Department-Specific Disaster Plan

UNIVERSITYHOSPITAL

DEPARTMENT-SPECIFIC DISASTER PLAN

FOR

(Your Department)– 2004

I.INTRODUCTION

This plan provides a system to identify what actions will be taken in the event of an internal or external disaster for the above-mentioned department at UniversityHospital. This plan works in conjunction with the University HospitalEmergency Operations Plan and the University Hospital Fire Safety and Emergency Evacuation Plan.

In the event of an actual disaster situation in this department or affecting this department, the Department-specific Disaster Plan and the Hospitals Emergency Operations Plan would be activated. While the Department-specific Disaster Plan addresses what action would be taken by the staff in this department, the Emergency Operations Plan addresses the action that would be taken by hospital-wide staff during an internal or external disaster situation.

II.PURPOSE

This plan promotes a safe environment for our patients, staff, visitors and the community in the event of an internal or external event and exists to identify department-specific evacuation and disaster features.

III.ACCOUNTABILITY

The President and Chief Executive Officer has ultimate responsibility for ensuring compliance with this plan. The Vice Presidents have delegated implementation of this responsibility to the Executive Directors and Directors who in turn have delegated to the Department Managers.

IV.ROLES AND RESPONSIBILITIES

A.DEPARTMENT MANAGER OR DESIGNEE

1.Assist in the coordination of all activities.

2.Ensure that this Plan is reviewed and updated as frequently as necessary, but at least annually. Maintain the latest copy of the Plan in a central location within the Department at all times, and ensure that it is accessible to all for review.

3.Ensure that all staff under their supervision receives annual training on the UH Emergency Operations Plan and the Department-specific disaster plan and that this training is documented.

4.Account for all staff and patients under their supervision. Whenever a patient is transferred the following items will accompany the patient: chart, addressograph plate, kardex, medex, medications and all personal effects.

IV.ROLES AND RESPONSIBILITIES(continued)

B.STAFF

1.Be responsible for familiarization with and complying with the requirements in the University Hospital Emergency Operations Plan and their Department-specific DisasterPlan, including a clear understanding of their role.

2.Guide occupants to a safe area, if necessary, and assist with evacuation and other disaster procedures as necessary by providing necessary directions and information.

V.PROCEDURES

A.EVACUATION: In the event of an evacuation, all staff and patients will be accounted for. The following exit route(s) and designated relocation areas will be used as necessary:

Horizontal Evacuation relocation area:

Vertical Evacuation relocation area:

Primary exit route:

Secondary exit route:

**In the event of a complete hospital evacuation, the designated meeting place is the DOC circle. The alternate meeting place is the open area by the George F. Smith library.

B.MEDICAL GASES: Medical gases will only be turned off after approval and direction from the Department/Nurse Manager (designee) or the Fire Department

MEDICAL GAS / Location of Emergency Shut- off Valve / Areas that are tied into emergency shut-off valve

C.FIRE ALARM PULL BOX STATIONS: The nearest fire alarm pull box station will be activated when a fire is suspected or confirmed and any time that evacuation is deemed necessary. The following are the nearest fire alarm pull box stations:

Location:

Location:

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D.FIRE EXTINGUISHER: Staff will use a fire extinguisher only if they are trained and confident about using one. The following are the nearest fire extinguishers:

Primary: Type

Secondary: Type

E.HAZARDOUS EQUIPMENT AND/OR MATERIALS

MATERIAL / LOCATION / SPECIAL INSTRUCTIONS

F.PHYSICALLY CHALLENGED STAFF

Name(s):

Response Buddy:

G.EMERGENCY ELECTRICAL OUTLETS: Identified by a red cover plate marked, some marked “emergency”

Location(s):

H.TELEPHONE TREE

Location:

Note: The telephone tree will be activated by (include title here). Once activated, staff will report to(include location here)

I.SUPPLIES

Flashlight and extension cords: Call Physical Plant at 2-5400.

Other supplies: Contact the Command Post at 2-5800/5801

J. OTHERinformation specific to the department:

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Date Plan developed:

Date reviewed:

Reviewed by: Title:

Signatures:

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