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Pandemic Lockdown Drill Prep

Healthcare Security Weekly, September 29, 2006

Pandemic Drill-Down: Preparing for JCAHO's Revised EC.4.20

When the JCAHO revised its emergency management standard EC.4.20 to triple the requirements for emergency drills, hospitals put out the call to their emergency planners. Now, the pressure is really on. New obligations require hospitals to be extra vigilant in planning and conducting realistic pandemic drills and in showing evidence of incorporating what they've learned.

This pressure on security staff-who are at the epicenter of emergency management in handling surge, keeping staff and patients safe, managing communication, and working with the first responders who serve the facility-is one reason why HCPro is publishing Pandemic Drill-Down: Preparing for JCAHO's Revised EC 4.20, slated to appear in the November. It is written by Peggy Prinz Luebbert, CIC, CHSP, MT(ASCP), a systems consultant for infection control and epidemiology at Alegent Health, headquartered in Omaha, NE.

We will return to our standard format next week.

-Mary Cresse, Editor, Healthcare Security Weekly.

Pandemic Exercise, Internal Drill: Lockdown

Most facilities will expect staff who are in the facility when a disaster is announced to return to their respective departments to await further assignments. During these phases, facilities may go into "lockdown" procedures where all movement in and out of a facility is controlled.

Scope:

During an influenza pandemic, it may be necessary to control access into a healthcare facility. This exercise will test lockdown procedures in a 350-bed hospital for a 24-hour period to control movement of all employees in and out of the facility.

Type: Internal Drill Exercise

Objectives:

This exercise will test:

  1. Communication between the Command Center and Security after a lock down has been requested.
  2. Security departments' recall and communication of its employees
  3. Accurate and efficient communication of the initiation and discontinuation of the lockdown to all employees entering into and leaving the building as well as those not in the facility at the time of the lockdown.
  4. Effective lockdown management of all access doors in the facility during the 24-hour period.
  5. Management of information to patients, families and visitors concerning the lockdown.

Players:

Includes all employees entering the building during the 24-hour exercise and all security and command center staff. Simulators acting as "employees" will try to enter unapproved entrances.

Scenario:

For the last three months, there has been a widespread outbreak of avian flu in populations of people in Vietnam, Laos and Cambodia. Since person-to-person spread has been recognized, all employees, patients and visitors entering our healthcare facility have been asked if they have traveled to any of these sites and or have been in contact with anyone who has traveled.

Three days ago, a 45-year old woman presented to the emergency department of another facility in our community with fevers, chills, malaise, cough and shortness of breath for three days. She noted that she and her husband had just returned from Vietnam, where they were visiting family. They'd been back just a week. Since returning, the woman had spent time with her family and friends and attended her son's basketball game. Her chest x-ray on admission indicated pneumonia with severe respiratory distress. She was later intubated and placed on a ventilator. The ED physician immediately isolated the patient and contacted public health. Appropriate lab tests were completed and initial results indicated influenza A.

The night before, two similar cases were identified at the same facility. At the basketball game, each of the new cases had come in close contact with the first patient. Local public health officials were contacted, and they released a Health Alert on the Health Alert Network (HAN). This alert requested that all healthcare facilities in the region assess all patients and employees for signs and symptoms of influenza and isolate appropriately.

Expected Actions:

  1. Command Center requested control of movement of all employees into and out of the facility.
  2. Security leader implemented previously established lockdown procedures.
  3. All Security staff were contacted and informed using recall list.
  4. All employees were directed to one door for entering and exist.
  5. Communication was made to all employees, whether at work or not, of the lockdown.
  6. All other doors were manned and posted in new procedure. Visitors and patients were reassured of the process in place.
  7. Employees who entered were given an ID sticker identifying that they entered appropriately.
  8. Command Center discontinued lockdown
  9. Lockdown ceased with proper communication to security staff
  10. Discontinuance was communicated to all employees. Employees in facility were assessed for ID sticker. Those without were interviewed for entry into facility.
  11. Hotwash completed.

Simulators:

  • Employees trying to get into locked doors
  • Media trying to get information on how things are working and wants to film activity.

Messages

    One hour into lockdown, a representative from a local television station calls security office want to film activity and interview security office at door.

    Media representative tries to enter facility with a camera to film.

    Employee calls in noting that a media rep is in the employee parking lot filming and traying to interview staff.

    Appendices:

  • Protocols for lockdown of facility
  • Stickers for ID badges

Evaluators:

  • Chosen doors that should be locked down
  • Door where employees will enter
  • Command Center

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