GRHC IAP

For Official Use Only

COVID-19 Pandemic
Incident Action Plan (IAP)

Operational Period 67: 6/14/21 - 6/21/21 08:00am - 08:00am

HICS 201 Incident Briefing

431826241204016767616651365741310 Situation Summary:

Task Force SitRep click here
- For text updates on COVID-19 and other Community related information, text GILARIVER to 797979
Targeted Testing of GRHC Employees - approx. 45,562 completed as of 6/15/21
Targeted Testing of Community Members - approx. 25,474 completed as of 6/15/21

On Campus Surveillance Testing Weekly Numbers (6/14-6/21)
- ED Drive Thru Weekly: 21
- KHC Weekly: 1

Influenza Vaccination Campaign Totals (as of 6/11) | Goal is 15,000 Immunizations
- GRHC Patients: 10,321
- GRHC Employees: 2,469
- Total Vaccinations: 12,262

Community COVID-19 Cases | (See Data Dashboard below)
- *GRIC Total Positive: 2,765
- *GRIC Confirmed Positive D1 - D7: 2,192
- (*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: 288

GRHC Employees - Current Quarantine
- As of 6/16: 22

GRHC Census Information (updated 07:30am and 1:30pm daily)
- HHK Inpatient
  - 2 Inpatient (0 COVID+)
  - 8 available Negative Pressure beds
  - 4 available Regular beds
  - 0 patient pending transfer
  - 0 patient recently transferred

- HHK ED Current Census
- 5 Patients
  - Fast track area: 0 occupied- 6 open
  - Cabana negative pressure area: 0 occupied- 6 open
  - Isolation negative pressure: 0 occupied - 7 open
  - General Beds: 5 occupied - 3 open
  - Holds: 1 waiting on admission
- HHK ED Yesterday's Census (6/15)
  - 64 Total Patients
  - 1 admissions to Inpatient
  - 8 patients recently transferred out
  - 13 Drive Through Testing
  - 11 Pediatric patients
  - 0 Pediatric Admits
  - 0 Pediatric Transfers

GRIC Members currently in other Hospitals
- 40 members
  - COVID+: 1
  - Suspected COVID+: 0
  - Influenza: 0
HHK Mobile Hospital Unit
- 0
- 10 beds
TCH
- 74 Residents
- 26 Open Rooms
RTC
- Building 100: 4 clients, 17 open beds
- Building 200: 3 clients, 21 open beds
- Building 400: 3 clients, 7 open beds
- Building 300 (Quarantine): 0 guests, 7 open beds

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
Appropriate PPE
COVID Vaccination
If working outdoors, make sure to stay hydrated and take frequent breaks

The Weather Network

Very hot temperatures will persist through the rest of the week. An Excessive Heat Warning is in effect through Sunday for Phoenix and Saturday for the rest of south central Arizona (begins Saturday in Phoenix). Isolated storms are likely through Friday or Saturday over the Arizona high terrain with strong winds and blowing dust possible even into the Phoenix area.

HICS 202 Incident Objectives

IMT Directives (ELT/BOD driven)

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.

HICS 203 Organizational Assignments List

Incident Commander	Div Chief Patrick Peterson
Senior Advisors	.
BOD/ELT (Policy Group)	GRHC BOD / GRHC ELT
Human Resources	Denise Murphy
Employee Health	Bob Kiesecker
OMI	Allen Penry
EMS Medical Director	Dr. Ryan Southworth
	-
Safety Officer	James Ornellas
Liaison Officer	-
Public Information Officer	Veronica Vaughn
Planning Section Chief	Angie Downs
Finance Section Chief	Doug White
Logistics Section Chief	Mario Torres
Support Branch Director	Angie Ramirez
Service Branch Director	Roland Enos
Operations Section Chief	Steve Schoffstall
Acute Care Branch Director	Steve Melin
Non-Acute Care Branch Director	Michelle Kopec
TCH Branch Director(s)	Ron Preston/Traci Haynes/Teresa Ratliff
Security Branch Director	Lantz Biles

HICS 204 Assignments - Acute Care Branch

Operations Section Chief	Steve Schoffstall
Acute Care Branch Director	Steve Melin

Acute Care Group: ED | Inpatient | EMS | DRS

Group Supervisor: Diana Peters

Objective	Strategy/Tactic	Resources Required	Unit Assigned
Monitor Inpatient and ED census and continue to increase ability for transfers and higher acuity patients	Daily reporting of inpatient census Monitor ability to transfer patients Inpatient disassembling Peds Equipment BOD has approved ED and Inpt travel RN, ED Tech and RT extension	Census Report Manpower	ED Inpatient IT/IP
Continue preparation for live patients in MHU	Determine if any areas and processes need improvement Dry contacts install by OGSI for required alarms	Manpower Supplies/O2	ED Nursing Facilities/Contractors
Continue care and maintain safety of Staff and Inmates	Surveillance testing Quarantine any new intakes until test results available Utilize Illuvia units	Manpower Illuvia/Filters	DRS IT
Continue Staff Training and Preparedness	Continue Vapotherm fabrication and training - on hold pending Medical Air cylinders from manufacturer	Manpower	EMS
Standby as needed at Vaccination sites	Assist at D3, Rawhide as needed in prep for upcoming events with Phx Rising and State Fair Assist at various Community events	Manpower	EMS

Public Health Group: PHN | PCD | School Health | Screening

Group Supervisor: Dr. Duc Vo

Objective	Strategy/Tactic	Resources Required	Unit Assigned
Support temporary quarantine housing	Monitor patients in quarantine space for COVID+ GRIC Members	Manpower	PHN
Ongoing COVID-19 patient monitoring	Testing and follow up with patients as needed Lab received HIS allocation for Ellume Home COVID testing	Manpower PPE/Supplies	PHN
Continue Medication, Vaccine and Supply Delivery	Delivery of medications and household supplies as needed	Manpower	PHN
Continue preparation for in clinic outpatient visits	Increase in person provider appts Actively hiring MAs and RNs	Signage Test kits/Vaccines PPE Manpower	HHK PCD KHC PCD AKC
Continue COVID Vaccination distribution clinic	Administer COVID vaccines in clinic (avg 12-16/day) Screening team has disbanded	Manpower	HHK PCD KHC PCD
School Health Services to support organzation needs	Staff and stock all screening stations with appropriate items Staff will return to schools on 7/1 - 25% capacity at BWS and St. Peter's Continue collaboration with PCD Peds Dept	Manpower PPE	SHS

Dialysis Group: Dialysis East | West

Branch Director: Angie Bitoon

Objective	Strategy/Tactic	Resources Required	Unit Assigned
Continue to distance, isolate, and treat PUI’s and COVID+ Patients in Dialysis isolation area	PUI’s are spaced 6’ apart Acute RNs have been onboarded	Manpower Designated Supplies	Dialysis Group Transportation
Continue Dialysis services at all necessary locations - TCH, Inpatient	Continue to staff and stock supplies, review vendor contracts Received grant for new machines at TCH. Also, expanding the peritoneal dialysis program	Suplies/PPE Manpower	Dialysis Group TCH Inpatient

HICS 204 Assignments - Non-Acute Care Branch

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. Safe and secure COVID vaccination storage Training/education for nursing staff that assist with mixing vaccine Monitor Vanish Point syringe inventory and availability Provide support at Community Vaccination Events	Manpower Supplies Vaccines	Pharmacy
Medical Imaging will continue to support COVID-19 Response operations.	Provide Imaging support to HHK, TCH, RTH	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 Provide support at Community Vaccination events	Manpower	Patient Registration
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 Ancillary group will reinforce protocols and compliance.	Manpower	Ancillary Care Group Central Sterile
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
Laboratory will continue to support COVID-19 Response operations.	Provide COVID Testing, Supplies and Support	Manpower Test Kits	Lab
Install new analyzers at HHK and KHC	Validation and training go live TBD	Manpower Supplies	Lab

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	Manpower Supplies	Outpatient Care Group
Ensure compliance with Consistent wearing of Face Masks, Social Distancing, Eye protection (front line staff), and ensure frequent cleaning	Reinforce protocols and compliance. Frequent cleaning and disinfection of high touch surfaces	Manpower PPE Items	Outpatient Care Group
Continue Community Outreach with vaccinations	Team is assisting with Vaccine Administration Program COVID Surveillance testing as needed	Vaccines Manpower	COMU
Pediatric Dental Screenings and Fluoride Treatments	Pediatric patients seen in PCD will be evaluated for dental screening and fluoride	Manpower Supplies	Dental PCD SHS
KHC Life Center planning for increased services	Services: Urgent NP visit, RN-Diabetes Education and Meter Distribution Virtual Appts: Diabetes Medical Nutrition, Counseling and Support, Prevention and Exercise/Fitness Hours: M-F 8-6	Manpower	LC Team and Director

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
CARES Team to support GRHC staff who are experiencing mental/ emotional stress and burnout.	Current support functions: 24/7 support line On site counselors available Creating "need to know" document for remote employees returning to work on campus Coffee break sessions for employee support Leadership training sessions to be recorded and uploaded in Bridge	Manpower PPE/Supplies Signage	Employee Wellness CARES Team PIO BHS Group, IT
Maintain BHS presence to provide crisis services and support for remote staff.	Continue crisis services per best practices and GRHC policy/procedures Staff member will be present at COVID vaccine stations for employee support	Policies and trained Staff	BHS

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

flow_chart_emergency_quarantine_housing_rtc_building_300_05-18-20.pdf
File Size:	82 kb
File Type:	pdf

Objective	Strategy/Tactic	Resources Required	Unit Assigned
Customer Service continue to provide quality care and service for patients / visitors.	Proactive at all sites, Recruitment ongoing Participating in Community Vaccination events	Education resources PPE	Customer Service Infection Prev.
MM continues to locate and obtain supplies and equipment	Remain in contact with all contracted vendors Fulfill 213's and ensure adequate supplies	All requested supplies	Supply Unit Facilities Mgt. Security Finance
Case Management Dept continue to providing quality care and follow-up for patients.	Assist in obtaining needed appts, supplies and DME post d/c Provide daily updates on admissions to outside facilities to the IMT Transition from remote work to in person hospital visits	Manpower	Case Mgmt. RTHHC ACS Group Inpatient PRC
Case Management to assist Tribal Health Departments with records	Work with Tribal Health to provide hospitalization information for Medsis Report	Manpower	Case Mgmt Tribal Health
Employee Health continues to support Surveillance Testing, Daily Duties and Influenza/COVID Vaccination planning	Complete exposure investigation, secondary screenings/testing, and return to duty screenings Routine surveillance testing at HHK WashRack Tracking COVID Vaccination administration and any responses/adverse reactions	PPE Test Kits	Employee Health Labor Pool IMT
Continue assessment for current scrub numbers and use within the organization	Scrubs reduced to 4 depts: ED, Inpt, Pediatrics and EVS Collection of scrubs from other depts in progress Temp space to former Podiatry Lobby	Staffing	Scrubs Task Force
Provide labor pool staffing positions for various departments	Ongoing recruitment for temp. MA positions Continue to manage assignments for Pharmacy Runners, MVU, KHC PCD, Screening Stations, Scrubs and EHS	LP Request Form Labor Pool Assignment Master List	HR/Labor Pool Directors/Supervisors
Transportation continue to provide safe environment for staff and riders	Follow IP Policies and protocols Ongoing recruitment for drivers	Disposable seat covers PPE EMS/MTS vehicles	MTS EMS

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