Disaster Pre-JPATS Patient Evacuation Situation Report
PURPOSE:
The Joint Patient Assessment and Tracking System (JPATS) is an application in the National Disaster Medical System (NDMS) Disaster Medical Information Suite (DMIS) that is designed to track every patient moved by the Federal government from start to finish. JPATS is also used by State and local health departments for their own isolated incidents, for State-to-State responses and for larger events when the Federal government responds. https://files.asprtracie.hhs.gov/documents/jpats-overview-and- factsheet.pdf
When patient movement is requested from a site, this form is aligned with categories and information that the JPATS application requires. This WinLink form can be used to facilitate an initial request for JPATS transport and to begin capturing patient data at the point of origin. Capturing patient data and care documentation early during the initial phase of a disaster response from the patient’s point of origin is something that initial responders can do with this Winlink form.
The purpose of a Winlink form is to provide a standardized format for transmission of this information by emergency communications methods. If the situation dictates, patients could also be listed only by designated unique tracking number, gender, year of birth (age) and withholding the name and full birthdate personally identifiable information when appropriate. That data should be maintained at the site so it can be provided directly to the arriving transport team.
Archived WinLink forms can be used to track patients who have been transported from their points of origin to their entry in JPATS .
NOTES
The form is completed upon decision that first patient may require JPATS transport. It is updated periodically, at least every operational period. If additional pages are needed, use another JPATS form and repaginate as needed.
1. Incident Name:
Enter the name assigned to the incident.
2. Operational Period
Enter the start date (mm/dd/yyyy) and time (24-hour clock) and end date and time for the operational period local time to which the form applies.
3. Site Name
Enter the site location name
Spreadsheet Columns (see notes below)
Tracking Number Enter site tracking number. For example, this may be a field triage tag
number or hospital medical record number, as applicable
Name
Enter the last and first name of patient
Sex
Enter M for male, F for female, or O for patient prefers other gender designation
DOB / Age
Enter complete date of birth OR age, if known
Unaccompanied Minor Yes or No
Patient Type if applicable, 1 – Federal Patient 2-State/Local 3-Federal non-medical 4- State/Local non-medical
Health Status 1-Critical 2-Priority 3-Routine 4-Deceased 5-N/A
Bed Type 1-Med/Surg 2- Psychiatric 3-Burns 4-Pediatric 5-Critical 6- Unknown Injury/Nature Diagnosis or Chief complaint requiring transport e.g. Dialysis
Notes Additional key transport information e.g. ETT, chest tube, burn level, GCS score
Disposition Current JPATS status 1-Staged 2-Registered 3-Departed site or blank Disposition Time
Enter the disposition Time, 24 hour clock.
Prepared by
Enter the name of the person preparing the form. Since this is a radio delivered form, a typed name is same as signature. Enter date (m/d/y), time prepared (24-hour clock), and site/station from which it was sent
More Information
You can save your completed HTML to a text file. This will allow you to reload the JPATS form with ALL entered form data. You do this prior to submitting the form. Then you can open a new 254 and load the saved HTML form data. NOTE: Date and Times will be the previous, so change if needed. This is much like using FireFox and the addon Formlet. It will save the info as a text file with the Date and Time as a file name. Now you can use any browser, save your form, (as many versions as you like), and then re-populate.
This form also allows for pasting data from a spreadsheet with TAB delineation. You would create a spreadsheet to MATCH the HTML template for data in "3. Area". Do not exceed the data entry box input lengths or the info will not be seen properly if printed. You can do 10 columns and up to 10 rows of data. It is suggested you experiment and test to understand how this works. Once mastered it can be a time saver in the field for data entry.
NOTE on printing.
Printing this form is dependent upon your selected printer and its settings. Various Web Browsers and their viewing sizes are not all the same. Printing from a browser’s print function may be different from the operating systems default print mode. Select what works for you, for both printing and viewing. You may print direct to the printer as a HTML or save as a PDF then print the PDF. In some instances, Landscape mode may print better than Portrait.