Date post: | 12-Apr-2017 |
Category: |
Healthcare |
Upload: | bcpsqc |
View: | 108 times |
Download: | 0 times |
Healthcare Response in the Fort McMurray Wildfires:
Managing the Beast
David Matear
Senior Operating Director
Northern Lights Regional Health Centre/Area 10
Quality Forum 2017, March 1-3, 2017
2
Agenda
• Alberta, Area 10 North Zone, and Fort McMurray
• Fort McMurray Pre-Evacuation
• City and Hospital Evacuation
• Suncor Firebag
• Fort McMurray emergency support
• Recovery
3
AHS Zones
4
Area 10 TOTAL PERMANENT (USUAL) POPULATION 81,948
Urban Service Area (Fort McMurray) 78,382
Nine Rural Communities 3,566
TOTAL SHADOW POPULATION 43,084
Urban Service Area (Fort McMurray) 4,342
Nine Rural Communities 478
123 Project Accommodations 38,264
TOTAL POPULATION 125,032 (Regional Municipality of Wood Buffalo Municipality Census Report 2015)
5
Fort McMurray
6
Northern Lights Regional Health Centre
7
Hospital/NLRHC Overview
• Numbers of acute beds: 105
• Number of LTC beds: 31
• Clinical Services
– Acute Care: Ambulatory and Respiratory Care, Critical Care, Maternal Child and Pediatrics, Medicine, Psychiatry, Surgical Services
– Cancer Care, Renal Dialysis,
– Diagnostic Imaging, Clinical Laboratory
– Allied Health: OT, PT, SLP, Recreation Therapy, Audiology, Social Work
– Seniors Health
• Community-based services
8
Wildfire Facts – The Beast
• On average 2.3 million hectares across Canada burn each year
• In 2014, more than 51,000 forest fires burned over 4.5 million hectares
• In 2015, nearly 4 million hectares burned around 6,700 fires by early September
“The Beast”
• Fort McMurray evacuation is largest wildfire evacuation in Canada on record, and the third-largest environmental disaster evacuation
• Covered 600,000 hectares (1.5 million acres)
• Destroyed over 2,400 homes
• Began on May 1, 2016; declared under control on July 5, 2016
• Defied wildfire laws in movement and spread
• Created its own microclimate
9
How The Beast Grew
Fort McMurray Pre-Evacuation
11
The Days Before – May 1, 2016
12
The Days Before – Sunday May 1
• Fires in and around Fort McMurray
• Emerging Issue Report generated for May 1, 2016 (00:25 May 2)
Sit Rep #1 May 01, 2016 20:53
• Recovery Centre in Fort McMurray was evacuated due to fire getting closer to the building
• Code Green was activated and patients were evacuated and positioned in the parking lot
• No injuries reported
• Decision was made to send some patients to their families in Forth McMurray and house the remainder in a hotel downtown Fort McMurray
13
NLRHC and Gregoire
5km
Recovery Centre
14
The Days Before – May 2, 2016
City and Hospital Evacuation
16
E Day – May 3, 2016 • Sunny clear day
• Normal business including arranging birthday cake event for 1400
Meeting May 3, 2016 1100–1130
• Review Incident Action Plan
• 3/19 fires out of control in North Zone – Fort McMurray, High Level
• Forecast “Dynamic Fire Conditions, high temperatures until after May long
weekend
• Fort McMurray Fires (2) – EDM
– South
• Centennial park still mandatory evacuation
– North
• Wood Buffalo – Fire growing, winds favorable, smoke is main concern
• REOC
– Site crew to Wood Buffalo
– Severe fire conditions
– Evacuation order lifted in Prairie Creek
– MacDonald Island Reception Centre – Only 3 spent night between May 2 and 3
• PPIH
– MacDonald Island Reception Centre – AHS Strike Teams there only 12 spent
at the site
– REOC stated no longer needed AHS
• AMH – Programs delivered from hotels
• Logistics – Hotel Booking for May 3 night
• Next steps – REOC evacuation plans to NLRHC
– Anzac Reception Centre
– REOC at Fire Hall #5
– Leadership may change if event continues
• Next meeting - Touch base at 1600
17
E Day – May 3, 2016 • HIM email 1400 – Staff asking to leave early
and for direction.
Emergency Incident Meeting 1415-1445 (Invite sent at 1403)
• All Managers invited
• Mandatory evacuation – Abasand
– Beacon Hill
– Dickensfield
– Grayling Terrace
– Gregoire
– Waterways
– Wood Buffalo (including Golf course)
– AMH patient evacuation
– No access for medications and pets
• Voluntary evacuation – Thickwood*
– AHS • Thickwood Medical Centre
• Home Care
• Thickwood Public Health (some staff deployed to MacDonald Island)
• YMCA – Adult Day Program
– 30 minute standby for evacuation
• Register at MacDonald Island evacuation centre
– Prepare to up to 25,000 evacuees
• NZEOC formally established
• ICP to be formally established in NLRHC
• NLRHC began evacuation planning and action – Closed Ambulatory Care Clinics
– All staff memo drafted (before 1600)*
18
Evacuation Areas
19
AHS Facilities Thickwood
20
E Day – May 3, 2016 Incident Command Post Meeting 1600-1630
• Patient count: Acute 73, LTC 32, Visitors 22
• ICP formally established
– Immediate coordination of patient movement
• Status
– Highway 63 closed south
– Lower downtown evacuated, except MacDonald Island
– Evacuate Fort McMurray residents north to Norelta lodge (40 kms)
NLRHC evacuation options
• Transport
– 1 medevac
– 6 ambulances
– 17 buses (8 transit/city buses and 9 highway buses)
• North
– Airport location
– Suncor/Syncrude sites being explored
– Suncor Medical Centre
• Priorities vent and stretcher patients
– Ambulances deployed for evacuation
• Priority for Patients and Staff
21
Oil Sands Sites
22
E Day
HWY 63 Closed
Medevac 1
Getting out
Airport Time Lapse
23
E Day – May 3, 2016 Incident Command Post Meeting 1745-1815
• Fort McMurray mandatory evacuation
– Abasand, Beacon Hill, Dickinsfield, Draper, Grayling Terrace, Gregoire, Saline Creek, Thickwood, Waterways, Wood Buffalo.
• Confirmed evacuation of all patients and staff
– Evacuation site confirmed as Suncor Firebag and ultimately to AHS sites
– Requesting air ambulances
– Ordered 737 Westjet to Suncor Firebag
– Ultimate destination Edmonton
– Evacuation site on MacDonald Island under evacuation order
• Notes:
– Patient movement had started prior to 1700
– 1727 ICP confirmed NLRHC shortly to evacuate with Communications
– 1730 staff memo with updated evacuation information
– RCMP to aid with final sweep of NLRHC
24
NLRHC North West
25
Evacuation Route
26
Patient Transport
Suncor Firebag
28
Firebag First 12 hours
The Largest Emergency Airlift in Canadian History
• 33 aircraft
• 40 Flights
29
Fire Map – May 4, 2016 1300
• Fire covering 10,000
hectares (25,000 acres)
• 1,600 homes destroyed
• Evacuation of patients and
majority of staff from Firebag
completed at 1230
31
Oil Sands Community Evacuation - May 5-6, 2016
Gog
Shughie
32
May 7, 2016
• Fire 156,000 hectares (390,000 acres)
• Fort McKay voluntary evacuation begins
• Air quality 10+
• Fort Chip LTC evacuated
• Oil sands camps on evacuation notice
• AHS supporting CANTF2 medical operations
• Reduced activity at Firebag
33
Last Out, First Back
Fort McMurray Emergency Support
35
Keyano Location
AHS Medical Clinic
Can TF2
36
AHS Medical Clinic – Gregoire
Fort McMurray Recovery
38
The Damage
39
Access
40
The Site
• Fort McMurray Urgent Care
Centre (May 12 – June 7,
2016)
• Syncrude Sports and
Wellness Centre
41
Portable Isolation Containment System (PICS)
First Full Deployment
• Edmonton Zone
• Calgary Zone
42
UCC Initial Plan (with OR)
43
Fort MASH
Initial Setup
UCC Complete
44
UCC Support
Registration
Supplies
Staffing
45
Panoramic Green Area
Stretchers/Yellow Area
46
Patient Services
Inpatient Beds Isolation Beds
Resuscitation & Pharmacy Operating Room
47
Diagnostics
Diagnostic
Imaging
Mobile Whole
Body CT Scanner
Laboratory
48
Air Quality
49
Incident Command
50
Incident Command Post
51
FMMUCC – SSWC
Incident Command DI
Lab WHS
Medical
Affairs
52
Fire Map – May 16, 2016
53
Health Services and NLRHC Phased Opening
• Phase 1
– Resumption Date: June 1, 2016 of : ED, Lab, DI, temporary Pharmacy, HIM, Food Services
• Phase 2
– Anticipated reactivation date: June 15, 2016:
– Actual Reactivation date: June 11, 2016
– Fully Operational ED, ICU (3 beds), Surgical OR (2 theatres for life or limb), Ambulatory Care, Ortho Clinic, CWS, RT, Mat/Child(6 beds) NST Clinic, Surgery opening (10 beds), Pediatrics (3 inpatient beds), MH Crisis Supports, Allied Health, Social work, OT/PT, Educators (4 for BLS certifications and front line work requirements), PCC coverage.
– Subbasement - support services: CPSM, MDC, MDR, Laundry/linen
– Basement: Admin, Volunteer Resources, Medical Affairs, IT/Computer services, Nutrition/Food Services/Cafeteria
• Phase 3:
– Anticipated Reactivation Date: June 20, 2016
– Actual Reactivation Date: June 13, 2016
– Floors 3 and 5: Medicine Unit, Inpatient Psychiatry, Pharmacy, Renal Dialysis, Allied Health
• Phase 4:
– Anticipated Reactivation Date: July 25, 2016
– Actual reactivation Date: July 14, 2016
– Floor 4: Long Term care
54
RMWB Rentry Plan
55
SSWC Community Services
56
Task Force Transition – June 4, 2016
57
NLRHC Task Force
58
UCC Activity DATE PTS CTAS 1 CTAS 2 CTAS 3 CTAS 4 CTAS 5 CTAS 9 MEDIVAC AG
May 12 9 4 5
May 13 13 1 10 2 1
May 14 19 1 13 2 3 1
May 22 37 7 26 4 3
May 23 24 1 8 14 1 7
May 24 22 2 2 13 4 1 1
June 4 40 1 12 18 6 3 1
June 5 36 13 13 9 1
June 6 30 1 6 12 11
TOTAL 698 13 153 363 132 37 8 42
59
Timeline Conclusion
June 27
• ZEOC North and Task Forces closure
July 26
• Debriefs at NLRHC start
July 27
• Debriefs at NLRHC continue
July 28
• Debriefs at NLRHC finalize
60
NLRHC Remediations
61
ED Opening – June 1, 2016
62
NLRHC ED Activity DATE PATIENTS CTAS 1 CTAS 2 CTAS 3 CTAS 4 CTAS 5 CTAS 9 MEDIVAC AG
May 31
June 1 23 2 9 8 2 2 1 7
June 2 43 2 14 23 3 1 6
June 3 85 8 23 43 11 1 1?
June 4 69 2 13 48 6 2 5
June 5 77 4 22 44 7 1 1 4
June 6 106 1 6 29 59 11 1
TOTAL 406 1 24 111 228 40 4 6 68
63
NLRHC Bed Opening Plan NLRHC BED OPENING SCHEDULE
JUN-20 JUN-27 JUL-04 JUL-11 JUL-18 JUL-25
MEDICINE 20/43 26/43 36/43 43/43 43/43 43/43
ICU 3/6 3/6 3/6 6/6 6/6 6/6
SURGERY 10/27 25/27 25/27 25/27 25/27 25/27
PEDS 3/8 8/8 8/8 8/8 8/8 8/8
PSYCHIATRY 9/10 10/10 10/10 10/10 10/10 10/10
MAT/CHILD 6/11 11/11 11/11 11/11 11/11 11/11
LTC 5/31 (JUNE 24) 13/31 (JUNE 30) 21/31 (JULY 7) 31/31 (JULY 14) 31/31 31/31
64
Celebrations
65
Happy Ending
Back in Phoenix,
enjoying Halloween!
Gog
Shughie
66
Discussion and Questions