Continuity of Operations Plan

Healthcare Continuity of Operations

The Continuity of Operations Plan (COOP) for Wyoming Region 1 Healthcare Coalition, Inc. (R1HCC) embodies our commitment to ensuring that vital healthcare operations persist seamlessly, even in the face of disruptions and emergencies. This section delineates the underlying purpose, background, and scope that guide the establishment, functionality, and continuous improvement of the COOP. By detailing our guiding principles and operational framework, this section provides a foundational understanding of the Coalition's dedication to preserving the health and well-being of the communities we serve.

Purpose

The purpose of the Healthcare Continuity of Operations plan for the R1HCC is to ensure a coordinated, efficient, and effective response to, and recovery from, situations causing a surge in healthcare demands within the counties of Campbell, Crook, Johnson, Sheridan, and Weston in northeast Wyoming. R1HCC, while not directly providing patient care, plays a pivotal role in enabling the seamless operation of its core member agencies, which includes hospitals, EMS agencies, public health departments, and emergency management agencies.

Furthermore, we recognize and welcome additional members who contribute towards the preparedness, response, and recovery during such surge events. By drawing together a broad spectrum of healthcare and emergency professionals, we aim to create a robust network capable of maintaining the health and safety of the northeast Wyoming community amidst any challenges.

Understanding the unique needs and challenges of our region, this plan is designed to foster collaboration and mutual assistance among member agencies, ensuring that they are well-prepared and equipped to handle a range of scenarios. These might include natural disasters, pandemics, or other events leading to a significant surge in healthcare needs.

Through this plan, R1HCC underscores its commitment to strengthening the healthcare backbone of our region, ensuring that every individual has access to timely, uninterrupted, and high-quality medical attention, regardless of the circumstances.

Background

The roots of the R1HCC can be traced back to initiatives driven by the Wyoming Department of Health (WDH). For nearly a decade, the coalition functioned under the WDH, but in 2022, R1HCC transitioned to operate as an independent nonprofit entity. This evolution marked a significant step in its journey to enhance healthcare preparedness in the region.

Historically, the events of September 11, 2001, prompted the WDH to secure funding aimed at bolstering hospitals' disaster response capabilities. Over time, this initiative expanded in scope to envelop a wider segment of the medical community, bringing in emergency medical services, long-term care facilities, community clinics, hospice, and home care under its purview.

The global COVID-19 pandemic served as a testament to the pivotal role R1HCC plays within the region's healthcare ecosystem. The challenge posed by the pandemic reinforced the need for a structured, cohesive, and efficient response mechanism to handle medical surges and emergencies.

Today, R1HCC stands fortified by its diverse local stakeholders, functioning in tandem to bolster the region's emergency preparedness. As a coalition, R1HCC operates in alignment with guidelines from the Assistant Secretary for Preparedness and Response (ASPR), drawing from the Hospital Preparedness Program (HPP) to ensure that the region's healthcare framework is both agile and resilient.

Scope

The R1HCC COOP is formulated to ensure that the core functions and responsibilities of healthcare entities and associated stakeholders within the five-county region of northeast Wyoming continue seamlessly during and after disruptions or emergencies.

Geographical Reach

This COOP is all-encompassing, addressing the needs and intricacies of Campbell, Crook, Johnson, Sheridan, and Weston Counties, ensuring every corner of the region is prepared for continuity challenges.

Member Inclusion

Core Members: The fundamental pillars of the R1HCC are the hospitals, EMS agencies, public health departments, and emergency management agencies across our five counties.

Extended Members: Beyond the core group, R1HCC's mission is furthered by various other entities that collaborate in various capacities. Their expertise and resources, while different from core members, are crucial in the broader context of continuity and preparedness.

Emergency Types

This COOP emphasizes maintaining continuity during events leading to patient surges. Though we have annexes that target specific emergencies like chemical, infectious disease, trauma, pediatric, and burn incidents, our continuity protocols cater to all kinds of patient surge events.

Operational Role

At its essence, the R1HCC is poised to act as an information coordination center, consolidating communication and data flows among members. As we redefine and refine our mission, this role might undergo shifts to resonate more with regional necessities and board aspirations.

Availability

The ultimate goal is for R1HCC to be operational around the clock every day of the year. Given constraints such as reliance on volunteers and a 20-hour managerial week, there are challenges. Nevertheless, efforts are underway to potentially augment this availability.

Integration with Other Plans

The COOP is intricately woven to align with and complement both the R1HCC Preparedness Plan and the R1HCC Response Plan, along with their respective emergency-specific annexes. Additionally, guidelines from the Wyoming Department of Health's Crisis Standards of Care (CSC) are integrated, ensuring our operations and protocols are consistent with state-level directives.

Review & Revisions

The scope and tenets of this COOP are subject to an annual review. Adjustments reflect the evolving needs of the region, feedback from activations, and stakeholder inputs. Special reviews might also be triggered by significant regional changes or incidents.

Stakeholder Engagement and Communications

Effective stakeholder engagement and clear, consistent communication are vital to the successful implementation and operation of the R1HCC's COOP. This section underscores the importance of forging and maintaining strong relationships with all members and partners, ensuring that every entity involved is aligned with our shared objectives. By detailing our strategies and methodologies for consistent communication, this section highlights the Coalition's proactive approach to keeping all stakeholders informed, aligned, and prepared for potential contingencies.

Internal Communications

Effective communication remains a cornerstone of R1HCC's operations, enabling our organization to stay agile, informed, and coordinated, especially during emergencies. The internal communications strategy ensures timely information dissemination and fosters cohesion and mutual understanding among our members.

Key Personnel and Entities

Ultimate decision-making authority within R1HCC resides with the Board of Directors and its officers. These individuals hold the responsibility for crucial communications, especially during emergencies and significant organizational shifts.

Communication Channels

• Software Suite: The primary channel for emergency communications is the Juvare software suite. This tool allows for real-time alerts, updates, and coordination during critical events.
• Meetings: Regular communication is maintained through monthly Board of Directors meetings and monthly general membership meetings. These platforms serve as a venue to discuss updates, challenges, and upcoming initiatives.
• Newsletters: The R1HCC monthly newsletter, dispatched via email, keeps our membership abreast of regular updates, upcoming events, and other relevant information.
• Call Tree: The R1HCC Coordinator will reach out via text as a secondary route of communication.

Information Classification

• General Communications: Regular updates, like our monthly newsletter, fall under this category.
• Urgent/Emergency Alerts: Sent out in real-time as emergencies or significant events unfold, ensuring that all relevant entities are promptly informed and can take necessary actions.

Backup Communication Systems

In the event of communication channel failures, the R1HCC is equipped with a communications cache. This backup system includes:

• Portable radios to ensure intra-agency communication.
• A portable wireless internet hub, enabling online communications during outages.
• An all-band HAM radio, ensuring broad-spectrum communication capabilities even in isolated scenarios.

Record Keeping

While the establishment of a central repository is ongoing, the R1HCC maintains a digital drive containing all essential documents. The Board of Directors can readily access this drive, ensuring continuity of information. Distribution of these documents can be executed as needed.

Feedback and Reviews

To continuously refine our communications and response processes, the R1HCC implements after-action reviews (AAR) post every exercise and real-world event. This system allows for reflection, feedback, and identification of areas for improvement.

Training and Familiarization

Though there isn't a formalized training for new members regarding communication protocols currently, the R1HCC aims to institute this in the future, ensuring all members are well-acquainted with communication standards and tools.

Review of Communication Protocols

Annually, the R1HCC reviews its communication plan, ensuring it remains updated and effective in addressing the ever-evolving challenges and needs of the organization.

Challenges

The predominant challenge in communications stems from the geographic remoteness of the region. However, through technology, regular meetings, and backup communication systems, the R1HCC endeavors to bridge this gap, ensuring seamless information flow irrespective of the distance.

External Communications

The effective dissemination of information and coordination with external entities is crucial for R1HCC to function optimally. Our principal external communications partner is the WDH, which bridges the connection between our coalition and both state and federal entities. During large-scale emergencies, WDH assumes the role of Emergency Support Function #8 (ESF #8): Public Health and Medical Services within the overarching FEMA structure.

Objectives

• Liaison and Coordination: The primary goal of our external communications is to ensure seamless liaising and coordination. Through our communication, we aim to ensure that all partners are on the same page and that resources and information are optimally utilized.

Communication Channels

• Primary Channels: The main channels of communication with external entities include telephone and email. These ensure quick and direct interactions.
• Emergency Communications Cache: Our communications cache, which consists of portable radios, a portable wireless internet hub, and an all-band HAM radio, serves as a versatile tool, beneficial for both internal and external communications, especially during emergencies.

Public Relations

While R1HCC does not have a designated Public Information Officer (PIO) at present, discussions are underway to establish such a role. This would ensure that the coalition has a dedicated representative for handling media inquiries, official statements, and ensuring consistent messaging.

Protocols and Practices

• Information Sharing: We firmly believe in the power of information sharing, especially during emergencies. The coalition operates under the premise that rapid dissemination of information, even if not fully verified, can be more beneficial than its withholding. This approach is founded on the belief that prompt information sharing carries more advantages than associated risks. However, the coalition highlights that the information shared can be sensitive and might not always be completely accurate due to the urgency of certain situations. Members should exercise sound judgment when considering sharing information externally.
• Confidentiality: While there isn't an explicit confidentiality protocol, members are urged to respect the sensitive nature of disseminated information. Miscommunication can have significant repercussions, hence the emphasis on sensitivity.
• Review and Updates: The Communications Plan undergoes a thorough review at least annually. If circumstances or insights from experiences demand, the review frequency can be increased.

Engagement with External Entities

External agencies are invited to participate in our after-action reviews (AARs) when deemed appropriate. This inclusion ensures a comprehensive evaluation of situations and reinforces the collaborative spirit of the R1HCC's mission.

Training and Familiarization

Presently, specific training for members on handling external communications, particularly in emergency or sensitive situations, is not in place. However, as the coalition evolves and the need arises, this can be an area of future development.

In sum, the R1HCC's approach to external communications is built on a foundation of rapid information sharing, collaboration, and transparency. By working closely with entities like WDH and others, we aim to create a cohesive response mechanism to address any patient surge event.