August 12 – 18, 2019

The Northwest Region Healthcare Coalition’s next meeting is the Cardinal Resolve Table Top Exercise on August 15th. The Table Top Exercise is the first of two joint exercises by VDH and VHHA. Please see the flyer below for more information.

1. Save the Dates

Upcoming exercises: We will be participating in a Joint VHHA and VDH Table Top Exercise this Thursday August 15th in-place of our regional coalition meeting. This exercise is a lead-up to the Joint Full Scale Exercise October 23rd. Questions regarding the upcoming exercises, please contact our Exercise and Training Coordinator, Matt Cronin. Please see the Cardinal Resolve TTX Flyer for more details.

Upcoming regional training: The Coalition will host the MGT – 349 Pediatric Disaster Response and Emergency Preparedness course November 18 – 19, 2019 in Harrisonburg, VA. Questions regarding upcoming training, please contact our Exercise and Training Coordinator, Matt Cronin. Please see the link for more details.


2. Clinical Advisor

The Northwest Region Healthcare Coalition is seeking a part-time physician to serve as a clinical advisor. The job announcement can be found here. We ask healthcare organizational staff to please assist us by spreading the word about this open position. As part of our grant funding requirement, we must hire a physician before the next grant period begins.


3. Memorandum of Understanding

We are pleased to announce that the Northwest Region Healthcare Coalition continues to receive requests to sign a Memorandum of Understanding (MOU) between the coalition and non-hospital facilities. The MOU is designed for healthcare facilities that are not classified as an Acute Care or Critical Access hospital, and it is good for five (5) years before it will need to be renewed. If your organization resides within the Northwest Region and you have not signed the MOU, you can contact either the Regional Coordinator or the Medically Vulnerable Populations Coordinator to find out more details.

We are expanding our outreach to healthcare agencies within the region as a way of offering assistance to you and your organization. We ask for everyone’s help to spread the word by talking with your colleagues about the Northwest Region Healthcare Coalition. You can contact us by clicking the Contact Us tab on our website.


Click here to access our website. Don’t forget to visit the Events calendar for upcoming training and exercise events.


We have developed a one page understanding of the regional coalition that can be shared between coalition partners. Please click here to view the regional “one-pager”.

Virginia Hospital & Healthcare Association Credit:

Virginia Department of Health

Save the Date for the 2020 Virginia Public Health & Healthcare Preparedness Academy

Virginia Public Health & Healthcare Preparedness Academy will be held in Harrisonburg, VA. The dates are March 23 – 25, 2020 at the Hotel Madison & Shenandoah Valley Conference Center. Because this event will be held in the Northwest Region next year, we would ask that as many of our healthcare partners that can attend do so. We hope to make a great showing and showcase how the Northwest Region supports emergency management and preparedness efforts. Details about lodging and other topics such as allowable travel and reimbursements will be provided as we receive them. 

So, for now, please put this event on your calendar as we hope to see as many of you that can attend.

 Assistant Secretary for Preparedness and Response


Assistant Secretary for Preparedness and Response Technical Resource,                                                                                                                             Assistance Center, and Information Exchange

Hospital Preparedness Program




Mass Violence Technical Resources

Mass violence incidents require efficiency and coordination among multiple response entities. Efforts may need to be directed toward doing the greatest good for the greatest amount of people, which is counter to day-to-day trauma triage. These ASPR TRACIE-developed resources can help our stakeholders prepare for, respond to, and help their communities recover from these traumatic events. 

No-Notice Incident Tip Sheets

Topic Collections

Additional Resources


Credit: Centers for Disease Control and Prevention


Credit: U.S. Food & Drug


Credit: Centers for Medicare and Medicaid Services


         U.S. Department of Homeland Security 

Federal Emergency Management Agency


Virginia Department of Emergency Management

Course Offerings

Emergency Management Professional Program Basic Academy Course Announcements. Please see the flyer for additional details.

EMPP Basic Academy Announcement and Application

ICS 400 Advanced Incident Command Systems course is scheduled for August 28-29, 2019. Please see flyer for additional details.

Course Announcement ICS 400 Madison

L0146: Homeland Security Exercise Evaluation Program (HSEEP)
Dates: September 4-5, 2019 at the Virginia Emergency Operations Center, 7700 Midlothian Turnpike, Richmond, VA 23235
To Register:  Click  (last day to register August 23rd)
Prerequisite: IS 120.c ( and complete form FEMA 119-25 (

ICS 300 Intermediate ICS for Expanding Incidents course is scheduled for September 14-15, 2019. Please see flyer for additional details.

Course Announcement ICS 300 Shenandoah

MGT-418 Readiness: Training Identification and Preparedness Planning (RTIPP) course is rescheduled for September 23-24, 2019. Please see the flyer for additional details.     

MGT418 Course Announcement – Spotsylvania VA

PER-335 Complex Coordinated Attacks (CCA) course is scheduled for October 15-16, 2019. Please see the flyer for additional details.

PER335 Course Announcement – Fredericksburg, VA

1. Central Region Healthcare Coordination Center Manager Job Opening

The Central Region is seeking candidates to fill a job opening as their Regional Healthcare Coordination Center Manager. All of the information can be found in this attachment. The closing date is August 15, 2019.

2. Think carefully before using security officers to monitor high-risk patients

As CMS, The Joint Commission and other accrediting organizations continue their focus on preventing suicide risk, some facilities are turning to their security department for help.

If your hospital is considering using its security officers or police as sitters for patients at high risk of self-harm, make sure the conversation includes the need for resources to ensure the officers are trained and can show competency in CMS requirements regarding appropriate seclusion and restraint (S/R). They also should fully understand their role as a one-on-one observer.

Probably the best practice, however, is not to use them at all, say experts.

If your hospital does decide to use officers in one-on-one observation, explain to your C-suite that they must invest in the training and continuous oversight of those officers. CMS is calling out hospitals when officers use inappropriate S/R methods or when they are used as observers because other staff were not available (for examples, see p. xyxyxXYxyy).

Your hospital must also maintain the integrity of overall hospital security when a security officer is otherwise assigned, says a new policy guideline, “Security Role in High-Risk Patient Watches,” made available in June by the International Association for Healthcare Security & Safety (IAHSS).

“The Healthcare Facility (HCF) should establish policy and procedures to provide guidance for the constant observation of patients, including the use of security in a patient watch role. The long-term use of security as sitters or in patient watch situations should be avoided unless dedicated security staffing resources have been allocated for this specific purpose,” according to the guideline’s opening statement.

Among other key points leading the guidelines, “If on-site security resources are used for patient watch, the overall posture of safety on campus should be maintained to the largest degree possible. In general, on-site security should be used in defined circumstances to supplement and not replace clinical staff members.”

Officers have different duties

The IAHSS is not alone in its concerns about regularly using officers as sitters for at-risk patients.
“Police and/or security officers should not be used as one-to-one observers unless they have had significant training in behavioral health disorders and are trained on the purpose of these tasks. Police are trained to protect the public, not a patient with mental illness,” says Kevin Ann Huckshorn, PhD, MSN, RN, CADC, ICRC, a national behavioral health consultant with years of experience in hospital settings and now the director of evidence-based practices and programs for Wellpath Recovery Solutions.

In her previous service as director of the Office of Technical Assistance for the National Association of State Mental Health Program Directors (NASMHPD) and the National Coordinating Center for Seclusion and Restraint Reduction, she led the development of an evidence-based model to prevent violence and the use of S/R, called “Six Core Strategies to Prevent Conflicts and Violence in Inpatient Settings©.”

Close observation of high-risk patients is always a challenge, notes Huckshorn. Determining when a patient must be in close observation is “generally a nursing and psychiatry decision based on a number of risk factors that are identified on admission or sometime during the individual’s admission as risk factors often change. The most common risk factors looked for are suicidal intent, self-harm, or aggression toward others.”

Training for the staff asked to do close observation is crucial.

“Since these are human interventions, there are often situations where the direct care staff tasked to do these jobs are either poorly trained or just inattentive. Frankly, being assigned to one-to-one duties without a clear understanding of why or how to perform these duties can be mind-numbingly boring for staff assigned,” says Huckshorn. “That is why most hospitals limit this work to two hours, for staff involved, and have supervisors round consistently to be sure these duties are being done competently.”

CMS, The Joint Commission (TJC), and other accrediting organizations have increased scrutiny on suicide prevention and mitigating ligature risk. When the physical environment cannot be minimized to remove elements patients might use to harm themselves, hospitals have been instructed to use constant visual observation.

“For patients identified as high risk for suicide, constant 1:1 visual observation should be implemented (in which a qualified staff member is assigned to observe only one patient at all times) that would allow the staff member to immediately intervene should the patient attempt self-harm,” reads one frequently asked question (FAQ) TJC recently highlighted online. “The use of video monitoring or ‘electronic-sitters’ would not be acceptable in this situation because staff would not be immediately available to intervene. The use of video monitoring would only be acceptable as a compliment to the 1:1 monitoring, and not acceptable as a stand-alone intervention.”

Ensure staff qualified for role

TJC also has emphasized that the monitor must be a qualified staff member.

In another FAQ about patients in the emergency room, TJC stated that “only patients with serious suicidal ideation (that is, those with a plan and intent) must be placed under demonstrably reliable monitoring. Most importantly, the monitoring must be linked to immediate intervention by a qualified staff member when called for.”

One-to-one observers should be well trained in safety and “know what to look for related to effects of mental illness on behavior, safety to the patient and others, and on how to ‘get to know and engage’ the patient,” advises Huckshorn. “Close observations should not be seen as a punishment or a criminal or legal action.”

Such monitoring is to keep the patient and others in the environment safe. The only time police or security should be used is in emergency departments when there are absolutely no other staff available or “for individuals with very serious criminal charges and,” Huckshorn emphasizes, “who might be able to hurt a staff person or others in that location.”

Huckshorn warns that using uniformed police or security staff as a monitor could actually aggravate or “escalate the individual in care. That is not the outcome or point of close observations.”

Source: A. J. Plunkett of HCPro