Emergency Operations Plan Department of Surgery Purpose This document serves to provide department-specific responses to an emergency in accordance with the TTUHSC Emergency Operations Plan (HSC Op 76.01) and School of Medicine (SOM) Addendum for Clinical Affairs. The SOM Dean will assume Incident Command of SOM Emergency Operations in the area of clinic operations.

Objectives Department responsibilities in the event of an emergency/disaster include:  Support and coordination with the SOM Incident Command Center,  Establishing chain of command during an emergency,  Communication - identification of key staff and means by which to contact them,  Planning for orderly shut-down of department processes,  Identification of resources (staff, supplies and/or space) available in support of UMC,  Planning for recovering and restoring department services following a disaster,  After-Action reports to evaluate department responses to an emergency/disaster or drill, and  Ensuring that departmental faculty, staff, student, contract employees and volunteers have a working knowledge of this plan.

Department Plan 1. Department Leadership The following faculty and staff will assume responsibility for the role of the Department of Surgery in an emergency. (In the absence of a team member, the back up will be called.)  Dr. John Griswold (Surgery Chair)

(Ari Halldorsson, Vice Chair)  Lane Beasley (Administrator) (Dustin Knowles, Associate Administrator)  Kim Robison (Nurse Manager) (Carol Mattox, R.N.) Upon activation of the SOM Incident Command, those identified above should proceed immediately to 2B152 (unless alternate location is communicated), for communication and direction from SOM Incident Command related to the nature of the incident.

2. Communication: (Call list attached) -See attachment 1.1 for Chain of Communication Development of the Surgery Emergency Operations Team

-The following faculty and staff will assume responsibility for the role of the Surgery Emergency Operations Team: (In the absence of a team member, the back up will be called.)  Dr. John Griswold (Chair) o Dr. Ari Halldorsson (Vice Chair)  Lane Beasley (Administrator) o Dustin Knowles (Associate Administrator)  Lavoyce Nabors (Unit Safety Officer)  Kim Robison (Nurse Manager) o Carol Mattox (R.N.)  Dustin Knowles (Associate Administrator) o LaVoyce Nabors ( Human Resources Coordinator)  Dr. Jan Simoni (Lab) o Dr. Kendra Rumbaugh (Lab)  In the event of an emergency, Dr. Griswold will communicate with Lane Beasley (Administrator), the need for emergency reaction.  Lane Beasley will instruct all members of the Surgery Emergency Operations Team to meet in the Department Command Center (3A119G).  Each member of the Surgery EOT will be responsible in distributing information and responsibility within his/her designated area.  Upon activation of a Surgery Incident Command, those identified above should proceed immediately to the Department Command Center (3A119G), unless alternate location is communicated, for communication and direction related to the nature of the incident.

3.

UMC Liaison/Support -See attachment 1.2 for UMC Physician Assignment List Surgery physicians will be notified should emergency services be assigned by UMC. In the event that physicians are assigned an emergency designation, clinics will be cancelled using the following protocol.  If it is prior to the beginning of a clinic or patients arrival, patients will be bumped from the schedule by the Clinic supervisor.  The patient service specialist will consult with the nursing staff to triage and prioritize patient appointments.  Patients will be notified promptly and courteously, and appointments will be rescheduled for the next available time.

 The PSS supervisor will be responsible for ensuring that all patients are notified and appointments rescheduled.  For any patients that arrive in the clinic for an appointment, the patient service specialist will explain the situation and reschedule the appointment at the next available time, after consultation with the nursing staff to determine priority.  All staff will remain in the clinic to assist any patients that come to the clinic because they were not able to be notified, unless a suspension of operations is necessary. 4. Suspension of Operations If it becomes necessary to evacuate the building, the following guidelines apply to all personnel in our department:  All incoming calls should be directed to the answering service (Stenocall).  The Surgery EOT will be responsible for the entire evacuation procedure. They will supervise the evacuation, and assist the nursing staff in fulfilling their evacuation responsibilities.  Patients and visitors will be evacuated appropriately.  Registered Nurses will be responsible for making sure that all patients have left exam rooms, that doors to exam rooms are closed, and that all other areas (such as waiting rooms, offices in the clinic, etc.) have been evacuated.  The PSS Supervisor will be responsible for securing cash from the cash drawers.  The Licensed Vocational Nurses and the Nurses’ Aids are responsible for assisting the Registered Nurses in their evacuation responsibilities, and for helping direct evacuating employees, patients, patient visitors, and all other people to the appropriate stairwells. 4A. the building is to be evacuated during the following emergency codes:  Code Red - Fire Emergency  Code Green - Internal Disaster  Code Black - Bomb Threat  Code White - Building Evacuation -Anytime the building is evacuated, it should be done using “CODE RED” (Fire Emergency = R.A.C.E) Procedures. -Evacuation should be performed according to R.A.C.E Procedures:  R= Rescue anyone who may be in danger  A= Activate the nearest fire alarm pull station and call 9-911 from a safe location.  C= Contain the fire by closing doors as you leave fire areas (be sure that doors are unlocked).  E= Evacuate (by stairs only) to the pre-assigned location, outside the building. 4B. The building does NOT evacuate during the following emergency codes:  Code Brown - Tornado Alert/Severe Weather Emergency  Code Yellow - External Disaster  Code Orange - Security Assistance/Aggressive Situation  Code Blue - Medical Emergency  Code Pink - Possible Child Abduction

-There are specific guidelines to follow each code. Refer to TTUHSC Policy for proper evacuation procedures. 5. Recovery and Restoration: An Emergency Response Team (ERT) will be developed to determine the level of disaster. ERT will go in and investigate the clinic, evaluate the situation, and then meet with the EOT and determine recovery and restoration. -

Emergency Response Team:

Lab: Captain: Dr. Jan Simoni -Dr. Grace Simoni - Dr. Kendra Rumbaugh

Clinic: Captain: Lane Beasley –Kim Robison -Dustin Knowles

6. Ongoing Education and training:  There will be mandatory meetings held annually for new employees, physicians, and nurses.  Will be trained by Unit Safety Officer for proper procedures and guidelines to follow in the event of an emergency.  Most important aspect of training and education is to control the situation so there is no chaos and panic. 7. Evacuation Routes and Assigned Meeting Places a.

Administration Area (HSC) Evacuation Route i. All administrative area employees should evacuate via the A pod stairs and meet in the visitor parking lot (C1) in front of the HSC 1. This process should be followed for evacuations that do not require employees to physical leave the campus. (Code Red, Green, & White). b. Clinic Employees in the Medical Pavilion Evacuation Route i. Employees in the pavilion will follow #4 of this policy for evacuation. The designated meeting place is the grassy hill in front of the pavilion by parking lot B1 1. This process should be followed for evacuations that do not require employees to physical leave the campus. (Code Red, Green, & White). 8. Department Acknowledgement of Employee Safety for Evacuation of Campus a.

In the event of a campus evacuation the department will perform the following: i. The management team (Administrator, Associate Administrator, Nurse Manger, & PSS supervisor), Unit Safety Officer (USO), and IT Evacuation Coordinator (EC) will conduct the following: 1. All employees will be notified via STAT alert and overhead pages of evacuation a. This evacuation will be to leave the premises/campus completely 2. Evacuation of patients will follow #4 of this Policy 3. The following assignments will be made for reconciliation of staff safety: a. PSS Supervisor – responsible for PSS and Coders b. Nurse Manager – responsible for nurses and vascular technician c. Associate Administrator – back up to clinic management team and responsible for patient’s evacuation and management teams safe reconciliation. Also, responsible for the administrator d. Administrator -- responsible for faculty and back up to USO and IT EC. Also, responsible for the associate administrator

e. IT Evacuation Coordinator – responsible for all offices on the back (south) hallway of the administrative area f. USO – responsible for all offices within the middle pod of A in the HSC as well as the hallway on the east side that includes the ENT division g. Residency coordinator – responsible for all residents h. Research coordinator – responsible for all lab personnel 4. The department will maintain complete flowcharted list of employees, faculty, and residents that the management team, USO, and IT EC will keep at all times a. In the event of an evacuation each member listed above will confirm the safety of all employees, by text or phone call, assigned to them and report back to the administrator or associate administrator who will report to the evacuation incident command that all employees are safe and accounted for or not. i. The management team, USO, and IT EC will keep a copy of this updated list at all times that can be grabbed during evacuation or kept in their vehicle 9.

Drills a.

During either an evacuation drill (code red, black, green, or white) the process listed in item #8 will be followed by the management team, EC, and USO for reconciliation of staff for practice. i. A report will be submitted to the USO of how the process worked and if improvements are needed ii. Employees who do not respond to the drill text notification from the management team, USO, and IT EC will need to be informed that in the event of a real emergency the response is required.

Attachment 1.1 Department of Surgery Chain of Communication

Lane Beasley Administrator

Dr. John Griswold Surgery Chair Lavoyce Nabors Unit Safety Officer

Kim Robison Nurse Manager

Dustin Knowles Assoc. Administrator Administrative Staff

Clinic Personnel and Nursing Faculty and Residents

Dr. Jan Simoni Research Labs Lab Personnel

Attachment 1.1 Department of Surgery Emergency Operations Call List

Work Pager Cell Home

Dr. John Griswold 743-1615 765-4040 NA 798-7983

Work Pager Cell Home

Dustin Knowles 743-2373 n/a 806-662-2562 NA

Dr. Ari Halldorsson 743-2370

LaVoyce Nabors 743-2373 NA NA 757-2323

Administrative Staff General Administrative Area 743-2370 Call Center 743-2373 Billing and Coding 743-2373 Legend:

Indicates Primary Contact Person Indicates Back Up Contact Person

Lane Beasley 743-2370 n/a 789-0490 794-0206

Dustin Knowles 743-2370 n/a 806-662-2562 NA

Kim Robison 743-2373 NA 806-632-1132 NA

Carol Mattox 743-2373

Faculty/Residents General Surgery 743-2373 ENT 743-2373

Clinic and Nursing Staff General Surgery 743-2373 ENT 743-2373

Lavoyce Nabors 743-2370 NA NA 757-2323

Dr. Jan Simoni 743-2370 NA 787-5452 780-8677

Dr. Kendra Rumbaugh 743-2370 NA 441-9921 798-0192

Lab Personnel Surgery Labs 743-2370