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PAGING SYSTEM FAILURE
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PRIMARY RESPONSIBILITY
Maintain a functioning paging system to ensure optimal long range and in-house paging capability.

PERSONNEL TO CONTACT

Systems:
Help Desk X3337 or 646-227-3337
Jacqueline Woods, Manager, Telecom Design and Engineering, x123-2325 or x122-2326, p8332, Cell 646-235-1496
John Guy, Senior Network Architect/Engineer, X122-6606 or x123-3031, p2939, Cell 646-879-0886

Operations:
Help Desk X 3337 or 646-227-3337
Pat Black, Manager, Telecom Operations, 123-3790, p3790/917-205-1318, Cell
917-217-6777
Lisa Vreeland, Manager, Call Center X122-3194, p3194, Cell 646-210-3304
Rachel Heftler, Associate Director, Client Services X123-3382, p6090, Cell 917-731-6923

DESCRIPTION OF FAILURE
There are two possible scenarios for a paging system failure; failure of the Zetron (in-house) paging system, or failure of the long range paging system (i.e., satellite malfunction or Siemens System failure).

In-house Paging System Failure
Telecommunications is notified of an in-house paging system failure three ways, when other employees report to operators that test codes are not received, or when the vendor (Zetron) notifies MSK that there is a system wide problem. The third way is the veri-page process. There are two pagers that are attached to the Zetron system. A signal is sent to these pagers every 4 minutes, if the signal is not received an automated phone call is made to the operators that there may be a problem with the system. The call will be repeated every 5 minutes until acknowledged.
System Dependencies:

1. The Zetron Paging System is a computer based in-house paging system with transmitters located on the premises.

2. In the event of a Zetron (in-house) paging system failure, the hospital would utilize the Long-Range Paging System (Long-Range only). The Public Address System would supplement as a means of notifying personnel within the Hospital. An email announcement will also be sent to all MSKCC personnel.

3. The Zetron (in-house) Paging System is dependent on outside vendors and technicians for service repairs; however there is a second fully redundant Zetron system located in Telecommunications. If one system is out of order the second is used.

CODE TEAM NOTIFICATION IS DEPENDENT ON IN HOUSE PAGING SYSTEM
1. If the in house system is down the code team can only be notified by the overhead system, located in MB-42, and an email announcement will also be sent to all MSKCC personnel.

2. Only the telephone operators have access to the public address system.

Long Range Paging System Failure
A Long range paging system failure is usually detected three ways; employees advise the operator that they cannot receive pages, the vendor (USA Mobility) advises MSK of a system wide failure, or the telephone operators receive a build-up of messages when putting calls on hold for people they want paged. The calls ring back to the operator because the party paged did not pick up his/her call (s).
System Dependencies:

1. The long-range Paging System relies on satellite transmission of paging signals. Service restoration is dependent on vendor remediation.

2. In the event of a long range paging system failure, the Zetron (in-house) Paging System may be utilized.

3. The Public Address System and the Alternate (red) Phone System are also utilized to notify personnel within the Hospital.

4. WCTP paging USA Mobility is paging through the network.

HICS TEAM NOTIFICATION IS DEPENDENT ON LONG RANGE PAGING SYSTEM
1. Dual pagers are those with both in-house and long-range capacity.

2. ALL HICS TEAM MEMBERS CARRY DUAL PAGERS. A long range paging system outage leaves MSK unable to issue alert pages to the HICS Team.

3. In this instance, HICS Team members would be notified via phone.

4. As a back-up, the HICS Team has been issued Nextel radios for everyday and emergency use.

5. The long-range Paging System is dependent on the outside vendor to provide an alternate means of communication.

6. Dual pagers may be temporarily turned in for in-house pagers in the event of an emergency.

RESPONSOBILITIES OF KEY PERSONNEL DURING A DISASTER

A. Telecommunications Operators
1. Place service calls with the vendors to find out what the problems are and when they will be fixed. Contact the Help Desk to send out a page to IS Staff.

2. They will then notify the Director, Associate Directors and designated managers of the Infrastructure, Client services and Technical Resources subdivision of Information Systems who in turn will make decisions on notification of the rest of the department and will ensure that we have adequate staff available.

B. Technicians
During normal working hours, technicians are paged to come down to MB-42 and will be made available to assure that if needed they will be able to set up temporary phones or relocate the ones that need to be moved. After hours they are paged and asked to come in.

C. Vendors
If emergency occurs during working hours, MSKCC technicians and vendors are to immediately work on securing the system that is theirs. If the problem is with their system they are to work on getting it operational again. If the emergency occurs after hours, the service reverts to the individual Maintenance/Service contracts, which we have Emergency Service on. They respond within 2 hours for the vendor to come on site, but immediate response to dial into the system and see if it can be solved on line.

D. Management
Telecomm management must report immediately to the telephone room in MB-42, coordinate any moves or changes that need to be done, and distribute the coordinators and technicians to where they should be. If the emergency
happens after hours Management is to come into the hospital and assure the safety of employees and equipment.

MAIN CAMPUS TELEPHONY SYSTEM FAILURE/ALTERNATE (RED) TELEPHONE SYSTEM

PRIMARY RESPONSIBILITY
Provide and maintain an alternate means of communication in the event of a Siemens Telephone System failure the alternate telephone system or red phones will be used. Please note there are three Siemens telephony systems servicing 1275 York, all of which are a mix of TDM and VoIP endpoints.

PERSONNEL TO CONTACT

Systems:
Help Desk X3337 646-227-3337
Jacqueline Woods, Manager, Telecom Design and Engineering, x123-2325 or x122-2326, p8332, Cell 646-235-1496
John Guy, Senior Network Architect/Engineer, X122-6606 or x123-3031, p2939, Cell 646-879-0886

Operations:
Pat Black, Manager, Telecom Operations, 123-3790, p3790/917-205-1318, Cell
917-217-6777
Lisa Vreeland, Manager, Call Center X122-3194, p3194, Cell 646-210-3304
Rachel Heftler, Associate Director, Client Services X123-3382, p6090, Cell 917-731-6923

DEPARTMENTAL PLAN
A. Telephone Operator will notify the Managers of Telecommunications, Siemens Technician and Hospital Technician.

B. The most senior telecom manager on site will maintain constant contact with the HICS Communications Unit Leader to relay system status reports.

C. All personnel will be instructed to use the Red Telephones via the Public Address system. An email announcement will also be sent to all MSKCC personnel.

D. The Public Address System can also be used to page staff; however this method should be used with care to minimize excess overhead announcements.

E. Instructions and guidelines for appropriate use of Red phones in the event of an emergency is found in the institution's Telephone Directory. Staff should always refer to the latest version of the Telephone Directory booklet or web site for the most current list of red phones.

F. Absent Siemens Phones, pages can be issued via the computer based paging application. The computer based paging application is a featured page on the MSKCC intranet. Follow the instructions found on the web site. Keep in mind, text messages MUST be limited to 240 characters.

G. Once the Siemens System has been repaired, notification will be made to IS managers, and an email announcement will be sent to all MSKCC personnel. Also, an announcement can be made over the public address system “Attention, main campus telephone service is now back in working order.”

Important Notes:

Medical or Fire Emergency
In the event of a Medical or Fire Emergency, during a SIEMENS system failure, you should report it to 717-3150 from any Red Phone.

Instructions for Red Phone Use
To place calls outside of MSK or to any 639 extensions from, it is necessary to first dial 9 followed bu the 7 digit number. You may also dial the last 4 digits of the number you are calling if the number is within the same exchange.

Maintenance of Red Phones
Alternate Telephones should be checked periodically by each department to ensure that they are in working order. Broken or missing phones should be reported to Telecommunications at 639-4357. All red phones are tested twice a year by Help Desk Personnel.

RESPONSIBILITIES OF KEY PERSONNEL DURING AN EMERGENCY
A. Operators - It is the responsibility of the telephone operators to make sure that all predefined personnel are notified of a system failure. Telecommunications staff and vendors are to be notified first so that repair is expedited.

B. Technicians - Technicians are to report back to the telephone area so that they can receive trouble calls, etc. from the coordinators and/or operators.

C. Management - Management is to ensure that all personnel is being utilized according to plan and that the vendor is working to fix the problem in a timely manner, and if it cannot be to re-route calls through other channels.

D. Vendor/Siemens - It is Siemens responsibility to fix the problem that is causing the switch to be down.

PATIENT NURSE COMMUNICATION SYSTEM FAILURE

PRIMARY RESPONSIBILITY
Maintain two-way communication between patients, key staff work areas, and nursing station personnel.

DESCRIPTION OF FAILURE
A system failure would normally be isolated to a single floor, area of a floor, or individual room. Nurse call systems are connected to emergency power.

An outage would be detected by unit staff and reported to the Charge Nurse and the Help Desk.

NOTIFICATION PROCESS
A. Notify the Nurse Managers or designee on the affected inpatient unit(s) and the Help Desk.

B. Nurse Manager should notify the Director of Clinical Nursing at x2098.

RESPONSE PLAN
A. The Help Desk will notify Information Systems Field Services group, which is a 24x7 operation.

B. A field service technician will respond immediately and will work to rectify the problem.

C. If the problem cannot be corrected thirty minutes, a wireless backup nurse call system will be deployed by field services. System will remain deployed until the floor nurse call system is returned to normal operation.

D. In the event of a multi-floor problem that extends beyond the capabilities of MSKCC's wireless backup solution (the unlikely scenario of more than two hospital floors being down) staff will be stationed in quadrants on the floor to periodically check patient rooms and respond to patient requests.

a. During the day shift, the Nurse Manager/Charge Nurse will identify available personnel and reallocate them to the affected area.

b. On evenings and nights the Nursing Supervisor will identify available personnel and reallocate them to the affected area.