Hospital Continuity of

Operations PlanningTeodoro J. Herbosa MD FPCS

Professor Surgery, Emergency Medicine

University of the Philippines, Manila Undersecretary, Department of Health 2010-2014

Former Board Member World Association for Disaster and Emergency Medicine

Typhoon “Yolanda” Storm Surges

What happened?

Disaster Risk Reduction

Hazard AnalysisRisk Management or MitigationVulnerability AssessmentDisaster Risk Reduction and Management

Disaster Planning

Incident Command System

Operations

Logistics

Finance

Contingency Planning

Contingency Planning

No disaster plan

With a disaster plan but situation was not predicted

There is a disaster plan but those managing the disaster are not familiar with the disaster plan

entry of external help who are not at all familiar with the disaster plan

* Includes infra and/or equipment costs for affected hospitals, RHUs and BHS

Initial Estimates of Damage of Health Facilitiesin Regions IV- B, VI, VII, VIII

Provinces BHS RHUs Hospitals Total No. of Health

Facilities Affected

Estimated Amount*

Region VIII 996 3,928,512,300

Leyte 176 56 17

249 1,205,618,500

Northern Samar

97 30 11

138 661,555,900

Biliran 46 9 2

57 187,636,900

Eastern Samar

165 29 12

206 723,485,200

Southern Leyte

68 23 8

99 385,290,500`

Western Samar

202 33 11

246 704,925,300

DOH-EV Office

1 60,000,000

Region VII 60 21,880,000

Cebu 43 15 2 60 21,880,000

Region VI 1,216 49,932,500

Aklan 133 19

9 161 5,244,000

Antique 152 18

6 176 10,528,500

Capiz 287 17

6 310 4,085,000

Iloilo 512 43

14 569 30,075,000

Region IV B 8 82,060,000

Culion, Palawan

7 1 8 82,060,000

GRAND TOTAL

1,888 292 99 2,280 4,082,384,800

Timelines

Checklist

Job description

Basis for changes in your disaster plan

Review of the events

Job Action Sheets

job description

based on the timelines

triage of what needs to be done

delegation of tasks

lack of manpower

Elements of COOPContinuity Plan - implementation & management of the Continuity Program. 

Outline the ff overarching continuity requirements

Essential Functions – subset of governance & organizational functions w/c are critical activities used to identify supporting tasks and resources that must be included in the organization’s continuity plan

FEMA

Elements of COOPContinuity Plan - implementation & management of the Continuity Program.  Outline the following overarching continuity requirements

Orders of Succession – essential in a continuity program to ensure that personnel know who assumes authority/responsibility if leadership is incapacitated/unavailable during a continuity situation. “Chain of Command”

Delegations of Authority – provide personnel with the authority to make key decisions during a continuity situation where the primary decision maker is not available. 

FEMA

Elements of COOPContinuity Facilities – alternate facilities from which to perform essential functions in a threat-free environment

Continuity Communications – ability of an organization to execute its essential functions at its continuity facilities depends on the identification, availability/redundancy of critical communications and information technology (IT) systems to support connectivity among key leadership personnel, internal elements, other agencies, critical customers and the public during crisis and/or disaster conditions.

Elements of COOPEssential Records Management – identification, protection and availability of electronic & hard copy documents, references, records, information systems, data management software and equipment needed to support essential functions

Human Resources – guidance to emergency employees and other categories of employees who are activated to perform response duties

Elements of COOPTests, Training, and Exercises – identification, training, and preparedness of personnel capable of relocating to alternate facilities to support the performance of essential functions

Devolution of Control and Direction – to transfer statutory authority/responsibility for essential functions from an agency’s and organization’s primary operating staff and facilities to other agency and organization employees and facilities, and to sustain that operational capability

Elements of COOP

Reconstitution – process by which surviving and/or replacement agency and organizational personnel resume normal agency operations from the original or replacement primary operating facility

Four Phases of Continuity of Operations Activation

Phase I – Readiness and Preparedness.

Phase II – Activation: plans, procedures, and schedules to transfer activities, personnel, records, and equipment to alternate facilities are activated.

Phase III – Continuity Operations: full execution of essential operations at alternate operating facilities is commenced.

Phase IV – Reconstitution: operations at alternate facility are terminated and normal operations resume.

Conditions in which the Continuity Plan will be

ActivatedThe plan could be activated in response to a wide range of events: a fire in the buildinga natural disaster the threat or occurrence of a terrorist attackemerging infectious diseases  Any event that makes it impossible for employees to work in their regular facility could result in the activation of the continuity plan

Conditions in which Continuity Plan will be

Activated"Continuity planning is simply the good practice of ensuring the execution of essential functions through all circumstances, and it is a fundamental responsibility of public and private entities responsible to their stakeholders."

Lessons from Typhoon Yolanda

A. Factors for Better Patient Outcome • Timeliness of intervention• Competency of Health Personnel• Adequacy of Service Providers• Available logistics • Team Work

B. Existing Partnerships and Agreements• Facilitates Movement and Entry of Responding Countries , Teams and Partners

Recommendations Increase the logistics capacity and lifelines for health

sector response:◦ Emergency communications system

◦ Air Transport to, and within the affected areas◦ Emergency logistical needs such as generators, hospital tents,

etc. Build resilient health facilities

◦ Hospitals as the last facility standing◦ Hospitals as hubs for energy, water, logistics, communications,

and shelter Develop self-sufficient teams

◦ Properly equipped Mobile surgical, public health teams◦ Physically and psychologically prepared teams to withstand

the disaster conditions

Recommendations Improve preparedness, response, and

rehabilitation planning across different levels

◦ Include worst case scenarios/ mega disasters◦ Consolidation of top-bottom and bottom-up

planning Strengthen systems for service delivery

◦ Improved inter- and intra-operability among all responding agencies

◦ Improved information management systems◦ Improved logistics management systems

Sometimes it takes a natural disaster to

reveal a social disaster.

Jim WallisRead more at

http://www.brainyquote.com/quotes/quotes/j/jimwallis383544.html#jSqVmcZ7J0yJlHSg.99