Nurse

PICU

Code DELTA 1

  • Immediately send 1 (one) RN to the Emergency Department. This nurse should immediately seek out the ED Charge Nurse and state s/he is from the PICU
  • Complete and drop off Disaster Information Form to the Labor Pool located in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Work with Charge Nurse and Attending Physician to assess potential discharges or transfers
  • Prepare for potentially large volume of admissions
  • Assess that essential equipment is available
  • Assess stock of supplies
  • Reassure families only if prompted
  • Be prepared to initiate call trees if instructed by Incident Command
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

CICU

Code DELTA 1

  • Maintain regular patient care unless otherwise instructed by Incident Command
  • Complete and drop off Disaster Information Form to the Labor Pool located in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Work with Charge Nurse and Attending Physician to assess potential discharges or transfers
  • Prepare for potentially large volume of admissions
  • Assess that essential equipment is available
  • Assess stock of supplies
  • Reassure families only if prompted
  • Be prepared to initiate call trees if instructed by Incident Command
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

NICU

Code DELTA 1

  • Immediately send 1 (one) RN to the Labor Pool located in 1F-53 (conference room behind Atrium Desk).  This nurse should immediately seek out Labor Pool coordinators and state s/he is from the NICU
  • Complete and drop off Disaster Information Form to the Labor Pool located in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Work with Charge Nurse and Attending Physician to assess potential discharges or transfers
  • Prepare for potentially large volume of admissions
  • Assess that essential equipment is available
  • Assess stock of supplies
  • Reassure families only if prompted
  • Be prepared to initiate call trees if instructed by Incident Command
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Emergency Department

Code DELTA 1

  • Charge Nurse should validate one nurse from each of the following units has reported directly to the Emergency Department: PICU, 3E, 4E, 4W
  • Ten (10) wheel chairs and ten (10) stretchers will be parked outside in the ARB hallway
  • Three (3) crash carts will arrive from materials management
  • Three (3) medication drawers will arrive from the pharmacy
  • Flow Supervisor and Attending Physician will identify potential discharges or transfers
  • Prepare for potentially large volume of admissions
  • Be prepared to initiate call trees if instructed by Incident Command
  • For any requests call Incident Command at 53-6900
  • See below for Emergency Department Specific Roles

Assignment of Treatment Areas by ED Flow Supervisor (Emergency Department Supervisor)

Triage

  1. Clear ED triage rooms 1 & 2, re-route incoming patients to ambulance entrance (via signage or staff for 2 locations)
  2. Set up Disaster Triage in ambulance entrance
  3. Staff: ED Nurse, ED registration clerk
  4. Assign all incoming patients a Zone based on acuity using disaster labels & record on Disaster Log (Red, Yellow, Green)

Red - Yellow - Green  Zones

  1. Re-label patient treatment rooms/areas with Zone room numbers
  2. Assign incoming staff to room/patient assignments
  3. Immediate Red Zone Needs: 1 (one) physician & 1 (one) RN/Zone, 2 (two) RT
  4. Immediate Yellow Zone Needs: 1 (one) physician & 1 (one) RN
  5. Immediate Green Zone Needs: 1 (one) physician & 1 (one) ED tech
  6. Assign patients from Triage to rooms, & record on Zone Log their Disaster/MR number
  7. Determine other staffing needs based on patient volume and acuity Determine equipment, supplies based on patient needs
  8. Move stabilized patients to Staging Area for Admission or to the Discharge Unit

Staging Area

  1. Re-label patient treatment rooms/areas with Zone room numbers
  2. Assign incoming staff to room/patient assignments
  3. Immediate Needs: 1 (one) physician and 1 (one) RN
  4. Determine patients ability to be transferred as inpatient or discharge
  5. Identify any extra staffing, equipment or supply needs

Clerk

  1. Confirm admit-on-call and Nursing Supervisor is paged
  2. Confirm three crash carts arrived from Materials Management
  3. Confirm three (3) medication draws have arrived from pharmacy
  4. Confirm ten (10) stretchers and ten (10) wheel chairs have arrived from Environmental Services
  5. Place disaster signs in designated areas
  6. Post Incident Command and Labor Pool phone numbers in easily visible location
  7. Direct arriving personal to staging areas
  8. Update ED Flow Supervisor (Charge RN) of completion of tasks
  9. Be prepared to assist with other tasks upon completion of above duties

Emergency Department

  1. Continue to treat present ED patients, Emergent patients can be moved to the Red Zone, Urgent patients can be moved to the Yellow Zone
  2. Identify any extra staffing, equipment or supply needs

Morgue

  1. Log all fatalities on Morgue Log sheet using the Disaster Identification Number.

Some standards that should be followed because they interact with other departmental/hospital plans:

  • The ED Attending assumes the role of the Emergency Treatment Director. Their role is to organize patient care, assign physician assignments, assess medical needs (decontamination) and communicate with the Incident Command the number of patients, acuity and disposition.
  • The Flow Supervisor assumes the role of the Emergency Department Supervisor. Their role is to assign zone leaders, help the Emergency Treatment Director in the organization of patient care, and communicate essential needs from each zone leader to the Emergency Treatment Director. They need to maintain a total census of every patient in the department and their disposition.
  • The Zone leaders (Red - Yellow - Green and Staging) are RNs (the Green leader can be an ED tech to help with RN staffing) - their role is assure the rooms are labeled, identify immediate and on going staffing and equipment needs, communicate the needs to the ED Supervisor (Charge RN), make staffing assignments and maintain a census for the zone. Their role is not patient care, but a "charge RN" for that zone.
  • The zones can represent acuity - highest (red) assigned the closer rooms, to low (green) assigned to the outpatient area for future evaluation.
  • The zones can be used to divide the volume of patients with similar acuity levels.
  • Zones can be ignored and "code teams" assigned for each acute patient (best done with a small number of patients - e.g., 4 critical patients from a house fire.
  • In Flu pandemic the zones can be assigned to the outpatient modules and teams of staff assigned to quickly decompress volume of non-acuity patients.
  • The Staging area is meant for patients awaiting discharge or admission and is generally in 1A. If this need does not exist that area should be utilized as an additional treatment area for disaster patients.
  • The proposed room assignments can be altered, but should be properly labeled to minimize confusion
  • These decisions are decided by the ED Treatment Director with the help of the ED Supervisor. Communication of the plan is key

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Surgical Services

Code DELTA 1

  • All Surgical Department procedures in progress should be completed without delay
  • No surgical procedures should to be started unless the patient is classified as high-risk. Notify Incident Command if a high risk procedure is indicated
  • Review surgical and procedural schedule. Prioritize any high risk surgeries or procedures and notify Incident Command
  • Await approval from Incident Command to cancel elective and non-high risk surgeries and procedures
  • Notify patient and family of cancellations related to the activation of a mass causality response
  • If and when appropriate, reschedule procedures and surgeries
  • Complete and drop off Disaster Information Form to the Labor Pool located in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Assess that essential equipment is available
  • Assess stock of supplies
  • Reassure families only if prompted
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

2B

Code DELTA 1

  • Immediately send 1 (one) RN to the Labor Pool located in 1F-53 (conference room behind Atrium Desk)
  • Complete and drop off Disaster Information Form to the Labor Pool located in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Work with Charge Nurse and Attending Physician to assess potential discharges or transfers
  • Assess that essential equipment is available
  • Assess stock of supplies
  • Reassure families only if prompted
  • Prepare for potentially large volume of admissions
  • Be prepared to initiate call trees if instructed by Incident Command
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

2 West

Code DELTA 1

  • Immediately send 1 (one) RN to the Labor Pool in 1F-53 (conference room behind Atrium Desk) and state that s/he is from 2West
  • Complete and drop off Disaster Information Form to the Labor Pool located in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Work with Charge Nurse and Attending Physician to assess potential discharges or transfers
  • Assess that essential equipment is available
  • Assess stock of supplies
  • Reassure families only if prompted
  • Prepare for potentially large volume of admissions
  • Be prepared to initiate call trees if instructed by Incident Command
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

3 East

Code DELTA 1

  • Immediately send 1 (one) RN to the Emergency Department. This nurse should immediately seek out the ED Charge Nurse and state s/he is from the 3East.
  • Complete and drop off Disaster Information Form to the Labor Pool located in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Work with Charge Nurse and Attending Physician to assess potential discharges or transfers
  • Assess that essential equipment is available
  • Assess stock of supplies
  • Reassure families only if prompted
  • Prepare for potentially large volume of admissions
  • Be prepared to initiate call trees if instructed by Incident Command
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

3 West

Code DELTA 1

  • The 3West Charge Nurse and the Hospitalist will round on all inpatient units to assess for potential discharges 
  • Complete and drop off Disaster Information Form to the Labor Pool located in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Work with Charge Nurse and Attending Physician to assess potential discharges or transfers
  • Assess that essential equipment is available
  • Assess stock of supplies
  • Reassure families only if prompted
  • Prepare for potentially large volume of admissions
  • Be prepared to initiate call trees if instructed by Incident Command
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

4 East

Code DELTA 1

  • Immediately send 1 (one) RN to the Emergency Department and immediately seek out the Charge Nurse and let them know s/he is from 4East.
  • Complete and drop off Disaster Information Form to the Labor Pool located in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Work with Charge Nurse and Attending Physician to assess potential discharges or transfers
  • Assess that essential equipment is available
  • Assess stock of supplies
  • Reassure families only if prompted
  • Prepare for potentially large volume of admissions
  • Be prepared to initiate call trees if instructed by Incident Command
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

4 West

Code DELTA 1

  • Immediately send 1 (one) RN to the Emergency Department. This nurse should immediately seek out the ED Charge Nurse and state s/he is from the 4W.
  • Complete and drop off Disaster Information Form to the Labor Pool located in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Work with Charge Nurse and Attending Physician to assess potential discharges or transfers
  • Assess that essential equipment is available
  • Assess stock of supplies
  • Reassure families only if prompted
  • Prepare for potentially large volume of admissions
  • Be prepared to initiate call trees if instructed by Incident Command
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Outpatient

Code DELTA 1

  • Complete and drop off Disaster Information Form to the Labor Pool located in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Review clinic schedule and assess for critical patient visits and patients traveling long distances for appointments
  • Await Incident Command decision for appointment cancellation. Notify families of cancelled appointments.
  • If appropriate, reschedule or resume patient appointments
  • Assess that essential equipment is available
  • Assess stock of supplies
  • Reassure families only if prompted
  • Be prepared to initiate call trees if instructed by Incident Command
  • Prepare for possible reassignment of nursing staff
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Specialty Nurses

Code DELTA 1

Specialty Nursing Includes But Is Not Limited To: Clinical Nurse Educators, Advanced Practice Nurses, Nursing Advancement, IV Therapy Nurses, Nursing Informatics

  • Complete and drop off Disaster Information Form to the Labor Pool located in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM FOR DIRECT PATIENT CARE FORM or CLICK TO ACCESS DEPARTMENTAL/DIVISION FORM
  • Work with Charge Nurse and Attending Physician to assess potential discharges or transfers
  • Assess that essential equipment is available
  • Assess stock of supplies
  • Reassure families only if prompted
  • Prepare for potentially large volume of admissions
  • Be prepared to initiate call trees if instructed by Incident Command
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Nurse Supervisor

Code DELTA 1

CLICK TO ACCESS ALL LABOR POOL FORMS

During 8 am to 5PM:

  • Code DELTA 1, 2, or 3 situation: Upon notification from Emergency Department of an influx of patients, the supervisor would do the following:
    • During regular business hours, notify Paul Kempinski, Incident Commander, and brief the situation, asking for activation of either Code DELTA 1 or 2 If he is off campus, unavailable, immediately notify Administrator on Call for activation order.
    • Call Command Center to activate Code DELTA notification
    • Notify Administrator on Call
    • Insure Labor Pool is activated and manned appropriately
    • Report to Incident Command
    • Insure security has opened file cabinet containing Emergency Operations Plan and Incident Command Vests
    • Be prepared to brief Incident Command Chiefs and Commander:
      • Pertinent, available information on the situation
      • Status of current patient population, census, and staffing
      • Specific number of patients in the following areas:
        • PICU, number of vented patients, CRRT, and ECMO
        • NICU, number of vented patients and ECMO
        • CICU, number of vented patients, CRRT, and ECMO
        • 2A, number of vented patients
        • BBMT
      • Emergency Department
        • Currently being treated
        • Observation cases
        • Number of waiting patients
      • Dialysis patients being treated
      • PeriOp:
        • Scheduled cases
        • Cases in progress
        • Number of critical cases versus elective cases on schedule
        • Ask surgical leadership to review potential cases for cancellation
      • Clinics
        • Status of current patients

After hours, 5PM to 7AM:

  • In the absence of Paul Kempinski or an onsite Administrator on Call, the Supervisor assumes the Incident Commander responsibilities
  • Follow day time supervisor responsibilities
  • Refer to Incident Command Checklist
  • Be prepared to brief Incident Command upon arrival of team

Respiratory

PICU

Code DELTA 1

  • Assure that Respiratory Therapists in area are accounted for on the appropriate Labor Pool Form
  • Two pre-designated Respiratory Therapists will report to the Emergency Department
  • Additional therapists may be requested by Incident Command through the Therapist In Charge
  • Assess that essential equipment is available
  • Assess stock of supplies
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

CICU

Code DELTA 1

  • Assure that Respiratory Therapists in area are accounted for on the appropriate Labor Pool Form
  • Two pre-designated Respiratory Therapists will report to the Emergency Department
  • Additional therapists may be requested by Incident Command through the Therapist In Charge
  • Assess that essential equipment is available
  • Assess stock of supplies
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

NICU

Code DELTA 1

  • Assure that Respiratory Therapists in area are accounted for on the appropriate Labor Pool Form
  • Two pre-designated Respiratory Therapists will report to the Emergency Department
  • Additional therapists may be requested by Incident Command through the Therapist In Charge
  • Assess that essential equipment is available
  • Assess stock of supplies
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Emergency Department

Code DELTA 1

  • Two pre-designated Respiratory Therapists will report to the Emergency Department
  • Additional therapists may be requested by Incident Command through the Therapist In Charge
  • Assess that essential equipment is available
  • Assess stock of supplies
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Surgical Services

Code DELTA 1

  • Assure that Respiratory Therapists in area are accounted for on the appropriate Labor Pool Form
  • Two pre-designated Respiratory Therapists will report to the Emergency Department
  • Additional therapists may be requested by Incident Command through the Therapist In Charge
  • Assess that essential equipment is available
  • Assess stock of supplies
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

2B

Code DELTA 1

  • Assure that Respiratory Therapists in area are accounted for on the appropriate Labor Pool Form
  • Two pre-designated Respiratory Therapists will report to the Emergency Department
  • Additional therapists may be requested by Incident Command through the Therapist In Charge
  • Assess that essential equipment is available
  • Assess stock of supplies
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

2 West

Code DELTA 1

  • Assure that Respiratory Therapists in area are accounted for on the appropriate Labor Pool Form
  • Two pre-designated Respiratory Therapists will report to the Emergency Department
  • Additional therapists may be requested by Incident Command through the Therapist In Charge
  • Assess that essential equipment is available
  • Assess stock of supplies
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

3 East

Code DELTA 1

  • Assure that Respiratory Therapists in area are accounted for on the appropriate Labor Pool Form
  • Two pre-designated Respiratory Therapists will report to the Emergency Department
  • Additional therapists may be requested by Incident Command through the Therapist In Charge
  • Assess that essential equipment is available
  • Assess stock of supplies
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

3 West

Code DELTA 1

  • Assure that Respiratory Therapists in area are accounted for on the appropriate Labor Pool Form
  • Two pre-designated Respiratory Therapists will report to the Emergency Department
  • Additional therapists may be requested by Incident Command through the Therapist In Charge
  • Assess that essential equipment is available
  • Assess stock of supplies
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

4 East

Code DELTA 1

  • Assure that Respiratory Therapists in area are accounted for on the appropriate Labor Pool Form
  • Two pre-designated Respiratory Therapists will report to the Emergency Department
  • Additional therapists may be requested by Incident Command through the Therapist In Charge
  • Assess that essential equipment is available
  • Assess stock of supplies
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

4 West

Code DELTA 1

  • Assure that Respiratory Therapists in area are accounted for on the appropriate Labor Pool Form
  • Two pre-designated Respiratory Therapists will report to the Emergency Department
  • Additional therapists may be requested by Incident Command through the Therapist In Charge
  • Assess that essential equipment is available
  • Assess stock of supplies
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Outpatient

Code DELTA 1

  • Assure that Respiratory Therapists in area are accounted for on the appropriate Labor Pool Form
  • Two pre-designated Respiratory Therapists will report to the Emergency Department
  • Additional therapists may be requested by Incident Command through the Therapist In Charge
  • Assess that essential equipment is available
  • Assess stock of supplies
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Physician

PICU

Code DELTA 1

  • PICU Attendings and Fellows report to the PICU
  • PICU Residents report to Emergency Department during Off Hour Shifts
  • Administrator or designee send current list of departmental physicians in house at the time of the Code Delta announcement to the Labor Pool and attach to DEPARTMENTAL LABOR POOL FORM (CLICK)
  • Assess for potential transfers and discharges
  • Prepare for possible large volume of admissions
  • Prepare to activate call tree
  • Await specific instructions from Incident Command

All other physicians can be found or contacted at the locations listed below

  • Critical Care Physicians Report to your specific ICU: PICU/NICU/CICU unit
  • Anesthesiologists Report to 2nd floor Preoperative Services Area
  • Surgeons Report to 2nd floor Preoperative Services Area
  • Emergency Division Physicians Report to Emergency Department
  • Medical Imaging Physicians Report to Medical Imaging
  • Pediatric Admitting Resident Reports to Emergency Department during day shift and then assesses the need to call Ortho, Trauma, Critical care to the Emergency Department
  • Ortho, Trauma, Critical Care Residents and Pediatric Admitting residents on Call Report to Emergency Department during Off Hour Shifts
  • 3 North resident remains on 3 North
  • Department of Pediatrics Report to the back of 3 F Nursing Unit for further instructions
  • 2A Charge Nurse will round with the Hospitalist to assess for potential discharges

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

CICU

Code DELTA 1

  • CICU Attendings and Fellows report to the CICU
  • CICU Residents report to Emergency Department during Off Hour Shifts
  • Administrator or designee send current list of departmental physicians in house at the time of the Code Delta announcement to the Labor Pool and attach to DEPARTMENTAL LABOR POOL FORM (CLICK)
  • Assess for potential transfers and discharges
  • Prepare for possible large volume of admissions
  • Prepare to activate call tree
  • Await specific instructions from Incident Command

All other physicians can be found or contacted at the locations listed below

  • Critical Care Physicians Report to your specific ICU: PICU/NICU/CICU unit
  • Anesthesiologists Report to 2nd floor Preoperative Services Area
  • Surgeons Report to 2nd floor Preoperative Services Area
  • Emergency Division Physicians Report to Emergency Department
  • Medical Imaging Physicians Report to Medical Imaging
  • Pediatric Admitting Resident Reports to Emergency Department during day shift and then assesses the need to call Ortho, Trauma, Critical care to the Emergency Department
  • Ortho, Trauma, Critical Care Residents and Pediatric Admitting residents on Call Report to Emergency Department during Off Hour Shifts
  • 3 North resident remains on 3 North
  • Department of Pediatrics Report to the back of 3 F Nursing Unit for further instructions
  • 2A Charge Nurse will round with the Hospitalist to assess for potential discharges

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

NICU

Code DELTA 1

  • NICU Attendings and Fellows report to the NICU
  • Administrator or designee send current list of departmental physicians in house at the time of the Code Delta announcement to the Labor Pool and attach to DEPARTMENTAL LABOR POOL FORM (CLICK)
  • Assess for potential transfers and discharges
  • Prepare for possible large volume of admissions
  • Prepare to activate call tree
  • Await specific instructions from Incident Command

All other physicians can be found or contacted at the locations listed below

  • Critical Care Physicians Report to your specific ICU: PICU/NICU/CICU unit
  • Anesthesiologists Report to 2nd floor Preoperative Services Area
  • Surgeons Report to 2nd floor Preoperative Services Area
  • Emergency Division Physicians Report to Emergency Department
  • Medical Imaging Physicians Report to Medical Imaging
  • Pediatric Admitting Resident Reports to Emergency Department during day shift and then assesses the need to call Ortho, Trauma, Critical care to the Emergency Department
  • Ortho, Trauma, Critical Care Residents and Pediatric Admitting residents on Call Report to Emergency Department during Off Hour Shifts
  • 3 North resident remains on 3 North
  • Department of Pediatrics Report to the back of 3 F Nursing Unit for further instructions
  • 2A Charge Nurse will round with the Hospitalist to assess for potential discharges

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Emergency Department

Code DELTA 1

  • Emergency Department lead physician identifies need for increased support/resources due to present patient requirements or impending patient arrival: Administrator on Call notified, situation reviewed, and decision made to activate code delta process.
  • If an immediate need exists to activate a Code Delta the ED Lead Physician and Nursing Supervisor are empowered to call a Code Delta and notify the Administrator On Call (e.g. No estimated time of arrival of mass causality or patients already present)

Emergency Department Physician response to active Code Delta:

  • Administrator or designee send current list of departmental physicians in house at the time of the Code Delta announcement to the Labor Pool
  • The ED attending assumes the role of Emergency Treatment Director. Their role is to organize patient care, assign physician assignments, assess medical needs (decontamination) and communicate with the Incident Command the number of patients, acuity and disposition.
  • The Charge Nurse assumes the role of Emergency Department Supervisor. Their role is to assign zone leaders, help the Emergency Treatment Director in the organization of patient care, and communicate essential needs from each zone leader to the Emergency Treatment Director. They need to maintain a total census of every patient in the department and their disposition.
  • The Zone leaders (Red - Yellow - Green and Staging) are RNs (the Green leader can be an ED tech to help with RN staffing) - their role is assure the rooms are labeled, identify immediate and ongoing staffing and equipment needs, communicate the needs to the ED Supervisor (Charge RN), make staffing assignments and maintain a census for the zone. Their role is not patient care, but a "charge RN" for that zone.
  • The zones can represent acuity - highest (red) assigned the closer rooms, to low (green) assigned to the outpatient area for future evaluation.
  • The zones can be used to divide the volume of patients with similar acuity levels.
  • Zones can be ignored and "code teams" assigned for each acute patient (best done with a small number of patients - i.e., 4 critical patients from a house fire.)
  • In Flu Pandemic, the zones can be assigned to the outpatient modules and teams of staff assigned to quickly decompress volume of non-acuity patients.
  • The Staging area is meant for patients awaiting discharge or admission and is generally in 1A. If this need does not exist that area should be utilized as an additional treatment area for disaster patients.
  • The proposed room assignments can be altered, but should be properly labeled to minimize confusion
  • These decisions are decided by the ED Treatment Director with the help of the ED Supervisor. Communication of the plan is key

All other physicians can be found or contacted at the locations listed below

  • Critical Care Physicians Report to your specific ICU: PICU/NICU/CICU unit
  • Anesthesiologists Report to 2nd floor Preoperative Services Area
  • Surgeons Report to 2nd floor Preoperative Services Area
  • Emergency Division Physicians Report to Emergency Department
  • Medical Imaging Physicians Report to Medical Imaging
  • Pediatric Admitting Resident Reports to Emergency Department during day shift and then assesses the need to call Ortho, Trauma, Critical care to the Emergency Department
  • Ortho, Trauma, Critical Care Residents and Pediatric Admitting residents on Call Report to Emergency Department during Off Hour Shifts 3 North resident remains on 3 North
  • Department of Pediatrics Report to the back of 3 F Nursing Unit for further instructions
  • 2A Charge Nurse will round with the Hospitalist to assess for potential discharges

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Trauma

Code DELTA 1

  • Report to the Emergency Department
  • Trauma residents report to Emergency Department during Off Hour Shifts
  • Administrator or designee send current list of departmental physicians in house at the time of the Code Delta announcement to the Labor Pool and attach to DEPARTMENTAL LABOR POOL FORM (CLICK)
  • Assess for potential transfers and discharges of trauma service patients
  • Prepare for possible large volume of admissions
  • Prepare to activate call tree
  • Await specific instructions from Incident Command

All other physicians can be found or contacted at the locations listed below

  • Critical Care Physicians Report to your specific ICU: PICU/NICU/CICU unit
  • Anesthesiologists Report to 2nd floor Preoperative Services Area
  • Surgeons Report to 2nd floor Preoperative Services Area
  • Emergency Division Physicians Report to Emergency Department
  • Medical Imaging Physicians Report to Medical Imaging
  • Pediatric Admitting Resident Reports to Emergency Department during day shift and then assesses the need to call Ortho, Trauma, Critical care to the Emergency Department
  • Ortho, Trauma, Critical Care Residents and Pediatric Admitting residents on Call Report to Emergency Department during Off Hour Shifts 3 North resident remains on 3 North
  • Department of Pediatrics Report to the back of 3 F Nursing Unit for further instructions
  • 2A Charge Nurse will round with the Hospitalist to assess for potential discharges

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Physician Surgical Services

Code DELTA 1

  • All Surgical Department procedures in progress should be completed without delay
  • No surgical procedures should be started unless the patient is classified as high-risk
  • Coordinate with OR Nursing Staff and Incident Command to assess priority or critical surgical procedures
  • Surgeons report to Preoperative Services Area
  • Surgical residents report to the Emergency Department
  • Administrator or designee send current list of departmental physicians in house at the time of the Code Delta announcement to the Labor Pool and attach to DEPARTMENTAL LABOR POOL FORM (CLICK)
  • Assess for potential transfers and discharges or surgical patients
  • Prepare for possible large volume of surgical procedures
  • Prepare to activate call tree
  • Await specific instructions from Incident Command

All other physicians can be found or contacted at the locations listed below

  • Critical Care Physicians Report to your specific ICU: PICU/NICU/CICU unit
  • Anesthesiologists Report to 2nd floor Preoperative Services Area
  • Surgeons Report to 2nd floor Preoperative Services Area
  • Emergency Division Physicians Report to Emergency Department
  • Medical Imaging Physicians Report to Medical Imaging
  • Pediatric Admitting Resident Reports to Emergency Department during day shift and then assesses the need to call Ortho, Trauma, Critical care to the Emergency Department
  • Ortho, Trauma, Critical Care Residents and Pediatric Admitting residents on Call Report to Emergency Department during Off Hour Shifts 3 North resident remains on 3 North
  • Department of Pediatrics Report to the back of 3 F Nursing Unit for further instructions
  • 2A Charge Nurse will round with the Hospitalist to assess for potential discharges

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Gold Team

Code DELTA 1

  • Administrator or designee send current list of departmental physicians in house at the time of the Code Delta announcement to the Labor Pool and attach to DEPARTMENTAL LABOR POOL FORM (CLICK)
  • Assess for potential transfers and discharges
  • Prepare for possible large volume of surgical procedures
  • Prepare to activate call tree
  • Await specific instructions from Incident Command

All other physicians can be found or contacted at the locations listed below

  • Critical Care Physicians Report to your specific ICU: PICU/NICU/CICU unit
  • Anesthesiologists Report to 2nd floor Preoperative Services Area
  • Surgeons Report to 2nd floor Preoperative Services Area
  • Emergency Division Physicians Report to Emergency Department
  • Medical Imaging Physicians Report to Medical Imaging
  • Pediatric Admitting Resident Reports to Emergency Department during day shift and then assesses the need to call Ortho, Trauma, Critical care to the Emergency Department
  • Ortho, Trauma, Critical Care Residents and Pediatric Admitting residents on Call Report to Emergency Department during Off Hour Shifts 3 North resident remains on 3 North
  • Department of Pediatrics Report to the back of 3 F Nursing Unit for further instructions
  • 2A Charge Nurse will round with the Hospitalist to assess for potential discharges

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Silver Team

Code DELTA 1

  • Administrator or designee send current list of departmental physicians in house at the time of the Code Delta announcement to the Labor Pool and attach to DEPARTMENTAL LABOR POOL FORM (CLICK)
  • Assess for potential transfers and discharges
  • Prepare for possible large volume of surgical procedures
  • Prepare to activate call tree
  • Await specific instructions from Incident Command

All other physicians can be found or contacted at the locations listed below

  • Critical Care Physicians Report to your specific ICU: PICU/NICU/CICU unit
  • Anesthesiologists Report to 2nd floor Preoperative Services Area
  • Surgeons Report to 2nd floor Preoperative Services Area
  • Emergency Division Physicians Report to Emergency Department
  • Medical Imaging Physicians Report to Medical Imaging
  • Pediatric Admitting Resident Reports to Emergency Department during day shift and then assesses the need to call Ortho, Trauma, Critical care to the Emergency Department
  • Ortho, Trauma, Critical Care Residents and Pediatric Admitting residents on Call Report to Emergency Department during Off Hour Shifts 3 North resident remains on 3 North
  • Department of Pediatrics Report to the back of 3 F Nursing Unit for further instructions
  • 2A Charge Nurse will round with the Hospitalist to assess for potential discharges

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Red Team

Code DELTA 1

  • Administrator or designee send current list of departmental physicians in house at the time of the Code Delta announcement to the Labor Pool and attach to DEPARTMENTAL LABOR POOL FORM (CLICK)
  • Assess for potential transfers and discharges
  • Prepare for possible large volume of surgical procedures
  • Prepare to activate call tree
  • Await specific instructions from Incident Command

All other physicians can be found or contacted at the locations listed below

  • Critical Care Physicians Report to your specific ICU: PICU/NICU/CICU unit
  • Anesthesiologists Report to 2nd floor Preoperative Services Area
  • Surgeons Report to 2nd floor Preoperative Services Area
  • Emergency Division Physicians Report to Emergency Department
  • Medical Imaging Physicians Report to Medical Imaging
  • Pediatric Admitting Resident Reports to Emergency Department during day shift and then assesses the need to call Ortho, Trauma, Critical care to the Emergency Department
  • Ortho, Trauma, Critical Care Residents and Pediatric Admitting residents on Call Report to Emergency Department during Off Hour Shifts 3 North resident remains on 3 North
  • Department of Pediatrics Report to the back of 3 F Nursing Unit for further instructions
  • 2A Charge Nurse will round with the Hospitalist to assess for potential discharges

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Blue Team

Code DELTA 1

  • Administrator or designee send current list of departmental physicians in house at the time of the Code Delta announcement to the Labor Pool and attach to DEPARTMENTAL LABOR POOL FORM (CLICK)
  • Assess for potential transfers and discharges
  • Prepare for possible large volume of surgical procedures
  • Prepare to activate call tree
  • Await specific instructions from Incident Command

All other physicians can be found or contacted at the locations listed below

  • Critical Care Physicians Report to your specific ICU: PICU/NICU/CICU unit
  • Anesthesiologists Report to 2nd floor Preoperative Services Area
  • Surgeons Report to 2nd floor Preoperative Services Area
  • Emergency Division Physicians Report to Emergency Department
  • Medical Imaging Physicians Report to Medical Imaging
  • Pediatric Admitting Resident Reports to Emergency Department during day shift and then assesses the need to call Ortho, Trauma, Critical care to the Emergency Department
  • Ortho, Trauma, Critical Care Residents and Pediatric Admitting residents on Call Report to Emergency Department during Off Hour Shifts 3 North resident remains on 3 North
  • Department of Pediatrics Report to the back of 3 F Nursing Unit for further instructions
  • 2A Charge Nurse will round with the Hospitalist to assess for potential discharges

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Anesthesia

Code DELTA 1

  • Anesthesiologists report to the second floor Preoperative Services Area
  • Administrator or designee send current list of departmental physicians in house at the time of the Code Delta announcement to the Labor Pool and attach to DEPARTMENTAL LABOR POOL FORM (CLICK)
  • Assess for potential transfers and discharges or surgical patients
  • Prepare for possible large volume of surgical procedures
  • Prepare to activate call tree
  • Await specific instructions from Incident Command

All other physicians can be found or contacted at the locations listed below

  • Critical Care Physicians Report to your specific ICU: PICU/NICU/CICU unit
  • Anesthesiologists Report to 2nd floor Preoperative Services Area
  • Surgeons Report to 2nd floor Preoperative Services Area
  • Emergency Division Physicians Report to Emergency Department
  • Medical Imaging Physicians Report to Medical Imaging
  • Pediatric Admitting Resident Reports to Emergency Department during day shift and then assesses the need to call Ortho, Trauma, Critical care to the Emergency Department
  • Ortho, Trauma, Critical Care Residents and Pediatric Admitting residents on Call Report to Emergency Department during Off Hour Shifts 3 North resident remains on 3 North
  • Department of Pediatrics Report to the back of 3 F Nursing Unit for further instructions
  • 2A Charge Nurse will round with the Hospitalist to assess for potential discharges

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

General Pediatrics

Code DELTA 1

  • The Hospitalist will round on all inpatient units to assess for potential discharges.
  • Pediatric Admitting Resident Reports to Emergency Department during day shift and then assesses the need to call Ortho, Trauma, Critical care to the Emergency Department
  • If not in office or unit, assure Incident Command has an accurate means for immediate contact.
  • Administrator or designee send current list of departmental physicians in house at the time of the Code Delta announcement to the Labor Pool and attach to DEPARTMENTAL LABOR POOL FORM (CLICK)
  • Assess for potential transfers and discharges
  • Prepare for possible large volume of admissions
  • Prepare to activate call tree
  • Await specific instructions from Incident Command

All other physicians can be found or contacted at the locations listed below

  • Critical Care Physicians Report to your specific ICU: PICU/NICU/CICU unit
  • Anesthesiologists Report to 2nd floor Preoperative Services Area
  • Surgeons Report to 2nd floor Preoperative Services Area
  • Emergency Division Physicians Report to Emergency Department
  • Medical Imaging Physicians Report to Medical Imaging
  • Pediatric Admitting Resident Reports to Emergency Department during day shift and then assesses the need to call Ortho, Trauma, Critical care to the Emergency Department
  • Ortho, Trauma, Critical Care Residents and Pediatric Admitting residents on Call Report to Emergency Department during Off Hour Shifts
  • 3 North resident remains on 3 North
  • Department of Pediatrics Report to the back of 3 F Nursing Unit for further instructions
  • 2A Charge Nurse will round with the Hospitalist to assess for potential discharges

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

All Other Physicians

Code DELTA 1

All Other Physicians Including But Not Limited To: Orthopedics, Diagnostic Referral, Pathology, Primary Care, Developmental Medicine, Genetics, Immunology, Behavioral Health, Endocrinology, Hematology/Oncology, Neurology, Nephrology, Pulmonology, Rheumatology, Weight Management, Rehabilitation, Otolaryngology, Transition Team, Dentistry, Ophthalmology, Urology

  • Continue to provide regular patient care unless otherwise requested by Incident Command
  • If not in office or unit, assure Incident Command has an accurate means for immediate contact.
  • Administrator or designee send current list of departmental physicians in house at the time of the Code Delta announcement to the Labor Pool and attach to DEPARTMENTAL LABOR POOL FORM (CLICK)
  • Assess for potential transfers and discharges
  • Prepare for possible large volume of admissions
  • Prepare to activate call tree
  • Await specific instructions from Incident Command

All other physicians can be found or contacted at the locations listed below

  • Critical Care Physicians Report to your specific ICU: PICU/NICU/CICU unit
  • Anesthesiologists Report to 2nd floor Preoperative Services Area
  • Surgeons Report to 2nd floor Preoperative Services Area
  • Emergency Division Physicians Report to Emergency Department
  • Medical Imaging Physicians Report to Medical Imaging
  • Pediatric Admitting Resident Reports to Emergency Department during day shift and then assesses the need to call Ortho, Trauma, Critical care to the Emergency Department
  • Ortho, Trauma, Critical Care Residents and Pediatric Admitting residents on Call Report to Emergency Department during Off Hour Shifts
  • 3 North resident remains on 3 North
  • Department of Pediatrics Report to the back of 3 F Nursing Unit for further instructions
  • 2A Charge Nurse will round with the Hospitalist to assess for potential discharges

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Security

Command Center

Code DELTA 1

  • Confirm Security opened Labor Pool, located in 1F-53 (Emergency Department Associate hall)
  • Confirm Security brought Disaster Box to Incident Command Center
  • The Security Officer Recall Roster will be in effect. It will be the Emergency Department Security Officer’s responsibility for notifying all Security personnel of the threat status and advising them when/where to report for duty.
  • During off hours, Security Officers will be responsible for opening Incident Command Center if locked
  • If the situation warrants, the main and employee entrances will be closed off using cones or barriers and placed in a lock-down status. Security Officers 71 & 72 will relocate to the main and outpatient entrances and will assist with access control, package inspections, and building sweeps.

  • Mobile Patrol will initiate and operate an ID check post at the main vehicle entrance at Rockland Road and Children’s Drive. All vehicles and pedestrians are to be stopped at this location and Employee badges verified. The security vehicle and traffic cones will be utilized to block lanes and divert traffic in this effort. The patrol officer will be tasked with boarding all delivery trucks and performing a vehicle inspection prior to granting access. A phone call should be made to all receiving parties to verify delivery (this includes Materials Management deliveries). The security patrol will escort any responding police/ fire department personnel to the loading dock area. An interior security unit or manager will respond to the loading dock and provide escort for the emergency personnel to the incident scene.
  • Notify Facilities Managers and request assistance with access control, building sweeps, and package inspections by staff.
  • Contact the Incident Command Center to notify of severe threat status. Ask that each department conduct area sweeps. They will be tasked with conducting a department sweep once per shift and calling into the Command Center with results.

  • The patrol vehicle is to be parked at the main entrance creating a physical barrier. It will remain until the severe threat level is lifted
  • Receiving dock will not be accessed without a Materials Management representative present to verify delivery personnel and perform vehicle inspection.
  • During the evening shift all front row-parking spaces in lots 6 and 4 are to be cordoned off using security tape and/or cones.
  • All site construction projects will be reviewed by Facilities and Security Management to determine whether the project will be suspended until the severe threat level is lifted.
  • All special events will be cancelled during the severe threat event.
  • Exterior door inspections and exterior sweeps to all properties are to be performed once per shift.
  • Look for unattended packages, suspicious person(s) or unauthorized vehicles. Be sure to take down the vehicle tag number immediately upon identifying suspicious activity. Increased visibility of our patrols is the goal during such an event.
  • Patrol should report all exterior light and access failures immediately.
  • Do not allow vehicles to park alongside any of the buildings. Approach all illegally parked Vehicles and direct the driver to move immediately.
  • All exterior property fencing must be inspected every 12-hours.

  • The Incident Command Center will be the central contact for all appointments by contractors, Vendors and/or visitors requiring escort. Department contacts and/or escorts will be required to give 24 hours notice for scheduled visits. A daily list will be generated by the Incident Command Center and distributed to all posts including patrol. Only those visitors and vendors on the list will be admitted onto the site.
  • No personal deliveries will be permitted on site. This includes but is not limited to food and floral deliveries, etc.
  • Package inspections will be performed on all packages entering the buildings.
  • Badge spot inspections should be conducted on a continuous basis. Ensure all associates are wearing their identification badge in the building and advise those who are not that it is mandatory to do so.
  • Building exterior sweeps will be conducted each shift.

In the event of a severe threat, and as directed by AIDHC Executive Management, the following protective measures shall be implemented only at those facilities that may be at risk during a period of heightened alert. The Security OIC will be responsible for providing a detailed site-specific plan to cover any unique circumstances and/or operational requirements for that site.

  1. Notification to the following people and/or designee should take place during the first phase after Severe threat status is declared.
    1. Director of Security
    2. Administrator On Call
  2. The Incident Command Center will be responsible for notifying the following entities.
    1. Emergency Response Group
    2. Security Administrator
    3. Safety Administrator
    4. Security Officers to communicate the following suggestions to department managers.
      • Encourage car pools (3-4 per car) for people living in close proximity.
      • Limit the amount of hand carried items and packages brought into the facilities.
      • Implement a flex-working schedule, staggering starting times when applicable.
  3. The Healthcare Emergency Incident Command System (HEICS) will be implemented and the Code Delta Command Center (Facilities Conference Room) will be staffed 24/7 during a severe threat affecting any AIDHC Facility. All satellite status updates will be communicated through The Command Center.

Mass Casualty Incident with the anticipation of 25 or more patients.

  • Notification as per Emergency Management Plan
  • Staff pre-designated for Emergency Room report as directed.
  • Follow Emergency Management Plan
  • Establish Command Post and open Incident Command Center
  • Commence with documentation.

Local or Regional Emergency with the anticipation of fewer than 25 patients.

  • Notification of Emergency Department Physician in Charge and Administrator on-call.
  • Request for additional personnel made by the Emergency Department Staff.
  • Follow Emergency Management Plan.
  • Establish Command Post and open Incident Command Center.
  • Commence with documentation.

Operations Systems Failure

  • Notification to all personnel by email, pager, and overhead announcement.
  • Request for needed personnel, management and labor pool.
  • Establish Command Post and open Incident Command Center.
  • Commence with documentation.

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Other Security Personnel

Code DELTA 1

  • The Security Officer Recall Roster will be in effect. It will be the Emergency Department Security Officer’s responsibility for notifying all Security personnel of the threat status and advising them when/where to report for duty.
  • During off hours, Security Officers will be responsible for opening Incident Command Center if locked
  • If the situation warrants, the main and employee entrances will be closed off using cones or barriers and placed in a lock-down status. Security Officers 71 & 72 will relocate to the main and outpatient entrances and will assist with access control, package inspections, and building sweeps.

Mobilize, assign, and pre-position emergency response personnel

  • Mobile Patrol will initiate and operate an ID check post at the main vehicle entrance at Rockland Road and Children’s Drive. All vehicles and pedestrians are to be stopped at this location and Employee badges verified. The security vehicle and traffic cones will be utilized to block lanes and divert traffic in this effort. The patrol officer will be tasked with boarding all delivery trucks and performing a vehicle inspection prior to granting access. A phone call should be made to all receiving parties to verify delivery (this includes Materials Management deliveries). The security patrol will escort any responding police/ fire department personnel to the loading dock area. An interior security unit or manager will respond to the loading dock and provide escort for the emergency personnel to the incident scene.
  • Notify Facilities Managers and request assistance with access control, building sweeps, and package inspections by staff.
  • Contact the Incident Command Center to notify of severe threat status. Ask that each department conduct area sweeps. They will be tasked with conducting a department sweep once per shift and calling into the Command Center with results.

Close high risk and/or vulnerable facilities, if applicable

  • The patrol vehicle is to be parked at the main entrance creating a physical barrier. It will remain until the severe threat level is lifted
  • Receiving dock will not be accessed without a Materials Management representative present to verify delivery personnel and perform vehicle inspection.
  • During the evening shift all front row-parking spaces in lots 6 and 4 are to be cordoned off using security tape and/or cones.
  • The Incident Command Center will be the central contact for all appointments by contractors, Vendors and/or visitors requiring escort. Department contacts and/or escorts will be required to give 24 hours notice for scheduled visits. A daily list will be generated by the Incident Command Center and distributed to all posts including patrol. Only those visitors and vendors on the list will be admitted onto the site.
  • No personal deliveries will be permitted on site. This includes but is not limited to food and floral deliveries, etc.
  • Package inspections will be performed on all packages entering the buildings.
  • Badge spot inspections should be conducted on a continuous basis. Ensure all associates are wearing their identification badge in the building and advise those who are not that it is mandatory to do so.
  • Building exterior sweeps will be conducted each shift.

Immediate protocol alterations

  • The Incident Command Center will be the central contact for all appointments by contractors, Vendors and/or visitors requiring escort. Department contacts and/or escorts will be required to give 24 hours notice for scheduled visits. A daily list will be generated by the Incident Command Center and distributed to all posts including patrol. Only those visitors and vendors on the list will be admitted onto the site.
  • No personal deliveries will be permitted on site. This includes but is not limited to food and floral deliveries, etc.
  • Package inspections will be performed on all packages entering the buildings.
  • Badge spot inspections should be conducted on a continuous basis. Ensure all associates are wearing their identification badge in the building and advise those who are not that it is mandatory to do so.
  • Building exterior sweeps will be conducted each shift.

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Administration

Administration

Code DELTA 1

Administrator on Call for Code Delta 1, 2, 3 or special "Disaster Code"

  • Activation of a Code Delta 1, 2 or 3 occurs when the Nursing Supervisor contacts the Administrator on Call and reports a detailed scenario of what is occurring:
    • Estimated arrival of 25 or more patients to the Emergency Department (Code Delta 1)
    • Estimated arrival of 24 or less patients to the Emergency Department (Code Delta 2)
    • An infrastructure/operations failure directly impacting the delivery safe patient care i.e., power loss, fire. (Code Delta 3)

Note: Emergency Physician, in collaboration with the Nursing Supervisor, is empowered to make Code Delta activation if ETA of incoming patient influx is imminent and then notify the Administrator on Call

  • If this notification occurs during routine business hours, the Administrator on Call confers with the Incident Commander, COO Paul Kempinski, as to the activation of a Code Delta.
  • If this notification occurs after hours, the Administrator on Call is empowered to activate a Code Delta
  • After hours, the Administrator on Call assumes the responsibility as acting Incident Commander in the Incident Command Center

"Disaster Alert"

  • Some disaster situations may not require the immediate, full manpower response resulting from activating a Code Delta 1, 2, or 3. Yet, key stakeholders should be alerted to the actual or potential disaster situation and further discussion occurs whether to activate an actual Code Delta.
  • The Administrator on Call would then ask the Command Center to notify the following Leaderships personnel for further discussion:
    • Incident Commander
    • Safety Officer
    • Operations Chief
    • Planning Chief
    • Logistics Chief
    • Chief Medical Officer
    • Chief Nursing Executive
    • Any specific departmental/division leader directly impacted by that specific situation. i.e. , loss of HVAC, loss of computers

CLICK TO ACCESS INCIDENT COMMAND CHECK LIST

CLICK TO ACCESS ALL LABOR POOL FORMS

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Pharmacy

Pharmacy

Code Delta 1

  • Administrator or designee will fill out a Departmental/Divisions Labor Pool Form and submit to the Labor Pool in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Deliver three (3) medication drawers directly to the Emergency Department
  • Be available for support as requested by patient units and Incident Command
  • Prepare for potentially large amount of medication orders
  • Prepare to initiate call tree
  • For any requests call incident command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Clerk

Clerk/Aides

Code DELTA 1

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Social Work

Social Worker

Code DELTA 1

  • Administrator or designee will fill out a Departmental/Divisions Labor Pool Form and submit to the Labor Pool in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • A pre-designated Social Worker will report to the Emergency Department
  • All other social workers report to Labor Pool
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Pastoral Care

Pastoral Care

Code DELTA 1

  • Administrator or designee will fill out a Departmental/Divisions Labor Pool Form and submit to the Labor Pool in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • No specific required duties. Please be available if contacted by Incident Command
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Rehab and Therapy Services

Rehab and Therapy Services

Code DELTA 1

  • Administrator or designee will fill out a Departmental/Divisions Labor Pool Form and submit to the Labor Poolin 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • No specific required duties. Please be available if contacted by Incident Command
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Facilities

Facilities

Code DELTA 1

  • Administrator or designee will fill out a Departmental/Divisions Labor Pool Form and submit to the Labor Pool in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Be available for support related to building systems management
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Clinical Lab

Clinical Lab

Code DELTA 1

  • Administrator or designee will fill out a Departmental/Divisions Labor Pool Form and submit to the Labor Pool in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • No specific required duties. Please be available if contacted by Incident Command
  • Please be aware of STAT lab orders
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Information Systems

Information Systems

Code DELTA 1

  • Administrator or designee will fill out a Departmental/Divisions Labor Pool Form and submit to the Labor Pool in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • No specific required duties. Please be available if contacted by Incident Command
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Nutrition Services

Nutrition Services

Code DELTA 1

  • Administrator or designee will fill out a Departmental/Divisions Labor Pool Form and submit to the Labor Pool in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • No specific required duties. Please be available if contacted by Incident Command
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Radiology

X-Ray

Code DELTA 1

  • Clerk or designee report to Labor Pool (Room 1F-53) in Emergency Department Associate hall and initiate Labor Pool opening sequence Reliable Method (found in binder in 1F-53)
  • Administrator or designee will fill out a Departmental/Divisions Labor Pool Form and submit to the Labor Pool in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Radiologists report back to the Radiology Department
  • No specific required duties. Please be available if contacted by Incident Command
  • Please be aware of STAT or priority orders
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

MRI

Code DELTA 1

  • Clerk or designee report to Labor Pool (Room 1F-53) in Emergency Department Associate hall and initiate Labor Pool opening sequence Reliable Method (found in binder in 1F-53)
  • Administrator or designee will fill out a Departmental/Divisions Labor Pool Form and submit to the Labor Pool in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Radiologists report back to the Radiology Department
  • No specific required duties. Please be available if contacted by Incident Command
  • Be aware schedules may need to be rearranged to accommodate patients related to mass causality
  • Please be aware STAT or priority of orders
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

CT

Code DELTA 1

  • Clerk or designee report to Labor Pool (Room 1F-53) in Emergency Department Associate hall and initiate Labor Pool opening sequence Reliable Method (found in binder in 1F-53)
  • Administrator or designee will fill out a Departmental/Divisions Labor Pool Form and submit to the Labor Pool in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Radiologists report back to the Radiology Department
  • No specific required duties. Please be available if contacted by Incident Command
  • Be aware schedules may need to be rearranged to accommodate patients related to mass causality
  • Please be aware STAT or priority of orders
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Interventional

Code DELTA 1

  • Clerk or designee report to Labor Pool (Room 1F-53) in Emergency Department Associate hall and initiate Labor Pool opening sequence Reliable Method (found in binder in 1F-53)
  • Administrator or designee will fill out a Departmental/Divisions Labor Pool Form and submit to the Labor Pool in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Radiologists report back to the Radiology Department
  • No specific required duties. Please be available if contacted by Incident Command
  • Be aware schedules may need to be rearranged to accommodate patients related to mass causality
  • Please be aware STAT or priority of orders
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Ultrasound

Code DELTA 1

  • Clerk or designee report to Labor Pool (Room 1F-53) in Emergency Department Associate hall and initiate Labor Pool opening sequence Reliable Method (found in binder in 1F-53)
  • Administrator or designee will fill out a Departmental/Divisions Labor Pool Form and submit to the Labor Pool in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Radiologists report back to the Radiology Department
  • No specific required duties. Please be available if contacted by Incident Command
  • Be aware schedules may need to be rearranged to accommodate patients related to mass causality
  • Please be aware STAT or priority of orders
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Health Information Management

Health Information Management

Code DELTA 1

  • No specific required duties. Please be available if contacted by Incident Command
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Human Resource

Human Resources

Code DELTA 1

  • No specific required duties. Please be available if contacted by Incident Command
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Environmental Services

Environmental Services

Code DELTA 1

  • Administrator or designee will fill out a Departmental/Divisions Labor Pool Form and submit to the Labor Pool in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Immediately deliver 10 (ten) stretchers, 10 (ten) wheelchairs, and linen carts positioned in the linkage hallway connecting the main facility to the Administrative Research Building (ARB), outside the Emergency Department hall entrance
  • Be aware of STAT cleaning orders for potential admissions
  • Be available for additional support related to Environmental Services as requested by Incident Command
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Materials Management

Material Management

Code DELTA 1

  • Administrator or designee will fill out a Departmental/Divisions Labor Pool Form and submit to the Labor Pool in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Be available to assist with unit or Incident Command needs as instructed by Incident Command
  • Be aware of STAT supply requests
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Volunteer Services

Volunteer Services

Code DELTA 1

  • Administrator or designee will fill out a Departmental/Divisions Labor Pool Form and submit to the Labor Pool in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Volunteers should immediately report to the Labor Pool located in the MRI waiting area (first floor) and await instructions
  • Volunteers may be utilized as "runners"
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Critical Care Transport

Critical Care Transport

Code DELTA 1

  • Complete the Critical Care Transport Labor Pool Form and submit to the Labor Pool in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Provide Support as requested by Incident Command
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Child Life

Child Life

Code DELTA 1

  • Administrator or designee will fill out a Departmental/Divisions Labor Pool Form and submit to the Labor Poolin 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Provide support for patients, siblings, and parents if safe to do so. If available space is considered high traffic or being utilized by clinical staff, step outside of the room or to an area which would not disrupt the immediate view or contact of any patients from a clinical provider.

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Blood Bank

Blood Bank

Code DELTA 1

  • Administrator or designee will fill out a Departmental/Divisions Labor Pool Form and submit to the Labor Pool 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Be aware of STAT orders and STAT type and screens
  • Prepare for potentially large request of blood products
  • Be aware of STAT and priority orders for blood products
  • Prioritize blood product orders (I.E. RBCs for trauma patient vs. routine FFP for stable transplant patient)
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

Marketing and Public Relations

Marketing and Public Relations

Code DELTA 1

  • The Public Relations Spokespersons will handle all questions from the public and media
  • Administrator or designee will fill out a Departmental/Divisions Labor Pool Form and submit to the Labor Pool in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.

All Other Associates

All Other Associates

Code DELTA 1

  • Administrator or designee will fill out a Departmental/Divisions Labor Pool Form and submit to the Labor Pool in 1F-53 (Emergency Department Associate hall) CLICK TO ACCESS FORM
  • Provide Support as requested by Incident Command
  • For any requests call Incident Command at 53-6900

Location of the Emergency Management Plan: This 500 page document is physically located in or with Administration, Safety Officer, and in the Incident Command Code Delta box. A digital link to this plan is available only through the Nemours intranet.