Strategies for Managing Resources and Assets

Obtaining and replenishing medications and related supplies that will be required throughout the response and recovery of an emergency.

1. How the hospital will obtain and replenish medications and related supplies that will be required throughout the response and recovery of an emergency, including access to and distribution of caches that may be stockpiled by the hospital, its affiliates, or local, state, or federal resources:

St. Mary Medical Center maintains supplies on site that may be required for an extended emergency at all times. Supplies supporting operations for 96 hours should be obtained.

The amount, location, and process for obtaining and replenishing medical and pharmaceutical supplies, are established before an event.  For the duration of the emergency – including response and recovery phases – the Operations Section Chief and Staging Manager are responsible for monitoring the inventory of supplies, equipment, and pharmaceuticals. Replenishment from storage areas will occur on an as needed basis.

The amount and location of current supplies have been evaluated to determine how many hours the facility can sustain before replenishing.  This gives the facility a par levelon supplies and aids in the projection of sustainability.

Upon activation of the EOP, the Operations Chief and Staging Manager will coordinate the initial delivery of supplies, equipment, and pharmaceuticals to patient care areas. Prioritization will be given to those areas either immediately affected by the emergency, or are likely to be so. Carts containing pre-positioned supplies and equipment will be sent to designated staging areas.

The contents of the carts will be rotated out on a regular basis to prevent expiration. Equipment designated for pre-positioning is included in the organization’s medical equipment inventory.

For areas that do not have designated pre-positioned supplies, equipment, and pharmaceuticals, existing inventory should be utilized to respond upon activation of the EOP. If additional inventory is immediately needed, the Operations Section Chief / Staging Manager should be contacted.

2. How the hospital will obtain and replenish medical supplies and equipment that will be required throughout response and recovery, including personal protective equipment:

The amount, location, and process for obtaining and replenishing medical supplies and personal protective equipment, are established before an event.  The process for obtaining and replenishing those supplies once the par levelhas decreased also includes a list of the vendors and contractors that deliver supplies. 

For the duration of the emergency – including response and recovery phases – the Operations Section Chief and Staging Manager are responsible for monitoring the inventory of medical supplies, personal protective equipment, and equipment, in the various care areas.

A general inventory of medical supplies, personal protective equipment, and equipment will be taken in their respective storage areas for the duration of the emergency. Remaining inventory shall be measured against the rate of consumption that is occurring as a result of the emergency.

Specialty PPE (C suits and HAZMAT PAPRS) are stored in Labor and Delivery, Emergency Department, Facilities Department, Security Department and the Disaster Resource Center.

3. How the hospital will obtain and replenish nonmedical supplies that will be required throughout the response and recovery phases of an emergency:

St. Mary Medical Center maintains supplies on site that may be required for an extended emergency at all times. Supplies with short shelf life and those that require continual replenishment,for a minimum of 96 hours.

The amount, location, and process for obtaining and replenishing of nonmedical supplies including food, water, linen, and fuel are established before an event.   For those items that usage would exceed par levels as a result of a large scale incident or items that would expire, vendors will be utilized. The process for obtaining and replenishing those supplies once the par level decreases also includes a list of the vendors and contractors that deliver and sell required supplies. 

 4 & 5.  How the hospital will share resources and assets with other healthcare organizations within/outside the community:

Depending on the nature, scope, and duration of the emergency, it may be possible to share resources and assets with other healthcare organizations both within and outside the community. These assets and resources include, but are not necessarily limited to:

• Beds
• Transportation
• Ventilators
• Linen
• Fuel
• Personal Protective Equipment
• Medical Equipment and Supplies

Prior to making such assets and resources available, the organization must first confirm that sufficient assets and resources are maintained on-site to meet its own operational requirements.

For equipment and supplies, an accurate inventory should be maintained of what was sent to other facilities and when, so that appropriate reimbursement can occur.

6. How the hospital monitors quantities of its resources and assets during an emergency:

It is possible that the nature, scope, and duration of the emergency may preclude outside agencies, vendors, authorities, or other vital entities from assisting the organization in a timely manner. Outside assistance may not be available for up to 96 hours following initiation of the EOP. Upon evaluation of a prolonged event, vendors will be contacted for delivery and supply availability. Vendor’s disaster plans and inventory lists are available in the HCC and respective hospital departments.

96 Hours Self Sufficiency in:

Formal agreements and arrangements are in place so that patients may be transferred to a facility that can provide adequate patient care when hospital can no longer support care, treatment and services.  The Liaison Officer will be responsible for inter-facility communication between the hospital and the designated alternative care site, and for retaining records of which patients were transferred to and/or from an alternative care site. 

The patient care unit transferring the patient is responsible for obtaining copies of the patient’s medical records, gathering personal belongings and ensuring the patient’s medications are continued throughout the transfer.  If any hospital equipment is transferred with the patient, the patient care unit is responsible for documenting what equipment was transferred with the patient so that the equipment may be retrieved during the recovery phase post emergency.  The following may be used during a disaster:

• Ambulance contract agreements for transfer of patient between facilities.
• St. Mary Medical Center Transportation vans
• Transportation vehicles arranged by Los Angeles County Emergency Management Services (EMS).

8. The hospital’s arrangements for transferring pertinent information, including essential clinical and medication related information, for patients to an alternative care site:

When the environment cannot support care, treatment and services, and the IC has ordered evacuation of the hospital to an alternate care site, it will be necessary to transfer equipment, medication, essential clinical and medication-related information, and supplies to the alternate care site. 

The HICS 260 form: Patient Evacuation Tracking Form, and HICS 255 form: Master Patient Evacuation Tracking Form includes the following information:

• The patient’s name
• The patient’s medical record or other identification number
• The disposition of the patient (where the patient was sent to)
• If family was notified (attempts should be made to notify family prior to transfer)
• If the patient’s medical record was sent. At least copies of the H&P, operative reports, current medications (including last dose given), and most recent care records should be sent.
• When the patient was transferred
• When the patient arrived at the receiving facility and where the patient was placed
• When report was given on the patient to the receiving facility

Patients should be transported by BLS or ALS service as appropriate to their clinical condition. If necessary, qualified hospital HCWs should accompany the patient.