Planning for Hospital Emergency Preparedness, Response and Recovery

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


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.




Capacities usedTo manage Risks


Emergency

Disaster

Vulnerability AssessmentImpact to hospital (Risks)

Why did Risks happen?

(Vulnerabilities)


Components


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



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



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


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





Emergency

Disaster

Capacities used to manage Risks

Capacities Utilized,

Damaged


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!

Documents

Planning for Hospital Emergency Preparedness, Response and Recovery