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Volunteer Health Professionals Template

September 14, 2009

Rebekah R. VarelaSan Francisco Department of Public Health

Office of Policy and Planning

Agenda Overview

Management Actions Review

Personnel Requesting Process

Volunteer Intake: EVC

Volunteer Processing: Facilities

Volunteer Sources and Considerations

Toolkit and Resources

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Overview

Overview Funded by ASPR – Healthcare Facilities

Partnership in 2007

Completed in August 2009

Collaborative effort between: Letitia DiMeola, Saint Francis Memorial Hospital

Sarah J. Pope, U.S. Department of Veterans Affairs

Amy Ramirez, San Francisco Department of Emergency Management

Lann Wilder, San Francisco General Hospital

Rebekah Varela, San Francisco Department of Public Health

CirclePoint (Sarah Tyler, Project Manager)

Overview Written for San Francisco Hospitals with

application towards any hospital system. Contains some jurisdictional specifics such as the

concept of the Emergency Volunteer Center and the San Francisco Hospital MOU

More information is available on these supporting systems that are adapted for or created by City and County of San Francisco

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Overview Common abbreviations: CCSF = City and County of San Francisco

EVC = Emergency Volunteer Center

VHP = Volunteer Health Professional

DHVC = Disaster Healthcare Volunteers of California

TJC = The Joint Commission

HICS = Hospital Incident Command System

Planning Assumptions 1. HICS/DOC Activation Hospitals may grant disaster privileges to

volunteer[s…] only when the Emergency Operations Plan has been activated in response to a disaster and the hospital is unable to meet immediate patient needs. (Joint Commission EM 02.02.14 EP 1 and EM 02.02.15 EP )

The resource requesting process is predicated on the ICS structure, which requires local jurisdictional cooperation and leadership.

Planning Assumptions 2. Volunteers will be used in scenarios in

which all other resources are exhausted, including… Personnel from the hospital’s own staff (including

labor pool assets, contractors, etc.)

Personnel from hospital’s within the same jurisdiction, depending on the status of MOU’s

Personnel from unaffected affiliate sites

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Management Actions Review

Management Actions Overview Immediate (E + 2 hours) Assess current and project future staffing assets

and needs Coordinate internally and with the DPH DOC to

ensure incoming VHPs are permitted access to the facility

Coordinate internally to prepare systems to track documentation to support VHP management

Establish Labor Pool & Credentialing Unit: Credentialing Unit/Processing Area and procedures Labor Pool/Personnel Staging Area and procedures

Management Actions Overview Intermediate (2 – 12 hours) Continue to assess current and project future

staffing assets and needs Continue to coordinate internally and with the

Department of Public Health Department Operations Center to ensure incoming VHPs are permitted access to the facility

Deploy personnel from the Labor Pool/Staging Area to requesting patient care areas

Process incoming VHPs in the Credentialing Unit/Processing Area

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Management Actions Overview Intermediate (2 – 12 hours) Cont. Perform VHP orientations Facility orientations in the Labor Pool &

Credentialing Unit Safety and unit-specific clinical

orientations in patient care areas Provide appropriate oversight over the care

VHPs provide Implement documentation tracking systems

to support VHP management

Management Actions Overview Extended (12+ hours) Continue to assess current and project future

staffing assets and needs Continue to coordinate internally and with the

DPH DOC to ensure incoming VHPs are permitted access to the facility

Continue to deploy personnel from the Labor Pool/Staging Area to requesting patient care areas

Continue to process incoming VHPs in the Credentialing Unit/Processing Area

Management Actions Overview Extended (12+ hours)

Continue to perform VHP orientations

Facility orientations in the Labor Pool & Credentialing Unit Safety and unit-specific clinical orientations in patient care areas

Continue to provide appropriate oversight over the care VHPs provide

Continue to implement documentation tracking systems to support VHP management

Oversee out-processing for demobilizing VHPs and coordinate with DPH DOC

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Management Actions Overview Demobilization/System Recovery

Oversee completion of out-processing for demobilizing VHPs and coordinate with DPH DOC

Finalize documentation in VHP management documentation tracking systems

Documents/Tools CCSF Convergent Volunteer Registration Form CCSF Volunteer Health Professional Registration Form Facility Volunteer Health Professional Processing Form Volunteer Health Professional Performance Assessment

Form HICS Form 252+ Section Personnel Timesheet

Step 1: Resource Requests

Resource Requests After exhausting existing personnel

resources, requests may be made to the DOC or EOC that is managing resource requests in your area.

These requests must: Be Specific

Specify Amount

Include Location

Consider Time

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Resource RequestsEV

EN

T

EO

P A

cti

vate

d

Assess and Project Personnel Needs Request Personnel

Resource Request Form

Ongoing

Step 2: Volunteer Intake: EVC

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Volunteer Intake: EVC Following a major disaster, the CCSF will establish

an Emergency Volunteer Center (EVC) as a centralized processing point to incorporate individuals into the disaster response workforce.

The EVC will process unaffiliated convergent volunteers, some city workers and some volunteers received through SEMS/NIMS resource requests.

Volunteer health professionals may come through any one of these three channels.

Volunteer Intake: EVC Because of the specific credentialing requirements,

DPH will initially send all volunteers responding to SEMS/NIMS requests to the EVC.

Emergency Volunteer Center processing protects not only the individual volunteer, but also the healthcare facility to which (s)he is assigned.

SF DPH’s screening activities at the EVC are designed to facilitate the VHP credentialing that healthcare facilities will perform to meet the Joint Commission standards.

Volunteer Intake: EVC CCSF EVC VHP in-processing includes

three steps for general CCSF processing, and VHP screening:

1. CCSF Volunteer Registration (Basic Registration)

2. CCSF Volunteer Health Professional Registration (VHP Registration)

3. Disaster Service Worker Processing

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Volunteer Intake: EVC

Vo

lun

tee

r A

rriv

es

at

EV

C

Basic Registration

Oath Administered CCSF DSW Badging

VHP Registration DSW Processing

CCSF VHP Registration Form

CCSF Volunteer Registration Form

Fa

cil

ity

A

ss

ign

me

nt

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Step 3: Volunteer Processing: Facilities

Volunteer Processing: Facilities The HICS Logistics Section’s Labor Pool &

Credentialing Unit at the assigned facility will oversee facility-based intake processing, which consists of five steps: Verification of identity

In-person licensure/certification/credential/registration verification

Primary source verification of licensure, certification, credential and/or registration

Disaster privileging

Facility badging

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Volunteer Processing: Facilities Following these in-processing procedures,

volunteers will be incorporated into the response through the following steps: Clinical assignment

Preceptor assignment

Facility orientations

Performance assessment and oversight of volunteers’ care

Volunteer demobilization

Volunteer Processing: Facilities

Volu

nte

er re

port

s

to L

abor Pool

Patient Care

Orientation and Performance Assessment Forms

Ongoing

Facility Processing in Labor Pool

Facility VHP Processing Form

Section Personnel Timesheet

Volu

nte

er

assig

ned Assignment

complete; VHP reports back to Labor Pool

Volunteer Processing: Facilities Clinical Assignment

Clinical volunteers will receive their assignments from the Labor Pool & Credentialing Unit, based on volunteers’credentials and experience.

The most appropriate approach to clinical assignment of volunteers must be determined by the individual healthcare facility.

While many facilities plan to establish one-on-one relationships between individual volunteers and assigned preceptors other facilities minimize the distribution of VHPs, limiting volunteers to response in particular patient care areas of the facility, such as the emergency department.

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Volunteer Processing: Facilities Preceptor Assignment

For each patient care assignment, volunteers will be assigned a preceptor, who will be responsible for unit-specific volunteer orientation and oversight.

The preceptor is a facility staff member of equal or greater licensure than the volunteer, and is responsible for: Performing the VHP’s environment of care, safety, and

department-specific orientations. Volunteer oversight

Many healthcare facilities establish a one-on-one relationship between preceptors and volunteers, but others identify a ‘central’ preceptors for the unit, such as the department head, to be the preceptor for all volunteers serving in the unit.

Volunteer Processing: Facilities Facility Orientations

Providing VHPs with an orientation to the facility will enable them to perform their duties effectively.

Healthcare facilities should consider developing handouts in advance of disaster to distribute to incoming VHPs to allow them to reference information included in their orientations.

In general, volunteer orientations should emphasize that volunteers may be working in an austere environment, without all of the tools and services they might have normally.

Additionally, volunteers should be reminded that they may be contributing to patient care in a different capacity than their normal work.

Volunteer Processing: Facilities Performance Assessment and Oversight of

Volunteers’ Care San Francisco’s Saint Francis Memorial Hospital (SFMH) incorporates

VHP oversight procedures into its general VHP management procedures.

Through the preceptor system described previously, SFMH assigns oversight duties to the preceptor, who in turn is issued a Performance Assessment Form

Upon the completion of the VHP’s shift, the preceptor completes the Performance Assessment Form, and returns the form to the Labor Pool & Credentialing Unit staff with a recommendation as to whether the VHP’s disaster privileges be continued, rescinded or adjusted for future assignments.

While a performance assessment form must be tailored to address the standards of each facility Department and unit therein, this procedure supports active management of responding VHPs (and supporting documentation for use during and after the event response.)

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Volunteer Processing: Facilities Volunteer Demobilization

Demobilization procedures are as important to maintaining effective event response as VHP intake procedures.

While demobilization procedures occur at the end of a volunteer’s service at the facility, volunteers should be made aware of demobilization procedures at the outset of their service—ideally, in their facility orientation

Four key components should be included in a facility’s VHP demobilization process: general debrief mental health debrief documentation communication

Volunteer Sources

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Volunteer Sources Healthcare facilities may receive Volunteer

Health Professionals who are affiliated with: Disaster Healthcare Volunteers of California

(DHVC) California Medical Assistance Team (CalMAT)

(State) Disaster Medical Assistance Team (DMAT)

(federal) American Red Cross (nongovernmental) Medical Reserve Corps (community-based)

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Volunteer Considerations

Volunteer Considerations Healthcare facilities’ emergency operations plans are expected

to include provisions for support of the workforce, to ensure that personnel can continue contributing to the facility’s emergency response.

The Joint Commission states its related accreditation Standard [EM 02.02.07 EP 5]:

“The Emergency Operations Plan describes how the hospital will manage staff support needs (for example, housing, transportation, incident stress debriefing.”

Generally, healthcare facilities are advised to make the same provisions to support responding volunteer health professionals as they would for members of the existing workforce.

Volunteer Considerations These provisions include:

Housing, rest and sleep On-site Sheltering

Pillows, blankets and sheets Showers, towels, soap, shampoo Access to laundry services, if possible, or provisions for

scrubs Designated restrooms Male/female sheltering provisions

Off-site Sheltering: Facilities may be able to identify available space in hotels,

although they will be challenged to compete for limited space with State and federal entities.

Facilities are advised to work with the DPH DOC to identify potential sheltering options for staff that are proximal to the facility location.

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Volunteer Considerations Feeding:

Healthcare facilities should include volunteers when determining food and beverage needs for the facility’s surge staffing levels.

In addition, they should identify the locations where food and drinks will be served in a disaster response and share that information with incoming Volunteer Health Professionals.

Volunteer Considerations Communications:

It is important for staff and volunteers to feel a connection with the outside world during their disaster service at a healthcare facility.

Healthcare facilities should provide access to television and radios for staff and volunteers to keep in touch with what is going on in the outside world.

Healthcare facilities should frequently communicate updates about the status of the disaster to volunteers and staff members.

Facilities should consider making provisions and regulations forvolunteers and staff to make personal phone calls and to have email access.

For volunteers and staff alike, peace of mind about their families status will help to ensure that they can retain their focus on their work.

Volunteer Considerations Mental and Physical Health

Maintaining responders’ health will help to ensure that they can continue responding.

Facilities should have a plan in place for how volunteers and staff will be dealt with should they become injured or ill whileworking.

Volunteers and facility staff are likely to be placed in emotionally stressful situations during their responses.

Hospital Incident Command System (HICS) positions indicate that people should be looking out for one another. Volunteers should have access to mental health services during their support time.

Volunteers should have the option of a mental health debrief upon the completion of their service.

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Volunteer Considerations Transportation

Coordination of transportation assets will be required to move Volunteer Health Professionals to and from the facility.

Transportation assets may be facility-owned or procured post-disaster through private vendors, the facility’s Corporation, agreements with other local facilities and/or through SEMS/NIMS channels.

Incoming Volunteer Health Professionals will likely require transportation to the facility from Volunteer Intake at the Emergency Volunteer Center.

Volunteer Considerations Volunteer Recognition and Appreciation

Volunteers’ efforts need to be recognized and celebrated, even if the response effort dictates that official volunteer appreciation efforts must wait until the event is over.

Recognition can range from purely informal contact with volunteers, one-on-one or in groups, where genuine appreciation and interest are expressed. Conversely, more formal recognition ceremonies can feature awards and public statements.

Facilities will need to choose the combination of volunteer recognition activities that are best suited to the response situation.

Volunteer Considerations Convergent Volunteers

Convergent volunteers can become a management burden rather than a benefit to facility operations.

Healthcare facilities are not an appropriate entry point into the disaster response effort.

Volunteers must enter the system through official incident management channels so they can be vetted and deployed to the sites where their skills are most needed, based on the context of the disaster overall.

This centralized processing of convergent volunteers will ensure that facility staff resources (be they security or administrative) will only be used for final vetting of volunteers selected based on their abilities and the facility’s needs.

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Toolkit and Resources

Toolkit and Resources Toolkit Broad set of tools included in the plan (on the

CD).

Vary from management crosswalks and HICS job sheets to sample press releases for convergent volunteers.

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Thank you!

Rebekah Varela(415) 554-2894

Rebekah.Varela@SFDPH.org