emergency preparedness in health facilities first national course on public health emergency...
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Emergency Preparedness in Health Facilities
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Learning Objectives:After the session the participants will be able to:
1.Define the common terms being used in Hospital Emergency Management2.Explain the concept of “Hospitals Safe from Disaster” concept3.Discuss the Structural, non-structural, and functional capacity of hospitals in managing emergencies or disaster4.Elaborate the concept of “Surge Capacity”5.Discuss hospital capacity to prepare, respond to, and recover from emergency or disaster6.Explain Health Care Facility emergency management planning process
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Health Facility building where medicine is practiced
Health care facility medical building structure that has a roof and walls and stand more or less permanently in one place
Hospital a health facility where patients receive treatment
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Hospital - a health facility where patients receive treatment
Physical structure Health systems health workforce and other resources
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Q & A
What are the types of hospitals in Omanand describe?
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Types of hospitals
1. Primary Hospitals
2. Secondary Hospitals
3. Tertiary Hospitals
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Q & A
What are the roles of these hospitals during emergencies?
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Significant Roles of a Hospital in Emergency or Disaster
Receiving end of victims
Responders to emergencies/disasters
Direct life saving roles
Symbol of social progress
Prerequisite for social stability and
economic development
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Public health roles of hospitals
Offers curative, rehabilitative and preventive medical services
Host to public health reference laboratories Contribute to diagnosis, prevention and
control of diseases Signal early warning of communicable
diseases Resource Center for public health education Centers for research
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Hospital Safe from Disaster
that which health services remain accessible and functioning at maximum capacity during and immediately after disasters/emergencies
Will not collapse in disasters killing patients and staff; will be able to continue to function and provide critical services in emergencies; will be organized, with contingency plans in place and health personnel trained to keep the network operational
Hospital safe from disaster must be structurally, non structurally and functionally sound
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Paradigm Shifts in Emergency Management
Organizational shift
Emergency preparedness over response
Altered standards
From quality to preparedness, to safety and resliency
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
New Facilities:Risk reduction in designand construction
Existing Facilities:Improve non-structural andfunctional vulnerability
Critical Facilities:Legislation & financialmeasures to retrofit
THREE SITUATIONS INTHREE SITUATIONS INPROTECTING HEALTH FACILITIESPROTECTING HEALTH FACILITIES
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
1. Ensure structural resilience to protect the life of patients and staff
2. Ensure functional continuity of hospital services in the aftermath of emergencies and disasters
3. Ensure that hospitals have risk and emergency management capability to operate in emergency settings
4. Multidisciplinary involvement in identifying and reducing risk as well as resilience building
Objectives of “Safe Hospital”
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Objectives of “Safe Hospital”
5. Protect the lives of patients and health workers by ensuring structural resilience of health facilities
6. Ensure health facilities and services function in the aftermath of emergencies when they are most needed
7. Improve risk reduction capacity of health workers and institutions including emergency management
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
What are the essentials in supporting Safe Hospitals?
1. Buildings - location, design specification, and resiliency of the materials used
2. Patients: increased in times of disaster
3. Hospital beds – availability of beds decreases as the demand of emergency care increases
4. Medical and support staff – loss or unavailability of personnel disrupts the care of the injured
5. Equipment and facilities – damage to non-structural elements can surpass the cost of the structure and
can force the hospital to halt operations
6. Basic lifelines and services – hospital’s ability to function relies on other basic services
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Three elements of safe hospital
Safe Structure
FunctioningFacilities
Prepared Staff
SAFE HOSPITAL
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
I. Structural Components of hospital
• those that resist gravity, earthquakes, wind and other types of loads• load bearing components that make a building stand• Include the following:
– columns (posts and pillars)– beams (girders, joists)– walls that strengthen the infrastructure
• Product of Structural Engineers, masons, labor contractors
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
II. Non-structural Parts of hospital• all non-load bearing parts including content of the building or attached to the structure• Includes:
– ceilings, windows– equipment– HVAC (heating, ventilating, air con)– furnishings, lights, etc
• Done by:– Architects, interior designers– Mechanical and electrical engineers– purchased by owners after construction
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
III. Functional components of hospital
• Include physical design, maintenance, and administration– the site, external and internal
distribution– of space, access routes
• Ensure that hospitals continue operating when most needed
Hospital workforce – the people involved in the
hospital emergency operations
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
III. Functional elements of hospital
To ensure that health services will keep running to meet the demands of the community at a time when these are most needed:
1. General physical layout of the facility including its location, accessibility, and the distribution of areas within the facility
Ex. Near good roads with adequate means of
transportation
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Accessibility
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Emergency Room
- Proximity of service areas to diagnostic and ancillary services
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
2.Individual services vital to the continuous operation of the facility
both medical (equipment and supplies) and non-medical (utilities, transportation and communication)
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
3. Public services and safety measures available inside the facility
Hospital service area Hospital zoning (interoperability) Facility’s design Systems, plans, policies, SOPs, etc
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Hospital Operation during disaster depends on:
1. Organizations2. Systems3. Resources4. Relationship
These elements are interdependent and interoperating
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Organizations:
• Designated/organized body
• Defined organizational structure
• Authority and control
• Clear roles and directions
• United action or functions
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Systems:
• systems operating at each administrative level
• systems to manage specific types of risks (hazards and vulnerabilities)
• systems for specific functions or services
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Resources: People
People contribute to organizations and systems by providing:
• skills, knowledge and attitudes • Competency
Capacity: Trained people
• Organized Emergency Response Teams• Trained volunteer and community• Competent managers, coordinators, responders• Skilled response team members
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Resources: Peso and logistics
Peso (Financial) Budget is a necessary support in running emergency management operation
Logistics• Supplies, Materials, Equipment• Drugs/Medicines• Transport• Infrastructures
Together they build the machineries for emergency management operation
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Relationships
• Alliance building
• Coordination, collaboration
• Network building
• Gaining political will and support
• Social mobilization
• Sharing of good practices
• Integrated and coordinated response
• Delivery of package of services
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Elements of Functionally Safe Hospital
1. Policies2. Guidelines3. Procedures4. Plans5. People6. Peso/logistics7. Partnership8. Promo/Advocacy9. Practices10. Performance
Organization
Systems
Resources
Relationships
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Indicators of Functionally Safe Hospital
A. Site and Accessibility
1. No obstructions2. Access to good road and transportation3. Separate ingress and egress routes4. Presence of directional signages 5. Corridors, hallways and aisles must be 2.4 meters in width6. Presence of ramps7. Available stairways with railings8. Available safe parking lots
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
B.Internal circulation and inter-operability
1. Nurses at Stations can oversee the wards and accessible to patients
2. Proper zoning of service areas a. Departments most closely linked to the community
are best located nearest to the entrance (OPD, ER, Admin., Primary Health Care support)
b. Departments that receive their workload from above should be next closest to the entrance (Radiology, Laboratory)
c. In-patient departments should be in the interior zones or wards
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
B.Internal circulation and inter-operability
3. Gender based wards and sanitary toilets
4. Secured and under control points of entry
5. General services areas are located in a separate structure to house: power plant, boilers,
water storage facilities, kitchen, laundry area, and
communications center
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
B.Internal circulation and inter-operability
6. Identified spaces to be converted to accommodate
patients during disaster situation
7. Morgue is located separately from the service areas
8. Diagnostic areas with heavy equipment arepreferably at the ground floor
9. Available/identified evacuation/holding area
10. Laboratory, Radiology, and Radio-nuclear diagnostic
units are restricted areas
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
C. Equipment and Supplies
1. Available basic equipment should be available at least one set per ward or treatment area
2. Presence of inventory of these sets of diagnostic and therapeutic tools which are functional and properly labeled
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
D. Hospital Emergency Management Policies, Guidelines, Procedures, and Protocols
1. SOP/Guidelines on Infection Control
2. Decontamination Procedures/Guidelines
3. SOP for internal and external referral of patients
4. Emergency /response Procedure/Guidelines
5. Treatment Guidelines/Protocols
6. Special Administrative Procedures for Disasters
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
D. Hospital Emergency Management Policies, Guidelines, Procedures, and Protocols
7. Procedures for resource mobilization (funds, logistics,
human resources)
8. SOP for admission to emergency department
9. Procedures to expand services, usable spaces and beds,
in case of surge of patients
10. Procedures to protect patient’ records
11. Procedures for regular safety inspection by appropriate
authority and preventive maintenance
12. Procedures for hospital epidemiologic Surveillance
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Hospital Emergency Management Policies, Guidelines, Procedures, and Protocols
13. Procedures for preparing sites for temporary placement of dead bodies for forensic medicine
14. Procedures for transport and logistic support
15. SOP/guidelines for food and supplies of hospital staff during emergency
16. Measures to ensure well being of additional personnel mobilized during emergency
17. Procedures for response during evening, weekend, and holiday shifts
18. Guidelines for Mental Health and Psycho-social Support
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
E.Hospital Systems
1. Logistics Management System
a. System for estimating drug requirement, maintaining
an inventory, storing and stocking, issuing and controlling the use of drugs
b. Stockpile of emergency medicines
c. Special arrangement with vendors/suppliers for emergency purchase in times of disaster
d. Allotting contingency fund for emergency purposes
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
E.Hospital Systems
1. Logistics Management System
e. System of rotating items that will expire first while placing in stock those with later expiration
dates
f. Process allocating resources and recording utilization
g. Presence of Emergency Kits
h. Presence of adequate blood bank facility with SOP or
guidelines on correct storage and handling of blood and
blood products and quick procurement in emergency
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
2. Water Supply System
a. Presence of adequately safe and potable water in times of emergency at 5 liters/out patient/day and 40-60 liters/in-patient. And Addition liters for laundry, flushing toilets and other utilities
b. Presence of alternate source of water in case the main supply is cut off
c. Identified agencies responsible for timely restoration of water service, supplementary pumping system in case system fails or services disrupted or alternative water supply system
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
3.Electrical Systems
a. Hospital’s electric supply in terms of amperage or cyclage
b. Location of control panels and power distribution lines should be marked in the floor plan
c. Presence of emergency power generator or alternative power for emergency lighting and operation of
essential equipment
d. Generating set should be located on the premises but not adjacent to the OR or ward areas.
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
3.Electrical
e. Recommended circuits to which power should be provided:
i. Lighting:
All exits, including exit signs, stairways and corridors
Surgical, obstetrical and ER operating lights Nursery, laboratory, recovery room, ICU, nursing stations, labor room, and pharmacy Generator set location, electrical switch-gear
location, and boiler room One or two lifts, if needed for emergency Telephone operator’s room Computer room
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
3.Electrical ….
ii. Equipment
- Nurse’ call system - Alarm system, including fire alarm - Fire pump for central suction system - Blood bank refrigerator - Sewerage or pump lift system - Equipment necessary for maintaining
telephone service - Equipment in operating, recovery, intensive
care and delivery rooms - One electrical sterilizer if installed
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
3.Electrical
iii. Heating, cooling, and ventilation system
- OR, DR, LR, RR, ICU, Nurseries, and patients’ rooms
g. Emergency lights should be available for use during
the period of transfer switching. They should not
substitute for the generator
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
A. Medical Gases Distribution System
a. Properly maintained medical gas
b. Tanks and /or medical gas pipes regularly inspected for good condition
c. For piped-in gases, there should be safety
d. valves installed to prevent leakage
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
5. Early Warning System and Safety Equipment
a. Signs in the hospital should indicate the location of escape routes and fire-fighting equipment
b. There should be a building layout diagram provided for easy identification where to go during evacuation
c. There should be smoke detectors at proper intervals to cover the entire building
d. Regular checks of the detectors must be done to ensure that these are functioning and they have adequate power supply
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
5. Early Warning System and Safety Equipment
e. Available, visible, and accessible equipment for local fire control which includes fire hoses and fire
extinguishers which should be placed strategically, in corridors, exit routes, and at the entrances to high-risk rooms such as laboratories
f. Regular maintenance is mandatory especially the fire extinguishers, the contents of which expire over time and must be replaced regularly
g. Guidelines for proper placement of fire detectors and fire fighting equipment
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
6. Security System
a. Available security unit in the hospital
b. SOP/Protocol on tightening of security in certain high-risk areas such as the main entrance and exit points, storage areas for controlled substances and volatile chemicals, and areas containing high-value medical equipment
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
7.Transportation and Communication System
a. Available back-up communication facilities (cellular phone, handheld radios, satellite communication facilities, etc)
b. Available equipped ambulances for transport of casualties from the field to the hospital, for moving patients to other facilities in cases of referral or overload, or for evacuating and relocating a hospital service
c. List of identified available and capable ambulances for
use during emergency
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
8.Public Information
a. Presence of established Public Information Center
where public can go to request information concerning family members
b. Public Information Center is coordinated by a social
worker and staffed by personnel or volunteers
c. Available public awareness and public education campaign with warning messages or risk communications
d. Procedures for communicating with the public and
media
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
9.Hospital Emergency Incident Command System
a. The Chief of Hospital as the Incident commander and other staff to fill up the position of the Incident Command Structure
b. System of activating and deactivating the Incident Command System
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
10. Hospital Early Warning and Code Alert System
a. Hospital alert in order for hospital to prepare and mobilize resources in response to early warning signs or signals
b. System of recalling of staff and positioning them for possible response to emergencies
c. System of activating and deactivating the Code Alert
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
11. Information Management System
a. Preparation of a census of admitted patients and those referred to other hospitals
b. Proper recording and reporting using standard forms
c. Ways of sharing information with proper authorities
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
F. Operational Plan for internal or external disasters Contingency Plans and Business Continuity Plans
1. Available, accessible, tested, updated and disseminated HEPRRP which contains Hazard
prevention and mitigation Plan, Vulnerability Reduction Plan and Capacity Development Plan.
2. Plan includes developed systems, guidelines, SOPs and protocols for emergency management
3. Evacuation plan in times of emergency
4. Plan for expansion of services in times of sudden surge of patients
5. Procedures to activate and deactivate the plan
6. Contingency Plans and Business Continuity Plans
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
G.Plans for the operation, preventive maintenance, and restoration of critical Services
a. Electrical supply and back-up generatorsb. Drinking water supplyc. Fuel reservesd. Medical gasese. Standard and back-up communication systemsf. Wastewater systemsg. Solid waste managementh. Maintenance of fire suppression system
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
H.Human Resources
1.Organization of Hospital Disaster Committees and Emergency Operation Center
a. Crisis Management Committee b. Emergency Response Teamc. Health Emergency Planning Group d. Safety Committee headed by a Safety Officere. Hospital Operation Center – headed by HEM
Coordinator, monitors incidents of emergency or disaster, dispatches response teams, mobilizes other emergency resources, operational 24/7, has designated office or unit equipped with communication facilities, and computer system, directories and with alternate communication system
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
2. Capability Building of Personnel
a. 100% of health workers trained in BLS-CPR b. 100% of health workers trained in SFAc. ER medical staff must be trained in ACLS and PALSd. Hospital Responders must be trained on EMRTe. Hospital managers must be trained on HEICS
3. Drills and Exercises
a. Conduct of Fire drills at least once a yearb. Conduct of simulation drills or exercises at least once a year
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
I. Availability of medicines, supplies, instruments, and other equipment for Disasters
a. Emergency medicines at ER and critical service areas b. Items for treatment and other suppliesc. Instruments for emergency proceduresd. Medical gasese. Ventilatorsf. Electro-medical equipmentg. Life support equipmenth. Personal Protective equipment for epidemics (disposable)i. Crash cart for cardio-pulmonary arrestj. Triage tags and other supplies for managing mass casualties
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
J. Monitoring and Evaluation
a. Conduct of post-incident evaluation of emergencies or disasters responded
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Preparedness measures to build capacities to respond to, and recover from emergencies
Capacityability to manage risks by:
•reducing hazards•reducing vulnerabilities•reducing consequences by responding to, and•recovering from emergencies
In terms of:•Organization; systems; and resources
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Hospital emergency Preparedness, Response and Recovery Plan
1. Emergency Preparedness Program or A risk reduction program includes:
A hazard prevention program
A vulnerability reduction program
An emergency preparedness program (or capacity development program)
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Capacity is directly associated to emergency preparedness
10 elements of Emergency Preparedness:
• Legal framework• Policies• Guidelines• Procedures•Plans• Knowledge• Attitude• Skills• Resources
Organizations
Systems
People and other resources
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Emergency Preparedness Program
Program to build response capacity of the hospital1. Policies, Protocols, Guidelines and Procedures
2. Plans
3. People
4. Promotion and Advocacy
5. Partnership Building
6. Physical (Facility Enhancement)
7. Program Development
8. Practices
9. Peso and Logistics
10. Package of Services
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Water tank has provision of bolting
at the base but nor bolted
The machine fixed to the floor by casting concrete base
Risk Reduction Program
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Bolting tall and narrow objects to the wall to avoid overturn
Cylinder chained to save from falling
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Chaining of equipment on the
bed like oxygen cylinder
This hanging light fixture needs extra support to keep it free from falling
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Window glass can cause risk: plastic lamination prevents risk
Equipment on trolleys in OR: tie on steel frame to save from falling
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
These are volted to the wall to prevent from rolling or tumbling down
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
ER Pharmacy ER Laboratory
Chemical and bottles on shelves pose risk of falling: strapping the shelves with nylon rope after anchoring the rack to the wall make this safe
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Chaining of equipment to prevent from falling
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
2. Emergency Response Plan
to use existing response capacity, includes :
Policies for direction and plans to be activated Systems and Procedures to be activated/implementedOrganized team to respond to emergenciesAvailable logistics and funds for the operationEstablished networks for emergency management
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Emergency Response PlanA. Activation of Code Alert System
B. Activation of the Plan
C. Activation of the ICS
D. Activation of the Operation Center
E. Implementation of the RESPONSE Standard
Operating Procedures/ Protocols for Internal and
External Emergencies
F. Implementation of existing Standard Operating
Procedures
G. Initiation and Maintenance of Coordination and
networking for referrals of cases
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Emergency Response Plan
H. Initiation and Maintenance of Mental Health and Psychosocial Support Services for casualties, patients, hospital staff and other responders,
bereaved
I. Management of Information
J. Activation of plan in the event of complete isolation of hospital for auxiliary power, water and food rationing, medication/ dressing rationing, waste and garbage disposal, staff and patient morale
K. Provision of the Public Health Services of the Hospital
L. Management of the Dead
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
3. Recovery and Reconstruction Plan
A plan to restore services and replace damaged elements of hospital for the better
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
3. Recovery and Reconstruction PlanEx. of Recovery/Rehabilitation Planning Activities
Damage and needs assessment Post Incident Evaluation Documentation of lessons learned Research and development Review and update of HEPRP Psychosocial interventions Repair of damaged health facilities and lifelines Replenishment of utilized resources Awarding and Recognition Rites for the major key players Provision of overtime compensation to the responders
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Form Planning Group
Hazard Analysis
Develop Strategies andSystems
Describe ManagementStructure
Describe Roles andResponsibilities
Emergency Planning
Process
Define the plan
Analyze resources
“Hospital Emergency Preparedness, Response and Recovery Plan Development ‘08”
Vulnerability Analysis
Risk Analysis
Problems/Gaps Analysis
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Elements of Hospital Preparedness, Response and Recovery Plan
I. BackgroundII. Plan descriptionIII. Goals and objectivesIV. Planning GroupV. Emergency Preparedness Plan
Hazards prevention Vulnerabilities reduction Risk reduction
VI. Management StructuresVII. Roles and responsibilities
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Elements of Hospital Preparedness, Response and Recovery Plan
VIII. Hospital Response Plan Policies, guidelines, protocols for the developed
systemsIX. Recovery and Reconstruction PlanX. Annexes
GlossaryAbbreviationsDirectory of contact personsInventory of resources of hospital and partner agenciesHospital policies, guidelines, protocols, and other
issuances relevant to emergency or disaster management
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
HospitalSystem
Health System
Epidemiology andSurveillance
Prevention and Control of Communicable Disease
Food and Water andNutrition Sanitation
Preparedness
Response
Recovery
Health System
1. Service delivery2. Health workforce3. Information4. Medical products and
technologies5. Health financing6. Leadership/governance
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
The Planning Process Determine the authority responsible for the process Establish a planning committee and objectives; management structure of the processAssign responsibilities Conduct a risk assessment - hazards and community vulnerabilities (core elements) Identify and analyse capacities and resources Stakeholders analysis Develop strategies, emergency management systems and arrangements Document the plan Test the plan; Disseminate the plan Review and update the plan on a regular basis
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
What is Medical Surge Capacity
The ability to provide adequate medical evaluation and care during events that exceed the limits of the normal medical infrastructure of an affected community
Medical surge capacityEvaluate and care for increased volume of patientsExtend beyond direct patient care
Medical surge capabilityThe ability to manage patients requiring unusual or very specialized / medical evaluation and care
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Integration strategy (within the MOH)
scalability of the response
Inter-sectoral cooperation
Planning based on existing resources (all types)
Decentralization of the response capacity
Community participation (and end-users)
Institutionalization of an emergency/disaster Unit within
the MOH
Promoting risk reduction activities
Overall strategy of the MOH for enhancing readiness (contribution to surge capacity)
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
“OPD” capacity …. a pre-established strategy
Intended to serve outpatient needs in events with sharp increase for medical care delivery
Functions can include:o distribution of self-help information and
instruction for home careo triage for large numbers of people seeking care
(lightly injured or for non urgent medical problems)
o distribution of mass prophylaxis During an infectious disease event, ill or infected
individuals should not be in contact with individuals seeking information or coming to a mass prophylaxis centre
Example: Neighborhood Emergency Help Centre as a alternative to hospital based OPD
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Community “acute care” centre (1)
• Provides medical care in a community-based setting
• Provides limited care to patients that generally would require short hospitalization (non emergency patients)
• Designed to provide the most good for the greatest number of people when there are limited resources
• Designed to care for patients until the healthcare system (mainly hospitals) can take care of the extended load
• The ACC may provide mass isolation of individuals who cannot be isolated in their own homes
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Community “acute care” centre (2)
• Pre-established strategy for staffing; pre-positioning of equipment; logistics; communications; security
• Importance of developing MOU with main stakeholders and surrounding HCF (provision of medical support / supplies / referral system / coordination / functional working relationships with hospital OPD and neighborhood emergency help centre / home care )
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Buildings opportunities for opening an community acute care centre
• Large facilities, not normally used for health care services, but which have the basic utilities needed to support medical functions
• Ideally have internal systems to handle medical oxygen and vacuum capability – but this is unlikely
• Common buildings of opportunity include schools, gymnasiums, and community centers
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Field Hospitals and mobile hubs as contribution to surge capacity
1. A mobile, self contained, self-sufficient health care facility capable of rapid deployment and expansion or contraction to meet immediate emergency requirements for a specified period of time (WHO)
2. Use of “local” Field Hospitals or mobile “hubs”
3. Possible use of Foreign Field Hospitals (in major disasters as offered by countries willing to assist)
o Essential requirements
o Optional criteria
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Surge Capacity in pandemic
Efficient use of hospitals:
– expanding the capacity– releasing capacity by prioritizing services– prioritizing patients and clinical
interventions to control demandReinforcement of out-of-hospital treatment
capacity– triage and referral systems– alternative treatment sites– cooperation of all stakeholders
Whole-health approach (vaccines; prophylaxis; etc.)
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Exercise: Preparation for the Field Visit:Objective:
To assess the structural, non-structural, and functional capacity of hospital in managing the risks of disasters
Mechanics:Develop your assessment tool for the following:
i.For structural capacity assessmentii.For non-structural capacity assessmentiii.For functional capacity assessment
Elements of preparedness (program) Response Plan Recovery Plan Contingency Plan Business Continuity Plan Surge capacity Management
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman
Thank You!