Evaluation of Hospital Disaster Drills: Main Spreadsheet (continued)

Evaluation of Hospital Disaster Drills

Main Spreadsheet (continued)

Hospital	#	Question		Incident Command Center	Decontamination	Triage	Treatment
Section	#	Question		Incident Command Center	Decontamination	Triage	Treatment
Communications		Communication device(s):
	C36	2-way radio/ phone	a. Present
			b. # available
			c. Used in drill
			d. Comments
	C37	Direct line	a. Present
			b. # available
			c. Used in drill
			d. Comments
	C38	Landline phone	a. Present
			b. # available
			c. Used in drill
			d. Comments
	C39	Wireless/cell phone	a. Present
			b. # available
			c. Used in drill
			d. Comments
	C40	AM/FM radio	a. Present
			b. # available
			c. Used in drill
			d. Comments
	C41	Television	a. Present
			b. # available
			c. Used in drill
			d. Comments
	C42	Numeric paging	a. Present
			b. # available
			c. Used in drill
			d. Comments
	C43	Overhead paging	a. Present
			b. # available
			c. Used in drill
			d. Comments
	C44	Text paging	a. Present
			b. # available
			c. Used in drill
			d. Comments
	C45	Email & Internet access	a. Present
			b. # available
			c. Used in drill
			d. Comments
	C46	FAX machine (s)	a. Present
			b. # available
			c. Used in drill
			d. Comments
	C47	Intercom	a. Present
			b. # available
			c. Used in drill
			d. Comments
	C48	Megaphone	a. Present
			b. # available
			c. Used in drill
			d. Comments
	C49	Runner	a. Present
			b. # available
			c. Used in drill
			d. Comments
	C50	Other (Write In)	a. Present
			b. # available
			c. Used in drill
			d. Comments
	C51	Other (Write In)	a. Present
			b. # available
			c. Used in drill
d. Comments
C52	Other (Write In)	a. Present
		b. # available
		c. Used in drill
		d. Comments
C53	How incoming information in zone recorded	a. Computer (other electronic device)
		b. Notepaper
		c. Posted paper
		d. White board/chalk board
		e. Not recorded
		f. Other (specify)
	Comments:
Information Flow	C54	How zone notified of event	a. FAX
			b. Runner
			c. Telephone
			d. Not notified
			e. Other (specify)
	C55	Who notified zone of event	a. Drill organizer
			b. ICC
			c. Media
			d. Other hospital staff
			e. Outside source
			f. Victims arriving
			g. Not notified
			h. Other (specify)
	C56	Updates received regarding situation outside hospital	Y / N / U
	C57	Who sent updates from outside hospital	a. City/state health department
			b. EMS
			c. ICC
			d. Media
			e. State disaster agency
			f. Did not receive
			g. Other (specify)
	C58	Method for keeping zone aware of situation within hospital	a. Calls from ICC
			b. FAX from ICC
			c. Other contact from ICC
			d. Runners from ICC
			e. Contact from other internal sources (specify)
	C59	Were problems created due to delays in receiving information? (Specify in comment box)	Y / N / U
		How often was info received by ICC?
	IC30	Available operating rooms	Once
			Multiple updates
			Unclear
			NA
	IC31	Available staffed floor beds	Once
			Multiple updates
			Unclear
			NA
	IC32	Available staffed intensive care beds	Once
			Multiple updates
			Unclear
			NA
	IC33	Available staffed isolation beds	Once
			Multiple updates
			Unclear
			NA
	IC34	Number of arriving victims	Once
			Multiple updates
			Unclear
			NA
	IC35	Estimated time window of victim's arrival	Once
			Multiple updates
			Unclear
			NA
	IC36	Expected triage level of victims	Once
			Multiple updates
			Unclear
			NA
	IC37	Number of victims ED can accept	Once
			Multiple updates
			Unclear
			NA
	IC38	Clinical staff available (e.g. physicians, nurses)	Once
			Multiple updates
			Unclear
			NA
IC39	Total number of expected victims	Once
		Multiple updates
		Unclear
		NA
IC40	Potential discharges of 'actual' patients	Once
		Multiple updates
		Unclear
		NA
IC41	Support staff available (registrar, security)	Once
		Multiple updates
		Unclear
		NA
IC42	Other (specify)	Once
		Multiple updates
		Unclear
		NA
IC43	Other (specify)	Once
		Multiple updates
		Unclear
		NA
IC44	Other (specify)	Once
		Multiple updates
		Unclear
		NA
IC45	Means used in ICC to receive data from within hospital	a. 2-way radio / phone
		b. Cell phone
		c. Computer
		d. FAX
		e. Landline phone
		f. Pager
		g. Runners
		h. No data received
		i. Other (specify)
IC46	Activate MOU with external agency? (Specify in comment box)	Y / N / U / NA
	Was ICC in communication with outside agencies?
IC47	Ambulance systems	Y / N / U / NA
IC48	Disaster response	Y / N / U / NA
IC49	Fire	Y / N / U / NA
IC50	Health Department	Y / N / U / NA
IC51	Media	Y / N / U / NA
IC52	Military	Y / N / U / NA
IC53	Other hospitals	Y / N / U / NA
IC54	Police	Y / N / U / NA
IC55	Other (specify)	Y / N / U / NA
IC56	Other (specify)	Y / N / U / NA
IC57	Means used in ICC to receive data from outside hospital	a. 2-way radio / phone
		b. Cell phone
		c. Computer
		d. FAX
		e. Landline phone
		f. Pager
		g. Runners
		h. No data received
		i. Other (specify)
DE25	When was zone made aware of actual chemical or radiation agent?	Before first victim arrived
		Afer first victim arrived
		All victims completed decon
		Never made aware
		Unsure
DE26	Understanding of causative agent	a. Chemical
		b. Radiation
		c. Unclear
		d. No understanding
		e. Other (specify)
	Comments:

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