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Mass Casualty Incidents - Healthcare System Response

Introduction

1. It is key to apply all of the following principles to the planning process in order to develop an all-hazards plan for protecting lives, property, and the environment, except for:

A. Planning must be community-based, representing the whole population and its needs.

B. Planning considers all hazards and threats.

C. Planning must start from scratch.

D. Plans must clearly identify the mission and supporting goals, along with desired results.


2. Planners should view plans as living contingency plans because they provide the starting point for response operations if and when an emergency occurs.

A. True

B. False


3. Which of the following emergency planning considerations consists of actions that reduce risk from human-caused incidents, primarily terrorism, and also help mitigate secondary or opportunistic incidents that may occur after the primary incident?

A. Prevention

B. Protection

C. Response

D. Mitigation


4. The “Plan Development” step in the planning process includes which of the following?

A. Identify core planning team.

B. Identify threats and hazards.

C. Identify resources.

D. All of the above.


5. Preparedness is defined as “a continuous cycle of planning, organizing, training, equipping, exercising, evaluating, and taking corrective action in an effort to ensure effective coordination during incident response.”

A. True

B. False


6. National health security is achieved when the Nation and its people are _____ incidents with potentially negative health consequences.

A. Prepared for

B. Protected from

C. Able to recover from

D. All of the above


7. Post-incident health recovery should be incorporated into planning and begins with:

A. Risk assessment

B. Response

C. Training

D. All of the above


8. Response embodies the actions taken in the immediate aftermath of an incident to:

A. Save and sustain lives.

B. Meet basic human needs.

C. Reduce the loss of property and the effect on critical infrastructure and the environment.

D. All of the above.


Capability 1: Healthcare System Preparedness - Function 1: Develop, refine, or sustain Healthcare Coalitions

9. At a minimum, the Healthcare Coalition oversight and structure should include:

A. A leadership structure determined and appointed by the Healthcare Coalition.

B. An advisory board-like function with multi-agency representation from members of the Healthcare Coalition.

C. A clear structure that can coordinate with the local and state emergency operations center.

D. All of the above.


10. Whether the coordination is done through actual response or by planning, the multi-agency coordination should guide the protocols for all of the following, except:

A. Processes to implement and document the administrative responsibilities needed to maintain the Healthcare Coalition.

B. Healthcare organization coordination with ESF #8.

C. Information sharing procedures between healthcare organizations and incident management.

D. Resource support to healthcare organizations.


Capability 1: Healthcare System Preparedness - Function 2: Coordinate healthcare planning to prepare the healthcare system for a disaster

11. The components of the situational assessment include all of the following, except for:

A. Demographics of the planning area including identification of at-risk individuals that may require special medical needs.

B. Clearly defined roles and responsibilities for each participating member as it relates to disaster preparedness, response, and recovery.

C. Specific characteristics regarding at-risk individuals and those with special medical needs.

D. Geographical characteristics that may impede healthcare delivery.


12. The situational assessment, which includes the risk assessment or HVA, casualty estimates, and the development of healthcare priorities, is used to determine future preparedness activities including planning, training, exercising, and equipping.

A. True

B. False


Capability 1: Healthcare System Preparedness - Function 3: Identify and prioritize essential healthcare assets and services

13. Community healthcare assessments should identify which of the following critical services and key resources?

A. Critical medical services and medical support services.

B. Critical facility management services.

C. Critical healthcare information systems for information management / communications.

D. All of the above.


Capability 1: Healthcare System Preparedness - Function 4: Determine gaps in the healthcare preparedness and identify resources for mitigation of these gaps

14. The State and Healthcare Coalitions, in coordination with healthcare organizations, emergency management, ESF #8, relevant response partners, and stakeholders, develop, refine, and sustain coordinated resource processes that assist healthcare organizations to effectively obtain resources during response and recovery.  This should include processes to assist healthcare organizations to do all of the following, except:

A. Assist with information sharing between local and state partners during an incident or event.

B. Immediately request and obtain resources from available caches.

C. Retain viable options for resource allocation and sharing that involves the community, private sector, and other stakeholders.

D. Request resources from the local, state, and Federal level of emergency operations.


Capability 1: Healthcare System Preparedness - Function 6: Improve healthcare response capabilities through coordinated exercise and evaluation

15. Exercise implementation and coordination should include all of the following, except:

A. Exercises based on the guidance and concepts of HSEEP or equivalent program.

B. The encouragement of healthcare organization participation to address gaps in capabilities.

C. Roles and responsibilities of the participating healthcare entities.

D. Horizontal and vertical coordination with relevant response partners and stakeholders to include Federal, state, and local response teams.


Capability 2: Healthcare System Recovery - Function 1: Develop recovery processes for the healthcare delivery system

16. Healthcare recovery plans should include:

A. Assessment of the local healthcare system(s) to identify risks and vulnerabilities that may impede recovery.

B. Identification of local, state, and Federal disaster recovery coordinators that will provide recovery assistance.

C. A process to communicate needs with disaster recovery coordinators.

D. All of the above.


17. An assistance process implies that the State or Healthcare Coalition is responsible for reconstitution of a healthcare organization.

A. True

B. False


Capability 2: Healthcare System Recovery - Function 2: Assist healthcare organizations to implement Continuity of Operations (COOP)

18. A means to recognize and understand healthcare organizations shelter-in-place operations and alternate care site operations plan includes all of the following, except:

A. Orders of succession and delegations of authorities.

B. Monitoring COOP operations.

C. Location of continuity facilities.

D. Plan for management of vital services.


Capability 3: Emergency Operations Coordination - Function 1: Healthcare organization multi-agency representation and coordination with emergency operations

19. Which of the following is a process to determine healthcare organization representation in the local and state Emergency Operations Center (EOCs)?

A. Representation of the Healthcare Coalition on behalf of the healthcare organizations that integrates with Multi-Agency Coordination Systems (MACS) at the local and state EOCs upon request.

B. Identification of resource needs that require multi-agency coordination and representation of healthcare organizations.

C. Processes to request and activate multi-agency coordination.

D. All of the above.


Capability 3: Emergency Operations Coordination - Function 2: Assess and notify stakeholders of healthcare delivery status

20. Which of the following should be included in the healthcare organization resource needs assessment?

A. Protocols to ensure appropriate multi-agency coordination for emergency response and recovery operations.

B. Protocols to communicate the operational status of healthcare organizations.

C. Protocols to communicate the resource needs of affected healthcare organizations at the outset of any emergency.

D. All of the above.


21. A plan for communication that provides a unified message about the status of healthcare delivery through a Joint Information System (JIS) for dissemination to the community overrides a healthcare organization’s ability to provide messages to the community by requiring “one voice” during public messaging as advocated by NIMS.

A. True

B. False


Capability 3: Emergency Operations Coordination - Function 3: Support healthcare response efforts through coordination of resources

22. The process of coordinating resource allocation for healthcare organizations by assisting incident management with decisions regarding resource availability and needs should continue throughout incident response and recovery; including ongoing coordination to track resources for decision-making and optimal resource allocation.

A. True

B. False


Capability 5: Fatality Management - Function 2: Coordinate surges of concerned citizens with community agencies responsible for family assistance

23. Guidance should be obtained from the responsible agency for family support in the community that can provide which of the following?

A. Locations of family assistance centers as related to mass fatality, or coordination with family reception centers if no FAC is operational.

B. Protocols to ensure healthcare organizations can connect with family assistance centers.

C. Both (A) and (B).

D. None of the above.


Capability 5: Fatality Management - Function 3: Mental / behavioral support at the healthcare organization level

24. Consideration should be given to the inclusion of all of the following elements for a contact list of pre-identified resources that could provide mental / behavioral health support to responders and families according to the nature of the incident, except for:

A. Spiritual care providers

B. Attorneys

C. Hospice

D. Translators


Capability 6: Information Sharing - Function 1: Provide healthcare situational awareness that contributes to the incident common operating picture

25. Protocols need to be established for healthcare organizations to provide and receive timely, relevant, and actionable information that can be used to:

A. Assist with the creation of an incident common operating picture that provides information about the operating status of healthcare organizations and their immediate resource needs.

B. Inform local, state, and/or the Federal incident management and other relevant response partners about healthcare organization resource needs to assist with the decisions regarding resource allocation.

C. Inform healthcare organizations with relevant incident information and status of healthcare delivery operations within the community.

D. All of the above.


26. Electronic exchange of personal health information should meet applicable patient privacy-related laws and standards, including state or territorial laws.

A. True

B. False


27. The patient tracking system should have the ability to do all of the following, except:

A. Maintain operational status during an incident.

B. Satisfy regulatory / confidentiality requirements.

C. Report aggregate bed tracking data.

D. Track patients from entry into the healthcare system through discharge.


Capability 10: Medical Surge - Function 1: The Healthcare Coalition assists with the coordination of the healthcare organization response during incidents that require medical surge

28. Plans to ensure healthcare organizations are represented in incident management decisions during medical surge incidents should have processes that do all of the following, except:

A. Guide healthcare organization coordination and integration with ESF #8.

B. Develop processes to enhance the regional surge capacity and capability of the healthcare delivery system.

C. Assist with healthcare organization information sharing procedures during medical surge operations.

D. Assist with healthcare organization resource coordination during medical surge operations.


Capability 10: Medical Surge - Function 2: Coordinate integrated healthcare surge operations with pre-hospital Emergency Medical Services (EMS) operations

29. The most current guidance regarding EMS disaster triage, transport, and CBRNE treatment provided to healthcare organizations should include protocols for all of the following, except:

A. Transport of mass casualties during medical surge.

B. Decision making regarding patient care that require multi-agency coordination.

C. Disaster documentation during incident.

D. CBRNE exposure care.


Capability 10: Medical Surge - Function 3: Assist healthcare organizations with surge capacity and capability

30. Protocols for the management of assistance with healthcare organization surge resources should include:

A. Resource request processes from local incident management.

B. Processes to allocate locally or regionally controlled assets if available.

C. Assistance with the implementation of other resource processes when requested.

D. All of the above.


31. Protocols to assist with activation of alternate surge sites if requested by the healthcare organization may include all of the following, except:

A. Coordination with alternate care sites developed at non-healthcare facilities.

B. Processes to supply surge tents or trailers and equipment to serve as additional treatment areas for patients when available.

C. Processes to assist healthcare organizations request staffing to operate surge sites when requested and available.

D. Coordination of assets requested through the Emergency Management Assistance Compact.


32. Maximum facility surge capacity is the provision the lowest level that can be provided to patients in the available beds that can be staffed and also have the required resources for care.  This is guided by risk assessments and gap analysis regarding the estimated surge.

A. True

B. False


33. Decontamination assets should have the ability to:

A. Decontaminate more than one patient simultaneously.

B. Decontaminate both ambulatory and stretcher patients.

C. Include provisions for at-risk individuals and those with special medical needs.

D. All of the above.


Capability 10: Medical Surge - Function 4: Develop Crisis Standards of Care guidance

34. The need for crisis standards is justified by specific circumstances and is always triggered by the formal declaration of emergency, disaster, or public health emergency, in recognition that crisis operations will be in effect for a sustained period.

A. True

B. False


35. If an emergency declaration is made, it changes the legal environment and enables specific legal and regulatory powers and protections for public health and healthcare providers concerning their actions and omissions associated with allocating and utilizing scarce medical resources and implementing crisis standards of care.

A. True

B. False


36. Which of the following is not one of the five key elements to include in the development of collaborative crisis standards of care guidance?

A. A strong ethical grounding.

B. Assurances regarding legal authority and environment.

C. Recognition of a surge above the normal operating capacity of the healthcare system during a disaster.

D. Clear indicators and roles and responsibilities.


Capability 10: Medical Surge - Function 5: Provide assistance to healthcare organizations regarding evacuation and shelter in place operations

37. Evacuation plans are not required by The Joint Commission standards for Hospitals, Critical Access Hospitals, LTC, Home Care, Ambulatory Care, Behavioral Health Care, Labs EM.02.01.01 EP 2.

A. True

B. False


Appendix

38. At-Risk Individuals are defined as those having needs in which functional area?

A. Communication

B. Medical care

C. Transportation

D. All of the above


39. Crisis Standards of Care usually incorporate all of the following principles, except for:

A. Prioritize individual outcomes rather than population health.

B. Respect ethical principles of beneficence, stewardship, equity, and trust.

C. Modify regulatory requirements to provide liability protection for healthcare providers making resource allocation decisions.

D. Designate a crisis triage officer and include provisions for palliative care in triage models for scarce resource allocation.


40. Which of the following is a collaborative network of healthcare organizations and their respective public and private sector response partners that serve as a multi-agency coordinating group to assist with preparedness, response, recovery, and mitigation activities related to healthcare organization disaster operations?

A. Healthcare Coalition

B. Healthcare System

C. Healthcare Intra-organization

D. Healthcare Inter-organization


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