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Early days, needed to create space for supplies. Facilities department prepared that space and ready. SNHD able to work different hours and change their schedules. Community partners assisted with getting the vaccines to the public. Adapted and overcame barriers. Everyone was motivated to assist. From testing to distribution of vaccine.
Worked with State NV to get vaccines needed. IMT and all agencies: getting information to gather supplies. Documents were done very quickly to get the vaccines out as fast as we did.

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Mobilize pretty quickly, dedicate personnel, assist to community partners for those accepting COVID patients. Were able to work with everyone to coordinate. Administer vaccine and ensure doses were not wasted. Had space to store PPE in-house.
PPE coordinated with County and got some on own. Pulled from County for mask once.

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PPE was an issue with everyone; found our way to get mask, gloves, etc. very quickly. Focused more on vaccines side and not too much hands-on on PPE. Unsure if there were some serious barriers. Everyone had focused roles.

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Worked very well with SNHD. Able to make adjustments pretty quickly. Does not know any challenges with SNHD

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MSST, unit within Clark County MACC - PPE coordination, transport decision

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Face some issues with communication. Sometimes there are too side groups and hands in the pie so the communication does not flow to everyone. What the centers, what kind of patients... Miscommunication and took quite a lot of effort to iron out the communication with how long they could stay and what they could bring. Sometimes there are too many people and no everyone gets the information. Logistic effort challenges with everyone including Catholic Charities but other groups would come in and give different information. There needs to be one department, one unit, or one something. No information from volunteer organization. VOAD to coordinator to center to flow information. One person who could speak for all centers. Learned with hands-on. Flowing system was much better towards the end. Need to work on how information is disseminated.

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Information from Emergency Declaration needed to have another document to explain the declaration. Information from the top down also needs to be clearer.

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Challenge - some many people in mix and no hard line of policies; this is kind of what we are doing today. I would tell hotels and agencies one thing but they would say something different. So many people... the amount of groups, where people got their information. Huge barriers to get people moved. Coordination issues transport and transfer patients. Phone conferences and zoom meetings and every groups would have different information. I would correct them but it kept going. Issues: how would a positive patient be moved; how would a hotel accommodate. Some hotel would kick out patient if positive. At 3 AM, would need to figure out how to move someone who was positive. Policy of who goes where; I would suggest but people needed solid guidance, needed SOP but it was not happening. Lots of confusions. Criteria for transport and nailing down procedure.

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Had infectious policies but did not have any that address at the mass scale. Working with globally organization to get policies that are in line with SNHD policies.

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Some challenges with some hotels doing their own thing and having their own SOP. Need to have more of a procedure. Did not have direct contact with hotels. Will see if I can get information.

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CARES money used some of the funds for transportation with no private information or Medicaid. Used for veteran care homes or homeless patients.

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EMS transport and non-medical transport - there needs to be different policies and procedures. EMS is under SNHD but not non-medical.

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COVID positive but no-medical transport. Payment issues but need to get more background information.

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Transport to Cashman, non-hospital.

Jessica:
Difficulties to hotels

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Move recommended improvements to this column.

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Move recommended improvements to this column.

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Better tracking system; such as smart sheets. Using technology to our advantage. Difference application to better track

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private sector side for EMS; staffing is a huge issues. Back log of students getting everyone through. Reduction in desire to do this for a living. A lot of burned out and are now doing something different. Shortages issues, reduction in work flows and supplies. Difficulties getting IV tubing and need to try to get other suppliers. Staffing and equipment challenges are biggest too. Medical supplies, AEDs take a long time to get.

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County with UMC - Lost 400 people with early retirement offer in 2020. Just now are replacing that work force.

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SNHD utilized every employees in all areas. People were tired. Initial push with all the overtime and working on days off. Able to meet the need with staffing and also brought people on. Staffing was not such a barrier.

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Shortage getting ambulances - unique shortages that did not exist in the past.

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First surge, 911 volume decreased due to COVID but now is back. Less staffing but normal volume 911 calls.

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Good questions to think about more details and answers