Harborview Medical Center is committed to providing a safe, functional, supportive and effective environment for patients, staff and visitors. The Environment of Care (EOC) committee at HMC maintains seven JCAHO-required management plans, plus two additional plans* to ensure EOC standards and the mission of the hospital are met. The following are our management plans:

• Emergency Management
• Fire Prevention Management
• Security Management
• Hazardous Materials & Waste Management
• Safety Management
• Utilities Management
• Medical Equipment Management
• Accessibility*
• Workplace Violence Prevention*

The Emergency Reference Guide (Flip Chart) is designed to help staff know what to do during an emergency or incident involving the Environment of Care at HMC. The Emergency Reference Guide provides brief information. It is designed to complement department plans and medical administration policies, which give you further information. Emergency Reference Guides MUST be kept in a location where you can see and get to them easily.

 The Emergency Reference Guide is a resource for how to complete a code. Harborview's expectation for all staff is that you are able to identify the meaning of the code without the assistance of the guide.  Additionally, each staff member is expected to know what to do during all the major codes (fire, hazardous materials spill) without the support of the guide.  It is important to know how it differs by location.

Many hospitals share physicians, nurses, and other health care professionals. These employees jobs are complicated by the fact that that they have to use different emergency code in each hospital that they are working in. This increases the likelihood of confusion and error with the potential to harm to patients.

Washington hospitals are in the process of standardizing practices to make care safer and reduce complexity for nurses and physicians.  The Washington State Hospital Association (WSHA) has recommended a set of standardized codes to be adopted by the hospitals in Washington and Oregon State.  Harborview is participating in the project.   

Starting October 1, 2009, many of the emergency codes will be changing at Harborview.  These are the new codes:

An external disaster is an event where many people are injured outside the hospital and brought to HMC for treatment.

HMC staff and employees must take special actions to provide effective patient care.

When the External Disaster Plan is activated, it will be announced on the overhead page, "External Triage + number of injured persons expected."  Follow the departmental disaster plan. If your department does not have a disaster plan, follow the hospital disaster plan (see the Administrative Policy and Procedures Emergency Response External Disaster Plan).

   Knowing when to evacuate the Medical Center is important. Follow these guidelines:

• Evacuate when you hear the emergency announcement, "Internal Triage: Echo and the name of your unit or floor."
• Evacuate when there is a clear danger to any HMC building and to the health and safety of anyone by fire, chemical spill, bomb threat, explosion, or earthquake conditions.
• If you are unsure, check with your supervisor or someone else in charge before you start to evacuate yourself or others.

Evacuation Methods

Follow the instructions on the overhead page, or follow the evacuation routes that are posted on each floor in the elevator lobby area.

  Horizontal or Lateral: Evacuate people to another unit on the same floor or level. Lateral is the preferred method of evacuation at Harborview.

  Vertical: When lateral is not possible, move people downward three floors from the floor being evacuated. The West Clinics, Harborview Hall, Pat Steel Building, and most off-campus buildings can only be evacuated vertically.

Follow the procedure below when there is an earthquake:

  DROP: If you are indoors, stay there. Take shelter under a table or desk. Seek cover against an interior wall or in a doorway.

COVER: Protect your head and neck with your arms. Stay away from windows, movable equipment, and objects hanging on the wall.

  HOLD: If you take cover under a piece of furniture, hold onto the legs and be prepared to move with it. Stay under cover until the shaking stops and it is safe to move. Be prepared for after shocks.

After you determine that you, your co-workers, patients and visitors are safe, you should follow your departmental disaster plan.

"Code Amber" means a child abduction has occurred.

When a "Code Amber" is called, immediately check hallways and exits in and around your department for suspicious persons that are escorting, carrying, or even concealing a baby or small child.

Continue monitoring the hallways and exits until the "Code Amber" has been called off.

Call 4-5555 to report a possible abductor.

"Code Zebra" is a communications alert that may be called for many different reasons.

When a "Code Zebra" is called, check your email and/or the Harborview Information Line at 4-INFO for more information. Details should also be available from your supervisor.

An incident is an unexpected condition or event that may lead to an accident. It is also often referred to as a "near miss."

An accident is an unexpected event that results in physical injury and/or results in property loss or damage.

All staff and students may contact Employee Health for evaluation or treatment of any injury or accident.  They can be reached at  206-744-3081.

Report any incidents or accidents occurring in and around the hospital, including any work-related illness, or any on-the-job incident that could have caused an injury or illness.

  To report an incident or accident, use the Patient Safety Net (PSN), an online method for completing all incident and accident reports. If you do not have access to PSN, talk to your supervisor or manager.

If you discover a fire, or potential fire situation, always use the R-A-C-E procedures:

R = RESCUE patients, visitors and/or staff, if it is safe to do so.

A = ALARM pull the nearest fire alarm and call ext. 4-5555 if in HMC, R&T or Harborview Hall, or 911 if you are at an off-site location.

C = CONTAIN the fire by closing all doors and windows.

E = EVACUATE all public and ambulatory areas.

DO NOT use the elevators in the wing where the fire is reported. Use the stairs only.

DO NOT try to put out the fire with an extinguisher. Only Engineering, Public Safety, and the Seattle Fire Department are certified to operate fire extinguishers at HMC.

Fire Safety is every staff member's responsibility at Harborview. You must know the following:

• The emergency code for fire is "Code Red"
• First make sure you are safe
• The R-A-C-E procedure
• The nearest pull/fire alarm to your work area
• The nearest fire extinguisher (Only Engineering, Public Safety, and the Seattle Fire Department are allowed to operate fire extinguishers at HMC.)
• The nearest exit to your work area
• How to notify the hospital in case of a fire in the hospital (Pull the fire alarm and call extension 4-5555 to report the location of the fire.)
• Who authorizes an evacuation (Evacuations are directed by orders from one or more of the following: Department Emergency Warden, Nursing Supervisor, Administrator On-Call, and the Seattle Fire Department.)
• The evacuation route in case of an emergency
• Evacuate ambulatory patients before non-ambulatory
• Who is authorized to turn off Medical Gas/Air (Engineering)
• Who the Emergency Warden is in your area

If you do not know the above information, ask your manager or supervisor.

Emergency Warden

Each area has a designated Emergency Warden. In the patient care areas, the Charge Nurse is typically the Emergency Warden.

Emergency Wardens will wear an orange vest during an emergency or fire. Follow the instructions provided by the Warden. Wardens are trained by the Safety Officer.

HMC requires all staff, employees, contractors, vendors, temporary employees and volunteers to wear HMC Photo ID.

Dangerous weapons are NOT allowed in any HMC buildings, except for authorized personnel (e.g. Police).

The emergency phone number for the Department of Public Safety is 4-5555.

For crimes or emergencies off-campus, call 911.

Here are some tips to help you stay safe:

• Don't "look like a victim." Walk confidently and be aware of what and who is around you.
• Stay in lighted areas at night, avoid alleys and shortcuts. Walk with others if possible.
• Have your keys or bus pass ready, carry as few items as possible.
• If you have a problem, leave the area, go into a business, shout "Help!" or "Call 911!"
• Report suspicious persons to Public Safety by calling 744-5555.
• Use the Escort Service provided by HMC.

    Here are some tips to help you protect your property:  

• Always lock office doors when you are not there or when you are working alone.
• Lock your car and don't leave anything of value where anyone outside of the car can see it. Lock it in the trunk or take it with you.
• Property Identification: Engrave your driver's license number on personal items.
• Never leave items unattended alone in a public place.
• Report thefts to Public Safety at 744-3193.

Workplace Violence means any verbal assault, threatening behavior or physical assault in, or arising from the workplace. The Administrative Policy and Procedures on Workplace Violence is in place to promote a safe environment for patients, staff and visitors.

All HMC staff and employees are responsible for reporting workplace violence.

No smoking is allowed inside any building at HMC.

No smoking is allowed in any state-owned vehicles.

Smoking outside is allowed ONLY in designated areas 25 feet away from entrances, to minimize the effects of second-hand smoke.

Disciplinary action may result if a staff member repeatedly violates the smoking policy.

Always label the container right away when you pour a chemical substance into it.

New Staff Orientation is available to provide basic hazard communication information. Some employees, including laboratory staff, need specialized training before handling certain regulated hazardous materials. Staff receives department-specific HAZMAT training from their supervisor, when appropriate.

Chemical Spills: Emergency Procedures

In the event of a chemical spill, follow these procedures:

• Rescue patients, staff and visitors (if safe).
• Call Public Safety at 4-5555 and state "Code Orange" and location of the spill. Engineering and Public Safety will respond.
• If you are trained and it is possible, contain the spill.

Clean-up Procedures:

• Minor Spills- Refer to the Material Safety Data Sheets (MSDS) or the MyChem web portal at www.ehs.washington.edu/epomychem for safety information and clean-up procedures.
• Major Spills- These are cleaned-up by a contractor.

Evacuate, if necessary.

If an exposure occurs, immediately go to the Emergency Department.

Complete an Incident/Accident Form.

HMC's Safety Officer can be reached at  4-8742.

Safety inspections are done monthly through the Environment of Care (EOC) Rounds by the Safety Audit Team.

EOC Rounds are done twice a year in patient areas. Non-patient care areas are checked once a year. Contact the Safety Officer if your area has not been inspected.

The Safety Audit Team has representatives from Engineering, Clinical Engineering, Public Safety, Safety, Infection Control, and Environmental Services.

Below are a list of systems and who to contact in the event of their failure.

Computer System: ITS, 3-7012

Total Electrical Power: Engineering, 4-3191

Elevators Out of Service: Engineering, 4-3191

Heating, Cooling, Ventilation: Engineering, 4-3191

Medical Gas & Vacuum: Respiratory Care, 4-2004

Telephone: Voice dial 4-4357

Water Supply (loss of water pressure, toilets, etc.): Engineering, 4-3191

After normal business hours, contact: Nursing Supervisor On-Call, 4-3000.

Elevator Failure

If elevators break down, contact  Engineering at 4-3191.
If you get stuck in an elevator, stay calm and use the emergency phone located in the elevator.

Power Failure

If a power failure occurs, contact Engineering at 4-3191.

During a power failure, the emergency power generators will provide power to life safety systems, selected lighting, red outlets and equipment.

Clinical Engineering must inspect all powered (electrical, pneumatic, or battery) equipment used in patient care areas before their first use.

Loaner, rental, physician owned and evaluation equipment must also be inspected prior to being used in a patient care area.

Patient care areas are defined as patient rooms, exam rooms, surgical suites and special procedures rooms (e.g. radiology). Nurse stations, etc. are NOT patient care areas.

Clinical Engineering (4-3496) is the primary contact for the repair of patient related technologies.

Cellular Phones & Radios

Cellular phones and radios are allowed at HMC. However, their use inside patient care rooms is discouraged.

Radios may not be used beyond the red line in the Operating Room, except in emergent situations.

To minimize any interference on medical devices and diagnosis, all installed wireless systems must be approved by Clinical Engineering prior to use.

If you notice any interference to medical technology, please ask the cell phone or radio user to step back three feet and initiate an incident report.

Extension Cords

Extension cords are not allowed in patient care areas unless approved by Clinical Engineering.

Clinical Engineering is responsible for service on patient care equipment, including beds, stretchers, wheelchairs and Operating Room tables.

Hours of Operation: Monday-Friday, 6:30 a.m. - 5:00 p.m.

Telephone Number: 4-3496

STAT Pager: (206) 540-1162

Director: Pam Jorgensen

Email: pamj@u.washington.edu

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