Atlantic Health System vision

The Clinical Engineering/BioMed Department at Overlook Medical Center:

The Clinical Engineering/BioMed Department at Newton Medical Center:

Located Ground Level, Administration Building. 

The Clinical Engineering/BioMed Department at Chilton Medical Center:

 CMC: call 973-845-7589

Located Ground Level

Hours are 7:00am to 4:00pm
OMC:  call 908-522-2903 
Located on the 3rd Floor. 

Inspects and repairs all medical equipment throughout hospital. All medical equipment must be inspected prior to use; and all medical equipment requiring repair should be taken out of service and reported to the Clinical Engineering/Biomed department. In addition, all medical equipment must have an inspection sticker. If the “Inspection Due” date has expired, do not use the device, return it to the Clinical Engineering/BioMed department at the facility.

Chemical Spills require notification to Environmental Services Department at X5030 at MMC and X2169 at OMC and X8304 at NMC so that they may ensure proper clean-up. Be sure to call and give information on what, where, and how much was spilled.

Certain clinical activities involve potential exposure to ionizing radiation. These include X-ray imaging, radioactive materials to diagnose and treat, and certain radioactive materials to irradiate blood samples. People working in these areas are required to participate in radiation monitoring and will be provided a radiation badge they are required to wear. Only people approved for this area may work there.
If you are injured while working at one of the facilities, you need to report your injury using an incident report and seek medical attention. If you are not an employee of Atlantic Health, being treated at an Atlantic Health facility may be subject to your own medical insurance.
Life Safety
Although rare, fires do happen in healthcare facilities. Life and Fire Safety Guidelines require everyone to know that oxygen enriched environments enhance the spread of fire, can generate large volumes of toxic gas, and intense heat. In the event of a fire be sure to follow the steps in the R.A.C.E. acronym when responding:

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  Rescue those in immediate danger and conduct a systematic search for others in the area.
  
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  Alarm the nearest fire alarm pull station and then dial extension 8888 at MMC, X777 at OMC and X8888 at NMC to report the location of the fire.
  
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  Contain the fire by closing ALL doors and windows.
  
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  Extinguish the flames using a fire extinguisher if it’s a small fire just getting started, or evacuate to behind the nearest fire doors.
  

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  Pull the pin from the handle of the fire extinguisher.
  
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  Aim at the base of the fire.
  
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  Squeeze the handle of the fire extinguisher to activate and discharge the extinguisher on the fire.
  
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  Sweep the base of the fire until it’s out or the extinguisher is empty.
  

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  Class A: Ordinary combustible or fibrous materials. Examples: wood, paper, cloth, rubber, and some plastics.
  
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  Class B: Flammable or combustible liquids. Examples: alcohols, xylene, gasoline, kerosene, paint and paint thinner, and propane.
  
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  Class C: Energized electrical equipment. Examples: appliances, switches, panel boxes and power tools.
  

Be sure to follow the proper steps in evacuating from a fire area. Step 1 – move horizontally to next smoke zone; Step 2 – move vertically – down two flights. Compartmentalization allows us to isolate the smoke and fire to the unit where the fire occurs minimizing the amount of evacuation necessary.

The Protection and Security Services departments at the hospitals are a 24/7 department. The department is located on Simon B level in MMC, with a telephone number of 973-971-5555. At OMC, the Security Command Center is located on the 5^th Floor with a phone number of 908-522-5529, at NMC on 973-383-2121. This department is responsible for the physical safety of the hospitals and its sites, as well as issuing ID badges and parking decals. Other services include monitoring security sensitive areas, investigating, responding to various codes, providing support for employee escorting, and maintaining a constant security presence throughout the hospital. All staff, volunteers, students, physicians and vendors must wear ID badges when present in the facility.

If you observe unusual or suspicious activity, please report it to the Security Command Center at X5555 (MMC) or X5529 (OMC), at X8888 (NMC).

Code Pink/Code Adam: When these codes are announced all departments adjacent to entryways, exits, stairwells and elevators are required to “Adopt an Exit.” Monitoring these accesses is important to ensure all suspicious activity is reported immediately.

Code Lockdown: This code is enacted when there is a “potential or active shooter.” If involved in a code lockdown at the point of origin, Dial “9-then 9-1-1, and the internal emergency number X8888 (MMC) or X7777 (OMC), X8888 (NMC) as soon as possible, advise telecommunications from the nearest safe area. Stay on line if possible to provide further information. Seeking safe shelter within the building, assisting patients and visitors, as necessary, are what all employees are instructed on. An “All Clear” will only be called by the Security Department.


Workplace Violence

There are three regulatory agencies that require Atlantic Health to work to prevent workplace violence: OSHA, Joint Commission, and NJDHSS.

Workplace Violence is defined as any physical assault, threatening behavior, or verbal abuse occurring in the work setting.
Atlantic Health has a policy on Workplace Violence that prohibits conduct that includes threats, threatening language, or other any aggressive behavior including verbal or physical harassment. Disciplinary actions up to and including termination may be initiated after investigation of a claim of workplace violence. Also, any employee who makes false accusations will be subject to similar disciplinary actions. Atlantic Health completes an annual risk assessment, analyzes reportable incidents, and does workplace violence training.

All incidents of workplace violence should be reported to security.

With regard to patients and patient families, a Code White should be called when the caregiver feels a patient’s behavior presents an imminent danger to self, others and/or property. Call X8888 (MMC) or X7777 (OMC), X8888 (NMC) to issue a Code White.

Mandatory Education Review
1. The Atlantic Health Exposure Control Plan is available to all hospital personnel on the hospital Infection Control intranet site or in hard copy in the libraries of the hospitals.
TRUE__________ FALSE__________
2. Bloodborne Pathogens (BBP) exposure can occur through sharps injury, scalpel, or anything that can pierce the skin.
TRUE__________ FALSE__________
3. Following standard precautions includes washing your hands and personnel protective equipment (PPE) to reduce exposure risks.
TRUE_________ FALSE__________
4. Contaminated body fluids may be disposed of in regular medical waste containers.
TRUE__________ FALSE__________
5. Particulate respirators must be worn when entering patient rooms on airborne precautions.
TRUE__________ FALSE__________
6. Caregivers are not required to have an annual tuberculin test.
TRUE__________ FALSE__________
7. Hand washing or using alcohol rubs is the number one way to prevent the spread of infection.
TRUE__________ FALSE__________
8. Isolation precautions are only required to be followed by employees.
TRUE__________ FALSE__________
9. Only Security has a role in the Atlantic Health’s Emergency Management Plan.
TRUE___________ FALSE__________

10. Match the following codes:

a. Pass, Aim, Switch, and Spread

b. Pull, Aim, Squeeze, Sweep

NAME:__________________________________ DATE:________________________


(To review the answers to this quiz, please see the following page)

Answers to Quiz

Mandatory Education Review

1. The Atlantic Health Exposure Control Plan is available to all hospital personnel on the hospital Infection Control intranet site or in hard copy in the libraries of the hospitals.

9. Only Security has a role in the Atlantic Health’s Emergency Management Plan.

10. Match the following codes:

a. Pass, Aim, Switch, and Spread

b. Pull, Aim, Squeeze, Sweep

ATLANTIC HEALTH SYSTEM

INFORMATION SECURITY AWARENESS
Introduction –

Welcome to the Atlantic Health System, Information Security Awareness training module. This mandatory training course has been designed primarily for non Full time, Part time or Per Diem workforce members. Examples of who are required to complete this training include (but are not limited to); business partners, nursing students, volunteers and contractors or consultants. This would include anyone with electronic access to Atlantic Health Systems either on the property of one of our facilities or someone requiring remote access to Information Resources. At the end of the course you will be required to agree to a “Statement of Understanding” assuring that you have viewed the course and understand your responsibilities in assuring we maintain a secure environment.

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  If you will be using a non Atlantic Health System (AHS) issued device such as a laptop computer you will only have access to the AHS “Guest” wireless network
  
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  At no time will you be permitted to plug a non-AHS issued/managed laptop into our “wired” network or connect to the AHS wireless business network.
  
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  If necessary you will be provided an AHS loaner laptop if deemed a requirement during your engagement. This should be discussed with the Manager you will be reporting to prior to beginning your assignment.
  
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  If a non-AHS issued laptop is used to store any type of proprietary AHS data it must have full disk encryption installed. In addition all security updates must be current and Anti-Virus software must be installed with the most recent virus definitions.
  
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  Removable media such as CD’s, DVD’s, flash drives or portable hard drives are utilized to store any AHS proprietary data they must be encrypted.
  

Laptops and other mobile devices are expensive and small making them good targets for theft. Some surveys indicate over 10,000 laptops are lost every week in US airports alone.

Studies indicate the cost associated with a lost or stolen laptop containing sensitive information can cost an organization in excess of eight million dollars not to mention reputational damage that is hard to quantify.

Limited incidental personal use of Atlantic Health System information systems, including the telephone is permissible provided that the usage is

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  De minimis – so little that there is no impact on AHS systems
  
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  Does not interfere with job performance,
  
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  Does not impact or affect other Users’ access to the system assets,
  
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  Does not incur significant costs and
  
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  Cannot be reasonably carried out during non-working hours with non-Atlantic Health System Information Assets.
  

Examples of inappropriate use include:

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  Conducting a personal business or performing work for another client while being paid by AHS
  
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  Interfering with Atlantic Health System business
  
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  Illegal activities
  
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  Visiting websites that are sexually oriented, allow gambling, or promote negative beliefs such as hate language, harassment, or threats.
  
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  Using Atlantic Health System computing devices to complete paid surveys.
  

Any inappropriate use of computing equipment is a reportable incident.

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  All activity performed while utilizing the AHS wired or Guest network is monitored and logged.
  
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  There should be no expectation of privacy when using the AHS network. All activity is monitored and logged by Information Security personnel.
  

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  Atlantic Health System maintains multiple technologies to provide remote access
  
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  Services such as LogMeIn, GoToMyPC and Webex are not allowed for remote access into AHS systems
  
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  Work with your AHS manager to have proper remote access setup
  

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  FTP should never be used to transmit any AHS proprietary data as it is sent un-encrypted
  
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  SFTP is an acceptable solution for configuring automated transfers
  
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  Atlantic Health System employs ShareFile for sending or receiving files securely. If you need access to ShareFile please contact the Customer Support Center at 973-971-7272
  

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  If you are issued an AHS email account all outbound messages to recipients who are not part of the AHS domain will be automatically encrypted if they contain PHI or PII.
  
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  Personal email accounts must never be used to conduct AHS business. Only secure email platforms shall be used for email communications. Any email containing PHI/PII/PCI information must be encrypted.
  

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  Any form of a generic account is prohibited for accessing AHS systems. All accounts must be a unique naming convention that links a specific individual to their activity
  
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  All passwords must be complex to include the use of upper and lower case letters, numbers and at least one special character.
  
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  At no time should your credentials be shared with anyone.
  
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  Your computer must be configured to automatically lock the system after fifteen minutes of inactivity. When you step away from your computer the screen shall be manually locked to prevent unauthorized access.
  

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  AHS employs content filtering so not all websites will be accessible.
  
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  All internet activity is monitored and logged
  

With proper authentication and a mobile device, access to sensitive information is available almost anywhere. Personnel with remote access have a responsibility to support our Information Security policies by protecting access to information from outside threats.

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  Encrypt any sensitive information while in transit. This includes transit on physical devices, which are easily lost or stolen such as CDs, thumb drives, and backup disks.
  
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  Email containing sensitive or protected information must use authorized encryption. Contact the ISS Customer Support Center at 973-971-7272 if you need assistance.
  
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  Never use a personal email account to send or receive any Atlantic Health System business. Policies are clear that you may only use your Atlantic Health System email for conducting Atlantic Health System business.
  
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  Authenticate requestors of sensitive information, or refer them to designated employees.
  
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  Do not retain sensitive information longer than needed and dispose of hardcopies using authorized means such as a ShredEx bin.
  
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  Report any suspicious attempt to obtain patient, Atlantic Health System, or employee information.
  
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  AHS automatically encrypts anything copied to removable media such as a flash drive, CD or DVD from an Atlantic Health System owned and managed Information Asset.
  

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  Incident Reporting is a critical element of an effective Information Security program. Reporting what you believe is a small incident may prevent a loss of Atlantic Health System or patient information that can prove costly and cause reputational damage.
  

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  Workforce Members who receive a report of identity theft from a customer must immediately notify Corporate Compliance in writing or e-mail about the report and provide details and any background documentation in support of same.
  

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  Be vigilant, and report any suspicious incident immediately such as missing, lost, or stolen equipment, suspicious visitors, inappropriate requests for information, inappropriate access to sensitive information, or misuse of computing equipment.
  

Everyone with access to Atlantic Health System information systems has a responsibility to follow and enforce Information Security policies and act in a manner that protects information assets.

To protect sensitive information, your responsibilities include:

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  Log off or Lock your computer when it is unattended.
  
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  Report suspicious events and security incidents quickly.
  
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  Never share passwords with anyone.
  
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  Use your Atlantic Health System computer and IT assets appropriately.
  
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  Use best practices to protect Atlantic Health System and patient information.
  
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  Comply with all Atlantic Health System Information Security, Corporate Compliance, Protection and Security Services, HR and ISS policies, which can be found on the intranet.
  

Information Security is a responsibility we all must share. Please sign the attestation on the next page and submit it to the AHS manager you will be reporting to.

Please complete the following and submit to manager:

(Print clearly)

EMPLOYEE ID #:_________________________________________

As a user with access to Atlantic Health System computer systems or data, I understand that I am required to comply with all AHS policies (including Information Security policies)s as well as the information I have reviewed above and report the misuse, loss, abuse, or unauthorized access of Atlantic Health Information Systems. Information Security policies are available via our intranet. Please ask the person you are reporting to for the specific location.

SIGNATURE:_______________________________________ DATE:____________________