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Hazard and Vulnerability Assessment

OSHA Training Institute – Region IXUniversity of California, San Diego (UCSD) - Extension

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Discuss methods of conducting a hazard vulnerability analysis (HVA)

Identify how the HVA is applicable to preparedness and evacuation

Practice effective training techniques in conducting a HVA

Objectives

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The HVA and the Relationship to Evacuation

The HVA is a tool used to evaluate the potential risks for a facility

It is not an evaluation of the potential for evacuation

However, risks identified in the process may focus the organization toward the need to mitigate and prepare for circumstances that could include evacuation

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The Purpose of the HVA

The purpose is a prioritization process that will result in a risk assessment for “all hazards”

The tool includes consideration of multiple factors

The focus is on organization planning and resources and /or the determine that no action may be required. This is an organization decision

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Is this required?

The Joint Commission, previously called the Joint Commission of Accreditation of Healthcare Organizations (JCAHO), requests an HVA for organizations to determine the focus of their emergency planning

There is no specific tool nor method defined

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HVA Categories for Evaluation

There are categories considered in a formal process of assessing an HVA

Most HVA tools include an assessment of the following factors: Probability that an event will occur The risk of disruption to the organization associated

with the event scored as high, moderate or low or a similar description.

The level of preparedness

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Probability of Occurrence

The probability may be based on statistics and objective information but also may be intuitive and highly subjective.

The following factors are often considered: Known risk Historical data Manufacturer or vendor statistics

American Society of Healthcare Engineering 2001

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Historical Data

Natural events Hazardous material

releases Technological

accidents Infrastructure

problems

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Risk Assessment

The risk of an event is assessed based on:Threat to life and/or healthDisruption of servicesDamage for failure possibilitiesLoss of community trustFinancial impact and legal issues

American Society of Healthcare Engineering 2001

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Preparedness

Preparedness of the organization’s ability to manage risks, can include items such as: Status of current plansTraining InsuranceBack up systemsCommunity resources

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Models

There are a number of models for an HVA. Two well known models are from

American Society of Healthcare Engineering (ASHE) Kaiser Foundation

Both models can be adjusted to fit the organization

Security organizations and other vendors also market HVA tools

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Medical Center HVA Model

Kaiser model also includes: Probability Response factors Human, property and business impacts, each

considered as a separate issue

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A Comparison of Threat Events Considered in HVA Models

ASHE Model 2001

Human Events Natural Events Technological Events

Kaiser Foundation Model 2001 Human Events Natural Events Technological Events Hazmat Events

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Natural Events

Risks common to the area or geography of the region, for example: storms, earthquakes, floods, and tornadoes, and other natural causes of damage

The impact may be able to be mitigated or may result in a partial or complete evacuation

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Mitigation Plans for Regions

Other models use sophisticated software to determine the hazards by cities, counties or regional areas

Are used for the development of mitigation plans for multi-jurisdictions

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Drill HVA

Grayville Hospital Location: Grayville, CA; Eastern Sierras Population: 150,000 Description: small town with general

services, small businesses, surrounded by rural areas and ranches

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Grayville Hospital

70 Beds Two story building; 50 years old ED: 5 beds; in West Wing of hospital

West Wing is single story, recently renovated and structurally reinforced 5 yrs ago

ED connected to hospital by an enclosed corridor

Patient units on second floor of hospital

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Grayville HospitalOn the first floor: Six bed ICU/CCU Two room Labor and Delivery Ten bed family unit Small nursery OR:

4 suites, 2 procedure rooms 5 gurney recovery room

Radiology and Laboratory Five Administrative offices

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Why is this Important to Worker Well-being? Preparedness efforts, plans and resources are

directly related to the organization’s HVA Engineering controls may occur as a result of

HVA thus reducing risk for the work force Safety factors are considered Process promotes understanding of current

resources that may not have been known beyond the “expert”

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Evacuation Implications

When a risk is identified in the HVA that would potentially result in an evacuation, the organization should focus on issues that could impact the need to evacuate or to mitigate the risk. Examples: Routes Locations Personal Protective Equipment (PPE) Communication to employees with special needs Special situations - management of family on site

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What Does It All Mean?

HVA tools, used to prioritize specific and overall relative risks, are based on mathematical formulas that are either embedded in the document or managed manually

The factors considered in the assessment includes the assumption that the risk occurs at the worst possible time and with a full patient census

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Summary: What is the greatest risk?

The HVA process helps an organization prioritize in the order of criticality

The efforts to decrease the consequences of a possible event can be focused upon. This includes evacuation.

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Examples of HVA Tools

American Society for Healthcare Engineering of the American Hospital Association www.ashe.org

Kaiser  Permanente’s interactive HVA tool available at: www.emsa.ca.gov/dms2/kp_hva.xls

Emergency Management Program GuidebookPublished by VHA Center for Engineering & Occupational Safety andHealth, St. Louis, MOvaww.ceosh.med.va.gov  

For review of an HVA sample go to:http://www1.va.gov/emshg/apps/emp/emp.htmClick HVA under index link

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References American Society of Healthcare Engineering 2001

WWW.ashe.org FEMA. Emergency Management Institute Hazard

vulnerability analysis and risk assessment. Unit 2 http://www.training.fema.gov/emiweb/EMICourses/E464CM/02%20Unit%202.pdf

Joint Commission Resources Hazard vulnerability analysis (HVA), May/Jun 2002, 2-3

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More References

Kaiser Permanente. Medical center hazard and vulnerability analysis. 2001 Kaiser Foundation Health Plan, Inc.

Schwartz RB. Hospital preparedness for mass casualties in disasters. Institute of Disaster Medicine Medical College of Georgia slide set www.achd.net/swprjttf/pubs/pdf/hospitalprep.pdf