justin Usery 8 (801) 824-9347 06:00-14:00
Willy Bridenbaker
Justin Usery 8 (435) 260-2578 06:00-14:00
Yesenia Flores
Justin Usery 8 (928) 660-3235 06:00-14:00
Matthew Butterfield
Justin Usery 8 (435) 260-2728 15:00-23:00
Kylie Thomas
Justin Usery 8 (435) 260-8258 16:00-00:00
JT Edwards
Justin Usery 8 (435) 210-4299 16:00-02:00
Anita Del Val
Justin Usery 8 (720) 595-6049 18:00-02:00
Kyha Gritts
Justin Usery 8 (435) 210-4895 19:00-03:00
Steven Mason Justin Usery
8 (435) 210-8709 19:00-03:00
6. Work Assignments: Cathy Somerville: Laundry Room. Jeneane Coesens: ED. Willy Bridenbaker: Laundry Room. Yesenia Flores: MED/SURG. Matthew Butterfield: Ancillary Services. Kylie Thomas: Laundry Room. JT Edwards: Public Areas. Anita Del Val: Laundry Room. Kyha Gritts: Clinics/Urgent Care. Steven Mason: Float/Projects. Wear PPE in all areas of the hospital at all times unless at a predetermined eating area. You will DON your mask and goggles at Main Admissions, and DOFF your mask and googles at Main Admissions as you leave.
7. Special Instructions: ALL STAFF: LOG INTO RELIAS AND MAKE SURE YOU ARE CAUGHT UP ON ALL OF YOUR TRAININGS. As of now Antonia, Matthew, Anita, Laurie, Yesenia, and Steven all have units due. Day Crew: Please bring all gowns from your respective areas to the laundry room at 1:00 PM so that they can be washed. Day laundry employees will need to ensure that these items are thrown in the washing machines before they leave. Night Crew: Gather the dirty rags from your respective areas and replace with a few new ones (Public Areas: Main Admissions and Med/Surg. Clinics/Urgent Care: Admissions desks and nurses stations. Ancillary/Infusion: ED Admissions and ED Nurses Station. Public Areas Employee: Remove the red bags from the old recycle bins located in main admissions at 8:00 PM and take directly to the laundry room. Ancillary Services: Remove the red bags from the old recycle bins located in the ED and take directly to the laundry room. These bags contain reusable masks that are given to our patients, and will need to be laundered every night at 8 PM, and then delivered back to each area. All night Employees: Make sure that you are delivering the dirty homemade gowns that are in your areas to the laundry room by 23:00 (11:00 PM) every night so that the laundry room employees will have time to get them washed and put in the dryers. Night Laundry Employees: Upon arriving on shift, please move the gowns from the washer to the dryer if they have not already been moved. Then fold and deliver the gowns as dictated on the chart in the laundry room immediately. At the end of your shift, please throw another load of the gowns in the washer/dryer if there is enough for a load. These gowns must be washed every night, as they need to be delivered to their respective areas the following morning by 7:00 AM.
8. Communications (radio and/or phone contact numbers needed for this assignment): Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
ICS 204 Assignment List Purpose. The Assignment List(s) (ICS 204) informs Division and Group supervisors of incident assignments. Once the Command and General Staffs agree to the assignments, the assignment information is given to the appropriate Divisions and Groups. Preparation. The ICS 204 is normally prepared by the Resources Unit, using guidance from the Incident Objectives (ICS 202), Operational Planning Worksheet (ICS 215), and the Operations Section Chief. It must be approved by the Incident Commander, but may be reviewed and initialed by the Planning Section Chief and Operations Section Chief as well. Distribution. The ICS 204 is duplicated and attached to the ICS 202 and given to all recipients as part of the Incident Action Plan (IAP). In some cases, assignments may be communicated via radio/telephone/fax. All completed original forms must be given to the Documentation Unit. Notes: • The ICS 204 details assignments at Division and Group levels and is part of the IAP.
• Multiple pages/copies can be used if needed.
• If additional pages are needed, use a blank ICS 204 and repaginate as needed.
ASSIGNMENT LIST (ICS 204) 1. Incident Name:
COVID-19
2. Operational Period: Date From: 05/05/2020 Date To: 05/08/2020 Time From: 08:00 Time To: 08:00
Division/Group Supervisor: Justin Usery (970) 312-7931 or (435) 719-3590
5. Resources Assigned:
Contact (e.g., phone, pager, radio frequency, etc.)
Reporting Location, Special Equipment and Supplies, Remarks, Notes, Information Resource Identifier Leader
Cathy Somerville
Justin Usery 8 (435) 220-0081 06:00-14:00
Jeanene Coesens
Justin Usery 8 (801) 824-9347 06:00-14:00
Yesenia Flores
Justin Usery 8 (928) 660-3235 06:00-14:00
Willy Bridenbaker
Justin Usery 8 (435) 260-2578 06:00-14:00
Antonia Barajas Tellez
Justin Usery 8 (435) 260-8714 06:00-14:00
Matthew Butterfield
Justin Usery 8 (435) 260-2728 15:00-23:00
JT Edwards Justin Usery 8
(435) 210-4299 16:00-02:00
Kylie Thomas Justin Usery 8
(435) 260-8258 16:00-00:00
Anita Del Val Justin Usery 8
(720) 595-6049 18:00-02:00
Kyha Justin Usery
8 (435) 210-4895 19:00-03:00
Steven Mason Justin Usery
8 (435) 210-8709 19:00-03:00
6. Work Assignments: Cathy Somerville: Laundry Room. Jeanene Coesens: Laundry Room/Float. Yesenia Flores: ED. Willy Bridenbaker: Laundry Room. Antonia Barajas Tellez: MED/SURG. Matthew Butterfield: Ancillary Services. JT Edwards: Public Areas. Kylie Thomas: Laundry Room. Anita Del Val: Laundry Room. Kyha Gritts: Clinics/Urgent Care. Steven Mason: Float/Projects. Wear PPE in all areas of the hospital at all times unless at a predetermined eating area. You will DON your mask and goggles at Main Admissions, and DOFF your mask and googles at Main Admissions as you leave.
7. Special Instructions: Night Crew: Gather the dirty rags from your respective areas and replace with a few new ones (Public Areas: Main Admissions and Med/Surg. Clinics/Urgent Care: Admissions desks and nurses stations. Ancillary/Infusion: ED Admissions and ED Nurses Station. Make sure that you are delivering the dirty homemade gowns that are in your areas to the laundry room by 23:00 (11:00 PM) every night so that the laundry room employees will have time to get them washed and put in the dryers. Night Laundry Employees: Before leaving your shift for the night, ensure that all homemade gowns that have been delivered have been washed and moved to one of the available dryers. These gowns must be washed every night, as they need to be delivered to their respective areas the following morning by 7:00 AM. Public Areas Employee: Remove the red bags from the old recycle bins located in main admissions at 8:00 PM and take directly to the laundry room. Ancillary Services: Remove the red bags from the old recycle bins located in the ED and take directly to the laundry room. These bags contain reusable masks that are given to our patients, and will need to be laundered every night at 8 PM, and then delivered back to each area. Day Laundry Crew: Please make sure that ED is receiving 5 yellow isolation gowns/per day. The rest will continue to be stocked in the tent. All Employees: if you are scheduled to be working on the floor (not in laundry), you will now have a bag with more n95 masks. This bag is located I the laundry room back by the computer in a bin labeled either “Day Shift N95” or “Night Shift N95”. These masks are meant to be rotated. We can use one per shift. After using an N95, place it back in the bag in the tote in the laundry room, and allow the mask to rest for three days. At that point, it will have become decontaminated, and will be safe for use again. .
8. Communications (radio and/or phone contact numbers needed for this assignment): Name/Function Primary Contact: indicate cell, pager, or radio (frequency/system/channel)
ICS 204 Assignment List Purpose. The Assignment List(s) (ICS 204) informs Division and Group supervisors of incident assignments. Once the Command and General Staffs agree to the assignments, the assignment information is given to the appropriate Divisions and Groups. Preparation. The ICS 204 is normally prepared by the Resources Unit, using guidance from the Incident Objectives (ICS 202), Operational Planning Worksheet (ICS 215), and the Operations Section Chief. It must be approved by the Incident Commander, but may be reviewed and initialed by the Planning Section Chief and Operations Section Chief as well. Distribution. The ICS 204 is duplicated and attached to the ICS 202 and given to all recipients as part of the Incident Action Plan (IAP). In some cases, assignments may be communicated via radio/telephone/fax. All completed original forms must be given to the Documentation Unit. Notes: • The ICS 204 details assignments at Division and Group levels and is part of the IAP.
• Multiple pages/copies can be used if needed.
• If additional pages are needed, use a blank ICS 204 and repaginate as needed.
CORONAVIRUS/COVID-19 5/5/20 5/6/20
07:00AM 07:00AM
ANNIE RELPH 435-260-1485
WHITNEY MACK 309-532-2473
CHRISTINA ZUNICH 719-641-2296
ADMISSIONS
ADMIT
A
MAIN ADMISSIONS
TATIANA MARUSOVA MAIN ADMISSION
SHANESSA TURPIN MAIN ADMISSION
8-8PM PHONE 571-332-9480 MAIN ADMISSION/CLEAN
6:30-4:30 PHONE 435-419-0934 MAIN ADMISSION/CLEAN
MIKE CALVERT ER ADMISSION 7-7PM PHONE 360-298-4922 ER ADMISSION/CLEAN/PPE PRN
BRUCE MILLIS ER ADMISSION 7-7AM PHONE 435-260-7050 ER ADMISSION/CLEAN/PPE PRN
LIZ KIMPEL URGENT CARE 12-8PM PHONE435-241-8645 UC ADMISSION/CLEAN
JUSTINE WILLIAMS MRHC 7:30-4:30 PHONE 435-259-5844 MRHC ADMIISION/CLEAN
