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{"sheet":"Start Exercise","index":0,"n_rows":49,"n_cols":16,"rows_kept":49,"cut":false,"hidden":false,"merged":[[21,1,21,15],[16,2,16,13],[15,2,15,13],[13,2,13,13],[12,2,12,13],[0,0,0,16],[2,1,2,15],[19,1,19,15],[6,1,6,15],[8,1,8,15],[7,1,7,15],[3,1,3,15],[4,1,4,15],[9,1,9,15],[11,1,11,15],[1,6,1,9]]}
["Command Center Evaluation:  Bed Controller"]
[null,null,null,null,null,null,{"$f":"TODAY()","v":"2014-12-05"}]
[null,"You will be evaluating the movement of patients and the creation of new treatment space.  You will need to work closely with the person in the command center or elsewhere who is directing the flow of patients to and from beds (\"bed controller\").  "]
[null,"Patient movement includes:\n          • Admission of ED patients to ICU or regular beds\n          • Transfer of ICU patients to regular (medical/surgical) beds\n          • Discharge of patients from regular beds to home\n"]
[null,"Creation of new treatment space includes:\n           • Staffing beds that are currently unstaffed (including opening closed wards)\n           • Repurposing other beds (e.g., use post-anesthesia recovery room as overflow ICU beds)\n           • Placing beds or stretchers in other areas (e.g. hallways, lounges)"]
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[null,"Instructions:\n          1. Evaluators and trusted insider assemble at a pre-designated  place, approximately 30 minutes prior to exercise start.\n          2. Command center evaluators (2) should be escorted to position in or near the command center.\n"]
[null,"          3. Review the diagram below and familiarize yourself with the \"ICU\" tab and the \"Floor\" tab.\n          4. When the Incident Commander (IC) arrives, ask him/her to identify the person directing the flow of patients to and from beds (\"bed controller\"). \n          5. Introduce yourself to the “bed controller” and position yourself next to him/her."]
[null,"          6. Explain your role to the “bed controller” (as necessary).  \n          7. Collect baseline beds status:  Number of free ICU and floor beds, and total number of ICU and floor beds.\n          8. Using the \"ICU\" and \"Floor\" tabs, work with the bed controller throughout the exercise to record:\n                        a. ICU and floor beds assigned to ED patients"]
[null,"                        b. ICU or floor beds that are opened by transferring patients or discharging them \n                        c. New ICU or floor beds that are “created” \n          9. The ED should be making periodic requests for inpatient beds, and the bed controller should be providing beds to the ED.  If you do not observe this communication, then ask for clarification.\n        10. After the exercise ends, a formal hotwash will take place in the Command Center with all participants.\n        11. Use the Hotwash tab to debrief your portion of the exercise. "]
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[null,"Baseline Data:  At the start of the exercise:"]
[null,null,"How many staffed adult medical/surgical (non-ICU) beds are empty?",null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IFERROR(ROUND((1-T0ICUbedsavailable/TotalICUBeds)*100,0),\"\")","v":""}]
[null,null,"How many staffed ICU beds are empty?",null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IFERROR(ROUND((1-T0FloorBedsAvailable/TotalFloorBeds)*100,0),\"\")","v":""}]
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[null,null,"What is the total number (empty or occupied) of staffed adult medical/surgical (non-ICU) beds?"]
[null,null,"What is the total number (empty or occupied) of staffed ICU beds?"]
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[null,{"$f":"\"You are reporting that at the start of the exercise, your immediate bed availability is \"&T0ICUbedsavailable&\" ICU beds and \"&T0FloorBedsAvailable&\" floor beds.   \nICU beds are  \"&ICUpercent&\" % occupied, and floor beds are \"&Floorpercent&\" % occupied.\"","v":"You are reporting that at the start of the exercise, your immediate bed availability is  ICU beds and  floor beds.   \nICU beds are   % occupied, and floor beds are  % occupied."}]
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[null,"Throughout the exercise, record patient movement using the \"ICU\" and \"Floor\" tabs."]
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[null,null,null,null,null,null,null,null,null,"."]

{"sheet":"ICU","index":1,"n_rows":39,"n_cols":9,"rows_kept":39,"cut":false,"hidden":false,"merged":[[0,0,0,9],[2,1,3,8]]}
["ICU Bed and Patient Tracking"]
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[null,"This tab is used to record changes in the status of ICU beds.   The ED should communicate their need for ICU beds based on ED census at the start of the drill and newly arriving mass casualty patients.    When ICU beds are offered to the ED, record them in the first column.   Record ICU beds freed through transfer in the second column, and new ICU beds “created” in the third column."]
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[null,null,null,null,null,{"$f":"T0ICUbedsavailable+ICUtoFloor+NewICUBeds-EDtoICU","v":0}]
[null,null,null,null,null,{"$f":"TotalICUBeds-T0ICUbedsavailable+EDtoICU-ICUtoFloor","v":0}]
[]
[null,"ICU Beds Assigned to ED Patients",null,null,null,null,null,"New ICU Beds \"Created\""]
[null,"ICU Bed Location","Number of Patients",null,null,null,null,"ICU New Bed Location","Number of New Beds"]
[null,null,null,null,"ICU Beds Freed by Transfer"]
[null,null,null,null,"Floor Destination","Number of Patients"]
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[null,"Total",{"$f":"SUM(C19:C38)","v":0},null,"Total",{"$f":"SUM(F21:F38)","v":0},null,"Total",{"$f":"SUM(I19:I38)","v":0}]

{"sheet":"Floor","index":2,"n_rows":39,"n_cols":9,"rows_kept":39,"cut":false,"hidden":false,"merged":[[0,0,0,9],[2,1,3,8]]}
["Floor Bed and Patient Tracking"]
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[null,"This tab is used to record changes in the status of medical/surgical floor beds.   The ED should communicate their need for floor beds based on ED census at the start of the drill and newly arriving mass casualty patients.    When floor beds are offered to the ED, record them in the first column.   Record floor beds freed by discharging patients home in the second column, and new beds “created” in the third column."]
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[null,null,null,null,null,{"$f":"T0FloorBedsAvailable+FloorDischarged+NewFloorBeds-EDtoFloor-ICUtoFloor","v":0}]
[null,null,null,null,null,{"$f":"TotalFloorBeds-T0FloorBedsAvailable+EDtoFloor+ICUtoFloor-FloorDischarged","v":0}]
[]
[null,"Floor Beds Assigned to ED Patients",null,null,null,null,null,"New Floor Beds \"Created\""]
[null,"Floor Bed Location","Number of Patients",null,null,null,null,"Floor New Bed Location","Number of New Beds"]
[null,null,null,null,"Floor Beds Freed by Transfer"]
[null,null,null,null,"Floor Bed Opened Up","Number of Patients"]
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[null,"Total",{"$f":"SUM(C19:C38)","v":0},null,"Total",{"$f":"SUM(F21:F38)","v":0},null,"Total",{"$f":"SUM(I19:I38)","v":0}]

{"sheet":"Hotwash","index":3,"n_rows":13,"n_cols":9,"rows_kept":13,"cut":false,"hidden":false,"merged":[[12,2,12,14],[6,2,6,14],[5,2,5,14],[4,2,4,14],[0,0,0,15],[2,2,2,14]]}
["Command Center Hotwash: Bed Controller"]
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[null,null,"Hotwash Instructions:\n1.  At the end of the exercise, the ED players and evaluators will come to the command center for the hotwash.\n2.  Review the information provided below and prepare to present your observations.\n3.  Each member of the evaluation team should debrief their portion of the exercise using the \"Hotwash\" tab on their respective spreadsheets.  \n          a. The suggested order is:  (1) ED Exercise Controller, (2) ED Qualitative Evaluator, (3) CC Incident Commander Evaluator, (4) CC Bed Control Evaluator (you). \n4.  When it is your turn, summarize the information you collected and lead a discussion using the questions provided on this tab."]
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[null,null,"During the course of the exercise, I worked with the bed controller to track patient movements and new treatment spaces set up.  "]
[null,null,{"$f":"\"The hospital reported \"&T0ICUbedsavailable&\" ICU beds available at the start of the exercise.  During the exercise, \"&EDtoICU&\" patients were admitted from the ED to the ICU, \"&ICUtoFloor&\" patients were transferred from the ICU to the floor, and \"&NewICUBeds&\" additional ICU treatment spaces were set up and staffed.  \"","v":"The hospital reported  ICU beds available at the start of the exercise.  During the exercise, 0 patients were admitted from the ED to the ICU, 0 patients were transferred from the ICU to the floor, and 0 additional ICU treatment spaces were set up and staffed.  "}]
[null,null,{"$f":"\"There were \"&T0FloorBedsAvailable&\" adult medical/surgical beds available at the start of the exercise.  \"&EDtoFloor&\" patients were admitted from the ED to the floor, \"&FloorDischarged&\" patients were discharged home, and \"&NewFloorBeds&\" additional floor treatment spaces were set up and staffed.\"","v":"There were  adult medical/surgical beds available at the start of the exercise.  0 patients were admitted from the ED to the floor, 0 patients were discharged home, and 0 additional floor treatment spaces were set up and staffed."}]
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[null,null,null,null,null,"Initial Bed Availability","Patients Admitted from the ED","Patients Transferred Out or Discharged ","New Treatment Spaces"]
[null,null,null,null,"ICU",{"$f":"T0ICUbedsavailable","v":0},{"$f":"EDtoICU","v":0},{"$f":"ICUtoFloor","v":0},{"$f":"NewICUBeds","v":0}]
[null,null,null,null,"Floor",{"$f":"T0FloorBedsAvailable","v":0},{"$f":"EDtoFloor","v":0},{"$f":"FloorDischarged","v":0},{"$f":"NewFloorBeds","v":0}]
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[null,null,"Discussion Questions:\n           1. What was the largest barrier to obtaining adequate beds in the ICU? On stepdown units/floor?\n           2. Would there be enough equipment for any new beds created?\n                    a. What equipment would be needed?\n                    b. Where would it come from?\n                    c. How long would it take to obtain?\n          3. Would there be enough medical and nursing personnel to staff these beds?\n          4. How long would it take to obtain adequate equipment and staff?"]