internal emergency Infrastructure and other Code Yello · 2020. 2. 18. · Bec Smith, Regional...

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Code Yellow: Infrastructure and other internal emergencyBroome Regional Health Campus

WACHS Kimberley

Effective: 18/02/2020

Printed or saved electronic copies of this policy document are considered uncontrolled. Always source the current version from WACHS HealthPoint Policies.

Date of Last Review: February 2020 Page 1 of 46 Date Next Review: December 2020

Effective: < Insert Date >Effective: XXX

Emergency Response Procedures

Approval

These emergency response procedures assign responsibilities, actions and procedures that are implemented at Broome Regional Health Campus following the occurrence of an emergency.

These procedures have been formally endorsed by the Kimberley’s Emergency Management Committee as the Standard Operating Procedure to be followed during an emergency response at Broome Regional Health Campus.

Recommended Holly Kirwan, Business Manager

12/02/2020Dated

EndorsedWendy McKinley, Operations Manager

12/02/2020Dated

ApprovedBec Smith, Regional Director

18/02/2020Dated

Effective: 18/02/2020

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Broome Regional Health Campus: Code Yellow, Internal Emergency



Table of contents

1. Introduction ........................................................................................................41.1 Emergency response ........................................................................41.2 Classifying emergencies...................................................................41.2.1 Code Blue and Code Brown .............................................................51.2.2 Continuous improvement ..................................................................51.3 Business Continuity Plan ..................................................................5

2. Emergency Control Organisation.....................................................................62.1 First responder..................................................................................62.2 Emergency Response Coordinator...................................................62.3 Area Warden.....................................................................................62.4 Emergency Response Team ............................................................62.5 Communications Officer ...................................................................72.6 Medical Emergency Response Team ...............................................72.7 Scene-specific ECO structure...........................................................72.8 Site-wide ECO structure ...................................................................8

3. Documentation and equipment ........................................................................93.1 Emergency Control point ..................................................................93.2 Area Warden Points..........................................................................93.3 Action cards ......................................................................................93.4 Broome Regional Health Campus Communications Log................103.5 Equipment.......................................................................................10

3.5.1 Identification ...................................................................................10

3.5.2 Equipment checking and maintenance...........................................10

4. Communication................................................................................................104.1 Emergency Warning and Information System ................................10

5. Notification .......................................................................................................126. Post incident activities ....................................................................................127. Code Yellow – Infrastructure and other internal emergencies....................15

7.1. Introduction .....................................................................................157.2. Sub-plans........................................................................................157.3. Infrastructure damage.....................................................................157.4. Essential service disruptions ..........................................................15

7.4.1. Facility system status report ...........................................................16

7.5. ICT downtime procedures...............................................................177.6. Hazardous materials .......................................................................17

7.6.1. Hospital Response to a Code Yellow Hazardous Spill ...................17

7.7. Earthquake......................................................................................177.8. Missing Inpatient .............................................................................187.9. Code Yellow - facility system status report template ......................197.10. Code Yellow workarounds ..............................................................25

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7.11. Action Cards ...................................................................................26Action Card 1 First Responder ........................................................................27

Action Card 2 Emergency Response Coordinator ...........................................28

Action Card 3 Area Warden.............................................................................32

Action Card 4 Emergency Response Team Leader ........................................36

Action Card 5 Emergency Response Team Member ......................................37

Action Card 6 Communications Officer............................................................38

8. Appendices.......................................................................................................418.1 Appendix A – Communications Log.................................................428.2 Appendix B - Emergency Warning Information System instructions...438.3 Appendix C - Warden Intercommunication Point phones ...............44

This document can be made available in alternative formats on request for a person with a disability

Contact: Program Manager - Disaster and Emergency Management (T. Spicer)Directorate: Operations EDRMS Record # ED-CO-20-17187

Version: 1.00 Date Published: 18/02/2020Copyright to this material is vested in the State of Western Australia unless otherwise indicated. Apart from any fair dealing for the purposes of private study, research, criticism or review, as permitted under the provisions of the Copyright Act 1968, no part may be reproduced or re-used for any purposes whatsoever without written permission of the State of Western Australia.





1. IntroductionThese Emergency Response Procedures (ERP) outline the assigned responsibilities, actions and procedures to be undertaken at Broome Regional Health Campus to respond to and manage a potential or actual emergency affecting the facility.

The ERP forms the initial part of the emergency management suite of documents. It covers the roles, responsibilities, actions, equipment and procedures required during the emergency response phase, in line with the WACHS Emergency (Disaster) Management Arrangements Policy.

1.1 Emergency response The emergency response is the initial phase following the occurrence of an emergency. The ERP is the document that addresses the actions to be undertaken in the emergency response phase.

This ERP is facility-specific and covers: immediate actions to be taken by the first responder; and Follow-on actions (action cards) to be taken by members of the facility’s

Emergency Control Organisation (ECO).

Following the implementation of the ERP, the emergency may abate and resolve, or transition into the incident management and/or business continuity phases.

1.2 Classifying emergenciesEmergencies in hospitals are categorised into colour codes, as set out in Australian Standard (AS) 4083:2010 – Planning for emergencies – Health care facilities, and AS 3745:2010 – Planning for emergencies in facilities.

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Additionally, there are two subcategories of code black: Code Black Alpha – infant/child abduction Code Black Bravo – active armed offender.

Some hospitals may have separate emergency management sub-plans for specific hazards in their community, such as cyclones, bushfires, storm surge, and hazardous materials.

As a minimum, one printed copy of these procedures should be available on site, located at the Emergency Control Point (see section 3.1). Additional copies of these procedures may be printed and stored on site where required.

1.2.1 Code Blue and Code BrownCode Blue action cards are not included as part of these ERPs. Resources, information and templates pertaining to Code Blue Medical Emergency Response processes, please refer to the Clinical Escalation of Acute Physiological Deterioration including Medical Emergency Response Policy.

Code Brown action cards are not included as part of these ERPs. Please refer to the site’s Code Brown Emergency Response Procedure.

1.2.2 Continuous improvementThe ERP should be regularly reviewed, tested and updated based on lessons learned from actual emergencies or drills and exercises.

As per Clause 2.2 (d) of AS 3745:2010, the ERP is to be reviewed at least every five years.

1.3 Business Continuity PlanThis site’s Business Continuity Plan (BCP) documents the procedures and strategies to be enacted when critical business activities and/or services are disrupted. The BCP aims to restore disrupted services within acceptable pre-identified timeframes as part of the business continuity response phase to an emergency.

Code Red Fire / smoke

Code Blue Medical emergency

Code Purple Bomb threat / substance

Code Yellow Infrastructure and other internal emergencies

Code Black Personal threat

Code Brown External emergency

Code Orange Evacuation

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Business Continuity is not to be confused with contingency arrangements that are documented in the Code Yellow procedures. Code Yellow procedures deal with the initial emergency response to an infrastructure failure or other internal emergency, and the actions required to protect people and assets.

2. Emergency Control OrganisationThe ECO is a person or a group of trained persons that are responsible for directing and controlling the implementation of the site’s ERPs.

The primary role of the ECO is to ensure the safety of the facility’s occupants and protection of assets. Occupant safety always takes precedence over asset protection.

2.1 First responderAlthough not part of the ECO, the first responder is any staff member who first notices and initiates the response to an emergency. The first responder’s main responsibilities are to maintain safety of the building occupants, and to notify the ECO of the occurrence of an emergency.

2.2 Emergency Response CoordinatorThe Emergency Response Coordinator (ERC) leads the ECO for the entire site. The ERC has responsibility for commanding and coordinating the site’s emergency response in order to control the emergency. An ERC is rostered for all hours of Broome Regional Health Campus’s operation.

In the event of an emergency, the ERC has principal accountability of all patients, staff and visitors within the facility, regardless of their organisational position or tenancy arrangements. In complex emergencies or incidents that requiring ongoing incident or business continuity management, the ERC escalates the management of the emergency to the Hospital Incident Commander (HIC).

2.3 Area WardenIn each ward, department or area, an Area Warden is to be appointed during all times of operation. In the event of an emergency, the Area Warden has immediate responsibility of all staff within the designated area, regardless of their organisational position or tenancy arrangements

The Area Warden is normally the ward’s shift coordinator, nominated delegate, or otherwise senior person designated by the Site Service Manager or senior lead for the site.

2.4 Emergency Response TeamThe Emergency Response Team (ERT) may be mobilised to respond to an emergency. The ERT carries out front line actions for all emergencies except for Code Blue, at the direction of the ERC.

The ERT is led by the ERT Leader.





The role of the ERT is to: Attend the scene of a reported emergency within the facility grounds. Provide expert assistance where required. Prevent unauthorised people from entering the scene area. Liaise with emergency services personnel when they arrive. Assist staff to evacuate the area if the situation requires it.

2.5 Communications OfficerThe Communications Officer may form part of the ECO to assist with clerical support and record maintenance during an emergency response.

The Communications Officer is the single point of contact for any event affecting a facility. In the event of an actual or potential incident, the Communications Officer is responsible for:

a) Receiving the initial notification of an actual or potential incident. b) Notifying the ECO of any actual or potential incident.c) Assisting the ERC with clerical and record maintenance activities during an

emergency response.

2.6 Medical Emergency Response Team The Medical Emergency Response (MER) Team is a defined team of staff that respond to a medical emergency response, as defined by this site’s on site escalation procedure. The size and composition of the MER Team will be dependent on the facility’s staffing profile and rostering.

Resources, information and templates pertaining to Code Blue Medical Emergency Response processes, please refer to the Clinical Escalation of Acute Physiological Deterioration including Medical Emergency Response Policy.

2.7 Scene-specific ECO structureThe following diagram outlines the ECO governance structure for a scene-specific emergency response.

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EmergencyResponse

Coordinator(ERC)

Area Warden

Emergency

Response Team Leader

Emergency Response

Team (ERT)

Staff, patients and

visitors

Communications

Officer

2.8 Site-wide ECO structureThe following structure outlines the ECO governance structure for a site-wide emergency response.

EmergencyResponse

Coordinator(ERC)

Area Warden

Emergency

Response Team Leader

Emergency Response

Team (ERT)

Staff, patients and

visitors

Communications

Officer

Area Warden

Area Warden

Staff, patients and

visitors

Staff, patients and visitors





3. Documentation and equipment

3.1 Emergency Control point The Emergency Control Point is located at the Fire Indicator Panel in the waiting room of the Emergency Department. The Emergency Control Point serves as the staging area for the ERC, Communications Officer and the Emergency Response Team. The Emergency Control Point should contain:

Ring bound, laminated action cards for the ERC, ERT, and Communications Officer.

Radios and charging points for the ERC, ERT and Communications Officer. Tabards for the ERC, ERT and Communications Officer. Tabards should be

consistent with requirements in section 3.5.1. Contact list for the wards/departments, DECT numbers, WIP phone numbers,

PSTN emergency phone numbers. Map detailing the fire compartments throughout the facility. A laminated table of each ward/department, their primary and secondary stage

two and three assembly areas. Chinagraph pencils or other suitable writing instrument. Contact details for emergency services. A hard copy of these Emergency Response Procedures.

3.2 Area Warden Points Each area is to have an Area Warden Point. The point should be situated near a Warden Intercommunication Point (WIP) phone and have an Area Warden Pack contained with a box or document holder, ideally mounted and made of Perspex. The Area Warden Pack should contain:

Ring bound, laminated action cards for the Area Warden and First Responder Yellow Area Warden tabard with Area Warden clearly labelled front and back. Search map – a schematic of the respective area/fire compartment showing all

rooms, doors, and exits. This is used to conduct a search of an area during some emergencies (eg: fire, bomb threat, evacuation).

Chinagraph pencils or other suitable writing instrument. The primary and secondary evacuation routes and assembly areas. Instructions on operating the Warden Intercommunication Point (WIP) phone. An “area evacuated” sign.

3.3 Action cardsAction cards have been developed for first responders and each member of the ECO. When an emergency occurs, ECO members are to complete their respective action cards.

Following the emergency, the ERC is responsible for collating the action cards and sending them to the Communications Officer for collation, and the ERC for review. The ERC is also responsible for ensuring new action cards are printed and replaced in warden kits and muster points as soon as possible.





3.4 Broome Regional Health Campus Communications LogThe Communications Officer is to commence a communications log for following the code anouncement. The log should capture key decisions, communication details between key stakeholders, and any other relevant communications as part of the emergency response.

Once the emergency response is stood down, the ERC is to review the communications log for accuracy before sending to the Operations Manager. Once reviewed, the HSM is to attach the log to action card documentation for that event and electronically save the record. A communication log template is available in Appendix A.

3.5 EquipmentECO members are issued with pieces of equipment to assist them in responding to an emergency.

3.5.1 Identification ECO members are required by clause 5.8 of AS 3745 to identify themselves to allow for easy recognition. This site uses hats / vests .

The ECO positions should be identifiable by the following colours, with the position clearly labelled front and back.

Position Colour of tabard Emergency Response Coordinator WhiteEmergency Response Team OrangeEmergency Response Team Leader OrangeCommunications Officer WhiteArea Warden Yellow

3.5.2 Equipment checking and maintenanceECO members are responsible for checking their emergency equipment at the start of each shift to ensure it is in working order. Following the occurrence of an emergency, ECO members are responsible for refurbishing their equipment in warden kits and muster points.

4. CommunicationA series of communication systems may be used during an emergency to communicate with key stakeholders. This includes, but is not limited to:

4.1 Emergency Warning and Information System The Emergency Warning and Information System (EWIS) can notify building occupants of emergencies through the use of a series of audible tones. This includes an alert tone (BEEP… BEEP…) and an evacuation tone (WHOOP… WHOOP…). A Public Address (PA) system can also be used to allow the ERC or the emergency services to communicate to the entire facility or selected areas.





The EWIS can be operated from the Fire Indicator Panel(s), located at: The Emergency Department waiting room.

The EWIS is only be operated by DFES or the ERC who has been trained in its operation.

Instructions on how to use the EWIS system are listed in Appendix B.

4.2 Warden Intercommunication Point phones WIP phones are linked to the EWIS and allow the ERC or emergency services to directly communicate with Area Wardens for respective areas. Each department / ward should have one or more WIP phones located within their vicinity.

Instructions on how to use the WIP phones is listed in Appendix C.

4.3 Digital Enhanced Cordless Telecommunications This facility used Digital Enhanced Cordless Telecommunications (DECT) as part of its internal communication system. A number of paging groups have been set up to provide notification messages to predetermined handsets.

4.4 Two-way RadiosThis facility used Ultra High Frequency (UHF) two-way radios to communicate between key emergency responders during an emergency

These radios are checked by the Maintenance Manager on a monthly basis. Spare batteries are located at the Fire Indicator Panel, the Resource Room and the Executive Conference Room.

4.5 Mobile telephonesMobile telephones are a critical communication platform, and may be used to notify stakeholders on or off site.

4.6 Satellite telephonesSatellite telephones (sat phones) may serve as a primary notification method in some remote sites or as redundancy when other communication platforms are unavailable.

4.7 RunnersRunners are staff members who may be co-opted to relay key pieces of information or instructions. Runners may be used when conventional communication platforms become overwhelmed or unavailable.





4.8 Situation reportsA situation report (SITREP) is a short verbal summary of the current situation that can be used to inform decision making and actions required. A SITREP may be simply “all ok” or more detailed about the nature of the emergency and its current or anticipated impact. A SITREP should contain the below fields:

Current situation (what has happened, where did it occur, what time) What actions have been undertaken (what has been done) What actions still need to be completed (what needs to be done) Any other issues (anything of interest or noteworthy).

5. NotificationThere are a number of automatic and manual notification processes used by this facility. More detail on notification is provided in the specific emergency code sections.

5.1 Automatic notificationThis facility has a fire detection system installed to automatically detect smoke or fire. This includes smoke and thermal detectors, and sprinkler systems. These systems are linked to the Fire Indicator Panel and Building Management System (BMS).

This will also automatically notify the Department of Fire and Emergency Services (DFES) through the Direct Brigade Alarm (DBA).

5.2 Manual notificationA first responder can manually notify about the occurrence of any emergency by a number of methods, including:

A 56 emergency call, and announcing over the Public Audio system Manual call points (break glass alarms) Duress Alarms

6. Post incident activitiesFollowing the abatement or resolution of the emergency, the ERC is responsible for ensuring appropriate post-incident activities are implemented.

6.1 ReportingAll emergencies, regardless of whether they are false alarms or actual events, are to be reported on. There are three main avenues of reporting:

1. Emergency Code Reporting Tool. This online data collection tool is used to capture the occurrence of a code red false alarm, code yellow, code orange code purple, code black alpha, code black bravo, and code brown emergencies.

All reports submitted through this tool will require Tier 4 manager review and approval.

2. Safety Risk Report Form. This form is to be completed for all code red (real event) and code black incidents.





3. Code Blue emergencies – Medical emergencies are to be reported as per the Clinical Escalation of Acute Physiological Deterioration including Medical Emergency Response Policy.

Code Red – Fire / Smoke False Alarms only

Code Purple – Bomb Threat

Code Yellow – Infrastructure and other internal emergencies

Code Orange - Evacuation

Code Brown – External Emergency

Code Black Alpha – Infant / Child Abduction

Code Black Bravo – Active Armed Offender

Code Red – Fire SmokeConfirmed fires only

Code Black – Personal Threat

Code Blue – Medical Emergency

Emergency Code Reporting ToolEmergency Code Reporting Tool

Safety Risk Report FormSafety Risk Report Form

Datix / CIMSDatix / CIMS

Further information is available from the Reporting of Emergencies Procedure.

6.2 DebriefingFollowing the occurrence of an incident, the ERC should determine whether a debrief is warranted. There are two forms of debriefing:

a) Hot Debrief - A hot debrief is a quick and informal debrief. The main objectives of a hot debrief are to determine:

How the emergency or near miss occurred If any staff members, patients, and other building occupants have been

affected by the emergency, and any follow up actions that are required. This may include referrals to Employee Assistance Programs.

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If there are any ongoing potential hazard/s or risk/s to personnel Any urgent actions to mitigate risk/s Appropriate reporting and notification requirements

b) Formal Debrief – a formal debrief may be convened a number of days following the occurrence of the emergency. A formal debrief involves a more detailed analysis of the emergency to determine:

What was the cause of the emergency? What was the impact(s) of the emergency? Contributing factors that affected the outcome of the emergency. Any risks or issues that that have been identified as a result of the

emergency. Recognition of staff members involved in the emergency. Opportunities for continuous improvement with respect to training,

emergency response procedures or equipment. Any follow-up recommendations required to prevent a reoccurrence, or

mitigate the impacts, of the emergency,

The formal debrief may involve an investigation, and a formal report should be drafted and tabled at the «Region»’s Emergency Management Committee. The committee should track progress on the implementation of any recommendations.





7.1. IntroductionA code yellow emergency refers to emergencies that impact the facility and may be caused by infrastructure damage or other internal events that may adversely impact service delivery and/or the safety of staff, patients and visitors.

A code yellow emergency also covers emergencies that may originate external to a facility which may also impact on service delivery. Examples include failure or disruption to electricity, medical gases, water supply, information and communication technology and incidents involving hazardous materials.

7.2.Sub-plansThe following sub-plans have been established for Broome Regional Health Campus, based on the facility’s risk profile:

Code Yellow: Cyclone

7.3. Infrastructure damageThe Broome Regional Health Campus is made up of a number of structures where critical business functions are carried out. Damage to certain infrastructure may affect the effective functioning of units and may threaten the safety of patients, staff and visitors.

These Code Yellow (infrastructure damage) emergency response procedures address infrastructure damage through the implementation of emergency actions. Where emergency actions have failed and infrastructure damage disrupts critical business functions for periods greater than the tolerable period or threatens the safety of people, the Business Continuity Plan and code orange emergency response procedures is to apply.

7.4.Essential service disruptions The Broome Regional Health Campus is dependent on the integrity of a number of essential services. Numerous planned and unplanned incidents can disrupt the critical business functions of the Broome Regional Health Campus which may have adverse impacts on the safety of patients, staff and visitors.

Although the Broome Regional Health Campus has a number of contingencies in place to minimise the risk of essential service loss, these contingencies may also fail at a critical stage. These Code Yellow emergency response procedures address contingency failure through the implementation of manual workarounds. Where contingencies have failed and manual workarounds have become unsustainable,

12. Code Yellow – Infrastructure and other internal emergencies





causing disruption to critical business functions beyond tolerable periods, the Business Continuity Plan is to apply.

Refer to the Broome Regional Health Campus Business Continuity Plan to determine essential service contingencies and unit/area dependency levels on essential services.

The Business Continuity Plan contains contingency arrangements for the loss of key services are listed below.

This includes: Electricity supply disruption Water supply disruption Medical oxygen Natural Gas supply Air-conditioning system Fuel supply disruption (petrol and diesel) Sewerage / waste water Voice telephone system (PABX) ICT network 3G/4G network Wide Area Network Disruption. Paging system.

7.4.1. Facility system status reportThe Facility system status report is used to record the status of various critical facility systems and infrastructure. The form provides an overview of current and potential system failures or limitations that may affect incident response and recovery.

Should the facility’s infrastructure be damaged or impacted by a disruption or external hazard, an impact assessment should be undertaken to determine the status of particular systems throughout the hospital.

The report assesses seven key systems: Communications Power Lighting Water Sewerage / toilets Nurse Call System Medical Gases / Oxygen

When determining the status of systems, the status uses the following definitions: Fully functional: 100% operable with no limitations Partially functional: Operable or somewhat operable with limitations Non-functional: Out of commission N/A: Not applicable, do not have





7.5. ICT downtime proceduresA number of applications have formalised downtime procedures in place to deal with a disruption to ICT applications in systems. Other systems have no formalised downtime processes in place.

If loss of an ICT application or system results in wards or departments not being able to deliver their services, refer to the site’s Business Continuity Plan.

7.6.Hazardous materialsNumerous hazardous materials (HAZMAT) such as gases (medical and non-medical), flammable liquids, poisons, corrosive substances, radioactive materials and infectious materials are handled and stored within health service facilities. Additionally, HAZMAT may be transported along the main arterials near the health facility. HAZMAT incidents are most likely to be accidental, however may also be caused deliberately.

Although has a number of engineered control measures in place to minimise the risk of HAZMAT incidents, these control measures may also fail at a critical stage. These emergency response procedures address control measure failure through the implementation of emergency actions.

For further information, refer to the WACHS Managing Risks of Hazardous Chemicals and Dangerous Goods Procedure.

7.6.1. Hospital Response to a Code Yellow Hazardous Spill A ‘Code Yellow - Hazardous Spill’ may be declared should the spill of a hazardous substance impact on the normal operations of the hospital.

If the spill cannot be contained with a local response or it is having a significant impact on hospital functions, the Department of Fire and Emergency Services (DFES) should be contacted (via triple zero telephone call) for further advice and assistance. Appropriate Subject Matter Expertise should also be sought.

7.7.EarthquakeWestern Australia is a seismically active state, and has experienced many large magnitude earthquakes in its history.

When an earthquake occurs: DROP, COVER AND HOLD Do not leave the building as you may be in danger from falling debris. Stay where you are. Do not attempt to reach another area or floor within the

building until instructed to do so. Where possible ensure all persons are under beds, tables, benches or

doorframes to protect them from falling debris. If no cover is available, move into a corner or away from the centre of the

room and away from glass, walls/windows. Await instructions from the Area Warden or Emergency Services and evacuate

only on orders from them or the Emergency Response Coordinator or Area Warden

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Do not light matches or cigarette lighters, as there may be danger of explosion caused by ruptured gas lines. Use torches if there is no lighting.

For occupants outside buildings during an earthquake: Keep away from buildings, high walls and power lines. If you are caught beside a building, seek refuge under archways and

doorways. If you are driving, pull off the road and stop. After the shaking has stopped, do not enter damaged buildings.

Senior Person in the Area – actions to be taken: When the shaking has stopped, check staff and patients / visitors for injuries

and arrange appropriate first aid. Survey your area for structural damage, particularly stairwells. Check for fire

and fire hazards such as ruptured gas lines. If applicable, determine if medical gas supplies are functional by checking

the gas warning lights in the area. If there is interruption to the main supply it will be necessary to ensure that bottled gas (oxygen, air) is available for dependant patients.

Unless there is immediate danger, do not evacuate until instructed by the Area Warden, Emergency Response Coordinator, or Fire and Rescue Officers.

Ensure no one smokes inside the building or where a fire/explosion hazard exists.

Ensure all staff are accounted for and remain in the area until instructed to evacuate.

Assist emergency response team and Fire and Rescue officers. Participate in checking evacuation routes and, once in the assembly area, conduct a roll call to account for everyone.

Evacuation Do not evacuate the building during an earthquake. It is safer to remain within the building taking cover under tables, desks, doorframes and stairwells, to reduce the risk of injury from falling debris.

It may be necessary to check the evacuation routes before evacuation to ensure the area is safe. Stairwells may have collapsed. Do not use lifts.

7.8.Missing InpatientThe procedure for responding to a missing or suspected missing inpatients are managed under the WACHS missing or suspected missing inpatient procedure.

https://healthpoint.hdwa.health.wa.gov.au/policies/Pages/WACHS-Policies-Landing.aspxhttps://healthpoint.hdwa.health.wa.gov.au/policies/Policies/WACHS/Missing%20or%20Suspected%20Missing%20Inpatient%20Procedure.pdfhttps://healthpoint.hdwa.health.wa.gov.au/policies/Policies/WACHS/Missing%20or%20Suspected%20Missing%20Inpatient%20Procedure.pdf




7.9. Code Yellow - facility system status report template

1. Incident Name 2. Operational Period (# ) DATE: FROM: ______________________________ TO: _____________________________ TIME: FROM: ______________________________ TO: _____________________________

3. Name of Facility / Building Reporting Status Below

4. System 5. Status 6. Comments If not fully functional, give location, reason, and estimated time/resources for necessary repair. Identify who reported or inspected.

Communications

Fax Fully functional Partially functional

Non-functional

N/A

Information Technology System Network, applications

Fully functional

Partially functional

Non-functional

N/A

Nurse Call System Fully functional Partially functional

Non-functional

N/A

Overhead Paging Fully functional Partially functional

Non-functional

N/A

Paging SystemCode teams, standard paging

Fully functional


Non-functional

N/A

Radio EquipmentFacility handheld, 2-way radios, antennas

Fully functional


Non-functional

N/A

Radio Equipment EMS, local health department, other external partner

Fully functional


Non-functional

N/A

Radio EquipmentAmateur radio

Fully functional


Non-functional

N/A

Satellite Phones Fully functional Partially functional

Non-functional

N/A





Telephone SystemPrimary

Fully functional


Non-functional

N/A

Telephone SystemProprietary

Fully functional


Non-functional

N/A

Telephone SystemBack-up

Fully functional


Non-functional

N/A

Internet Fully functional Partially functional

Non-functional

N/A

Video-TelevisionCable

Fully functional


Non-functional

N/A

Infrastructure

Campus AccessRoadways, sidewalks, bridge

Fully functional


Non-functional

N/A

Fire Detection System Fully functional Partially functional

Non-functional

N/A

Fire Suppression System Fully functional Partially functional

Non-functional

N/A

Food Preparation Equipment

Fully functional


Non-functional

N/A

Ice Machines Fully functional Partially functional

Non-functional

N/A





Laundry / Linen Service Equipment

Fully functional


Non-functional

N/A

Structural Components Building integrity

Fully functional


Non-functional

N/A

(Note cracked walls, loose masonry, hanging light fixtures, broken windows)

Patient care

Decontamination SystemsIncluding containment

Fully functional


Non-functional

N/A

Digital Radiography System, Routine DiagnosticsPACS, CT, MRI, other

Fully functional


Non-functional

N/A

Steam / Chemical Sterilisers

Fully functional


Non-functional

N/A

Isolation Rooms Positive/negative air

Fully functional


Non-functional

N/A

Security

Facility Lockdown Systems Door/key card access

Fully functional


Non-functional

N/A

Campus SecurityExternal panic alarms

Fully functional


Non-functional

N/A

Campus SecuritySurveillance cameras

Fully functional


Nonfunctional

N/A

Campus SecurityTraffic controls

Fully functional


Non-functional

N/A





Campus SecurityLighting

Fully functional


Non-functional

N/A

Duress AlarmsInternal and other reporting devices

Fully functional


Non-functional

N/A

Utilities

Electrical PowerMains feed

Fully functional


Non-functional

N/A

Electrical Power Backup generator

Fully functional


Non-functional

N/A

Fuel Storage Fully functional Partially functional

Non-functional

N/A

(Note amount on hand)

Sanitation Systems Fully functional Partially functional

Nonfunctional

N/A

Water Fully functional Partially functional

Non-functional

N/A

Natural Gas/Propane Fully functional Partially functional

Non-functional

N/A

Air Compressor Fully functional Partially functional

Non-functional

N/A

Elevators/Escalators Fully functional Partially functional

Non-functional

N/A

HICS 251 | Page 4 of 6





Hazardous Waste Containment System

Fully functional


Non-functional

N/A

Heating, Ventilation, and Air Conditioning (HVAC)

Fully functional


Non-functional

N/A

Oxygen Fully functional Partially functional

Non-functional

N/A

(Note bulk, H tanks, E tanks, Reserve supply status)

Medical Gases, Other Fully functional Partially functional

Non-functional

N/A

(Note reserve supply status)

Pneumatic Tube Fully functional Partially functional

Non-functional

N/A

Steam Boiler Fully functional Partially functional

Non-functional

N/A

Sump Pump Fully functional Partially functional

Non-functional

N/A

Water Treatment System Fully functional Partially functional

Non-functional

N/A

Vacuum (for patient use) Fully functional Partially functional

Non-functional

N/A

Water Heater and Circulators

Fully functional


Non-functional

N/A





External Lighting Fully functional Partially functional

Non-functional

N/A

External StorageEquipment

Fully functional


Non-functional

N/A

External StorageVehicles

Fully functional


Non-functional

N/A

Parking Structures, Lots Fully functional Partially functional

Non-functional

N/A

(Power, panic alarms, access, egress, lighting)

Landing Zone Pads, lighting, fuel source

Fully functional


Non-functional

N/A

7. Remarks (Cracked walls, broken glass, falling light fixtures, etc.)

8. Prepared byPRINT NAME: ____________________________________________________________

DATE/TIME: ______________________________________________________________

SIGNATURE: __________________________________________________________

FACILITY: ______________________________________________________________





7.10. Code Yellow workarounds

Disruption / Incident Type Workarounds

Medical Gas Portable bottles at various locations

Suction Venturi twin o vac units at point of use Portable electric units

Water Bulk supply of bottled water located in the water plant room

Data Network (PC disruptions) Department specific

Landline Communications

Dedicated emergency mobile phones located in the Primary Emergency Operations Centre (code brown cupboard)

Runners Last resort phones

Mobile Communications

Satellite phones Landlines Runners Last resort phones

Paging system SMS to mobile phones Runners PA System

Nurse call bells

Unified devices Mobile phones Runners Patient phones Hand bells Increased staff surveillance/rounding

Air Conditioning

Blankets Natural ventilation Manual cool down methods (ice packs, moist towels,

showers etc.) Portable fans

Ventilation Natural Ventilation methods

Natural Gas Liquid Petroleum Gas





7.11. Action CardsCode Yellow action cards have been developed for the following positions:

Action card 1 First responder Action card 2 Emergency Response CoordinatorAction card 3 Area WardenAction card 4 Emergency Response Team LeaderAction card 5 Emergency Response Team memberAction card 6 Communications Officer





Code Yellow

Infrastructure and other internal

emergencies

Action Card 31

First Responder Action Card

1

Reports to: Area WardenResponsibilities:

Ensure the immediate safety of anyone within the vicinity of the hazard. Take measures to ensure that the person responsible for the emergency response

is notified.

On Identifying a Disruption to an Essential Service, Significant Infrastructure Damage or Hazmat Incident.

Time Sign

1. Remove all people from immediate danger.

2.

Establish contact the Area Warden

First Report:

a) Caller's Name and positionb) Exact location of the incidentc) Code Yellowd) Brief description of the incident / type disruption (essential

service/infrastructure)

3. Wait for directions from the Area Warden.

EARTHQUAKE Time Sign

1.

During an earthquake: DROP, COVER and HOLD Stay inside the building during the earthquake as you will be in

danger from falling debris. Where possible, move all persons are under beds, tables,

benches or doorframes to protect them from falling debris. Stay where you are. Do not attempt to reach another area or

floor within the building until you are instructed to by the Area Warden.

If no cover is available, move into a corner or away from the centre of the room and away from glass, walls and windows.

2.

After an earthquake: Wait for the directions of your area warden. Do not light matches or cigarette lighters as there may be a

danger of explosion caused by ruptured gas lines. Use torches if there is no lighting. Do not use lifts, and caution using stairs. They may be unsafe.





Code Yellow

Infrastructure and other internal emergencies

Action Card 32

Emergency Response Coordinator

Position: Most senior person on duty

Action Card

2

Reports to: Hospital Incident Commander or Executive on Call Responsibilities:

Control the internal emergency response of an emergency within the facility. Ensure the health and safety of patients (including permanent care residents), staff

and visitors when faced with an emergency.

ALERT Time Sign

1. Proceed immediately to the Emergency Control Point located at Fire Indicator Panel in the Emergency Department Waiting Room

2.

Collect tabard, action card and radio from EWIS panel.

a) Don tabard.b) Keep action card on hand.

3. Receive the first report from the Communications Officer and ascertain the nature and the location of the emergency.

4.

Instruct the Communications Officer to notify:

a) Engineering Officerb) Emergency services (where applicable)c) Service provider (where applicable and following discussion

with the Engineering Officer).

Establish estimated time of arrival/restoration time.

Note: Refer to associated documents – contact list.

5.

Activate the PA system for the entire facility and notify the site.

“Attention all areas, attention all areas, this is the Emergency Response Coordinator. Possible Code Yellow . Remain calm and wait for further directions.”

(Say twice).





Code Yellow


Action Card 32



Action Card

2

ALERT(Continued)

Time Sign

7.

Establish contact with the Area Warden of the affected area(s) via the Warden Intercommunications Point (WIP) phone and request a SITREP.

a) Critical business functions disruptedb) Manual workarounds in place.

Note: Where the Area Warden does not answer the WIP phone, use the PA system to ask the Area Warden/ Warden to attend to the WIP or deploy to Emergency Response Team to investigate.

8.

Establish contact with Area wardens adjacent to the affected area(s) and provide SITREP.

Current situation (what has happened, where did it occur, what time)

What actions have been undertaken (what has been done) What actions still need to be completed (what needs to be

done) Any other issues (anything of interest or noteworthy).

9.

Direct the Engineering Officer to complete an impact assessment using the Facility System Status Report template (Section 12.9) and determine:

a) Systems /infrastructure that are affected by emergencyb) Services / wards and departments that are impacted or

disrupted.c) Likely duration of impact / disruption.Refer to the site’s Business Continuity Plan.

Use the Consolidated Dependency Profiles – Infrastructure and Utilities, Equipment, ICT hardware and telecommunications, and ICT systems and applications, to determine:

Wards/departments/services that are highly dependent (dependency rating 4 or 5) on impacted resource / utility / system.

10.Brief the Engineering Officer, Emergency Response Team leader and emergency service personnel (where applicable) upon arrival on type of emergency, scope and location.





Code Yellow


Action Card 32



Action Card

2

RESPONSE Infrastructure Damage / Disruption / Earthquake

Time Sign

1.

Activate the PA system for the entire facility and notify the site.

“Attention all areas, attention all areas, this is the Emergency Response Coordinator. Confirmed Code Yellow - . Remain calm and wait for further directions.”

(Say twice.)

2. Establish contact with Area Wardens of affected areas and initiate appropriate workarounds. Refer to manual workarounds.

3. Ensure additional resources are sourced to support operations.

4.

Establish contact with the Hospital Incident Commander and provide SITREP:

a) Disruption typeb) Workarounds in placec) Critical business functions affectedd) Restoration timese) Maximum Tolerable Periods of Disruptions for affected

activities.

Determine the need to activate relevant Business Continuity Plans.

5. If Hospital Incident Commander takes control of the incident, respond to the directions of the Hospital Incident Commander.

6. Where necessary, activate Business Continuity Plan.

7. Maintain communications with key stakeholders.

HAZARDOUS MATERIALS Time Sign

1. Attempt to ascertain the substance involved in chemical spill and the areas affected.

2. If agent is known, source the appropriate Safety Data Sheet from ChemAlert and determine most appropriate action.

https://healthpoint.hdwa.health.wa.gov.au/policies/Pages/WACHS-Policies-Landing.aspxhttp://wachs.hdwa.health.wa.gov.au/index.php?id=15118




Code Yellow


Action Card 32



Action Card

2

3.

Only if safe to do so, direct the cleaning up of spill as per Safety Data Sheet instructions and in accordance with the Managing Risks of Hazardous Chemicals and Dangerous Goods Procedure. Source appropriate PPE and spill kits.

4.If unsure of agent or spill cleaning requirements, seek appropriate subject matter expertise, including advice from the Department of Fire and Emergency Services.

5.If substance is dangerous and volatile and presents a risk to staff, or if substance is affecting staff, patient and visitors, consider activating code orange evacuation procedures.

6.If further assistance or advice is required, direct the Communications Officer contact the Department of Fire and Emergency Services via a Triple Zero (000) call.

STAND DOWN Time Sign

1. Advise the Area Warden to wait for the arrival of Emergency Services or the Engineering Officer.

2.

Once the area is rendered safe and operational by Emergency Services Officer in Charge or the Engineering Officer, activate the PA system and notify the site.

“Attention all areas, attention all areas, this is the Emergency Response Coordinator. Code Yellow – Stand down.”

(Say twice.)

3. Refurbish tabard, action cards and radio in the Emergency Control Point.

4. Commence debriefing processes with all senior staff and key stakeholders.

5. Compile an emergency response report, as per reporting processes

https://healthpoint.hdwa.health.wa.gov.au/policies/Pages/WACHS-Policies-Landing.aspxhttps://healthpoint.hdwa.health.wa.gov.au/policies/Policies/WACHS/Managing%20Risks%20of%20Hazardous%20Chemicals%20and%20Dangerous%20Goods%20Procedure.pdfhttps://healthpoint.hdwa.health.wa.gov.au/policies/Policies/WACHS/Managing%20Risks%20of%20Hazardous%20Chemicals%20and%20Dangerous%20Goods%20Procedure.pdf




Code Yellow


Action Card 33

Area WardenPosition: Department Area Warden

Action Card

3

Reports to: Emergency Response Coordinator – Ext. Ext. Ext. 2854 in hours or Ext 2630 A/HResponsibilities:

Control the initial response to the emergency in the area

ALERT Time Sign

1. Proceed to the Area Warden Point.

2.

Collect tabard and Area Warden Pack:

a) Don tabard.b) Keep action cards on hand.

3. Direct staff to check the area/floor for any abnormal situations.

4. Commence code orange evacuation procedures if the situation in the area warrants this.

5.

Provide a SITREP to the Emergency Response Coordinator and any actions taken.




6.Remain within the immediate vicinity of the WIP Phone and maintain communications with the Emergency Response Coordinator.





Code Yellow


Action Card 33


Action Card

3

RESPONSE - INFRASTRUCTURE DAMAGE / DISRUPTION Time Sign

1. Respond to the directions of the Emergency Response Coordinator to implement workarounds

2.Liaise with Engineering Officer/Emergency Response Team Leader/Emergency Services and advise them of any particular hazards and areas for special consideration.

RESPONSE - INFRASTRUCTURE DAMAGE / DISRUPTION

(Continued)Time Sign

3.

Review resource requirements for business continuity. Report deficiencies to the Emergency Response Coordinator.

a) ICT systems and applicationsb) Specialised equipmentc) Office and Telecommunications Equipmentd) Workforcee) Essential services (power, water etc.)f) Physical Premisesg) Transport requirements.

4. Maintain communications with the Emergency Response Coordinator.

5. If Business Continuity Plan is activated, refer to the area’s Business Continuity Action Plan.

RESPONSE - HAZARDOUS MATERIALS Time Sign

1. Do not touch substance. Remove any personnel from the contaminated area.

2.

Only if safe to do so, attempt to ascertain the substance involved in chemical spill and share this information with the Emergency Response Coordinator. If not safe, treat the substance as unknown.





Code Yellow


Action Card 33


Action Card

3

3. Seek advice from the Emergency Response Coordinator as to whether the substance poses a risk to staff, patients and visitors.

4. Commence code orange evacuation procedures if the situation in the area warrants this.


6. Follow the instructions of the Emergency Response Coordinator and Emergency Services.

EARTHQUAKE RESPONSE Time Sign

1. Follow the First Responder Actions for earthquakes (Action Card 1)

2. When the shaking has stopped, check staff and patients / visitors for injuries and arrange appropriate first aid.

3. Survey your area for structural damage, particularly stairwells. Check for fire and fire hazards such as ruptured gas lines.

4.

If applicable, determine if medical gas supplies are functional by checking the gas warning lights in the area. If there is interruption to the main supply it will be necessary to ensure that bottled gas (oxygen, air) is available for dependant patients.

5.

Attempt to establish contact with the Hospital Emergency Coordinator. Provide SITREP.




6. Unless there is immediate danger, do not evacuate the area unless instructed to.

7.Ensure all staff are accounted for and await instructions from the Emergency Response Coordinator and/or Emergency Services personnel.

8. If instructed to evacuate, follow the Code Orange Evacuation Procedures.

9. Ensure there are no ignition sources, including cigarette lighters and matches, should there be gas leaks nearby.





Code Yellow


Action Card 33


Action Card

3


1. Where patients have been evacuated, coordinate their return to their wards or relocation as appropriate.

2. Instruct staff to reinstate the area to original operational status.

3. Refurbish tabard and Area Warden Pack at the Area Warden Point.

4.Act as directed by the Emergency Response Coordinator to compile a report of the actions taken during the emergency for the debrief.

5. Participate in the debriefing process.





Code Yellow


Action Card 34

Emergency Response Team Leader

Position: Most Senior Department Member

Action Card

4

Reports to: Emergency Response Coordinator – Ext. 2854 in hours or Ext 2630 A/HResponsibilities:

Lead the Emergency Response Team in carrying out emergency response activities.

ALERT Time Sign

1. Proceed immediately to the Emergency Control Point located at «Emergency_Control_Point_Location»

2.

Collect tabard, action card and radio.a) Don tabard;b) Keep action card on hand; andc) Turn radio on and radio check with the Emergency

Response Coordinator.

3.Where the Emergency Response Coordinator is absent, assume the responsibilities of the Emergency Response Coordinator (See Action Card 2) until they arrive.

4. Assemble other Emergency Response Team members.

5. Respond to the directions of the Emergency Response Coordinator.

CONFIRMED CODE YELLOW – RESPONSE Time Sign





2. Refurbish tabard, action cards and radio at the Emergency Control Point.






Code Yellow


Action Card 35

Emergency Response Team Member

Position: As directed by Team Leader

Action Card

5

Reports to: Emergency Response Team Leader Responsibilities:

Carries out emergency response actions at the direction of the Emergency Response Team Leader.

ALERT Time Sign

1. Proceed immediately to the Emergency Control Point located at Fire Indicator Panel located in ED Waiting Room

2.Collect tabard and action card.


3. Muster on the Emergency Response Team Leader.

4. Respond to the directions of the Emergency Response Team Leader.


1. Respond to the directions of the Emergency Response Team Leader.

2. Maintain communications with the Emergency Response Team Leader.


1. Respond to the directions of the Emergency Response Team Leader to clean, service and/or replace specialised equipment.

2. Refurbish tabard, and action cards at the Emergency Control Point.






Code Yellow


Action Card 36

Communications OfficerPosition: Main Receptionist (day shift only)Ext 9798. ED Clerical Officer (after 4pm)

Action Card

6

Reports to: Emergency Response Coordinator – Ext. Ext. 2854 in hours or Ext 2630 A/H

Responsibilities: Assists with clerical and record maintenance during and emergency response.

ALERT Time Sign

1. Ascertain the nature and location of the emergency from the first responder.

2. Notify the Emergency Management Team ‘possible code yellow’ by announcing over the Public Address system

3. Proceed immediately to the Emergency Control Point located at Fire Indicator Panel in the Emergency Department Waiting Room

4.

Collect the Communications Officer tabard and action cards.


5.

Provide the first report to the Emergency Response Coordinator.

a) Caller's Name and titleb) Exact location of the incidentc) Type of disruption/incident (e.g. essential services, hazardous

substance incidents, natural events).

6. Return to the switchboard and commence a running log of events and incoming calls.




1. Notify the Emergency Management Team ‘confirmed Code Yellow’ by announcing over the Public Address system .2. Continue logging events and incoming calls.

3. Maintain communications with the Emergency Response Coordinator and other key stakeholders.






Code Yellow


Action Card 36


Action Card

6


1. Activate the Emergency Management Team ‘Code Yellow – Stand Down’ by announcing over the Public Address system

2. Collate all action cards (complete and incomplete) and ensure logs and records are saved electronically and in hard copy format.

3. Refurbish tabard, action cards and radio at the Emergency Control Point at the Fire Indicator Panel


Time Participants Decision / communication / activity





Code Yellow


Action Card 36


Action Card

6





8. Appendices





8.1Appendix A – Communications Log

Date of incident: ____ / _____ / ______ Time of notification: ______:_______

Type of incident: ____________________ Location: ______________________

Name of Emergency Response Coordinator: ________________________________

Name of Communications Officer: _________________________________________

Note: This form serves as a record of all communications, activities and decisions made during the occurrence of an emergency. On resolution of the emergency, this form is to be electronically saved for review purposes.

Time Participants Decision / communication / activity





8.2Appendix B - Emergency Warning Information System instructions.

Standard Operating Procedure

Step ActionTo silence automatic tones, turn key to Manual, then press Buzzer mute Acknowledge, then Master Reset To make a PA announcement to all zones, switch key to MANUAL” then use “All PA”. Lift PA handset, press communication button on handset and make announcement. E.g. “Attention all staff, attention all staff, this is an unconfirmed code red for (state the work area) All area wardens are to proceed to the emergency control points and stand by WIP phones. Repeat announcement”, To cancel the All PA, press the Cancel button above the All PA button To make a PA announcement to individual zone/s, in EWS section of panel, select the zone/s by use of green zone button. Lift handset and make announcement To cancel the All PA, press the Cancel button above the All PA button.To initiate an “alert” to all zones, press the “ALL ALERT” Orange button. To “Cancel” the ALL ALERT, press the Cancel button above the All PA button.To initiate an “alert” to individual zones, in EWS section, press Orange button for the zone/s. To “Cancel” the Alert, press Cancel button for the EWS zone.To initiate an evacuation to all zones, press the “ALL EVAC” Red button. To “Cancel” the All EVAC, press the Cancel button above the All PA button.To initiate an evacuation to individual zones, in the EWS section, press the EVAC red button for the zone/s. To cancel the evacuation, press the cancel button above the zone. To answer an incoming WIP phone call, pick up phone, then in EIS section, press WIP Select where the indicator light is flashing. Indicator light will then stay on. On completion of the call, hang up receiver and indicator light will go out.To call an individual or several WIP phones at one time, pick up phone, then in EIS section, press WIP Select for those phones. On completion of call, hang up receiver and indicator lights will go out.When the emergency has been resolved and all activities are back to normal, check and clear all calls on the panel then press Master Reset. On completion, reset key switch back to “Automatic”.





8.3Appendix C - Warden Intercommunication Point phones

Warden Intercommunication Point (WIP) phones are located throughout this facility. WIP phones are used during emergencies to facilitate communication between Area Wardens and the Emergency Response Coordinator or Emergency Services at the main Fire Indicator Panel.

The location of WIP phones are detailed on evacuation diagrams.

To make a call:

1. Lift the handset and hold to ear.

(when the handset is lifted, the WIP phone automatically rings the phone at the main Fire Indicator Panel).

2. Talk

3. Replace handset at conclusion of discussion.

To receive a call

(when the designated WIP phone is called, it will make an constant beeping noise).

1. Lift the handset and hold to ear.

2. Talk

3. Replace handset at conclusion of discussion.

Note:

The Emergency Response Coordinator may be communicating with multiple people so only respond when requested and keep discussions succinct.


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