Medical Services Capabilities After a Disaster

Recommendations 14

• R1

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  OES/HS has to develop a strategic planning process and change the composition and use of the Disaster Council. The Disaster Council should become a true planning body, with high-level work groups having defined tasks and timelines. Hospitals want and need to be integral partners in the emergency planning process, including serving on the Disaster Council and in its work groups. (Recommendations A.1.a, A.1.b, B.1 and B.2)
• R2

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  The Mayor needs to ensure that a knowledgeable and experienced senior level person, with a proven track record of dynamic leadership, is recruited, preferably at OES/HS or possibly at DPH. This person needs to develop a process, in conjunction with the Mayor and Board of Supervisors, for incorporating the private sector fully into the emergency planning process and for ensuring that emergency procedures are achievable and understood by all city departments and the private sector. Another task involves assessing OPP and EMSA operations to determine appropriate placement of personnel and reporting lines. (Recommendations C.1, C.2 and C.3)
• R3

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  Emergency drills need to be realistic and test the ability of hospitals to meet surge goals and to properly use recently purchased or newly installed equipment. These drills should include local clinics to test their ability to handle patient overflow from nearby hospitals. The drills should also test all aspects of the City’s communication plan. “Dead spots” for the siren alerts system should be noted by neighborhood and corrected. (Recommendations D.1, D.2.a, D.2.b, D.3, F.1, F.2 and G.1.a.)
• R4

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  OES/HS should issue official After Action Reports for city-sponsored drills no later 34 than 45 days after their completion. To ensure that the Mayor is kept apprised about the performance of individual city departments during drills, the Mayor’s Office should review both initial write-ups and official After Action Reports for each drill. In this way, the Mayor will also see if the After Action Reports reflect the experience recorded by participants in the drill. (Recommendations E.1.a to E.1.c.)
• R5

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  The City needs to design and implement a mass media campaign to inform San Franciscans about the realities of a potential disaster and necessary steps to take in deciding when to seek medical care. The www.72hours.org Web site needs to have additional information on where and when to seek care. The City needs to designate specific radio stations and TV channels, in addition to Channel 26 and public radio/television, to receive “official” city announcements and updates. (Recommendations G.1.b to G.1.f)
• R6

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  Neighborhood disaster planning, as started in District 5, needs to be expanded to all districts. Implementation of neighborhood drills is recommended. (Recommendation G.2)
• R7

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  Develop a centralized community-wide patient locator system. System purchased, but not yet operational.
• R8

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  Engage the mass media in the emergency preparedness planning process. Not done.
• R9

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  Assure direct caregiver access to current information about the emergency on a continuing basis. Communications devices in place, but not always working.
• R10

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  Create redundant, interoperable communication capabilities. Partially in place.
• R11

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  Regularly test, at least yearly, community emergency preparedness plans through reality-based drill. Done semi-annually, but with limited success.
• R12

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  Prospectively establish appropriate metrics to assess effectiveness of emergency plan. Not done; reports on drills are inadequate and not timely.
• R13

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  Assure inclusion of all community emergency preparedness program participants in emergency plan tests. Clinics not included to date.
• R14

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  Explore alternative options for providing sustained funding for hospital emergency preparedness activities. Not done; City is currently dependent on federal grants. In summary, since the last Civil Grand Jury report of 2002-2003, much has been done to improve medical preparedness, thanks to the availability of federal funding and the work of OES/HS, DPH and SFFD. With federal funding likely to be curtailed, starting in 2007, the City needs to ensure that medical preparedness remains a high priority and that appropriate leadership is recruited to oversee the medical planning process. As noted in the write-ups on Katrina, it was “the failure of leadership” at the local, state, and federal level that led to the confusion in New Orleans after the hurricane. San Francisco needs to ensure that its local leadership never warrants similar criticism.