Resident Disaster Plan

Resident Handbook

  1. Introduction
    1. The ACGME defines a disaster as an event or set of events causing significant alteration to the residency/fellowship learning experience.
    2. An extreme emergent situation is a local event (such as a hospital-declared disaster for an epidemic) that affects resident education or the work environment but does not rise to the level of an ACGME declared disaster as defined above.
    3. A disaster would include any and all of the following:
      • Natural disaster such as an earthquake, forest fire, blizzard, etc.
      • Act of terrorism either physical or biological
    4. Provisions for resident safety and necessary evacuation follow.
    5. The Associate Dean for Graduate Medical Education (i.e., DIO) along with the program directors is responsible for ensuring that all procedures are followed.
  2. Procedure
    1. Communication is paramount in a disaster
      • DIO and program director information must be maintained in duplicative manner (cell phones, home phones, email, and pagers) to ensure appropriate communication. Programs must have their own communication systems.
      • The DIO and program directors will establish a central point of operations from which to manage the disaster response.
    2. Program directors must be able to account for all members of their programs to the Office of Graduate Medical Education.
      • All residents/fellows at orientation and annually will complete a form that will list contact numbers and potential places for evacuation.
      • All faculty and staff must maintain up-to-date personal contact information at all times.
      • When possible, residents and/or fellows will notify their program directors or the office of GME as to where they will be evacuating (if necessary) if time allows.
    3. Assessment of gaps in training must be made immediately by the Associate Dean for GME, the Dean and other institutional leadership.
      • Should training be interrupted for more than one month, arrangements with other programs will be made.
      • Support from the ACGME and the AAMC will be sought to help in making arrangements for resident deployment into other programs
      • Arrangements with state medical boards will also be addressed.
      • Maintenance of communication will be addressed to help residents maintain connection with their program and peers.
      • The DIO will ensure that financial and administrative support of all programs and residents will continue for the duration of the emergency. The majority of residents are paid by electronic direct deposit; it is not anticipated that any interruption will occur.
      • The DIO will notify the ACGME within 30 days of all structural changes that have been instituted as a result of the disaster. The report will also include anticipated durations for any changes as well as anticipated effects on residents, fellows and their training.
    4. Patients must be provided for in the event of a disaster.
      • Each department will have a protocol outlining resident responsibilities should a disaster occur. Program faculty, staff and residents are expected to attend to personal and family safety and then render humanitarian assistance where needed. For anticipated disasters, residents who are not designated to be at a clinical site for emergency staffing should prepare to evacuate.
      • Additional resident teams may be needed to stay at the hospital to ensure patient care is maintained. Duty hours and fatigue will be monitored in such situations.
      • Residents will follow departmental protocols to ensure that adequate provisions are made for patients before evacuating. Emergency teams will be required to stay and care for patients.
    5. In the event of an extreme emergent situation, the following should be followed:
      • At the Local (Institutional) Level:
        • The program directors' (PDs) first point of contact for answers to questions regarding a local extreme emergent situation must be their Office of Graduate Medical Education/DIO.
        • The DIO should contact the Executive Director, Institutional Review Committee (ED-IRC) via telephone only if an extreme emergent situation causes serious, extended disruption to resident assignments, educational infrastructure or clinical operations that might affect the Sponsoring Institution's or any of its programs' ability to conduct resident education in substantial compliance with ACGME Institutional, Common, and specialty-specific Program Requirements. On behalf of the Sponsoring Institution, the DIO will provide information to the ED- IRC regarding the extreme emergent situation and the status of the educational environment for its accredited programs resulting from the emergency
        • Given the complexity of some events, the ED-IRC may request that the DIO submit a written description of the disruptions at the Institution and details regarding activities the Institution has undertaken in response. Additional updates to this information may be requested based on the duration of the event.
        • The DIO will receive electronic confirmation of this communication with the ED- IRC which will include copies to all EDs of Residency Review Committees (RRCs).
        • Upon receipt of this confirmation by the DIO, PDs may contact their respective EDs-RRCs if necessary to discuss any specialty-specific concerns regarding interruptions to resident education or effect on educational environment.
        • PDs are expected to follow their institutional disaster policies regarding communication processes to update the DIO on the results of conversations with EDs-RRCs regarding any specialty-specific issues.
        • DIOs are expected to notify the ED-IRC when the institutional extreme emergent situation has been resolved.
      • Within the ACGME Office
        • The ED-IRC will alert EDs-RRCs when a Sponsoring Institution reports an extreme emergent situation. These communications will be included as interim correspondence in institutional and program files.
        • PDs from affected institutions may communicate directly regarding specialty- specific concerns once local extreme emergent situations have been confirmed through the ED-IRC.
        • After communication between a PD and an ED-RRC, the ED-RRC will notify the ED-IRC if there is a perception of substantive institutional accreditation issues occurring within the Institution during the event.
        • The ED-IRC will notify all EDs-RRCs when institutional extreme emergent situations have been resolved.