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Advisory 1 - Changes in Available Bed Status Reporting and Hospital Capacity (Diversion) Website

Sent to:

Chief Executive Officers

Member Hospitals

Health Systems

EMS Regional Directors

C-MEDs

From:

Nancy Ridley, Associate Commissioner, MDPH

Paul Dreyer, Associate Commissioner, MDPH

Dr. Lisa Stone, Acting Director, Office of Emergency Preparedness, MDPH

Karen S. Nelson, MPA, RN, Senior V.P. of Clinical Affairs, MHA

EFFECTIVE:

March 15, 2007 - HAvBED bed category definitions will be used for Level 1 bed counts.

April 6, 2007 - 1st statewide drill of the HAvBED bed categories.

April 16, 2007 - use of the MDPH system during the Boston Marathon

May 4, 2007 - 1st of a regular monthly bed count drills.

PURPOSE:

To inform hospitals, Regional EMS Directors and C-MEDs of the changes in bed categories and enhancements to the Hospital Capacity Website - https://hd.dph.state.ma.us/login.asp

BACKGROUND:

Following the events of September 11, 2001 and Hurricane Katrina, the federal government has emphasized the importance of hospitals and health care partners preparing for and responding to public health emergencies. Hospitals, particularly emergency departments, provide a critical role in the provision of care during a catastrophic disaster. Emergency department diversion, bed, mass decontamination, operating room and ventilator status are some of the essential components of emergency preparedness that the federal government has instructed MDPH to coordinate with hospitals and emergency medical services.

The federal government, through advisory group advice and consensus, has issued basic bed categories and accompanying definitions that each state's bed tracking system must collect and eventually report into a national system, HAvBED. The minimum set of collectable categories and definitions appear at the end of this memo.

PROGRESS:

MDPH completed programming to comply with these federal requirements. Simultaneously, MDPH developed new features that local officials identified as necessary to facilitate the management of an emergency, particularly medical surge. These additional features include:

  • The capacity to add/modify/change countable categories, such as bed availability, on the fly;
  • The ability of hospitals to report surge bed availability for specific timeframes. MDPH can collect surge bed data on a regional or statewide level. The surge area of the website addresses the hospital, regional and statewide ability to handle the influx of casualties during mass-casualty incidents or disease outbreak. MDPH based this feature on Boston's Surge Bed Matrix;
  • EMS Regional Administrators and their C-MEDs capability to define and request their own bed types, equipment and supplies, in addition to the HAvBED categories and any MDPH pre-defined types;
  • C-MEDs ability to update diversion, bed and equipment status for all hospitals in their region should hospitals be in a situation where they experience difficulties accessing or entering data in the online system;
  • The ability of the State Emergency Operations Center (SEOC) and City of Boston's WebEOC to link to the MDPH system. If a hospital logs on to the Boston WebEOC system to enter bed data, that data will automatically populate the MDPH Hospital Capacity Website data fields and vise-versa;
  • Hospitals can enter the number of pre-identified medical supplies and equipment when asked by MDPH or their regional C-MED. In turn, the hospitals can also report their need for supplies.

ACTION:

Starting April 6, 2007, MDPH will add a statewide bed count drill to its monthly schedule of hospital emergency preparedness communications drills (satellite phone, HHAN Hospital Emergency Notification role). MDPH will push a message via the HHAN and listserv that it is requesting a bed count. Various aspects of the updated site will be tested each month. This regular drill schedule will allow MDPH to troubleshoot any issues with the system and will keep hospital and C-MED users proficient in responding to a request and entering data.

MDPH and BEMA partners have set April 16, 2007, the Boston Marathon, as a goal date for the Region IV hospitals to exercise the enhancements to the MDPH Hospital Capacity Website.

WEBSITE:

https://hd.dph.state.ma.us/login.asp.  Please enable pop-up screens for full functionality of this website.

CONTACT:

Dana Ohannessian at dana.ohannessian@state.ma.us or 617-624-5015 to establish/confirm website user IDs and passwords. Regional C-MEDs will maintain a list of hospital user IDs and passwords.

HAvBED Hospital Bed and Other Category Definitions Requirements - the State's bed tracking systems must possess the following capabilities:

  • Be able to report aggregate State level data to the HHS Secretary's Operation Center (SOC) no more often than twice daily when requested. The frequency of data required from the hospitals is dependent on the incident. The time necessary for data entry must be minimized so that it does not interfere with the other work responsibilities of the hospital staff during an MCI. Daily and weekly fluctuations in bed capacity. Ideally, all institutions would enter data at the same time on similar days in order to reduce variability due to these fluctuations.
  • Possess the following Hospital Identification Information:

Hospital Name

Name of Chief Administrator

Street Address

City

State

Zip Code

Area Code

Local Telephone Number

County

  • Be able to report on the following categories as defined in the HHS HavBed system:

Staffed Vacant / Available Bed Count:

Intensive Care Unit (ICU)

Medical and Surgical (Med/Surge)

Burn Care

Peds ICU

Pediatrics (Peds)

Psychiatric (Psych)

Emergency Department (ED)

Negative Pressure Isolation

Operating Rooms

Emergency Department Divert Status

Decontamination Facility Available

Ventilators Available

Bed Definitions

Physically Available Beds: Beds that are licensed physically set up, and available for use. These are beds regularly maintained in the hospital for the use of patients, which furnish accommodations with supporting services (such as food, laundry, and housekeeping). These beds may or may not be staffed but are physically available.

Staffed Beds: Beds that are licensed and physically available for which staff members are available to attend to the patient who occupies the bed. Staffed beds include those that are occupied and those that are vacant.

Vacant/Available Beds: Beds that are vacant and to which patients can be transported immediately. These must include supporting space, equipment, medical material, ancillary and support services, and staff to operate under normal circumstances. These beds are licensed, physically available, and have staff on hand to attend to the patient who occupies the bed.

Adult Intensive Care (ICU): Can support critically ill/injured patients, including ventilator support.

Medical/Surgical: Also thought of as "Ward" beds.

Burn or Burn ICU: Either approved by the American Burn Association or self designated. (These beds should not be included in other ICU bed counts)

Pediatric ICU: The same as adult ICU, but for patients 17 years and younger.

Pediatrics: Ward medical/surgical beds for patients 17 and younger.

Psychiatric: Ward beds on a closed/locked psychiatric unit or ward beds where a patient will be attended by a sitter.

Negative Pressure/Isolation: Beds provided with negative airflow, providing respiratory isolation. Note: This value may represent available beds included in the counts of other types.

Operating Rooms: An operating room that is equipped and staffed and could be made available for patient care in a short period.

Surge Bed Level Definitions

Level 1 Surge Bed: Routinely available. The total number of staffed and equipped beds available on a routine basis.

Level 2 Surge Bed: Readily available (within 12 - 24 hours) if an event exceeds the Level 1 capacity. The total number of staffed and equipped beds that could be made available by discharging or transferring patients, canceling elective procedures, using endoscopy and other similar beds.

Level 3 Surge Bed: Unstaffed beds that could be made available in 72 hours.

Level 4 Surge Bed: The number of vacant beds (staffed, unoccupied) for each bed type that could be added within your hospital using non traditional patient care areas where there are no headwalls or gasses such as lobbies, cafeterias, waiting rooms, conference rooms when regional, state or federal materials and personnel resources are made available through DMAT, MMRS, SNS, etc. NOTE: These values are NOT included in column totals. Further information on the HAVeBED system can be found at www.ahrq.gov/research/havbed/ .

Use of these standardized definitions and estimates of future bed availability will provide greater consistency among hospitals in reporting bed availability information.