September Special Issue

Message from Dean Richardson: Are you ready?

A goal of Vision 2020 is to be a great organization, diverse in people and ideas. Fundamental to such greatness is maintaining and continually enhancing the quality of our working, learning and healing environment. This includes ensuring we are prepared to respond to all types of emergencies.

Welcome to a special issue of the Dean's newsletter focused on emergency preparedness and disaster response. This information should support your efforts to refresh or develop an emergency plan for yourself, your family and your department or unit.

The time is ideal to emphasize emergency planning in light of the events planned for Tuesday, October 16 when about 15,000 federal employees will take part in a disaster drill in Portland. During the TOPOFF 4 ("Top Officials") drill, officials from the U.S. Department of Homeland Security will simulate the detonation by terrorists of a dirty bomb in downtown Portland.

Oregon is one of only three sites selected to participate in the drill. Other states competed to take part because of the unique opportunity to test rarely-used response protocols to a large-scale simulated attack or natural disaster. State and local agencies working alone don't have the same resources and funding available to the U.S. Department of Homeland Security, and thus, are limited in the size of a standard emergency response drill.

Anticipation of the TOPOFF event provides a motivation to consider, revisit or begin your own planning process. Even if you don't complete a full plan by October 16, information gained before, during and after TOPOFF will undoubtedly enrich and inform your plans.

On October 16, a national and international spotlight will shine on Oregon and, for a short time, OHSU. We must be prepared. Not because of the attention – although this is unquestionably a strong incentive – but because every unit and every individual in the School of Medicine should know what to do in the event of a disaster. The aftermath of Hurricane Katrina continues to be a tragic and stark wake-up call to all of us.

It is impossible to plan for everything, of course. Each disaster or emergency is unique and aspects of each response will also be unique. But the more you plan ahead, the calmer you will be during an incident.

Next month, we will return to the traditional format of the Dean's newsletter with information on strategic initiatives, news about faculty and employee achievements, and feature articles.

Best regards,

Mark Richardson
Dean

TOPOFF 4 - What to expect and what not to expect

The detonation of a radiological dispersal device (RDD), otherwise known as a "dirty bomb," will be simulated in Portland on the morning of Tuesday, October 16, as part of a congressionally-mandated national preparedness exercise. This is a week-long exercise, although OHSU will participate only on the day of the simulated bomb detonation.

The exercise, called TOPOFF 4 ("Top Officials"), is under the direction of the U.S. Department of Homeland Security. During the week, simulated bomb detonations will also occur in Guam and Arizona.

Thousands of federal officials will be in Portland "playing" in the exercise. The drill will engage people at all levels of state government, local fire, EMS, police, search-and-rescue, public health, hospitals and the private sector. The intent is to test federal, state and local ability to provide an effective, coordinated response to a catastrophic event. OHSU is one of many participants, including all Portland area hospitals.

For OHSU, this is primarily a clinical, public safety and communications drill. Specifically, OHSU's clinical enterprise (hospitals and ambulatory services) will test its surge capacity and radiological decontamination protocols.

Our Emergency Department will receive approximately 120 patients on October 16. Some "moulaged" patients – a term used to describe fictitious patients who are made up to look like trauma victims or individuals exposed to radiation – will be transported to OHSU via first responders and/or Life Flight from the simulated bomb detonation site. However, most simulated patients will be transported by a special bus to OHSU so as to minimize disturbance to normal operations.

A decontamination tent will be set up in front of the Emergency Department on Sam Jackson Park Road. If "patients" arrive by Life Flight, these areas will be considered contaminated for purposes of the drill.

Undoubtedly, there will be some disruption to normal operations on the drill day. There will be signage throughout the hospital to let (real) patients know about the drill. Class schedules will not be affected.

The impact on traffic to and from Marquam Hill is not expected to be significant; however, there may be additional congestion the day of the drill. There is no intent to restrict access to major roads to and from campus, as might be the case in a real mass casualty. The metered parking spaces in front of Mackenzie Hall and Baird Hall will likely be restricted on October 16.

Federal, state and local officials/VIPs, as well as national and international media, will be in Portland during the drill, with a contingent observing and reporting from OHSU during the late morning and early afternoon on October 16. This national and international spotlight on OHSU will likely be brief because OHSU is only a small part of the city-wide exercise.

Details about TOPOFF are at: www.dhs.gov/topoff4

The OHSU Incident Command Center - A structured response

OHSU, like most large organizations and agencies, has an emergency response protocol based on the model supported by the National Incident Management System (NIMS).

Upon notification of an emergency situation, OHSU may establish a university-wide Incident Command Center (ICC). Whether or not an ICC is established is determined by the complexity, magnitude or multi-mission impact of the emergency on the university.

Notification of an ICC activation is made by page or phone call to the university's Threat Response Group (TRG). Public Safety manages the TRG, which includes OHSU staff who may be needed to coordinate a response. The "threat" may be any event that potentially affects the operations of all or part of OHSU. Examples include a broken pipe, a compromised phone system, an ice storm or earthquake.

The ICC is an emergency response structure that brings together the appropriate decision-makers from various major units necessary for an effective response to the specific incident (administration, facilities, public safety, logistics, clinical, communications, human resources, etc).

All decision-making authority and responsibility for operations and information flow are transferred to the ICC. The ICC is also charged with keeping university leadership informed as the event unfolds, and providing accurate, approved information to OHSU employees. One person, depending on the nature of the incident, is designated Incident Commander.

Most clinical faculty and staff are already familiar with the workings of the ICC. For education and research arms, these concepts may be new.

An important role of the ICC is to communicate to both internal and external audiences, and to ensure that the information is timely and accurate. At OHSU, two staff communicators are assigned to the ICC: one to coordinate internal/patient communications and the other to focus on public/media communications. This information is conveyed in a variety of forms to OHSU employees. Every employee should know how and where to get information in an emergency.

Materials describing existing OHSU emergency plans, including the OHSU Health System Emergency Management Manual, are available at: http://ozone.ohsu.edu/emergency

Accessing reliable information during an emergency

Accessing accurate and updated information during an emergency may be the difference between a small impact and a catastrophic impact. This article outlines your resources for information during an emergency.

Depending on the severity or complexity of the incident, the OHSU Incident Command Center (ICC) may be activated. Once activated, the OHSU ICC is the source of all approved messages relevant to emergency management at OHSU. For a MAJOR situation, however, county and/or city organizations may also activate their own ICCs, which means information may come from multiple sources, including media. During the TOPOFF drill, many ICCs will be active.

Whether an OHSU ICC has been activated or not, it is the responsibility of every student, faculty member and employee to be aware of the situation and its impact on operations, and to continue to seek updates as the emergency plays out. In addition, designated communicators should be part of a plan to convey ICC-approved information within their units, especially to employees without pagers or away from computers.

OHSU Information Resources

During an emergency incident, approved information from the Threat Response Group (see previous article) or the ICC will be posted or conveyed in one or more of the following ways, depending on the situation.

OHSU Alert Line (503) 494-9021

OHSU Intranet site (OZONE) http://ozone.ohsu.edu

Pagers – about 6,000 employees are assigned OHSU pagers. Please share emergency information received by page as appropriate to your situation.

OHSU e-mail – smaller, targeted e-mail groups are better because they speed up delivery of critical information. Please prepare these small groups in advance. Large group e-mails can clog the e-mail system. If used, the OHSU e-mail system is configured to send large groups alphabetically – people whose last names begin with "A" receive information sooner than others.

Computer screen pop-ups – during TOPOFF, the ICC anticipates testing a computer screen pop-up to convey information (similar to the pop-up that now appears for software updates).

Overhead paging – many buildings on Marquam Hill are covered by the overhead paging system.

Phone-trees – are highly effective but require that information be gathered in advance. Please consider doing this for your circumstances.

The School of Medicine Web page www.ohsu.edu/som – these postings are limited to MAJOR or SCHOOL-SPECIFIC events (such as closure). The School's Web page will be functional during TOPOFF.

Runners – during TOPOFF, the ICC and the Dean's office may use runners to convey information to isolated areas.

Person-to-person – never underestimate the power of shouting down a corridor.

The EAA or "Emergency Assembly Area"

In the case of severely compromised communications ability, due to loss of electric power and phone lines, for instance, the School of Medicine has a designated Emergency Assembly Area (EAA).

Any OHSU staff or students without pre-assigned clinical roles or in need of information may assemble at the EAA and, as long as it is safely possible, a School of Medicine representative will be present to support communications, response and recovery.

The School of Medicine EAA is the atrium in the BASIC SCIENCE ADDITION/CROET Building. In the event the building is compromised, the EAA is the area outside this building.

On the campus map, this is Building 18. A campus map is at: www.ohsu.edu/about/campusmap.pdf.

NOTE: The EAA will NOT be staffed during the TOPOFF exercise on October 16. This information is provided for future reference only.

Protecting research during an emergency

This information is provided by the OHSU Office of the Vice-President for Research.

Hurricane Katrina destroyed intellectual capital as well as human life and is a stark reminder of the vulnerability of research.

But emergencies don't have to constitute a disaster for research materials. Even if experiments vary significantly from week to week or month to month, there are steps to take to protect your research before disaster strikes.

The best way to recover data is not to lose it in the first place. Cultivate the habit of backing up data regularly. Data on OHSU network drives are backed up and stored on offsite servers every day, but the responsibility for data protection ultimately resides with the researcher. One approach is to use ITG's servers, even in labs that don't otherwise use ITG network systems, to store backup data.

Another approach is to back up the files you have been working on each day to a mobile storage device (e.g. thumb drive, CD, DVD or external hard drive) so that they can be transferred to your home computer - which should also be backed up. All such back-ups should be secured through encryption, passwords, and so on, to protect sensitive information.

However, even with these measures, recent news stories should make you aware that offsite backup carries its own risks. If research involves protected health or proprietary information, do not transfer it to a portable device, but use ITG's servers to safely store data.

ITG's guide to protecting research data can be found here: http://ozone.ohsu.edu/cc/sec/isg/res_sec.pdf

Obviously, if a threat is urgent - a fire is raging through the building, for example - your priority should be staff safety. But some situations provide some response or prep time; for example, if flood waters are rising or a major storm is on the way. A "closure" or "shut-down plan" could include:

• Make sure to protect important records by storing them out of the reach of water or wind in waterproof plastic containers. These records include your inventories of supplies, equipment, and controlled substances.

• Back up your hard drives and keep duplicate files offsite.

• Shut down and unplug computers, printers, and all other electronic equipment. If your experimental rig will take time to shut down, and there is sufficient lead time, start that process.

• Shut down sensitive equipment and other apparatus

• Make sure glassware is put away

• Properly store and protect hazardous materials; make sure incompatible chemicals are not stored together and that containers are properly sealed, and so on.

• Set refrigerators to the coldest temperature setting, but avoid freezing the contents.

• Have a plan to protect tissue samples.

• Arrange protective care for your animals.

• Latch filing cabinets and windows and remove things from window ledges.

• Take out trash if what's in there will decompose.

• Take your personally valuable things including your portable hard drive or other data storage system with you.

• Lock the door on your way out.

Over the next year, the OHSU Office of the Vice President for Research will be creating template plans for data protection and recovery. In the meantime, as these plans are being developed, every researcher must be conscientious about backing up data and protecting years of work.

Participating in the emergency "Personnel Pool"

Our community depends on OHSU for support during an emergency. Within OHSU's hospitals and clinics, existing phone trees and other pre-arranged forms of communication enable adequate immediate staffing and call-backs during an emergency.

However, depending on the size and duration of a mass casualty response – such as is planned for the TOPOFF drill – OHSU could need more personnel than are normally available. Everyone who works, studies or volunteers at OHSU could have a role to play.

The personnel needs could be clinical, but there are also likely to be staffing needs for dietary, clean-up, driving, answering telephones – the skill sets that could be useful are diverse. Many of us could fulfill any of these needs.

During the TOPOFF drill, OHSU will test a new concept for identifying employees, students and volunteers available to assist with an incident response.

The "virtual" Personnel Pool will provide a Web-based method for collecting pertinent information about individuals who have clinical and/or other skills. This information will then be the basis for deployment of volunteers.

A page will go out to ALL OHSU employees and students (who wear a pager) from the Incident Command Center (ICC) asking them to evaluate their availability to assist with the incident response – clinical, administrative, support, and other functions. About 6,000 employees or students have pagers at OHSU. The information in the page will also be posted or conveyed via other OHSU emergency information resources.

The text of the page will include a Web address at which employees are asked to input information about skills, availability and travel time to OHSU. The ICC Personnel Pool Coordinator will then use this information to organize relief support, contact available volunteers, and assign duties as needed and approved by the ICC.

During TOPOFF, this virtual Personnel Pool will ONLY test the process for collecting and organizing this information – no one will be activated or asked to physically report to duty. The database is incident-specific only. The data will be deleted after TOPOFF.

To effectively test the Personnel Pool concept, all employees and students are asked to fill out the Web page as requested by the ICC during the drill if doing so does not unduly disrupt your ongoing activities.

"Top 5" tips for emergency preparedness

This information was prepared by the OHSU Emergency Preparedness Advisory Group.

#1. Know your emergency resources: this includes knowing if your department or unit has an emergency response plan, where it's located, and what it says. This also means knowing to call OHSU Public Safety at 4-4444 on Marquam Hill Campus for any emergency, and knowing other emergency numbers, as appropriate.

#2. Minimize hazards in your workplace: store chemicals properly; anchor equipment and cabinets to the wall, back up computer databases and other essential documentation to the OHSU network. Use common sense.

#3. Be prepared to evacuate: know the evacuation route of your own building; if you are in an unfamiliar building, follow red or green lighted "EXIT" signs to safety; if you work in a hospital or clinic building, review the evacuation information in the OHSU Health System Emergency Management Manual at: http://ozone.ohsu.edu/emergency.

#4. Assist emergency responders: if emergency assistance is required inside a building, send someone outside your work area building to guide emergency responders to the area of need; provide emergency responders accurate and appropriate information.

#5. Be personally prepared: your potential contribution to health care or other community contribution during an emergency will be compromised if your family is not prepared and cared for. Take the time to plan today.

A few simple steps to prepare at home

This information is provided by the Oregon Department of Human Services/Public Health Division.

The Oregon Public Health Division encourages Oregonians to take a few simple steps to prepare for emergencies at home, including getting an emergency supply kit, making an emergency plan, and learning about different threats and how to respond to them. To prepare for emergencies:

• Have a plan that includes contact numbers for family and friends, including those who are out of town.

• Get a kit of emergency supplies that will last for at least three days. The kit should include basic items such as water, food, battery-powered radio, flashlight, medications and a first-aid kit.

• Designate a place where everyone should meet outside the home or neighborhood.

• Learn the evacuation plans for your children's school or day care center and other places where your family spends time, such as work.

• Learn more about different threats that could affect your community and appropriate responses to them.

• Learn about your community's warning signals: what they sound like and what you should do when you hear them.

• Find out how to help elderly or disabled persons, if needed.

Resources and guidance for personal planning are at:
http://www.oregon.gov/DHS/ph/preparedness
http://ozone.ohsu.edu/emergency