Hazard Planning for Hospitals Large and Small Darrell Ruby, CEM
Region 9 Coordinator
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Todays Discussion Emergency Planning. Hazard Vulnerability
Analysis (HVA). What is it, who does it, why? Why plan? Planning
references. Federal, State, Local Getting started. HVA Tool.
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Emergency Planning for Hospitals 5 Ws plus. Who should be
involved? What are the requirements? When should you do it? Where
do you begin? Why and How often? What resources do you use?
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Whole Community Unity of Effort Preparedness is a shared
responsibility. Everyone plays a role: Individuals and families,
including those with disabilities or others with access and
functional needs Businesses and nonprofits Faith-based and
community organizations Schools and academia Media outlets All
levels of government
Hazard Vulnerability Analysis (HVA) Hospitals are required to
conduct and annually review their Hazard Vulnerability Analysis
(HVA). The HVA provides a systematic approach to recognizing
hazards that may affect demand for the hospitals services or its
ability to provide those services. The risks associated with each
hazard are analyzed to prioritize planning, mitigation, response
and recovery activities. The HVA serves as a needs assessment for
the Emergency Management program. This process should involve
community partners and be communicated to community emergency
response agencies. It is important to note that cities and counties
are also required to prepare HVAs; the hospital HVA should consider
hazards identified in the community plans that may impact the
hospital. In some communities the hospital and community HVAs are
developed together. Also referred to as Hazard Identification and
Vulnerability Analysis (HIVA) or Threat and Hazard Identification
and Risk Analysis (THIRA) ~ New
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PPD - 8 Presidential Policy Directive (PPD) 8: National
Preparedness was released in March 2011 with the goal of
strengthening the security and resilience of the United States
through systematic preparation for the threats that pose the
greatest risk to the security of the Nation. PPD-8 defines five
mission areasPrevention, Protection, Mitigation, Response, and
Recoveryand mandates the development of a series of policy and
planning documents to explain and guide the Nations approach to
ensuring and enhancing national preparedness.
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National Planning Frameworks
http://www.fema.gov/medialibrary/mediarec ords/11954
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National Preparedness Goal Prevention. Prevent, avoid or stop
an imminent, threatened or actual act of terrorism. Protection.
Protect our citizens, residents, visitors, and assets against the
greatest threats and hazards in a manner that allows our interests,
aspirations, and way of life to thrive. Mitigation. Reduce the loss
of life and property by lessening the impact of future disasters.
Response. Respond quickly to save lives, protect property and the
environment, and meet basic human needs in the aftermath of a
catastrophic incident. Recovery. Recover through a focus on the
timely restoration, strengthening and revitalization of
infrastructure, housing and a sustainable economy, as well as the
health, social, cultural, historic and environmental fabric of
communities affected by a catastrophic incident.
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Mitigation Core Capabilities Mitigation ~ Sustained actions
taken to reduce or eliminate long-term risk to life and property
from hazards.* 44 CFR 201.2 Mitigation Planning - Definitions The
National Preparedness Goal identified 31 core capabilities - these
are the distinct critical elements needed to achieve the goal.
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CPG 101: Developing and Maintaining Emergency Operations Plans
(EOPs) This Guide provides information and instruction on the
fundamentals of planning and their application CPG Comprehensive
Preparedness Guide
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CPG 201: Developing and Maintaining Emergency Operations Plans
(EOPs) Threat and Hazard Identification and Risk Assessment (THIRA)
guide provides a comprehensive approach for identifying and
assessing risks and associated impacts. It expands on existing
local, tribal, territorial, and state Hazard Identification and
Risk Assessments (HIRAs) and other risk methodologies by broadening
the factors considered in the process, incorporating the whole
community throughout the entire process, and by accounting for
important community-specific factors CPG Comprehensive Preparedness
Guide
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CPG 201: Threat and Hazard Identification and Risk Assessment
(THIRA) Five Step Process 1.Identify the threats and hazards of
concern - What could happen in my community? 2.Give the threats and
hazards context - Describe how a threat or hazard could happen in
my community, and when and where it could happen. 3.Examine the
core capabilities using the threats and hazards - How would each
threat or hazard affect the core capabilities identified in the
National Preparedness Goal? 4.Set capability targets - Using the
information above, set the level of capability a community needs to
prevent, protect against, mitigate, respond to, and recover from
its risks. 5.Apply the results - Use the capability targets to
decide how to use resources from the Whole Community. CPG
Comprehensive Preparedness Guide
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Local Mitigation Planning Handbook Handbook highlights case
studies and tools for community officials providing practical
guidance on how to incorporate risk reduction strategies into
existing local plans, policies, codes, and programs that guide
community development or redevelopment patterns. Task 5 Conduct a
Risk Assessment
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Defining Risk Assessment Illustrates the concept of risk as the
relationship, or overlap, between hazards and community assets. The
smaller the overlap, the lower the risk.
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Risk Assessment Terminology Natural hazard source of harm or
difficulty created by a meteorological, environmental, or
geological event. Community assets the people, structures,
facilities, and systems that have value to the community.
Vulnerability characteristics of community assets that make them
susceptible to damage from a given hazard. Impact the consequences
or effects of a hazard on the community and its assets
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Risk Assessment Terminology (Continued) Risk the potential for
damage, loss, or other impacts created by the interaction of
natural hazards with community assets. Risk assessment product or
process that collects information and assigns values to risks for
the purpose of informing priorities, developing or comparing
courses of action, and informing decision making. Threat or
human-caused incident intentional actions of an adversary, such as
a threatened or actual chemical or biological attack or cyber
event.
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References/Statutes ** Revised Code of Washington, Chapters
38.10, 38.52, 43.21, 43.70 Public Health Service Act Public Law
93-288, as amended, "The Robert T. Stafford Disaster Relief and
Emergency Assistance Act" National Response Framework (NRF) Public
Law 107-188, Public Health Security Bioterrorism Preparedness and
Response Act 2002 Public Law 107-296, Homeland Security Act 2002
Federal Food, Drug and Cosmetic Act ** As identifed in the WA State
CEMP, ESF 8 Public Health and Medical Services
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Joint Commission (aka JCAHCO) Mission: To continuously improve
health care for the public, in collaboration with other
stakeholders, by evaluating health care organizations and inspiring
them to excel in providing safe and effective care of the highest
quality and value.
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So now that we are all on the same page Lets look at a specific
tool created for hospitals.
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Where do you start? Issues to consider for probability include,
but are not limited to: 1Known risk 2Historical data
3Manufacturer/vendor statistics Issues to consider for response
include, but are not limited to: 1Time to marshal an on-scene
response 2Scope of response capability 3Historical evaluation of
response success Issues to consider for human impact include, but
are not limited to: 1Potential for staff death or injury 2Potential
for patient death or injury Issues to consider for property impact
include, but are not limited to: 1Cost to replace 2Cost to set up
temporary replacement 3Cost to repair Issues to consider for
business impact include, but are not limited to: 1Business
interruption 2Employees unable to report to work 3Customers unable
to reach facility 4Company in violation of contractual agreements
5Imposition of fines and penalties or legal costs 6Interruption of
critical supplies 7Interruption of product distribution Issues to
consider for preparedness include, but are not limited to: 1Status
of current plans 2Training status 3Insurance 4Availability of
back-up systems 5Community resources Issues to consider for
internal resources include, but are not limited to: 1Types of
supplies on hand 2Volume of supplies on hand 3Staff availability
4Coordination with MOB's Issues to consider for external resources
include, but are not limited to: 1Types of agreements with
community agencies 2Coordination with local and state agencies
3Coordination with proximal health care facilities 4Coordination
with treatment specific facilities
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Threats/Hazards by Category
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Natural Hazards
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Technology Hazards
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Human Hazards
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Hazardous Materials
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Summary of Hazards
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Open Discussion How do you plan? Who do you plan with? Best
practices Lessons Learned Who should be involved? When do you do
it? Where do you begin? What resources do you use? Just your
hospital? How do you involve the community?
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Links and Articles California Hospital Association Website
http://www.calhospitalprepare.org/hazard- vulnerability-analysis
Planning Resources for Hospitals - CDC
http://www.cdc.gov/phpr/healthcare/hospitals.htm Strengthening HVA:
Results of Research in Maine
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056047/ Cyber hazards
and health care organizations,
http://www.hitrustalliance.net/news/index.php?a=128
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Thanks, for your time and participation. Contact info: Darrell
Ruby [email protected] 509-477-3006