PURPOSE: To provide continuing infusion services for patients in the event of an emergency situation or natural disaster that would result in the interruption of the delivery of care in the home.


POLICY: A written plan is in effect to guarantee that patient services will be efficiently and effectively maintained during emergency situations (e.g. loss of personnel due to work action or illness, accidents, disruption of public transportation, structural collapse, explosions (chemical or biological), damage to the facility from a fire or flood) and natural disasters (e.g. snowstorms, floods, earthquakes, tornados), industrial disasters(industrial plant explosion, fire, train derailment, mine collapse), and man-made disasters(warfare, criminal/terrorist action, civil disorder) wherever possible. For those patients who cannot be serviced by the organization, alternative plans will be made.


APPLICABLE DOCUMENTS/REFERENCES: Reference The Joint Commission Standard(s) EM.01.01.01, EM.02.01.01, EM.02.02.01, EM.02.02.03, EM.02.02.07, EM.02.02.11, EM.03.01.03 ACHC Standard(s) DRX7-4A; reference form #IV0065 Emergency/Disaster Preparedness Program; “Emergency Preparedness Plan-Regular Testing” for related procedures.


PROCEDURE: Please review the content below.

A. If an emergency situation is imminent (e.g. a blizzard is predicted), the management staff will decide what action is needed to avoid interruptions in care.

B. All staff are to keep a current copy of the “employee telephone list” with them at all times. In the event that action is taken (e.g., the office will open later or close earlier than normal, assignments will be redistributed based on geographical location of staff and patients), the assigned management personnel will initiate the telephone calls.

C. Patients will be prioritized by clinical managers and the highest at-risk patients will be identified based on:

1. Status of patient

2. Therapy being administered (medication and access device)

3. Type of pump or other equipment in the home

4. Level of caregiver support available in the home

D. All patients, beginning with those highest at-risk, will be contacted to advise them of probability of visits and to assess their needs.

E. If time permits prior to the emergency, patients will be contacted for an inventory of drugs and supplies and to review the emergency plan established. Deliveries will be made wherever possible.

F. All delivery vehicles will have a surplus of supplies.

G. Patients who reside in excess of 75 miles from the branch/facility will be sent extra supplies and back-up pumps/chargers where appropriate. (Critical: TPN, PCA, Inotropic therapies). Patients/caregivers will be instructed to charge all pumps when not in use.

H. Extra batteries will be sent to all appropriate patients. Patients/caregivers will be instructed on how to administer therapy via gravity flow under safe conditions when an electrical outage is expected to be greater than eight hours.

I. Proper refrigeration availability will be evaluated.

1. If localized outage, deliveries will be made daily and medications will be stored in coolers in the patient’s home.

2. If generalized outage, coolers and dry ice will be delivered to appropriate patients and deliveries will be increased.

J. If road conditions are too hazardous to attempt a visit, the physician will be notified and consulted, re: missing a dose and/or delaying to restart a peripheral IV.

K. If the medication must be infused, and the visit cannot be made, the local police department will be contacted by the Nurse or Pharmacy Manager. Arrangements for an emergency response will be coordinated with this department.

L. Until the emergency is resolved, staff will be expected to:

1. Leave their cell phones on.

2. Contact the facility on an hourly basis for updated information.

3. If no personnel are in the facility, phone contact will be maintained.

M. Tabletop Drill – A tabletop drill to evaluate the effectiveness of the Emergency Management Operations Plan may be utilized. This may be used as an adjunct, functional exercise to an actual response to emergencies.

N. Recovery Phase will be initiated:

1. Building re-inspections and/or building will begin immediately.

2. Temporary office space for Ashland will be provided by OLBH with contact person as Joe Buccheit, CFO(606-833-3333). Temporary office space for Charleston will be provided by CAMC General with contact person as Larry Hudson, CFO(304-388-5432). Permanent office space will be acquired within 1-2 months after disaster if needed.

3. Computer backup will be utilized.

4. All functioning leadership hospital pharmacies (OLBH, CAMC, St. Mary’s, St. Claire) and/or Infusion Solutions alternate facility will be utilized for compounding drug.

5. Emergency stock of supplies will be ordered immediately. Will utilize stock in delivery vehicles and alternate Infusion Solutions facility for emergent supply needs.

6. Employee postings will be made public within 2 weeks with the intent of replacing employees as needed.

7. Independent couriers will be utilized for deliveries.

8. Home computers/faxes will be utilized until equipment replacement is purchased.

9. All available staff will be asked to work 40 hours per week and overtime will be offered as needed until office is re-established.

10. If executive director is affected, director of pharmacy/operations manager will assume the duties of the executive director.

Chain of command as follows:
Philip Nelson – Executive Director
Blake Gillum – Director of Pharmacy/Operations Manager
Sheila Larsen – Nurse Manager
Sue Hesson – Billing Manager
Joe Buccheit – Board Chairman

O. Basic staff needs will be assessed by leadership and Infusion Solutions will provide housing, transportation, and food as need arises.