Emergency Management Healthcare

The 21st Century Playbook for Hospital Response to Crises

On Tuesday, June 2, 2015, Yale New Haven Health System – Center for Emergency Preparedness and Disaster Response (YNHHS-CEPDR) teamed up with Veoci to present their “Playbook for Disasters” to an audience of 78 from across the country. YNHHS is a nationally ranked hospital system with 3 acute care hospitals, including a level 1 trauma center, level 1 burn center and offsite locations throughout the state.

Nathaniel Ellis, Veoci Director of Solutions, joined Richard Smith of YNHHS-CEPDR to explain how their Ebola playbook, combined with Veoci’s virtual emergency operations center software provides YNHHS with real-time solutions to manage Ebola preparedness, drills and responses to suspected Ebola outbreaks. The discussion focused on why the playbook solution is successful and how it can be adapted for other hospitals dealing with possible Ebola outbreaks or other emergency situations, such as winter storms and major accidents.

What is the playbook?

Initial impetus came from the arrival in October 2014 of a suspected Ebola patient at Yale New Haven Hospital. While the situation was handled well, it did prompt a rethinking of how it could have been handled even better. Subsequently, a response walkthrough was conducted at Bridgeport Hospital to test preparedness. Note-takers from YNHHS-CEPDR tracked the actions and tasks required as the patients followed a path beginning with their arrival, moving on to the pre-admission area, triage, admission, etc., while allowing for options based on the need for other specialties, such as OB or pediatrics.

It was apparent that many corollary activities had to be coordinated and executed with extreme diligence, not just during but also before and after the patient’s movement through the hospital.

Using the Bridgeport Hospital walkthrough, YNNHS-CEPDR developed the first playbook that captured the process on a single, comprehensive sheet with a separate checklist for each of the teams. Having one specific sheet for each team saved nurses from having to tediously flip through binders. In particular, one aspect of the playbook that has proven to be particularly helpful is the two-column checklist, “Needed Information” and “Actions to Consider”. This provides hospital employees with a clear and quick breakdown of exactly what needs to be done and when. The success of the simple accessible checklist was evident when Smith witnessed a nurse utilizing the checklist on her own time.

Furthermore, the playbook format made it evident that it is certainly applicable beyond an Ebola response. Smith explained and demonstrated how the identical playbook format could also be used for winter storm procedures; a winter storm playbook would include further complexity with external information such as school closings, travel bans and other road services that affect employees.

How can Veoci help?

When it comes to bringing this playbook to an electronic platform, YNHHS-CEPDR finds that Veoci’s software is extremely well-suited to the sequential flow and time-sensitivity of the processes, while simultaneously enabling multiple means of input as the processes move along. The system can take in a lot of information at once, process it based on YNHHS-CEPDR’s requirements, and present it back to teams and responders in an organized, coherent manner, in real-time. A situational overview is developed automatically as teams go about their assigned tasks.

YNHHS-CEPDR uses Veoci to conditionally route processes and notifications based on selected categories, and furthermore automates the execution of detailed response plans. For instance, when a situation arises, a responder can select between various types of incidents, such as “Infected Patient” or “Weather Response”.  Based on that, pre-selected tasks are launched, specific sets of people are notified, and virtual collaboration rooms are opened that are tailored to the type of response required. The details of all of these activities are customized by YNHHS-CEPDR directly on the system with no coding required.

Ellis also pointed out Veoci’s simplicity and accessibility via its mobile app. All the features of the playbook template such as color-coding and checklists are available at the click of a button, along with immediate alerts and virtual maps depicting problem areas. Veoci made the YNHHS-CEPDR Playbooks into living programs that could be implemented rapidly even as the playbook was developed via walkthroughs.

How can we access it?

Veoci is a cloud-based system that is interactive through email, SMS, phone, web browser, and mobile app. No software needs to be installed, no special hardware is required to use it. The mobile format also includes offline options that allow users to collect/update data for later upload when they are out of range.

What’s next?

The playbook format and Veoci technology has provoked a lot of interest in expanding YNHHS-CEPDR’s playbook concept and emergency management systems to handle many more situations, including hurricanes and decontaminations. Indeed, participants in the webinar were thinking even bigger, asking whether this process and system could work for a governmental response. The answer is “Yes” – Veoci provides a framework that is applicable to most crisis operations. Veoci expands beyond the walls of a single hospital to interact easily with surrounding towns and other public health organizations like the Red Cross, and can scale up to regional, state, and international responses.

Since the latest Ebola outbreak, hospitals have spent millions on improvement preparedness and developing response plans for various crisis situations. The delivery of a response “playbook” on the Veoci platform may be the most effective next step for these hospitals – it transforms the plans they have developed into a live response system, efficiently orchestrating team actions that can be launched at the click of a button on a computer screen.

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