Hospital Decontamination: Planning Matrix

Form Template

Does your facility work collaboratively with a Planning Point of Contact (POC) from the agency, at least twice per year?

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Is a representative from the agency routinely present at Local Emergency Planning Committee (LEPC) meetings? Does your facility conduct training and exercises focused on or inclusive of hospital decontamination operations with the agency at least once annually? The hospital decontamination self-assessment app intended for use by hospital emergency preparedness planners, hospital decontamination team members, and other personnel with responsibility for their facility’s decontamination plans and procedures. The app is designed to walk the user through the emergency management cycle of a hospital response to a hazardous materials incident requiring decontamination of patients. The Hospital Decontamination: Planning Matrix mobile app allows you to replace your paper checklist with an iPhone, Android, tablet or Windows desktop computer. The mobile form includes fields to document items such as date, hospital, department/ unit, staff's name, and title and captures staff signature. Once the mobile app is filled out a secure PDF is generated. The PDF is easy to share, and a copy is stored in your account for your decontamination records. You can also use the App Builder to personalize and customize this mobile form.

Features
  • Signature Capture
  • Submission Editing
  • Reference Data
  • Dispatch
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Platforms
  • iPhone
  • iPad
  • Android
  • Windows
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Integrations
  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
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*The Capterra SoftwareAdvice ​and GetApp logos are a service mark of Gartner, Inc. and/or its affiliates and is used herein with permission.*

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