Dm plan

Planning for Hospital
Emergency Preparedness,
Response and Recovery

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 efficiently
Available
resources
Promote
Cooperation
Among sectors
And agencies
Create systems and networks for responding
To 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 and
Systems
Describe Management
Structure
Describe Roles and
Responsibilities
Emergency Planning
Process
Define the plan
Analyze resources
Vulnerability Analysis
Risk Analysis
Problems/Gaps Analysis

Elements of Hospital Preparedness,
I. Background
II. Plan description
III. Goals and objectives
IV. Planning Group
V. Emergency Preparedness Plan
 Hazards prevention
 Vulnerabilities reduction
 Risk reduction
VI. Management Structures
VII. Roles and responsibilities

Elements of Hospital Preparedness,
VIII. Hospital Response Plan
 Policies, guidelines, protocols for the developed
systems
IX. Recovery and Reconstruction Plan
X. 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
Representative
from 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 Ward
OR
Delivery Rm.
OR
Urology Ward
Legend:
Fire
Earthquake
Flood

Recovery/Rehabilitation Plan
Hospital
People
Property
Environment
Services
Livelihood
(Vulnerable)
Hazard Risks
People
Property
Environment
Services
Livelihood
(Damages
Needs)
Capacities used
To manage Risks
Recovery/
Rehabilitation
Emergency
Disaster

Hazard Reduction/Prevention Plan
Hazard Strategies/
Activities
Time
Frame
Resource Requirement Person
Resp.
Indi
cators
Req’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 Plan
Capacity
(10P’s)
Hospital
weaknesses
Strategies/
Activities
Time
Frame
Resource Req’t. Person
Resp.
Indi
cators
Req’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.

Vulnerability Assessment
Impact to hospital
(Risks)
Why did Risks happen?
(Vulnerabilities)
1. Property:
Structural; Non-
Components
1. Property: Structural; Non-
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
cators
Req’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 system
b. Public Information System
c. Incident Command System
d. Information Management System
e. MHPSS
f. Blood and blood products mobilization

management
g. Code Alert System
h. Infection Control
i. System to expand services, spaces and beds in case
of surge of patients
j. System on drills/simulation exercises
k. Stockpiling of emergency medicines and supplies

management
l. SOP on Operation Center
m. Referral System Procedures
n. Logistics management system
o. Decontamination procedures

D. Hospital Emergency Management Policies, Guidelines,
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 and
networking for referrals of cases

Response Plan
h. Initiation and Maintenance of Mental Health and
Psychosocial 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 Services
l. Management of the Dead

Hospital
People
Property
Environment
Services
Livelihood
(Vulnerable)
Hazard Risks
People
Property
Environment
Services
Livelihood
(Damages
Needs)
Recovery/
Rehabilitation
Emergency
Disaster
Capacities used to
manage Risks
Capacities
Utilized,
Damaged

Damages/
utilized
Resource
Req’t.
Resp.
Person
Time
Frame
Indicators

Next Actions
1. 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 plan
6. Review and update the plan regularly.

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