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6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
EXPO 2015
The Italian Experience
A. Rossodivita 1, G. Rizzardini1, M. Gismondo1, M. Guzzetti1 PF. Marino2,
GF. Villa3, C .Picco3, A. Zoli3
1Luigi Sacco Academic Hospital, Milan, Italy
2ASST Fatebefratelli-Sacco/ Fatebenefratelli Hospital , Milan, Italy
3AREU - Regional Emergency Medical Service Company of Lombardy, Italy
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
Mass Gatherings (MGs)
• WHO defines mass gatherings (MGs) as “ events attended by a
sufficient number of people to strain the planning and response
resources of community , state or nation “
• MGs have significant implications for public health beyond the acute
public health events which may occur and require rapid detection and
effective management. The public health response to MGs is
analogous to that for public health emergencies or disasters, with the
same implications for public health, health care and emergencies
service due to inadequate resources for the surge in demand, and also
having additional implication in homeland security.
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
EXPO 2015
“Feeding the Planet, Energy for Life”
• Mass Gathering (20 mil)
• Multinationality ( 147 countries)
• Prolonged (6 months)
• Seasonality
• Food theme
• Infectious Diseases Prevention
• Bioterrorism
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
Pre-planning and Planning Procedures
• Emergency Medical Services and Hospitals
• Infection Control
• Laboratory capacity
• Travel medicine
• Points of entry
• IT- Information Technologies and Communications
• Training activity & drills
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
Areas of Interventions
Expo Site
Metropolitan Area
Remaining Territory
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
Istitutions
• 40 ISTITUTIONs INVOLVED
• SIMULATION Black-out, traffic
accidents, hospitals drills…
• DRILLs
• AREU
• Ministry of Interior
• Lombardia Region
• Prefecture
• Military Army
• Civil protection
• Fire brigades
• 7 hospitals…
• ED – ACTIVATION HOSPITAL
PLANS FOR MCI
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
PLANNING PRE-INTRA HOSPITAL
PREPAREDNESS & RESPONSE
AREU
EXPO SITE
EC3
7 HOSPITALS
Regional Center for Syndromic
Surveillance & Epidemic Intelligence
1 BIOTERRRORISM UNIT
20 MINUTES
ACCORDION SYSTEM
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
Hospitals in EXPO Area
Emergency Room
Emergency Dept.
Emerg. Dpt High
Specialty
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
HOSPITALS MCIs MODEL
o TRAUMA
o NEUROSURGERY
o BIOTERRORIMS & INF. DISEASES
o GENERAL EMERGENCIES
o PEDIATRICS…
7 HOSPITALS
ISRAELIAN MODEL
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
EXPO SITE
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
First Interventions Points
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
First Intervention Point
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
Emergency Vehicles at First Intervention Point (PPI 1)
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
Hospital MCI Preparedness & Response
• Elements Disaster planning
• Emergency coordination
• Communication
• Expansion of hospital surge
capacity
• Personnel
• Staff rules
• Availability of equipment
• Stockpiles of medical supplies
• Expansion of laboratory
capacities
• Responding to security issues
• Drills ..
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
Operative Center- EC3
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
Bioterrorism
Infectious Diseases Emergencies
High Isolation Room
ED Sacco Hospital
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
During the six opening months, 13579 patients were
treated. Two 112 emergency operative rooms,
located in the Operative Central EC3 in Drago street,
received 8,350 emergency calls accounting for 7,250
interventions. Regarding the ambulatory activities,
the equipes of three First Aid facilities (one open
daily and the remaining two on weekends only)
visited about 9,500 people.
Hospitals treatment 1300 pts.
RESULTS
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
CONCLUSIONS
EXPO 2015 present a significant challenge to planners of
routine and emergency health service within the host city . The
multidisciplinary , collective, and integrated approach of all
entities involved, during EXPO was the winning key and was
necessary due to the complexity of this approach, in order to
successfully avoid adverse outcomes, in maximizing the
results, and disseminate good practice.
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
INTEGRATED ALL HAZARD RESPONSE
STANDARDIZING HOSPITALs DISASTER PLANNING & EMERGENCY
PREPAREDNESS
INTRA-EXTRA HOSPITAL RESPONSE
INTEGRATION CONVENTIONAL AND NON CONVENTIONAL
EMERGENCIES
INTEGRATED INTRA- INFRA HOSPITAL S DRILLS
COOPERATION BETWEEN DIFFERENT ISTITUTIONS, MULTI AGENCY
MODEL
CIVIL AND MILITARY COOPERATION
CONCLUSIONS
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org
Added Value for Integrative Risk Management and Urban
Resilience
The authors strongly recommended further developments on international public health
policy in the field of development and application of modern public health methods in
research topics for early detection and monitoring on communicable and non –
communicable diseases, on new programs of prevention and increasing activity in travel
medicine principles, the application of new tools in communication in order to minimising
the effects of public health events, in disaster risk reduction , ensuring and reinforcing the
International Health Regulation.
A multidisciplinary cooperation approach was suggested in order to develop a more
resilient framework to use in different context , to promote in different countries, especially
in “fragile poor countries”, in global health policy and creating future model idea of public
health behaviours.
6th
International Disaster and Risk Conference IDRC 2016
‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland
www.grforum.org

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EXPO 2015 The Italian Experience, Alessandra ROSSODIVITA

  • 1. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org EXPO 2015 The Italian Experience A. Rossodivita 1, G. Rizzardini1, M. Gismondo1, M. Guzzetti1 PF. Marino2, GF. Villa3, C .Picco3, A. Zoli3 1Luigi Sacco Academic Hospital, Milan, Italy 2ASST Fatebefratelli-Sacco/ Fatebenefratelli Hospital , Milan, Italy 3AREU - Regional Emergency Medical Service Company of Lombardy, Italy
  • 2. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org Mass Gatherings (MGs) • WHO defines mass gatherings (MGs) as “ events attended by a sufficient number of people to strain the planning and response resources of community , state or nation “ • MGs have significant implications for public health beyond the acute public health events which may occur and require rapid detection and effective management. The public health response to MGs is analogous to that for public health emergencies or disasters, with the same implications for public health, health care and emergencies service due to inadequate resources for the surge in demand, and also having additional implication in homeland security.
  • 3. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org EXPO 2015 “Feeding the Planet, Energy for Life” • Mass Gathering (20 mil) • Multinationality ( 147 countries) • Prolonged (6 months) • Seasonality • Food theme • Infectious Diseases Prevention • Bioterrorism
  • 4. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org Pre-planning and Planning Procedures • Emergency Medical Services and Hospitals • Infection Control • Laboratory capacity • Travel medicine • Points of entry • IT- Information Technologies and Communications • Training activity & drills
  • 5. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org Areas of Interventions Expo Site Metropolitan Area Remaining Territory
  • 6. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org Istitutions • 40 ISTITUTIONs INVOLVED • SIMULATION Black-out, traffic accidents, hospitals drills… • DRILLs • AREU • Ministry of Interior • Lombardia Region • Prefecture • Military Army • Civil protection • Fire brigades • 7 hospitals… • ED – ACTIVATION HOSPITAL PLANS FOR MCI
  • 7. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org PLANNING PRE-INTRA HOSPITAL PREPAREDNESS & RESPONSE AREU EXPO SITE EC3 7 HOSPITALS Regional Center for Syndromic Surveillance & Epidemic Intelligence 1 BIOTERRRORISM UNIT 20 MINUTES ACCORDION SYSTEM
  • 8. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org Hospitals in EXPO Area Emergency Room Emergency Dept. Emerg. Dpt High Specialty
  • 9. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org HOSPITALS MCIs MODEL o TRAUMA o NEUROSURGERY o BIOTERRORIMS & INF. DISEASES o GENERAL EMERGENCIES o PEDIATRICS… 7 HOSPITALS ISRAELIAN MODEL
  • 10. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org EXPO SITE
  • 11. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org First Interventions Points
  • 12. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org First Intervention Point
  • 13. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org Emergency Vehicles at First Intervention Point (PPI 1)
  • 14. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org Hospital MCI Preparedness & Response • Elements Disaster planning • Emergency coordination • Communication • Expansion of hospital surge capacity • Personnel • Staff rules • Availability of equipment • Stockpiles of medical supplies • Expansion of laboratory capacities • Responding to security issues • Drills ..
  • 15. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org
  • 16. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org Operative Center- EC3
  • 17. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org Bioterrorism Infectious Diseases Emergencies High Isolation Room ED Sacco Hospital
  • 18. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org During the six opening months, 13579 patients were treated. Two 112 emergency operative rooms, located in the Operative Central EC3 in Drago street, received 8,350 emergency calls accounting for 7,250 interventions. Regarding the ambulatory activities, the equipes of three First Aid facilities (one open daily and the remaining two on weekends only) visited about 9,500 people. Hospitals treatment 1300 pts. RESULTS
  • 19. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org CONCLUSIONS EXPO 2015 present a significant challenge to planners of routine and emergency health service within the host city . The multidisciplinary , collective, and integrated approach of all entities involved, during EXPO was the winning key and was necessary due to the complexity of this approach, in order to successfully avoid adverse outcomes, in maximizing the results, and disseminate good practice.
  • 20. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org INTEGRATED ALL HAZARD RESPONSE STANDARDIZING HOSPITALs DISASTER PLANNING & EMERGENCY PREPAREDNESS INTRA-EXTRA HOSPITAL RESPONSE INTEGRATION CONVENTIONAL AND NON CONVENTIONAL EMERGENCIES INTEGRATED INTRA- INFRA HOSPITAL S DRILLS COOPERATION BETWEEN DIFFERENT ISTITUTIONS, MULTI AGENCY MODEL CIVIL AND MILITARY COOPERATION CONCLUSIONS
  • 21. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org Added Value for Integrative Risk Management and Urban Resilience The authors strongly recommended further developments on international public health policy in the field of development and application of modern public health methods in research topics for early detection and monitoring on communicable and non – communicable diseases, on new programs of prevention and increasing activity in travel medicine principles, the application of new tools in communication in order to minimising the effects of public health events, in disaster risk reduction , ensuring and reinforcing the International Health Regulation. A multidisciplinary cooperation approach was suggested in order to develop a more resilient framework to use in different context , to promote in different countries, especially in “fragile poor countries”, in global health policy and creating future model idea of public health behaviours.
  • 22. 6th International Disaster and Risk Conference IDRC 2016 ‘Integrative Risk Management – Towards Resilient Cities‘ • 28 Aug – 1 Sept 2016 • Davos • Switzerland www.grforum.org

Editor's Notes

  1. AREU worked in prepare pre-palnning and planning Aan integrated model of intrahospital and extrahospital preparedness on site, involving 7 major hospitals in the metroplitan area of Milan, ready in 20 minutes to receive victims for both conventional and non conventional major incidents or CBRNE events
  2. All together, Where needed