planning for hospital emergency preparedness, response and recovery
TRANSCRIPT
Planning for Hospital Emergency Preparedness, Response and Recovery
INTRODUCTION
Role of Hospitals in Emergency Management (AO 6-B s. 1999)
Hospital shares the goal:
“To promote health emergency preparedness among general public and to strengthen the health sector’s capability to respond to emergencies, disasters or calamities”
Role of Hospitals in Emergency Management (AO 168 s, 2004)
The hospital shares the DOH mission:
“To lead in the formulation of comprehensive, integrated, and coordinated health sector response to emergencies and disasters”
Hyogo Framework for Action (2005-2015)
World Conference on Disaster Reduction in in Kobe, Japan in 2005
One of the key priorities for action “Promote the goal of “hospitals safe from disasters”
Inter-agency Task Force of the ISDR made “Safe Hospital” as the focus of the global risk reduction campaign (2008 – 2009)
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
Role of Hospital in Management of Emergencies
To protect public safety and public health, a hospital and its emergency services need:
• Capacity to reduce vulnerabilities• Capacity to respond• Capacity to recover
From: WHO – PHEMAP Course
“Submission of “Hospital Emergency Preparedness, Response, and Recovery Plan” is a requirement prior to the issuance of new hospital
licenses to operate and renewal of existing licenses”
Bureau of Licensing and Regulation
Risk Management in Hospital Planning
Disaster Management Cycle
Disaster Impact
Preparedness
Response
Recovery
Prevention
Mitigation
Development
Protect life, property, environment
Mitigate loss of services
HEM Planning ?Use efficientlyAvailableresources
PromoteCooperation Among sectors And agencies
Create systems and networks for respondingTo and recovering from emergencies
“Hospital Emergency Preparedness, Response and Recovery Plan Development ‘08”
Preparedness measures to build capacities to respond to, and recover
from emergencies
Capacity ability to manage risks by:
• reducing hazards• reducing vulnerabilities• reducing consequences by responding to, and• recovering from emergencies
In terms of:• Organization; systems; resources and partnership
Emergency Management Plan
An agreed set of arrangements for:
responding to, and
recovering from emergencies
Emergency Management Plan
A plan containing description of:
Responsibilities Command & coordination mechanism Management structures Resource management Information management and communication Training and exercises
Risk Management is a comprehensive strategy for reducing threats and
consequences to public health and safety of communities by:
preventing exposure to hazards (target = hazards)
reducing vulnerabilities (target group = community)
developing response and recovery capacities (target group = response agencies)
Hospital emergency Preparedness, Response and Recovery Plan
1. Emergency Preparedness Plan or A risk reduction plan includes:
A hazard prevention plan
A vulnerability reduction plan
An emergency preparedness plan (or capacity development plan)
Hazard Prevention Plan
plan to prevent exposure to hazards
not all hazards are predictable or preventable
Strategies/activities to prevent exposure to hazard
Vulnerability Reduction Plan
Plan to reduce consequences of exposure to hazards
Identify vulnerabilities specific to the five elements of the community
Strategies/activities to reduce the vulnerabilities
Building resilience of the hospital to withstand impact and consequences of hazard
Emergency Preparedness Plan Plan to build response capacity of the hospital
1. 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
2. Emergency Response Plan
to use existing response capacity, includes :
Policies for direction and plans to be activated Systems and Procedures to be activated/implemented Organized team to respond to emergencies Available logistics and funds for the operation Established networks for emergency management
Emergency Response Plan
use existing capacities to deliver relief or response
mobilization of resources
use of developed systems for emergency management
actual implementation of guidelines/proedures for the developed systems
3. Recovery and Reconstruction Plan
A plan to restore services and replace damaged elements of hospital for the better
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
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
Elements of Hospital Preparedness, Response and Recovery Plan
VIII. Hospital Response Plan Policies, guidelines, protocols for the developed
systemsIX. Recovery and Reconstruction PlanX. Annexes
Glossary Abbreviations Directory of contact persons Inventory of resources of hospital and partner
agencies Hospital policies, guidelines, protocols, and other
issuances relevant to emergency or disaster management
Hospital Emergency Planning Process
I. Background
Write in narrative form the background of your region or agency including the provinces, municipalities/communities within your area of jurisdiction.
Some data are better presented in tabular or graph forms for faster and easier comprehension of the reader or user.
Background
1. Name of the Hospital and address (narrative)
2. Geographic description (location: Low lying area? Etc.)
3. Demographic profile of catchments communities
4. Hospital Profile
5. Health statistics of the hospital (IMR, MMR, etc.)
6. Health facilities found in the municipality/city (tabular)
7. Health services areas/departments of the hospital
8. Manpower complementation of the hospital
9. Disasters responded/managed
10. Legal issuances establishing its authority in HEM
Significance:
a. Picture of the site and location of the hospital
b. Catchments areas provided with hospital services
c. Health resources in and around the hospital
d. Existing capacity and capability of the hospital
e. Partner agencies around the hospital
f. Anticipated hazards as basis for hospitals’ capacity and capability building
II. Plan Definition
Aim, objectives, and scope
Tasks to be performed
Resources to be needed
Framework which emergencies will be managed
Plan Definition
Brief description of the content of the plan Specific intentions relevant to set goals and objectives. Include the coverage, scope and limitations. Include the legal basis whereby the hospital is authorized
to act in disaster situations Legal issuances detailing the roles and functions of hospitals in managing all phases of emergencies or
disasters
Example: PLAN DEFINITION
The JRMH Health Emergency Preparedness and Response Plan defines the direction of the hospital in preparing for an effective and efficient response in any event of emergency or disaster. This embodies a set of strategies and activities based on the hazards and
vulnerabilities or risk analysis of the hospital.
Example: Context of JRMH HEPRRP
The JRMH Preparedness Plan contains strategies & activities that the hospital will carry out to build and enhance hospital capacity to respond to emergency or disaster, whereas its Response Plan includes strategies and activities in utilizing hospital resources for effective and efficient response during emergency or disaster. Likewise, this Response Plan includes policies, protocols, guidelines and procedures pertaining to various emergency management systems for more efficient response. The third set is the Regional Recovery or Rehabilitation Plan which entails strategies and activities in mainstreaming the hospital back to its prepared position for any forthcoming eventuality.
The JRMH Emergency Preparedness and Response Plan includes the inventory of its internal and external resources, in terms of inventory lists and directories, in the context of human resources, logistics, financial sources, existing systems and services. These are all found in the annexes of the plan.
Scope of the Plan
This Plan shall be implemented, by the JRMH together, (but not limited) with all other members of the regional hospital network concerned with emergency or disaster management.
Significance: Who will implement the plan Extent of implementation including limitations
III. Goals and Objectives
Gives the purpose of the plan from a broader to more specific perspectives.
Example :Goal: To build the hospital capacity for effective and
efficient response to and recovery from emergency
Objectives: To strengthen the hospital HEPRRP To develop systems and guidelines for emergencies To develop human resource competencies To upgrade hospital facility for better services To ensure availability of funds and logistics in times of
emergency or disaster
IV. Planning Committee
Hospital Planning Committee include major stakeholders
Permanent or “AD HOC Group” which convenes only for hospital emergency planning purposes.
This group shall be created through a hospital order. Roles and functions of the planning group/committee
Develops, reviews and updates the HEPRRP Gathers required information and gain commitment
of key people and organizations Initiates testing of the plan for its functionality and
adaptability to current situation
i.
Example: Planning Committee Structure
Hospital Director/CMPS/HEMS Coordinator Representative from Planning Division Representative from Administrative Division (especially
finance and logistics officers) Representative from areas of hospital operation Representative from the community
Hospital Planning Committee Structure
Hospital Director/CMPS/HEM Coordinator
Representativefrom areas of
hospital operation
Representative from
Administrative Division
Representative from Planning
Division
Representative from the
community
V. Emergency Preparedness Plan Development
1. Hazard assessment Identifying all the possible hazards that have the
potential to affect the hospital Identify the possible areas to be affected
Hazards Areas commonly affected
Translate into a Hospital Hazard Map
Example of Hospital Hazard Map
RadiologyLaboratory
Medicine WardPedia Ward
Admitting Sect.
Surgery Ward
Billing Sect.
OPD ER
OB Ward Ortho WardEENT WardOR
Delivery Rm. OR
Urology Ward
Legend:Fire
EarthquakeFlood
Recovery/Rehabilitation Plan
HospitalPeoplePropertyEnvironmentServicesLivelihood(Vulnerable)
Hazard RisksPeoplePropertyEnvironmentServicesLivelihood(Damages Needs)
Capacities usedTo manage Risks
Recovery/Rehabilitation
Emergency
Disaster
Hazard Reduction/Prevention Plan
Hazard Strategies/
Activities
Time
Frame
Resource Requirement Person
Resp.
Indi
catorsReq’d. Avail. Source
Identified Hazards Impact to hospital (Risks)
1. Property: Structural; Non-structural; Funtional
Components
2. People
3. Services
4. Environment
5. Livelihood
Risk Analysis
Risk Assessment
Hazards Vulnerabilities Risks
People
Properties
Services
Environment
Livelihood
Probability of death
Probability of spread of the disease
Prob. Of disease or injury (mental, physical)
Prob. Of contamination
Prob. Of displacement
Prob. Of loss of income or property
Prob. Of breakdown in security
Prob. Of breakdown in essential services
Preparedness PlanCapacity (10P’s)
Hospital weaknesses
Strategies/
Activities
Time
Frame
Resource Req’t. Person
Resp.
Indi
catorsReq’d Avail Source
From the results of the self assessment of the hospital, list down all the weaknesses based on the expected hospital capacities. List down all the strategies and activities to be done for capacity development.
Recovery/Rehabilitation Plan
HospitalPeoplePropertyEnvironmentServicesLivelihood(Vulnerable)
Hazard RisksPeoplePropertyEnvironmentServicesLivelihood(Damages Needs)
Capacities usedTo manage Risks
Recovery/Rehabilitation
Emergency
Disaster
Vulnerability AssessmentImpact to hospital (Risks)
Why did Risks happen?
(Vulnerabilities)
1. Property: Structural; Non-structural; Funtional
Components
1. Property: Structural; Non-structural; Funtional
Components
2. People 2. People
3. Services 3. Services
4. Environment 4. Environment
5. Livelihood 5. Livelihood
Vulnerability Reduction Plan
Hazard Vulne
rability
Strategies/
Activities
Time
Frame
Resource Req’t. Person
Resp.
Indi
catorsReq’d Avail Source
Activities during Response Phase
Utilization of capacities built
Activation of plans and systems developed
Activation of OPCEN
Mobilization of resources
Management of emergency cases
Validation and constant monitoring of the event
Hospital Emergency Management Policies, Guidelines, Procedures and Protocols
1. Available procedures, protocols, for emergency management
a. Security systemb. Public Information Systemc. Incident Command Systemd. Information Management Systeme. MHPSSf. Blood and blood products mobilization
Hospital Emergency Management Policies, Guidelines, Procedures and Protocols
1. Available procedures, protocols, for emergency management
g. Code Alert Systemh. Infection Controli. System to expand services, spaces and beds in case
of surge of patientsj. System on drills/simulation exercisesk. Stockpiling of emergency medicines and supplies
Hospital Emergency Management Policies, Guidelines, Procedures and Protocols
1. Available procedures, protocols, for emergency management
l. SOP on Operation Center
m. Referral System Procedures
n. Logistics management system
o. Decontamination procedures
D. Hospital Emergency Management Policies, Guidelines, Procedures and Protocols
2. Manual for the operation, preventive maintenance, and restoration of critical services
a. Electrical supply and back-up generators
b. Drinking water supply and alternate sources
c. Fuel reserves
d. Medical gases
e. Back-up communication system
f. Wastewater and solid waste water treatment
g. Fire suppression
D. Hospital Emergency Management Policies, Guidelines, Procedures and Protocols
3. Hospital policies on emergency/disaster management
a. Hospital policies related to disaster management
b. Policy on managing volunteers during emergency
VI. Response Plan
A. Management Structures
Incident Commander
Public Info. Officer
Liaison Officer
Safety Officer
Operations Logistics Planning Administrative/Finance
“Hospital Emergency Preparedness, Response and Recovery Plan Development ‘08”
Response Plan
a. 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 Emergencies
f. Implementation of existing Standard Operating Procedures/Guidelines for systems developed
g. Initiation and Maintenance of Coordination andnetworking for referrals of cases
Response Plan
h. Initiation and Maintenance of Mental Health andPsychosocial 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/CHD/community for auxiliary power, water and
food rationing, medication/ dressing rationing, waste and garbage disposal, staff and patient morale
k. Provision of the Public Health Servicesl. Management of the Dead
Recovery/Rehabilitation Plan
HospitalPeoplePropertyEnvironmentServicesLivelihood(Vulnerable)
Hazard RisksPeoplePropertyEnvironmentServicesLivelihood(Damages Needs)
Recovery/Rehabilitation
Emergency
Disaster
Capacities used to manage Risks
Capacities Utilized,
Damaged
Recovery/Rehabilitation Plan
Damages/ utilized
Resource Req’t.
Resp. Person
Time Frame
Indicators
Next Actions1. Write the Plan and have it approved by the head of the
agency. The Plan is not a plan until written and approved by the head of agency
2. Disseminate the plan to all the stakeholders and staff. Everyone needs to know the plan so that in emergency no one would ever say, “he does nothing cause he knows nothing”.
3. Test the plan. The plan is believed to be effective only when it is tested, be able to know its functionality, acceptability, and doability in the hands of the implementers.Update the plan
4. Implement the plan. 5. Monitor and evaluate the implementation of the plan6. Review and update the plan regularly.
Thank You!