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Planning for Health Emergency Management

Planning for Health Emergency Management. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman. Learning Objectives. By the end of this module, the participant should be able to: Describe the steps of emergency response

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Planning for Health Emergency Management

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  1. Planning for Health Emergency Management First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  2. Learning Objectives • By the end of this module, the participant should be able to: • Describe the steps of emergency response • planning process in terms of inputs, • outputs and outcomes • Create flowcharts for emergency response • planning • To identify the various plans that must be • developed and the harmonization • between them First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  3. The differences: Policy – what must be done Guidelines – how to implement the policy – technical how Procedures – how to implement the policy – administrative how • Protocols - step-by-step instructions to perform a given • activity Plan – who does what when to implement policy First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  4. The relationship: Mandates are needed to set policies Policies are needed to define guidelines and set procedures Guidelines and procedures are needed to make plans “Policy for health emergency management is set at the national or sub-national level, it is executed at the local level” First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  5. Example: Policy - All victims of all sorts of emergencies or disasters shall be searched, rescued, and managed timely and appropriately Guidelines – Case Definition of victims; Guidelines on search, rescue, and case management Procedures – Procedures of patient referral; emergency procurement of drugs and medicines Plans - Emergency Manager responsible for triaging; Details on who does what, responsible persons; plan changes from one facility to another; First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  6. THE CONTEXT OF COMMUNITY RISK MANAGEMENT Public Safety + Risk Management Emergency Management Hazard Prevention Damage Assessment & Needs Analysis Vulnerability Reduction Epidemiology & Reporting Emergency Preparedness Mass Casualty Management Hospital Planning Curative Care Shelter & Security Water & Sanitation First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Control of Communicable Disease Food & Nutrition Reproductive Health Psychosocial Needs Medical Supplies & Logistics Media & Public Information Recovery and Rehabilitation 6 safer communities

  7. From Policy, Guidelines and Procedures to Community Plans National level Policy, guidelines, procedures Special plans Mobilise extra-resources Provincial level International org & assistance Develop and implement First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Vulnerability reduction plans Community level Emergency response plans Preparedness programs National & provincial levels = support communities in their work

  8. What are the Emergency Management • Plans? • Emergency Preparedness Program/Plan • Hazard Reduction Program • Vulnerability Reduction Program • Emergency Preparedness (Capacity Building Program) • Emergency Response Plan • Contingency Plan • Business Continuity Plan • Recovery/Rehabilitation Plan First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  9. Defining the various plans: • National Plan – • multi-sectoral plan • developed for the situations that are not under the • direct responsibility of regional and local authorities • coordination, resource mobilization, information • management • includes contingency plan • includes all the regional plans First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  10. Defining the various plans: • Regional Plan – • multi-sectoral plan • developed for the situations that are not under the • direct responsibility of local authorities • coordination, resource mobilization, information • management, service delivery • includes contingency plan • includes all the local plans First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  11. Defining the various plans: • Local Plan – • multi-sectoral and multi-disciplinary plan • developed for local situations • operationalize the national policy and guidelines • coordination, resource mobilization, information • management, service delivery, etc. • includes contingency plan • includes business continuity plan First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  12. National Plan Regional Plan Regional Plan Regional Plan First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Local Plan Local Plan Local Plan Local Plan Local Plan Local Plan

  13. Context of emergency plans for a community Community Risk Management Plan Sectoral Plans Hazard Specific Plans Provincial Emergency Disaster Plans Agencies Specific Plans (hospitals) First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman National Emergency Disaster Plan Intersectoral in nature

  14. Disaster Management is: 80% generic 15% specific 5% unique to all disasters to the hazard to the event 1. Organization earthquake EOC time large numbers of trapped and injured coordination place large numbers of homeless and displaced communications weather large numbers of dead and missing transport logistics and supplies geography dead, injured and missing staff information and media climate damaged critical infrastructure / resources (hospitals, vehicles) reporting and surveillance loss of water, gas, electricity, phone, transport, fuel networks security 2. Response loss of road, sea, air, rail infrastructure / access search and rescue politics long period of SAR, victim extraction evacuation economy high demand for FA, stretchers, triage, medical transport mass casualty management governance high demand for beds, surgery, blood products, referral management of dead and missing wound infections, amputations, tetanus, dust inhalation security emergency management capacity high demand for orthotics, prosthetics, disability, dental temporary shelter, clothing and utensils logistics capacity demand for specialized spinal and head injury care emergency water, sanitation and energy disposal of inappropriate donations high demand for temporary shelter, food, utensils, stoves, emergency food supplies water, energy, clothing, tents, blankets emergency public and environmental health leadership high demand for psychosocial support of victims and staff emergency engineering and public works solidarity management of donated supplies / foreign teams morale First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman 3. Recovery few outbreaks of communicable diseases corruption variable demand for medicines and equipment crime (acute / chronic injury care - high, infectious disease - low, curative and public health care looting potentially unstable chronic disease - medium) education agriculture compensation claims contamination of water, air and soil trade and commerce insurance claims toxic chemical, sewerage and gas leaks / spills 4. Rehabilitation and Reconstruction urban fires, explosions ownership disputes contaminated, infested and unsafe foods people property disputes increased vector breeding property services loss of livelihoods, markets, distribution networks livelihoods environment THIS IS WHAT WE PLAN FOR ….

  15. Planning for Emergencies • Planning based on risk analysis is planning for any emergency, by predicting: • what might happen • when it might happen • where it might occur • how big it might be • what effect it might have • how long it might last (emergency + recovery period) • What are the strategies to respond and recover First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  16. Main characteristics • Clear responsibilities (who, what, when, how, with • whom, where) • All key stakeholders need to be involved in the planning • process, including: agencies with disaster responsibilities community members / groups Institutions and legal authorities • Relevant to emergency events: large scale; complex; relatively rare; hard to predict • Consequences of poor decisions can be acute • Scrutiny of mistakes is often in detail and in public First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  17. Essential Services The following sectors are involved in the emergency planning process: • communications • police • relief and rescue • health • social welfare • transport • public works • also agriculture, media, education, fire, ambulance, engineering, meteorology First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  18. Health Sector Response Plan must deal with….. • Casualty management (first aid, triage, transport, pre-hospital care, in-patient care, out-patient care) • Communicable disease control (surveillance, tracking, treatment, prophylaxis, isolation and quarantine) • Continuity of delivery of critical services for emergency patients • Management of the dead and missing • Management of information (public information; support activities; health info system) • Mental health • Environmental health • Reproductive health • Public health programs (continuity of essential programs) First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  19. THE EMERGENCY PLANNING PROCESS First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  20. Elements of Hospital Preparedness, Response and Recovery Plan I. Background II. Plan description III. Goals and objectives IV. Planning Group V. Emergency Preparedness Plan • Hazards prevention • Vulnerabilities reduction • Risk reduction (capacity development) VI. Management Structures VII. Roles and responsibilities First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  21. Elements of Hospital Preparedness, Response and Recovery Plan VIII. Response Plan • Policies, guidelines, procedures, protocols for the developed systems • Response, Contingency, Business Continuity plan • Recovery and Reconstruction Plan • Damage Assessment and Needs Analysis • Post-incident evaluation • Recovery and rehabilitation Plan based on lessons learned 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 First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  22. Emergency Planning Process Analyze resources Define the plan Describe Roles and Responsibilities Form Planning Group Hazard Analysis Describe Management Structure First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Vulnerability Analysis Risk Analysis Develop Strategies and Systems Problems/Gaps Analysis “Hospital Emergency Preparedness, Response and Recovery Plan Development ‘08”

  23. The Planning Process • Determine the authority responsible for the process • Establish a planning committee and objectives; management structure of the process • Assign responsibilities • Conduct a risk assessment - hazards and community vulnerabilities (core elements) • Identify and analyse capacities and resources • Stakeholders analysis • Develop strategies, emergency management systems and arrangements • Document the plan • Test the plan; • Disseminate the plan • Review and update the plan on a regular basis First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  24. Background Name of the agency and address Geographic description (location: Low lying area? Etc.) Demographic profile of catchments communities Community Profile Health statistics (IMR, MMR, etc.) Health facilities found in the municipality/city Available health services Manpower complementation Disasters responded/managed Legal issuances establishing authority in HEM First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  25. Significance: Picture of the site and location of the hospital Catchments areas provided with hospital services Health resources in and around the hospital Existing capacity and capability of the hospital Partner agencies around the hospital Anticipated hazards as basis for hospitals’ capacity and capability building First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  26. Define Plan • Determine the aim, objectives and scope of the • planning process • Identify the tasks to be performed, and the • resources needed • Identification of the framework in which • emergencies will be managed • legislation policy and guidelines must be • considered • and the resources that will be required: • stakeholders / agencies, etc. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  27. 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 First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  28. Scope of the Plan Significance: • Who will implement the plan • Extent of implementation including limitations Goals and Objectives First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman • Give the purpose of the plan from a broader to more • specific perspectives.

  29. Review Planning Group/Committee • Key Stake-holders to be represented • multi-disciplinary teams are essential to ensure • sufficient expertise • must have appropriate authority • political and economic circumstances may • influence choice of members • social and cultural issues must be considered • there must be an efficient reporting system First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  30. Planning Group/Committee • Planning Committee include major stakeholders • Permanent or “AD HOC Group” which convenes only for emergency planning purposes. • This group shall be created through an 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 First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  31. Example of Planning Committee Structure Director/Designate Representative from areas of operation Representative from Administrative Division Representative from Planning Division Representative from the Finance Division First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  32. Risk Analysis • planning group should know result of vulnerability analysis (at least core elements) • technique for identifying preventive and mitigation strategies; response and recovery strategies for identified problems • systematic breakdown of the problem into its components • techniques involves: • hazard analysis / vulnerability/risk assessment / developing response and recovery strategies / mitigation First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  33. Emergency Preparedness Program – Reminder • An integrated set of long-term, multi-sectoral development activities First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  34. Emergency Preparedness Program Goal: to achieve an increasing level of “readiness” within communities to cope with any situation which demands an emergency response, using their own resources. This requires the development and maintenance of : Political authority, policy for EM Plans and Procedures for EM and Recovery training and education Institutional and human resources for EM Public awareness & education System for the collection, analysis and distribution of information related to emergencies First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  35. ANATOMY OF COMMUNITY RISK MANAGEMENT Community risk readiness community = hazard  vulnerability multisectoral, all hazards indicators: indicators: indicators: indicators: probability scale/magnitude/ strength/intensity spread duration biological hazards: season, infectivity, latency, transmission resistance, etc. policy, plans, procedures knowledge, skills, attitudes resources legislation national & sectoral policy administrative procedures response & recovery plans preparedness plans technical guidelines management structure institutional managements information systems warning systems human resources material resources financial resources simulations & training education public information community participation research publications People: access to health care measles vaccination under 5 nutrition under 5 mortality access to clean water access to sanitation adequate housing employment/ income female literacy Property: health infrastructure vehicles medical supplies Services: curative care services ambulance services public health services health info system Environment: water/soil/air quality risk of: death injury (mental/ physical) disease (mental/physical) loss of life displacement loss of property loss of income secondary hazards breakdown in security damage to infrastructure breakdown in services Contamination natural phenomena famine diseases of epidemic potential events/crowds intoxification infestations transport accidents structural failures industrial accidents chemical accidents pollution refugees war terrorism First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Prevention & Mitigation Programme Vulnerability Reduction Programme Emergency Preparedness Programme = Community Risk Management  

  36. Emergency Preparedness Program Plan to build response capacity: • Policies, Protocols, Guidelines and Procedures • Plans • People (Human Resource development) • Promotion and Advocacy • Partnership Building • Physical (Facility Enhancement) • Program Development • Practices documentation • Peso (Finance) and Logistics • Package of Services First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  37. Resource Analysis • why? • to ensure that PRR strategies can be supported • to ensure that preparedness is coordinated • to ensure cooperation between agencies • to know who is responsible for supplying First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  38. Organizational Capacity • implemented selectively by those agencies which have been delegated that responsibility by the Government or by the community • it is vital that…..agencies…… • professionally managed • adequately resourced • highly trained • demonstrated competence • emergency management family First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  39. Assessment of Response Capacity of the Health Sector • mandate and authority to deliver relief (scope of responsibility) • management and command structure (coordination among stakeholders) • competencies of staff (knowledge and skills and ability) • the availability and accessibility of information • the existence and relevance of plans • the existence and relevance of procedures • the networking of the plans of the Health Sector with the plans of the other sectors First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  40. Step 5: Roles and Responsibilities • should be defined & described to ensure that each organization knows precisely what is expected of it and that everyone is aware of the general roles of all relevant organizations • multi-sectoral approach for national disaster plan • key issues: • Information management • resource management • evacuation • specific situation such as hazardous material… First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  41. Emergency Response Plan It is important to have Emergency Response Plan: • to have an orchestrated, timely, and appropriate • response actions • to save lives and reduce sufferings of the affected • population First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  42. Emergency Response Plan A plan containing description of: • Responsibilities • Command & coordination mechanism • Management structures • Resource management • Information management and communication • Training and exercises First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  43. Difference between Emergency Response Planning and Routine Planning • ERP focuses on: • Coordination and management systems of resources from several sectors • emergency management and incident management systems • Management of information • arrangements for intra-sectoral and inter-sectoral coordination of activities and mobilization of resources (surge capacity) • What are the characteristics of routine planning in your field of activity? First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  44. Key characteristics of an ERP • Emergency Response Plan and Recovery Plan • an agreed set of arrangements for responding to, and recovering from emergencies • plans involve the description of responsibilities management structures resource and information management Logistics management Training and exercises • plans focus on protecting life, property and environment • outcomes First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  45. Core Elements of an Emergency Response Plan Management Structures Incident Commander Safety Officer Public Info. Officer Liaison Officer First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Administrative/ Finance Logistics Planning Operations “Hospital Emergency Preparedness, Response and Recovery Plan Development ‘08”

  46. Emergency Response Plan Development • A response plan will define and discuss : • a line of authority and clear responsibilities of all • the stakeholders involved • the management systems: ICP; EOC; EEC • the communications system • alert and warning mechanisms • public information arrangements • resource management (human, financial and material) • Monitoring, reporting and accounting arrangements First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  47. Core Elements of an Emergency Response Plan Emergency Response Policies, Guidelines, Procedures and Protocols • Activation of Code Alert System • Activation of the Plan • Incident Command System • Activation of the EOC • Information Management System • MHPSS • Security system • Public Information System • Coordination, networking and referral system • Provision of public health services First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  48. Core Elements of an Emergency Response Plan Emergency Management Policies, Guidelines, Procedures and Protocols • k. Infection Control • l. System to upscale services in case of surge of patients • m. System on drills/simulation exercises • n. Stockpiling of emergency medicines and supplies • o. Logistics management system • p. Decontamination procedures • q. Management of the dead and missing persons during • disasters First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  49. Core Elements of an Emergency Response Plan Emergency Management Policies, Guidelines, Procedures and Protocols • p. restoration of critical services • Electrical supply and back-up generators • Drinking water supply and alternate sources • Fuel reserves • Back-up communication system • Wastewater and solid waste water treatment • Fire suppression • q. SOP on managing volunteers and donations First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  50. Recovery and Reconstruction Plan • Damage Assessment and Needs Analysis • Post-incident Management • Medium-term and long term recovery, reconstruction, • and development plan • Multi-sectoral initiative (education, agriculture, public • works etc.) First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

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