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MPMC Evacuation Plan 

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DEFINITIONS:

Evacuation:
Refers to the movement of patients and personnel from the hospital or from sections thereof in a rapid and safe manner under threatening conditions.

Protect in Place: 
Concept that remaining inside a fire-safe structure (i.e.: Hospital Facility) is safer than leaving that structure if threats to life and health can be controlled by relocating to other areas within the structure. NOTE: Protect in place concept does not apply to business occupancies or facilities outside the hospital building.

Authority Having Jurisdiction (AHJ): 
Public service agency in charge during a public emergency. AHJ will depend upon the nature of each emergency but could include local fire official, police official or others.

REASON FOR EVACUATION: 
To remove patients and personnel who are threatened by danger within the building and where protecting in place is infeasible.

AUTHORITY TO EVACUATE: 
The authority to evacuate shall be vested in the President/CEO or his designee, or the Administrator on call in conjunction with the AHJ during normal business hours (Monday- Friday 9am-5pm). Thereafter, the authority shall be vested in the Nursing Supervisor in conjunction with the Administrator on call and the AHJ.

FACTORS TO CONSIDER RELATING TO EVACUATION:
1. Know the evacuation routes posted in your area.
2. The need for evacuation shall be determined by the severity of the condition and measures that can be taken to control the condition. Patients should not be evacuated unless there is imminent danger to life and health that cannot be controlled by protecting in place.
3.  When imminent dangers to life or health are present evacuation should not be delayed while  obtaining administrative approvals.
4. Evacuation should take place in the following order:

a. Ambulatory/self-sufficient patients/staff first;
b. Semi-ambulatory or those needing minimal assistance second;
c. Those needing total support last.

5. Ambulatory personnel can sometimes provide assistance if properly instructed.
6. Evacuation will occur in the following order:

a. Horizontal from one building compartment to another first;
b. Vertical from one floor to lower floors, only when it is no longer safe to remain on the original floor;
c. Outside from inside to outside of building when safety can no longer be assured inside the structure.
7. Important: Medical records and medications must go with patients when evacuating.  Ambulatory patients may be given their own records/medications to carry with them.

EVACUATION INSTRUCTIONS
The following is a general list of evacuations points from each floor of each portion of the Maria Parham Medical Center Building Complex. In all cases, proceed to closest clear exit selecting from the available exits in each building/area. For details, see evacuation plans posted in buildings.

Main Hospital Building (Old Tower):

4th Level - North or South Stairs
3rd Level - North or South Stairs
2nd Level - North or South Stairs
1st Level - Closest exit posted
Ground Level - Closest exit posted


Main Hospital (New Addition):

4th Floor - East or North Stairs or Horizontally to Old Tower
3rd Floor - East or North Stairs or Horizontally to Old Tower
2nd Floor - East or North Stairs or Horizontally to Old Tower
1st Floor - Closest posted exit
Lower Level - Closest posted exit


JOHN T. Church Building:

1st Level - Proceed to closest clear exit selecting from the following:

Front Lobby Exit
West Stairwell
West Exit to Rear Grounds
Main Corridor to Front Lobby

Ground Level - Proceed to closest clear exit selecting from the following:

West Exit to Physician Parking Lot
North Exit at Main Employee Entrance
West Exit near Vending Machines/Cafeteria
Exit from Cafeteria Dining Room

Jenkins Medical Service Building:

1st Level - Proceed to closest clear exit selecting from the following:

Northwest Entrance at Administration
South Exit Stairs
North Exit Stairs

Ground Level - Proceed to closest clear exit selecting from the following:

North Entrance
South Entrance
North Entrance at Life Care

Brodie-Waddill Memorial Wing:

1st Level - West Stairwell, Main Lobby Entrance

Ground Level - North Exit at Main Employee Entrance, West Exit to Physician Parking Lot

SAFETY OF EVACUEES/ACTIONS FOLLOWING EVACUATION
1. If not already done, dial 911 and report nature of emergency and that evacuation may be necessary/is underway. Type and scope of emergency will determine type and number of emergency responders. Responders may include but are not limited to:

a. Fire Department
b. Police/Law Enforcement (Local, State, Federal)
c. Emergency Medical Services
d. Medical Evacuation Aircraft (Hospital Staff must ensure potential landing zones for aircraft are clear at all times)
e. Local, State or Federal Emergency Management
f. Public Health Officials
g. Local, State or National Disaster Relief Organizations

2. Patients should not be evacuated unless absolutely necessary. If evacuation is necessary, patients will be taken to:

a. Area Hospitals if medical condition warrants:

i. Granville Medical Center Oxford, N.C.
ii. Duke Medical Center Durham, N.C.
iii.UNC Hospital Chapel Hill, N.C.
iv.WakeMed Raleigh, N.C.

3. J.W. Jenkins Building Any office space available

4. John T. Church Outpatient Building Classroom, Auditorium, Library

5. Brodie-Waddill Memorial Wing Outpatient Rehab Area, Lobby

6. Medical Office Plaza Building Parking Lot, Lobby, All available spaces within building

7. President/CEO, his designee, Administrator on call, Nursing Supervisor or Incident Commander will immediately assign personnel to account for all patients and staff. Inventory of personnel should begin immediately following evacuation. Inventory must be reported to Administration/Incident Command immediately. Notify Administration/Incident Command immediately if patients or hospital staff is unaccounted for.

8. Hospital Staff will direct all evacuees a safe distance from the building; seek shelter if inclement weather.

9. Hospital Staff will assess need for essential medical services, supplies and manpower and report needs to Administration/Incident Command. NOTE: During evacuation, movement of personnel to safety is the top priority; only basic life support will be provided during the evacuation process. Additional services may be reestablished once personnel reach safety.

10. Incident Command in conjunction with the AHJ will establish Triage/Treatment areas, Transportation Staging Areas and will obtain appropriate transportation for those requiring transport. Important: Effort should be made to gather all evacuated patients into one Triage/Treatment Area if possible. An alternate approach may include establishing Ambulatory and Non-Ambulatory Treatment Areas adjacent to one another. The goal is to keep patients as close together as feasible to facilitate inventorying of persons as well as prevention of spreading staff and equipment across a large geographic area.

11. Incident Command in conjunction with the AHJ will work with Emergency Management to establish temporary shelters if needed.

EMERGENCY COMMUNICATION
1. When evacuation is necessary, the first contact should be 911.
2. Hospital Operator has Physician and Department Director call-back lists. If hospital phones are lost, Incident Command should immediately relocate Operator to alternate site where phone service is available. Alternate locations for Operator could include:

a. Other buildings on campus if Hospital is only structure affected;
b. Maintenance Shops behind Hospital if no threats to the Shops exist;
c. Health Department or Mental Health Buildings immediately adjacent to Hospital;
d. Vance Medical Arts Complex;
e. If no physical facility is available with phone service, Incident Command can provide Operator with Cell Phone to begin call-back until landline phone is available.
f. If all area phone service and cell service is out, Incident Command can request assistance from Emergency Management for contacting personnel.

RECOVERY
1. Incident Command in conjunction with the AHJ will continuously evaluate to determine when it is safe to return to the building.
2. Neither Hospital Staff nor patients will be allowed back into any facility until Incident Command and the AHJ have received confirmation from appropriate officials that the facility is safe for occupancy. Such confirmations may include but are not limited to:

a. Fire Department checks for fire or products of combustion;
b. Public Health/Federal Agencies/ Haz-Mat Teams for presence of Nuclear, Biological or Chemical contaminants;
c. Law Enforcement for presence of incendiary or explosive devices;
d. Law Enforcement for possible assailants;
e. Law Enforcement for preservation and retrieval of crime scene evidence if such exists;
f. Engineering Consultants for structural integrity of physical facility;
g. Hospital Maintenance for systems checks to ensure physical facility can sustain a safe environment of care.

3. Patients will return to the building in reverse order from the evacuation:

a. Those needing total support first;
b. Semi-ambulatory or those needing minimal assistance second;
c. Ambulatory/self-sufficient patients/staff last.