For Official Use Only
COVID-19 Pandemic
Incident Action Plan (IAP)
Operational Period 97: 1/3/21 - 1/17/21 08:00am - 08:00am
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. 72,767 completed as of 1/114/21
- Targeted Testing of Community Members - approx. 46,433 completed as of 1/114/21
- On Campus Surveillance Testing Weekly Numbers (1/10-16)
- ED Drive Thru Weekly: 1,322
- KHC Weekly: 398
- RTH Weekly: 206
- Community COVID-19 Cases | (See Data Dashboard below)
- *GRIC Total Positive: 5,310
- *GRIC Confirmed Positive D1 - D7: 4,202
- (*This does not necessarily reflect the current number of active cases but reflects the total since testing began. Data source: GRHC Outcomes Management & Informatics)
- Current Employee Vaccination Rate - EH Report (Updated Friday's)
- Fully Vaccinated plus Booster: 803
- Fully Vaccinated w/o Booster: 964 (total vaccinated 1,767)
- Received 1st of 2 dose series: 35
- Unvaccinated: 335
- Total Current Employees: 2,137
- GRHC Employees - Current Quarantine
- As of 1/12: 217
- Employee Case Positive Rate - Lab Report (Updated Friday's)
- GRHC Employees Symptomatic: 14.5%
- GRHC Employees Surveillance*: 17.1%
- *Excludes Dialysis E/W and TCH Testing
- Employee Test Positive Rate - Lab Report (Updated Friday's)
- Surveillance: 1.2%
- Symptomatic: 5.1%
- Total: 1.7%
- GRHC Census Information (updated daily)
- HHK Inpatient
- 11 Inpatient (5 COVID+)
- 3 available Negative Pressure beds
- 0 available Regular beds
- 0 patient transfer to higher level of care
- 0 patient transfer to SNF
- HHK Inpatient
- HHK ED Current Census
- 7 Patients
- Cabana negative pressure area: 0 occupied- 6 open
- Isolation negative pressure: 1 occupied - 6 open
- General Beds: 5 occupied - 3 open
- Holds: 1 triage, 3 waiting on transfer
- HHK ED Yesterday's Census (1/13)
- 82 Total Patients
- 1 admissions to Inpatient
- 7 patients recently transferred out
- 327 Drive Through Testing
- 19 Pediatric patients
- 0 Pediatric Admits
- 0 Pediatric Transfers
- GRIC Members currently in other Hospitals
- 46 members
- COVID+: 11
- Suspected COVID+: 0
- Influenza: 0
- 46 members
- HHK Mobile Hospital Unit
- 0
- 10 beds
- TCH
- 78 Residents
- 22 Open Rooms
- RTC
- Building 300 (Quarantine): 1 guests, 6 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
- If you are sick, stay home
- Keep informed
- Appropriate PPE
- COVID Vaccination
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 |
. |
|
GRHC BOD / GRHC ELT |
|
Sandra Speer |
|
Bob Kiesecker/Stephanie Garcia |
|
Carrie Trygstad |
|
Dr. Ryan Southworth |
|
- |
Safety Officer |
Willard Korges |
Liaison Officer |
- |
Public Information Officer |
Veronica Vaughn |
Planning Section Chief |
Angie Downs |
Finance Section Chief |
Doug White |
Logistics Section Chief |
Mario Torres |
|
Angie Ramirez |
|
Patti Renfro |
Operations Section Chief |
Steve Schoffstall |
|
Steve Melin |
|
Michelle Kopec |
|
Traci Haynes/Teresa Ratliff |
|
Lantz Biles |
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 census Monitor ability to transfer patients - increased hold times for non-COVID transfers |
Census Report Manpower |
ED Inpatient IT/IP |
Continue preparation for live patients in MHU |
Determine if any areas and processes need improvement |
Manpower Supplies/O2 |
ED Nursing PDC Facilities/Contractors |
Continue care and maintain safety of Staff and Inmates |
Quarantine any new intakes until test results available |
Manpower Illuvia/Filters |
DRS IT |
Continue Staff Training and Preparedness |
Cont. training staff with transferring Vapotherm patients |
Manpower |
EMS |
Standby as needed at Vaccination sites |
Assist as needed in prep for upcoming 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 |
Manpower PPE/Supplies |
PHN |
Continue Medication, Vaccine and Supply Delivery |
Delivery of medications and household supplies as needed |
Manpower |
PHN |
Continue clinic outpatient visits |
Monitor census with walk in patients |
PPE Manpower |
HHK PCD KHC PCD AKC |
Continue COVID Vaccination distribution clinic |
Administer COVID vaccines and boosters COVID clinic continues |
Manpower |
HHK PCD KHC PCD |
School Health Services to support organzation needs |
Collaborate with THD and School admin regarding contact tracing at schools Providing virtual education classes, possible return to in person week of 1/17 |
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 Evaluating possible move of Isolation wall |
Manpower Designated Supplies |
Dialysis Group Transportation |
Continue Dialysis services at all necessary locations - TCH, Inpatient |
Continue to staff and stock supplies, review vendor contracts |
Suplies/PPE Manpower |
Dialysis Group TCH Inpatient |
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 for Peds Doses 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 |
Laboratory will continue to support COVID-19 Response operations. |
Provide COVID Testing supplies and support |
Manpower Test Kits |
Lab |
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 |
Manpower Supplies |
Outpatient Care Group |
Continue Community Outreach with Vaccinations |
Continue Vaccine Administration at B&G and District events Assist with providing Surveillance testing |
Manpower Vaccines (COVID, Flu) |
COMU Operations |
BHS Group: New Beginnings | Oasis | RTC | RTHHC | Shegoi |
Group Supervisor: Kerry VanVolkinburgh |
Objective |
Strategy/Tactic |
Resources Required |
Unit Assigned |
Maintain BHS presence to provide crisis services and support for remote staff. |
Continue crisis services per best practices and GRHC policy/procedures |
Manpower Policies |
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 CARES team to merge into Employee Wellness Team |
Manpower PPE/Supplies Signage |
Employee Wellness CARES Team PIO BHS Group, IT |
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 COVID-19+ persons |
Coordinate with Public Health Nursing for ongoing operations. Coordinate with BHS |
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 Group |
Group Supervisor: Susan Cardona |
Objective |
Strategy/Tactic |
Resources Required |
|
Continue daily functions for RTH |
Screen and schedule patients as needed in participating depts Drive thru testing increase |
Manpower Equipment Supplies |
RTH Group Supply Unit Outpatient/Ancillary |
Targeted Testing Task Force |
Group Supervisor: Dr. Dean Fasciani |
Objective |
Strategy/Tactic |
Resources Required |
Unit Assigned |
Continue testing of GRHC employees at all locations - HHK, KHC, RTH and Dialysis E/W |
Retest Dialysis WEST employees/patients Testing at KHC and RTH Drive up M-F DRS Testing monthly |
Manpower Supplies |
Targeted Testing TF |
Operations Section Chief |
Steve Schoffstall |
The Caring House Branch Director |
Traci Haynes |
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 CV-19 testing in accordance with CMS Memo |
Vaccinated staff testing 1x/week and unvaccinated staff testing 2x/week |
Manpower Supplies/Testing Kits |
TCH Branch IP EH |
Continue to maintain the safety of Residents through regular cleaning and disinfecting |
Steramist units and established deep clean protocols for terminal disinfecting and cleaning |
HEPA Filtration Units Steramist Unit |
TCH Branch |
Ongoing audits of environment, hand washing and PPE |
PPE and surface tagging audits completed at both nursing shifts Audits returned to IP for any f/u education and feedback |
Staffing Audit Forms |
TCH Branch IP |
Continue to promote staff acceptance of receiving COVID Vaccination |
Provide education regarding safety of the vaccine Current staff rate 87%, resident rate 92% Boosters and flu shots for staff/residents |
Manpower Vaccines |
TCH Branch |
Prepare for CMS mandate and guidance for TCH facility |
AZ was not included in the CMS Vaccine mandate as of 12/15 - GRHC will continue staff education and encouragement in receiving Awaiting guidance on how GRHC sites will comply Review penalties for staff non-compliance |
Manpower |
TCH Branch ELT Employee Health |
CMS memo has lifted restrictions with In Person Visitation - plan for holiday visitation |
Positivity rates must be below 7% in both Pinal and Maricopa County - current rate 10.6% Compassion visits permitted for special circumstances CMS lifted restrictions RE in-room visitation, awaiting GRHC guidance |
Manpower PPE |
TCH Branch IP |
Resident outings permitted in accordance with CMS MEMO |
LTC Residents are permitted on therapeutic leave/outings following guidelines Will be tested on Day 3, 5 and 10 and remain in airborne contact isolation in own rooms for 14 days |
Manpower |
TCH |
| tch.120.107_public_health_emergency_covid_19_revised_time_lines.doc |
| tch-in-person-visitation-2021-v5pm.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 |
Ideal patient experience with consistent messaging on the patient hotline |
Hotline volume increased, continue to provided needed info for positive/negative results and all other questions Assisting with POST COVID clinic scheduling |
Manpower |
Hotline Staff PR IMT |
Customer Service Group |
Group Supervisor: Phillip Ahmsaty |
Supply Unit Group |
Group Supervisor: Mark Robles |
Transportation Group |
Group Supervisor: DeRees Clark |
Human Resources/Labor Pool Group |
Group Supervisor: Sandra Speer |
Case Management Group |
Group Supervisor: Michele Albrecht-Burke |
Employee Health Group |
Group Supervisor: Bob Kiesecker/Stephanie Garcia |
Scrubs Task Force |
Group Supervisor: Thomacita Sam |
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. |
Proactive at all sites, Recruitment ongoing |
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 |
Manpower |
Case Mgmt. 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 Surveillance testing at HHK/KHC/ RTH COVID boosters and flu vaccines for employees |
PPE Test Kits |
Employee Health Labor Pool IMT |
Continue assessment for current scrub numbers and use within the organization |
Scrubs depts: ED, Inpt, Pediatrics and EVS |
Staffing |
Scrubs Task Force |
Provide labor pool staffing positions for various departments |
Continue to manage assignments for necessary depts LP Reserve positions assigned as needed |
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 |
Logistics Section Chief |
Mario Torres |
Service Branch Director |
Patti Renfro |
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 |
Planning Design & Construction |
Group Supervisor: Dave Samples |
Objective |
Strategy/Tactic |
Resources Required |
Unit Assigned |
Continue to provide Food Services to HHK/RTH Inpatients and RTC Clients |
Continue meal delivery to patients and staff (HHK and RTH) |
Manpower Supplies |
Food Services |
Continue to ensure all areas remain clean |
Prioritize schedules with dedicated EVS staff at specific areas |
Manpower |
EVS |
Continue to provide IT capabilities to all GRHC sites including Alternate Care Site and MHU |
Standby for any IT needs including vaccination events |
Manpower Equipment |
IT |
Provide ongoing support for Surge Expansion Activity at all locations within GRHC (HHK/KHC/RTH) and MHU |
Request to OGSI to raise levels to 93% - TBD Assist any patient care areas as needed - ED, INpt, MVU with NP |
Staffing Supplies |
Facilities Mgt. PDC |
Support cleaning and sterilization for surgical instrumentation |
Support cleaning and sterilization of surgical equipment Provide EVS support w/ Steramist disinfection when needed |
Manpower |
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 |
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Payroll |
Continue to provide Financial Cost Summary for the previous day by 2:00PM |
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Section Chief |
Continue to adapt accounting system to process COVID-19 costs |
- |
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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. |
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Contracts & Grants |
| 12.10.21_incident_management_team_chart.docx |
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 |
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 |
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| 04-09-20_grhc_surge_consolidation_plan.docx |
| copy_of_20_11-20_grhc_tiered_response.xlsx |
| 20_11-20_tiered_response_overview.docx |
| final_covid_booster_faqs-9-1-21.pdf |
| covid-19-vaccination-program-interim_playbook.pdf |
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| 10.13.20_comp_exec_order_no9_tab.pdf |
| executive_order_no._12_8.2021.pdf |
| executive_order_no_9_amended11_13_2020.pdf |
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The HUB is a central location for all COVID-19 and Influenza Related information including Surveillance Testing, Quarantine Guidelines, Influenza Vaccination Locations and much more! Information is updated 2x/month.
Internal HUB: grhc/Intranet/main.aspx?tid=628
External HUB: grhc.org/Hub/
Internal HUB: grhc/Intranet/main.aspx?tid=628
External HUB: grhc.org/Hub/
| 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 |
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N95 Respirator Example
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Procedure/Surgical Mask Example
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| N95 Reuse Flyer |
| grhc_ppe_warehouse_10202021.png |
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 |
