For Official Use Only
COVID-19 Pandemic
Incident Action Plan (IAP)
Operational Period 33: 10/19/20 - 10/26/20 08:00am - 08:00am
65741310 Situation Summary:
- Task Force SitRep click here
- For text updates on COVID-19 and other Community related information, text GILARIVER to 797979
- For text updates on COVID-19 and other Community related information, text GILARIVER to 797979
- Targeted Testing of GRHC Employees - approx. 16,396 completed as of 10/23/20
- Targeted Testing of Community Members - approx 12,441 completed as of 10/23/20
- Influenza Vaccination Campaign Totals (as of 10/23) | Goal is 15,000 Immunizations complete by 10/31
- GRHC Patients: 6,539
- GRHC Employees: 1,976 (93%*) *Denominator = total # of employees - declination #
- Total Vaccinations: 8,068
- Community COVID-19 Cases | (See Data Dashboard below)
- *GRIC Confirmed Positive D1 - D7: 645
- *GRIC Total Positive: 817
- (*This does not necessarily reflect the current number of active cases but reflects the total since testing began. Data source: GRHC Outcomes Management & Informatics)
- GRHC Staff Positive COVID-19 Cases
- Since 03/12/20: 68
- Since 03/12/20: 68
- GRHC Census Information (updated 07:30am and 1:30pm daily)
- HHK Inpatient
- 2 Inpatient (1 COVID+)
- 7 available Negative Pressure beds
- 5 available Regular beds
- 0 patient pending transfer
- 0 patient recently transferred
- HHK ED
- 3 Patients
- Fast track area: 0 occupied- 6 open
- Cabana negative pressure area: 1 occupied- 5 open
- Isolation negative pressure: 1 occupied- 5 open
- General Beds: 0 occupied- 8 open
- Holds: 1 in triage
- 3 patients recently transferred out 10/23*
- 0 admissions to Inpatient 10/23*
- Drive Through Testing 10/23*: 4
- Visits 10/23*: 47
- (*Time stamp represents date with 24 period 1200am-1159pm)
- HHK Inpatient
- GRIC Members currently in other Hospitals
- 32 members
- COVID+: 3
- Influenza: 0
- Other: 29
- 32 members
- HHK Mobile Hospital Unit
- 0
- 10 beds
- RTHHC ACS
- 0
- 20 staffed beds available - 50 total
- 0 Patients transferred to outside facilities the day before
- 0 Patients discharged home the day before
- TCH
- 72 Residents
- 28 Open Rooms
- RTC
- Building 100: 6 clients, 15 open beds
- Building 200: 8 clients, 16 open beds
- Building 400: 0 clients, 10 open beds
- Building 300 (Quarantine ACS): 0 guests, 7 open beds
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Health and Safety Briefing:
- Response-Related Injuries - 4 (2 heat-related; 2 fall)
- Follow the guidelines on the ICS 208 Safety Message and HICS 215A Safety Analysis
- Maintain physical distancing
- Refrain from shaking hands and other close body contact
- If you are sick, stay home
- Keep informed
- Double Up (Influenza Vaccine and Surveillance Test)
- Monsoon Season has officially ended! There are still many days of dry and windy weather ahead. Wildfires continue to remain in many areas. The high and dry heat mixed with little moisture makes for an increase in wildfire dangers. Be mindful of local and state laws when it comes to campfires and keep home/areas clear of brush.
Double digits officially for the 7 day stretch. Mostly sunny and partly cloudy toward the end of the week. The dry weather continues with slight chance of rain next week.
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IMT Directives (ELT/BOD driven)
Incident Objectives (Incident Commander driven)
Command Emphasis
- Provide care to all patients who present as a result of the COVID-19 event.
- Provide for the safety of GRHC staff.
- Conduct initial and ongoing communications with internal staff and external response partners.
- Conduct screening for all patients, visitors, and staff at Entry points of each Building/Facility.
- Provide for public health with effective after care to those in quarantine.
Incident Objectives (Incident Commander driven)
- Limit access and provide access control to all facilities.
- Monitor and report on PPE and medical supply usage.
- Coordinate with GRIC task force to provide care to those in quarantine.
- Communicate with Branch Directors and Group Supervisors to identify challenges, Communicate and evaluate strategies and tactics.
- Prepare and submit plan elements to the Planning Section by 1100 daily in preparation for the 1130 Planning Meeting.
- Update the online IAP for all staff to access and stay informed.
- Administer 15,000 Influenza Vaccines to the Community and GRHC Employees by 10/31.
- Evaluate strategies used for Influenza Vaccine to guide COVID Vaccine Planning.
Command Emphasis
- All organization-wide communication will be through the PIO with Incident Command and Executive approval
- Stay Focused on your assigned HICS 204 Assignments form.
- Avoid freelancing and operating in silos.
- Communicate tasks, objectives and challenges with the Command and General Staff.
Incident Commander |
Div Chief Patrick Peterson |
Senior Advisors |
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GRHC BOD / GRHC ELT |
|
Denise Murphy |
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Bob Kiesecker |
|
Joe Jicha |
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Dr. Ryan Southworth |
|
Dr. Viji Murugavel |
Safety Officer |
Stacy Welch & Doug Huber |
Liaison Officer |
Anita Esquer |
Public Information Officer |
Veronica Vaughn |
Planning Section Chief |
Angie Downs |
Finance Section Chief |
Doug White |
Logistics Section Chief |
Mario Torres |
|
Angie Ramirez |
|
Richard Brache |
Operations Section Chief |
Steve Schoffstall |
|
Steve Melin |
|
Michelle Kopec |
|
Ron Preston/Traci Haynes/Teresa Ratliff |
|
Lantz Biles |
Operations Section Chief |
Steve Schoffstall |
Acute Care Branch Director |
Steve Melin |
Acute Care Group: ED | EMS | Inpatient | DRS |
Group Supervisor: Diana Peters |
Objective |
Strategy/Tactic |
Resources Required |
Unit Assigned |
Complete daily documentation of bed poll and COVID Survey on EMResource |
Complete bed poll and COVID Survey by 12:00pm daily. |
Manpower |
Inpatient |
Continue with ED drive-up testing 7 days per week, 12p-12a for those not requiring a MSE |
Monitor signage and traffic flow needs. Designate staff. |
Manpower PPE Test Kits |
ED |
Monitor PPE supply and ensure all units have appropriate PPE |
Monitor PPE daily tracking report Sign off 213RR’s |
All PPE |
ED Inpatient Mobile Unit Supply Unit |
Plan staff education on prone positioning drill |
Identify staff needed ED Nurse Educator setting up education and training |
Manpower |
RT's ED Inpatient Nursing |
Monitor Inpatient census and continue to Increase ability for higher acuity patients |
Daily reporting of inpatient census. Float staff to RTHHC ACS as census allows. |
Inpatient census report |
Inpatient |
Finalize process for pediatric readiness |
Assess space options Proposal to ELT this week for funding Assess required equipment needed Assess legal and regulatory requirements |
Manpower |
Inpatient |
Screen and administer flu vaccine to any patient who qualifies and consents |
Offer influenza vaccine to patients who come to the ED with appropriate care needs (i.e. non-febrile |
Manpower Vaccines |
ED |
Assist with the Community targeted testing at AKC |
Ambulance stand by at testing site. |
Manpower |
EMS |
Continue Staff Training and Development |
Work with Baxter to obtain online program for infusion pumps. Work with IT and other departments for a health information exchange. Develop employee training schedule |
Manpower |
EMS |
Add 6 new positions to assist with call-off, leave, and quarantine staff. |
Interview new candidates |
Manpower |
EMS |
Continue EMS testing their own staff every 2 weeks |
Test EMS staff every two weeks |
Manpower |
EMS |
Ensure safety of Inmates by identifying symptoms and ensuring infection prevention strategies are in place |
Daily temp and symptom monitoring by med staff 2 Illuvia units strategically placed. Enforce social distancing and mask wearing. |
Thermometers DRS Medical Staff Illuvia units/filters |
DRS |
Continue using OTTO telehealth platform for medical visits |
Utilize telehealth platform for medical visits that are not emergent |
Manpower |
DRS |
Isolate and test DRS Inmates to reduce transmission risk |
Continue to test new intakes daily. Continue regular biweekly testing of all inmates Test at ED if medical clearance is required. Mask and quarantine new intakes until test results are available |
Manpower Testing kits |
DRS |
Public Health Group: Primary Care | PHN | School Health | Screening |
Group Supervisor: Willard Korges |
Objective |
Strategy/Tactic |
Resources Required |
Unit Assigned |
Support temporary quarantine housing |
Maintain a safe space for GRIC Residents who are COVID+ and have no space to quarantine for 14days |
Manpower |
PHN |
Continue behavioral health support options for PHN experiencing patient/family loss. |
Coordinate with GRHC CARES Team as needed |
Manpower |
PHN BHS |
Ongoing COVID-19 patient monitoring. |
Phone calls every 48h to assess symptoms And reinforce quarantine, 7 days/wk Home visits as necessary |
Office and cell phones GSA vehicles PPE |
PHN |
Continue Medication and supply Delivery. |
Delivery of medications and Necessary household supplies primarily by District PHN’s |
Manpower |
PHN |
Provide Influenza support for COVID-19 Targeted Testing (5p-7p) |
Support expanded immunization efforts For community members SHN providing support Tuesday - Thursday in the morning with community TTT. PHN providing support Tuesday - Thursday in the evening with community TTT. |
Manpower |
PHN SHS |
Continue vaccine drive-through clinic |
Ensure resource and staffing needs are met. Closely monitor for any gaps or additional needs. Data collection with OMI |
Manpower |
KHC PCD HHK PCD |
Continue drive-up testing for PCD patients seeking COVID-19 testing only |
Designate staff to do COVID drive up testing. Co-locate flu shots stations. Ensure signage and traffic flow are clear. Have test kits readily available in department. |
Traffic cones Signage SQL Test kits PPE Staff |
HHK PCD KHC PCD PR Facilities Lab |
Continue Employee testing at KHC and AKC every 2 weeks |
Test employees every 2 weeks |
Manpower PPE Test Kits |
KHC PCD Ak Chin Lab |
Continue utilization of telehealth platform for appropriate outpatient visits |
Utilize OTTO Tele-Health platform for non-urgent outpatient visits |
Computers with microphone and speakers |
HHK PCD KHC PCD AKC IT |
Perform follow up to community members with surveillance testing results |
Attempt 2 phone calls, then send letter advising client of results |
Manpower |
HHK PCD KHC PCD OMI |
Complete required health screening at schools. |
Coordinate with school principle |
Manpower |
SHS |
Continue drive thru immunization clinic at the schools Mondays and Fridays |
Ensure adequate staff and resources. |
Manpower |
SHS |
Complete refresher training with Pharmacy on the Data Loggers used to monitor cooler temperatures |
Participate in Pharmacy led training to reinforce correct process for temperature excursion monitoring |
Manpower Supplies Vaccines |
PHN |
Dialysis Group: Dialysis East | West |
Branch Director: Angie Bittoon |
Objective |
Strategy/Tactic |
Resources Required |
Unit Assigned |
Continue to distance, isolate, and treat PUI’s and COVID+ Patients in Dialysis isolation area |
Ensure dedicated staff assigned daily. Ensure PUI’s are spaced 6’ apart in PUI cohort area. Continue with 3rd shift in both East and West Dialysis for ability to isolate . |
Dedicated machines, spaces and staff for COVID+ and PUI’s |
Dialysis Group |
Monitor PPE supply and ensure adequate supply at all sites |
Continue submission of 213RR’s. Visual monitoring of staff compliance |
Isolation gowns, face shields, masks, Shoe covers, gloves Infection Prevention |
Dialysis Group |
Continue Dialysis services at The Caring House and Inpatient. |
Continue to staff and stock supplies as needed. |
Dialysis equipment Manpower |
Dialysis Group TCH Branch Inpatient Group HR |
Monthly meetings with Gila River Dialysis Support Associates to address patient concerns. |
Participate in monthly meetings |
Manpower |
Dialysis Group |
Continue Dialysis services at RTHHC ACS. |
Ensure all supplies and machine are ready for implementation. Begin services as soon as there is a patient in need of Dialysis. |
Dialysis equipment Manpower |
Dialysis RTHHC ACS Group |
Manage staffing shortages of Dialysis Staff |
Monitor as needed |
Manpower |
Dialysis |
Operations Section Chief |
Steve Schoffstall |
Non-Acute Care Branch Director |
Michelle Kopec |
Ancillary Care Group: Lab | Pharmacy | Medical Imaging | Patient Registration |
Group Supervisor: Peggy Hunkele |
Objective |
Strategy/Tactic |
Resources Required |
Unit Assigned |
Pharmacy will continue to support COVID-19 Response operations. |
Provide medications and support. Request resources as necessary. Omnicell PO received by vendor, no ETA at this time |
Manpower Omnicell, vendor contacts, materials management, pharmacy management |
Pharmacy |
Ensure vaccine temperatures are maintained on and off site |
Re-training with staff who will be handling the vaccine |
Manpower Vaccine Supplies |
Lab |
Medical Imaging will continue to support COVID-19 Response operations. |
Provide Imaging support. 24/7 schedule for MI at RTH Ensure operations of portable X-ray at TCH. 1. Create 24/7 schedule for MI at RTH 2. Identify MI staff available to work at TCH Mammography schedule: 1. Self-contained mobile unit 1x/week on Tuesday's at 2 pts/hr) 2. Patients to be screened and banded by WHC and use WHC waiting room. |
Manpower Portable X-Ray Unit Training materials |
Medical Imaging IT |
Patient Registration will continue to support COVID-19 Response operations |
Provide Patient Registration needs and support. Request resources as necessary. |
Manpower |
Patient Registration |
Ensure ongoing and frequent General Environment Cleaning |
Daily cleaning and disinfection of work stations. Frequent cleaning and disinfection of high touch surfaces. |
Manpower PPE |
Ancillary Care Group |
Ensure compliance with Consistent wearing of Face Masks, Social Distancing, Eye protection (front line staff), and Break Room parameters. |
Department Directors/managers for each department within Outpatient Care group will reinforce protocols and compliance. Post related signage in all break rooms. |
Manpower |
Ancillary Care Group |
NEW: Laboratory will absorb Veritor Testing for TCH |
Provides testing for symptomatic residents and staff at TCH Create new policy and train lab staff |
Vaccines Manpower |
TCH Lab |
Laboratory will continue to support COVID-19 Response operations. |
Provide COVID Testing, Supplies and Support |
Manpower Test Kits |
Lab |
NEW Laboratory to obtain various testing measures for specific locations |
Binax Now (Abbott) has received policy and training documents and will convert format from IHS to GRHC Anti Xa (10a) has been validated and finalizing SOP, once approved will go live with date selected BioFire Torch (HHK) validation plan and SOP is being written. Will need to coordinate with Revenue Cycle and IT |
Manpower Supplies Kits |
Lab OMI Revenue Cycle IT |
Outpatient Care Group: Dental | Life Center | Optometry | PT | Podiatry | Women's Clinic |
Group Supervisor: Dr. Dean Fasciani |
Objective |
Strategy/Tactic |
Resources Required |
Unit Assigned |
Ensure Essential and emergent patient care needs are met on an ongoing an timely basis for PT, Podiatry, Optometry, Dental, Women’s Health, Life Center |
Continuous monitoring of PT, Dental, Podiatry, Optometry and Women’s health census and staffing plans. Adjust as required |
Staff and the same equipment and supplies as routine operations |
Outpatient Care Group |
Continue Optimization, monitoring, and secure PPE supply |
Request PPE items by submitting a Resource Request Form Secure PPE per department plan. Update PPE Inventory daily |
PPE Items |
Outpatient Care Group |
Continue to manage and disseminate information to subordinate clinics and back up the chain to leadership. |
Email, Huddles, Rounding, Meetings |
Manpower |
Outpatient Care Group |
Continue to manage the environment |
Review with all staff cleaning and use of PPE. Disinfect all equipment between patient use |
PPE Items Oxivir Wipes |
Outpatient Care Group |
Ensure ongoing and frequent General Environment Cleaning |
Daily cleaning and disinfection of work stations. Frequent cleaning and disinfection of high touch surfaces |
Manpower PPE |
Outpatient Care Group |
Ensure compliance with Consistent wearing of Face Masks, Social Distancing, Eye protection (front line staff), and Break Room parameters. |
Department Directors/managers for each department within Outpatient Care group will reinforce protocols and compliance. Post related signage in all break rooms. |
Manpower |
Outpatient Care Group |
BHS Group: New Beginnings | Oasis | RTC | RTHHC | Shegoi |
Group Supervisor: Kerry VanVolkinburgh |
Objective |
Strategy/Tactic |
Resources Required |
Unit Assigned |
Ensure ongoing and frequent General Environment Cleaning |
Daily cleaning and disinfection of work stations. Frequent cleaning and disinfection of high touch surfaces |
Manpower PPE Supply |
BHS RTC |
Continue to screen patients and monitor PPE supply. |
Utilizing PPE Plan and optimize supply. Maintain a minimally appropriate level. Ensure patients accurately screened. |
Manpower Employee Screening Form HICS-213RR form |
BHS RTC |
Maintain BHS presence to provide crisis services and support for remote staff. |
Continue crisis services per best practices and GRHC policy/procedures |
Policies and trained Staff |
BHS |
CARES Team to increase support for GRHC staff who are experiencing mental and emotional stress and burnout. |
Current support functions: 24/7 support line On site counselors available at NBB and KHC. Developed self-care videos Collaborate with PR and provide self-care tips Added support functions: Cross promotion with BHS staff assigned to scrub distribution detail. Develop strategies to help support staff through the holidays (i.e. Steps Challenge, Leadership training, Lifestyle Blog) Develop multi-disciplinary on-site support team. Provide self-care topics on WebEx during departmental team meetings. |
Manpower |
Employee Wellness CARES Team IT PIO BHS Group |
Ensure compliance with Consistent wearing of Face Masks, Social Distancing, Eye protection (front line staff), and Break Room parameters. |
Department Directors/managers for each department within Outpatient Care group will reinforce protocols and compliance. Post related signage in all break rooms. |
Manpower PPE |
BHS Group |
Quarantine Housing Task Force |
Task Force Leader: Shannon Sims |
Objective |
Strategy/Tactic |
Resources Required |
Unit Assigned |
Manage the Quarantine site at RTC building 300 to quarantine up to 11 COVID-19+ persons who have no options to quarantine at home or elsewhere. |
Coordinate with Public Health Nursing for ongoing operations. Coordinate with BHS as needed |
GRHC: Food service, IT , security, EVS, Linen, Transportation, PHN, Risk GRIC: Tribal Social Services, OEM, Housing |
Quarantine Housing TF PHN BHS |
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RTHHC ACS Group |
Group Supervisor: Susan Cardona |
Objective |
Strategy/Tactic |
Resources Required |
Unit Assigned |
Obtain 24/7 Staffing coverage for the ACS |
Schedule all labor pool staff shifts and times. Obtain additional staffing as needed to cover patient census. Staff numbers to accommodate 50 patients. RN's continue to be trained for relief charge 100% of completion for 50 patients for optimal condition. Working on 20% overage to cover call outs and PTO and Leave. 64 RN's and 41 MA's trained to date. |
RN Scheduler Labor pool Scheduling spreadsheet |
Labor Pool RTHHC ACS Group ELT |
Ensure all appropriate equipment and supplies are procured. |
Identify equipment that has not been received and f/u with vendors Stock supply rooms with needed supplies 99% equipment identified 95% completion due to arrival of supplies. Many varied ETA’s |
List of required equipment Materials Management and IT personnel PCD, Pharmacy personnel and various currently identified equipment |
Supply Unit IT Unit |
Continue plan for Pediatric Readiness at RTH ACS |
Needs assessment completed along with 3 Pediatric Readiness Meetings completed RN and MA training in the works as well as completion of telemetry monitoring training. Identify staff and resources needed |
List of patient supplies that are needed. Staff members to stock supply rooms. |
Supply Unit |
Continue scheduling and training of identified skills for RN’s and MA's as needed (including RPMS) |
Skills and training labs to be done weekly. No current ACLS certification classes scheduled. All current RN's and Providers are certified. RPMS training: Super-user will train any new staff members moving forward, next review set for 10/19/20 |
Manpower |
RTH ACS Staff Educator EMS NP’s Labor Pool HIM |
Identify staff’s completion of COVID-19 specific training in Bridge |
Review Bridge spreadsheet of staff assigned to: COVID-19 for Clinical Staff Hand Hygiene: The Basics Self-Paced Personal Protective Equipment Regulation Express: Transmission-Based Precautions Verify completion, address staff who have not completed and assign to those who need. 99% completed |
Specific spreadsheet from Bridge and staff |
HR RTHHC ACS Group |
Create plan for Demobilization of the ACS. |
Identify all equipment that needs to be stored/returned. Identify supplies that can be saved for future use and supplies that will be used now. Identify what equipment and supplies need to be returned to their original state. HICS 257 is 48% complete. Items being added as they are delivered. |
List of equipment that needs to be stored and locations. List of supplies that can be stored and location. List of what needs to be returned to original departments. |
RTHHC ACS Group Logistics Ancillary Care Group |
Create Loss of Power Plan for RTH ACS pending generator arrival. |
1. Collaborate with stakeholder departments to develop procedures 2. Identify supply and equipment needs 3. Educate staff on procedures 4. 46 rooms have emergency outlets 5. Next tentative "Power Outage Mock" on 12/28/20. ETA delivery date 12/20/20. |
Experts from Risk, Compliance, Emergency Preparedness, Facilities Current policy for Failure Response Plan |
RTHHC ACS Logistics Planning |
Create training program for MA’s for centralized telemetry monitoring COMPLETE |
Identify staff wanting and skilled to be trained as a monitor tech. Create training program for MA’s to become Cardiac Monitor techs. Super users will continue to train any staff that were unable to attend training. 50% completed, first class completed on 08/12 with 5 successful students. Next classes scheduled for October 12th and 19th |
Manpower Materials and Supplies |
RTH ACS Group Acute Care Group Educator |
Ensure ongoing and frequent General Environment Cleaning. |
Daily cleaning and disinfection of work stations. Frequent cleaning and disinfection of high touch surfaces. Ongoing plan of action set forth on daily check off to confirm this task is completed |
Manpower PPE |
RTHHC ACS Group |
Ensure compliance with Consistent wearing of Face Masks, Social Distancing, Eye protection (front line staff), and Break Room parameters. |
Department Directors/managers for each department within Outpatient Care group will reinforce protocols and compliance. Post related signage in all break rooms. |
Manpower |
RTH ACS |
Targeted Testing Task Force |
Group Supervisor: Dr. Dean Fasciani |
Objective |
Strategy/Tactic |
Resources Required |
Unit Assigned |
Ensure task force is held accountable for directives. |
Continue follow-up meetings every 1-3 days to determine status of directives |
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Targeted Testing TF |
Continue testing of GRIC members at Community Testing Sites. |
Communicate with key GRIC partners. Walk-thru site locations. Order PPE, supplies. Re-test AKC |
PPE, supplies. Applicable sites, rooms, bathrooms. EMS on site. |
Targeted Testing TF |
Continue testing of GRHC employees at all locations - HHK, TCH, KHC and Dialysis E/W |
Schedule dates/times at locations. Ensure PPE is available. Employee re-testing: Retest TCH employees and residents Retest Dialysis WEST employees/patients Retest DRS |
PPE |
Targeted Testing TF Employee Health |
Reassign Community Targeted Testing Team to assist Employee Health in GRHC Staff Surveillance Testing following the major holidays |
Re-schedule Community testing dates Work with EHS to determine most efficient workflow Determine testing location based on demand Work with PR for signage and staff education |
Manpower |
Targeted Testing TF PR |
Ensure compliance with Consistent wearing of Face Masks, Social Distancing, Eye protection (front line staff), and Break Room parameters. |
Reinforce protocols and compliance. Post related signage in all break rooms. |
Manpower |
Targeted Testing TF |
Continue Community Flu vaccination strategy in conjunction with Targeted Testing. |
Dates/times/location established Necessary documentation in EHR and Midas template created Weekly Webex Meetings |
Vaccination Supplies |
Targeted Testing TF Influenza Planning TF |
Ensure ongoing and frequent General Environment Cleaning. |
Daily cleaning and disinfection of work stations. Frequent cleaning and disinfection of high touch surfaces. |
Manpower PPE |
Targeted Testing TF |
Continue Saturday Surveillance Testing and Immunization within the Community |
Develop action plan including location, dates and times Determine staffing needs, schedule and supplies PR to assist with advertising 10/24 at HHK |
Manpower |
Targeted Testing Team Influenza Staffing PR |
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Operations Section Chief |
Steve Schoffstall |
The Caring House Branch Director |
Ron Preston |
Resident Care Group |
Group Supervisor: Theresa Ratliff |
Support Group |
Group Supervisor: Billy Estrada |
Logistics Group |
Group Supervisor: Max Haake |
Objective |
Strategy/Tactic |
Resources Required |
Unit Assigned |
Continue TCH Resident and staff CV-19 testing. |
Testing of residents and staff will continue weekly due to positivity rate spikes in Pinal and Maricopa Counties Identify any asymptomatic residents and staff. Implement further mitigation actions as necessary. Maintain regular communications with the testing schedule and results. Perform mitigation and response measures when positive results are reported among staff or Residents |
Manpower Supplies/Testing Kits |
TCH Branch Targeted Testing TF |
Determine visitation re-opening for residents while continuing to provide communication to Residents and Families |
Re-estabilish gradual, controlled, in person visitation per the CMS memo dated 9/17/20 Submit data on a weekly basis into NHSN/CDC per CMS. Maintain a "diary of actions and efforts taken on a weekly basis. PR to assist with info relayed to family. Personal telephone calls will be made to families/representatives as needed. |
Communication Topics |
TCH Branch PIO |
Continue Audits of hand washing and PPE. |
Audits include tagging surfaces and checking the thoroughness of the cleaning with with a UV light. Audits are performed, returned to TCH infection preventionist for review and necessary follow-up on education. Assure that education on hand washing and PPE use by staff is brought into the 90% completion range. Staff Development will monitor and report completion of required training and provide documentation of completion. |
Staffing Audit Forms |
TCH Branch |
Provide laundering of reusable cloth gowns for GRHC. |
Wash and deliver to a central location for redistribution Pickup truck will be used to pick-up dirty gowns and TCH van will be used to deliver clean gowns. Laundry Manager will provide information on necessary quantities of detergent. |
Manpower 2 vehicles Laundry Supplies & Equipment |
TCH Branch Acute Care Branch Non-Acute Care Branch Support Branch |
Plan of correction for recent CMS re-certification survey |
Survey received 10/14/20 with planned date of correction 10/28/20 Audits and training with glucometer, hand hygiene and donning/doffing PPE |
Activities Dept Infection Prevention |
TCH Branch |
Continue to maintain the safety of Residents through regular cleaning and disinfecting |
Add additional HEPA Filtration Units Steramist disinfecting unit to be used for terminal disinfecting of TCH. Weekly deep cleans on Wednesdays Deep Cleaning Protocol has been established to ensure consistency among staff |
15 HEPA Filtration Units Steramist Unit |
TCH Branch Facilities Mgt. TCH EVS |
Use Portable X-ray as needed |
Portable x-ray machine at TCH that will minimize potential Resident exposure to CV-19. X-Ray Tech will come to TCH for imaging services as needed. |
Portable X-Ray Unit Manpower |
TCH Branch Medical Imaging. |
Continue Resident Activity for overall wellness:1. "Cruiser" Program 2. Glow Worm, Glow Germ |
Allow a 1-hour drive around the Community to address the psycho-social and emotional needs of Residents. Allow Resident to choose the route they wish to take. Encourage residents to participate in hands on IP learning and will win prizes for best guess. |
Manpower Vehicle PPE |
TCH Branch Transportation Staff and Recreation Staff |
| tch.120.107_public_health_emergency_covid_19_revised_time_lines.pdf |
Operations Section Chief |
Steve Schoffstall |
Security Branch Director |
Lantz Biles |
HHK Group |
Group Supervisor: On-Duty Sergeant |
RTH Group |
Group Supervisor: On-Duty Sergeant |
KHC Group |
Group Supervisor: On-Duty Sergeant |
BHS Group |
Group Supervisor: On-Duty Sergeant |
Dialysis Group |
Group Supervisor: On-Duty Sergeant |
Objective |
Strategy/Tactic |
Resources Required |
Unit Assigned |
Maintain 24/7 Security support of all functioning GRHC facilities. |
Continuous monitoring of available manpower. Implementation of workforce triggers. |
Manpower |
Security Labor Pool |
Provide Security support for all patient screening locations during operation. |
Continuous monitoring of available manpower. Implementation of workforce triggers. |
Manpower |
Security Labor Pool |
Implement crowd and traffic control protocols as needed. |
Block/control access to identified parking areas and testing areas. |
Manpower |
Security |
Planning Section Chief |
Angie Downs |
Patient Communication Liaison |
Group Supervisor: Emily Robinson |
Objective |
Strategy/Tactic |
Resources Required |
Unit Assigned |
Continue plan for consistent and clear messaging with the patient hotline |
Weekly meetings to establish goals of the Patient Communication Liaison moving forward Communication between all staff on the phone lines needs to be consistent and clear for patients Train staff to send those specific questions to the necessary parties Working with PR to update content for central location (the HUB). |
HUB COVID and Influenza Hotline Manpower |
IMT PCD PR Supporting staff |
Continue to streamline COVID/Flu/Stress and Anxiety into Concierge Line |
Determine call schedule and staffing IT to assist with the necessary program installation for staff 2 Providers each on call for 12 hour shifts (7am-7pm). RTH staffing cover the evenings. Kick off date 10/19 |
Manpower |
Patient Communication Liaison IT COVID Hotline Staff RTH ACS staff |
Monitor call volume on the Concierge Line |
Will need to assess the number of calls received in the first few weeks to determine staffing needs |
Manpower |
Patient Communication Liaison IT COVID Hotline Staff |
Customer Service Group |
Group Supervisor: Joni Notah |
Supply Unit Group |
Group Supervisor: Mark Robles |
Transportation Group |
Group Supervisor: DeRees Clark |
Human Resources Group |
Group Supervisor: Denise Murphy |
Case Management Group |
Group Supervisor: Jerry Shinkle |
Employee Health Group |
Group Supervisor: Bob Kisecker |
Scrubs Task Force |
Group Supervisor: Paul Gibson |
Logistics Section Chief |
Mario Torres |
Support Branch Director |
Angie Ramirez |
Objective |
Strategy/Tactic |
Resources Required |
Unit Assigned |
Customer Service continue to provide quality care and service for patients / visitors. |
Reps to be proactive at entrances (all sites – HHK, KHC, RTH) Patient Advocates continue to round/assist patients at all sites. Currently interviewing for 2 Patient Advocates at HHK Cultural Customer Service Program is in editing phase Interpreter program forthcoming |
Education resources PPE |
Customer Service Infection Prev. |
MM continues to locate and obtain supplies and equipment |
Remain in contact with all contracted vendors Alternate routes for obtaining supplies – i.e. IHS, etc. Utilize AzCHER Vetted Vendors list as needed. Working with Finance for cost assignment and tracking |
All requested supplies |
Supply Unit Facilities Mgt. Security Finance |
Case Management Dept continue to providing quality care and follow-up for patients. |
Work with all needed depts. to ensure patients receive adequate after care post-discharge from Inpatient and/or ACS. Provide daily updates on admissions to outside facilities to the IMT. |
Manpower |
Case Mgt. RTHHC ACS Group Inpatient PRC |
Continue process for washing and transport of reusable gowns. |
Depts Using: ED, Inpatient, Dental, PCD, MI Assessing process for LP/EVS staffing to help with distribution in the mornings to all necessary depts. |
Reusable Gowns Laundry at TCH Disposable Laundry Bags Bins Signage |
Supply Unit ED Dental Inpatient TCH HHK PCD MI |
Employee Health continues to support GRHC Surveillance Testing |
Currently on 8th round Complete exposure investigation, secondary screenings/testing, and return to duty screenings. EH Guidelines for Clear Communication. |
PPE Test Kits |
Employee Health Labor Pool |
Continue process with employee flu shots for 2020-2021 season. |
Remainder of staff to complete at EH on walk in basis or other locations |
Manpower Flu Vaccine |
Employee Health Operations Planning Logistics PIO |
Transportation continue to provide safe environment for staff and riders. |
Follow IP Policies and protocols, ensure all with proper PPE. Keep same driver with same rider. Utilize Steramist units for disinfecting vehicles All employees must be trained and certified to use Steramist. |
Disposable seat covers Masks (N95/Procedure) Bags Non-emergent transportation, EMS/MTS vehicles |
MTS EMS Employee Health SOFR PIO |
Case Management to assist with documentation of COVID cases |
Continue working with Hospital Care Managers to f/u on O2 supplies, appointments, prescriptions and medical equipment Assist inpatient with obtaining DME |
NG Template |
Case Management |
Provide labor pool staffing positions for various departments and RTH ACS |
Recruitment for temporary MA positions ongoing Weekly meetings with LP and RTH Task Force to keep up to date with schedule plan |
LP Request Form 5.12.20 (in X Drive under Labor Pool) Labor Pool assignment Master List |
HR/Labor Pool Liaison Directors/Supervisors Med Staff Credentialing Team |
Labor Pool will continue process for solidifying agency staffing |
Fastaff nurse contracts have been extended to 3/2021 Previous AZ Surge nurse positions have been secured with Fastaff nurses |
Supply and Staffing List |
RTHHC ACS Group Labor Pool |
Continue adherence to infection control and safety guidelines. |
Ensure staff are always wearing appropriate PPE. Reinforce the importance of hand hygiene |
Manpower PPE/Sanitizer |
Scrubs Task Force |
Assess options for alternate scrub distribution strategies to free up labor pool staff |
Scrubs distribution has been approved for self serving machines to distribute scrubs to employees Determine process and flow for best and timely distribution |
Manpower |
Scrubs Task Force |
Logistics Section Chief |
Mario Torres |
Service Branch Director |
Richard Brache |
Facilities Group |
Group Supervisor: Keleto Sili |
EVS Group |
Group Supervisor: Curtis Osife |
Food Service Group |
Group Supervisor: Lenora Mora |
IT Group |
Group Supervisor: Scott McCrimmon |
Central Sterile |
Group Supervisor: Janice Nachie |
Objective |
Strategy/Tactic |
Resources Required |
Unit Assigned |
Continue to Support build-outs of surge space at HHK and RTHHC |
Moving equipment Set up negative pressure areas |
Staffing and supplies up to an including outside contractors |
Facilities Mgt |
Perform Daily testing of the Negative Pressure and Isolation Rooms at HHK, KHC, RTH and TCH |
Daily testing and information gathering on Air Handlers at HHK and KHC Possible addition of ICRA doors between rooms at KHC Dental |
Staffing and supplies |
Facilities Mgt. |
Provide additional Emergency power for RTHHC ACS |
Generator delivery date 12/20 Switch gear anticipated date early October, awaiting on arrival Electrical drawing complete and to 3rd party for review |
Electrical equipment and contractor |
Facilities Mgt. |
Continue renovation and construction of portable showers and toilets for RTHHC ACS |
Construction of 2nd restroom continues and anticipated completion is second week of November |
Per quote |
Facilities Mgt. |
Provide ongoing support to ED, PCD, MHU, Ak-Chin and RTC quarantine site. |
Provide support as needed. Provide square footage of all isolation and non-isolation rooms in ED |
Manpower |
Facilities Mgt. |
Continue to provide support to GRHC surge expansion activities for HHK, RTHHC, and the Mobile Hospital Unit |
Arrange for Med Gas Certified Plumber to begin O2 piping in place for new regeneration system OGS system requisition in the approval process Convert Inpatient Room at HHK into Pediatric Space Provide support to the IP and Central Strerile in preparation for N95 Sterilization |
Manpower and Supplies |
PDC Facilities Mgt. |
Continue to provide IT capabilities to all GRHC sites including Alternate Care Site and MHU |
Ensure IT services are available in all areas. Respond to service calls. Working with Philips and clinical staff to connect all telemetry devices to the same system to promote continuity of care when patients are transferred. In the processs of being submitted through ELT/BOD |
Staffing and equipment |
IT |
Continue to ensure all areas remain clean |
Prioritize cleaning schedules. Dedicated EVS staff in HHK PCD red banded area for quick turnover of rooms. EVS Management team trained in Steramist disinfecting equipment. Continue Streramist training at KHC and RTH and units have been approved for KHC and RTH |
Manpower |
EVS |
Continue to provide Food Services to HHK Inpatients and staff, RTC Clients, and patients at Alternate Care Sites |
Prepare and deliver food as necessary HHK Dining Room is open to staff only |
Supplies Manpower |
Food Services |
Continue to support cleaning and sterilization for surgical instrumentation |
HHK – CSD will support cleaning and sterilization surgical instrumentation for all patient care units in service. RTH CSD will operate all sterilization equipment to maintain optimal operability for readiness in place when needed and as a backup sterilization processing unit during the HHK CSD renovation Continue to prep Conf Room A and B for disinfecting N95 masks |
Manpower Supplies |
Central Sterile |
Continue to focus on utilizing Steramist and a developed process for disinfection of N95 and Face Shields. |
Develop process for disinfection utilizing Steramist system. Courier training for Steramist Perform training and competencies |
Steramist product information |
Central Sterile |
Finance Section Chief |
Doug White |
Objective |
Strategy/Tactic |
Resources Required |
Unit Assigned |
Continue to provide absentee report for previous day by 12:30PM |
- |
- |
Payroll |
Continue to provide Financial Cost Summary for the previous day by 2:00PM |
- |
- |
Section Chief |
Continue to adapt accounting system to process COVID-19 costs |
- |
- |
Finance |
Continue to assist Materials Management with the escalation of COVID-19 related purchases including expedition of specific vendor payments. |
Escalate specialized COVID-19 related purchases including expedition of specific vendor payments. |
- |
Finance |
Contracts & Grants Department continue to process contracts for COVID-related supplies, equipment, and services; and is applying for grant funding from the federal government. |
- |
- |
Contracts & Grants |
A daily HICS 214 is due by 1630 hrs daily by all Command & General Staff, Branch Directors and Group Supervisors. This log will represent your activities of the previous 24 hours. When completed, post to your ICS position folder on the X-Drive.
Report On:
Report On:
- Objectives
- Task/Assignments
- Meetings
- Successes
- Challenges
- Needs
- Example: Attended the morning Task Force Meeting (45 mins x 2 personnel)
- Example: Worked on developing our department’s employee screening process (1.5 hours)
| hics_214-activity_log.pdf |
| arizona_surge_line_minutes_10.22.docx |
| protocol__az_surge_line_out_of_state_requests.docx |
CDC Guidance
- Implementing Safety Practices for Critical Infrastructure Workers
- Risk Assessment & Public Health Management of Healthcare Personnel with Potential Exposure
- Criteria for return to work for Healthcare personnel with confirmed or suspected COVID-19
- Evaluating and Testing Healthcare Persons for COVID-19
| covid-19_informational_booklet_final_8-13-20.pdf |
|
|
| 04-09-20_grhc_surge_consolidation_plan.docx |
| use_of_cloth_mask_to_slow_spread_covid-19.pdf |
| covid-19-vaccination-program-interim_playbook.pdf |
|
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| 10.13.20_comp_exec_order_no9_tab.pdf |
| ehs__flu_vaccination_plan_08-31-20.pdf |
|
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| coronavirus_emergency_leave_policy_final_200406_hr.104.82.pdf |
| covid_patient_visitor_policy_05-18-20.pdf |
| hr_104.84_hero_pay_covid_19_policy_clean_rev_8.12.2020_-covid_policies.docx |
| mass_fatality_plan_06-18-20.doc |
Due to the worldwide supply chain issues, N95 respirators (for those departments issued these) should be practicing reuse procedures. Your department should also have a procedure/policy on when an N95 respirator is used versus a surgical/procedure mask.
GRHC is currently in Contingency Capacity Strategy: Measures may change daily standard practices but may not have any significant impact on the care delivered to the patient or the safety of healthcare personnel (HCP). These practices may be used temporarily during periods of PPE (Eye Protection, Isolation Gowns, Face Shields, Face Masks, and N95 Respirators) shortages.
GRHC is currently in Contingency Capacity Strategy: Measures may change daily standard practices but may not have any significant impact on the care delivered to the patient or the safety of healthcare personnel (HCP). These practices may be used temporarily during periods of PPE (Eye Protection, Isolation Gowns, Face Shields, Face Masks, and N95 Respirators) shortages.
| optimizing_ppe_supply_policy.doc |
|
N95 Respirator Example
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Procedure/Surgical Mask Example
|
| N95 Reuse Flyer |
Employees should wear appropriate PPE based on Department Policy, Procedures and Directives. Appropriate PPE is necessary to protect staff and patients. Below are some guidelines for the PPE staff should be utilizing.
| covid_employee_screening_flowchart_4-15-20.pdf |
