Planning for Health Emergency Management

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

2. Q & A What is the difference between : • Plans • Procedures • Guidelines • Regulations • Policies First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

3. Policy • a formal statement by a government, organisation or • institution that expresses a set of goals, the priorities • within those goals and the preferred strategies for • achieving those goals; policy is based on the • mandate of the institution (WHO) First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

4. The differences Policy – what must be done Guidelines – how to implement the policy – technical how Procedures – how to implement the policy – administrative how Internal Regulations – special procedures which often incur a penalty if not followed Plan – who does whatwhen to implement policy First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

5. Characteristics of Plans The information is volatile: • They lose relevance quickly because the information • in them decays over a short time • They need frequent revision Are local and specific: • They are made by the end-users • They apply in specific circumstances First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

6. The relationship Procedures, guidelines and authority are needed to make plans Policies are needed to define guidelines and set procedures Mandates are needed to set policies First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

7. Procedures Procedures are about allocating responsibility for resources i.e.: • Acquisition of new resources • Access to existing resources • Accounting for the use of resources First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

8. Guidelines Guidelines are about using resources: • Appropriate resources • Application of those resources • Evaluation of the effectiveness of resources First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

9. Emergency One characteristic of an emergency is that normal procedures are inappropriate or inadequate to deal with the situation In an emergency, special emergency procedures are needed to get the situation under control In an emergency, institutions are given specificresponsibilities which require extraordinary powers to be given to specific people for a limited time Those specific people must have plans for how those extraordinary powers will be used and for defining the resources they will need to meet their responsibilities First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

10. Planning for emergencies Planning elements Planning is a LOCAL activity, undertaken withina national legal and policy framework: • Define the planning objectives • Network with the stakeholders • Analyse the community and its risks • Plan for the priority risks • Resource the plan • Train and educate for the plan • Advocate for changing attitudes to the risks • Rehearse the plan • Review and revise the plan First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

11. The importance of planning • lack of planning means that a failure comes as a • complete surprise • a bad outcome is more often due to defective • planning, rather than lack of resources • emergency response planning is about making the • best use of available resources • Emergency preparedness planning is about getting • new resources First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

12. Information is key to planning bad or inadequate information  wrong planning parameters  bad plan First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

13. Participatory planning all those who are involved in implementation need to be involved in the planning process = the stakeholders First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

14. The planning process • Determine the authority responsible for the process • Establish a planning committee • Conduct risk analysis - hazards and communityvulnerabilities • Set the planning objectives • Define the management structure for the process • Assign responsibilities • Identify and analyse capacities and resources • Develop emergency management systems andarrangements • Document the plan • Test 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

15. Outputs of the process A set of risk reduction plans – how can we prevent emergencies from occurring in our community A set of emergency response plans – who does what when usingexisting capacity: • search and rescue plan • evacuation/temporary shelter plan • mass casualty management plan • restoration of lifelines plan • security plans A set of disaster recovery plans (public health, education, agriculture, transport, public works etc.) First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

16. Outcomes of the process Planing process is a sequence of steps whereby a community agrees on ways to enhance and protect it’s own safety. It is an interactive and iterative process that should lead to: • better understanding of the roles and responsibilities of • all members of the community in prevention and response • greater awareness of risk reduction in the community • higher levels of readiness to respond • A set of 3 basic plan sets – a risk reduction plan, an • emergency response plan a recovery plan (reconstruction • plans can only be made after a disaster but should be • based on existing policies and guidelines) • increased public safety First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

17. 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 period + • recovery period) First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

18. Common planning mistakes • Making a “national plan”: emergency plans only work for • institutions and communities – provinces and states need to • develop policies, procedures and guidelines to direct planning • process and support local response agencies in an emergency • the plan is given more importance than planning process itself • not all community members aware of the existence of a plan • testing and revision is overlooked • emergency planning is not integrated into normal activities • different plans are developed for different hazards by different • agencies – the all hazards approach should be preferred First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

19. Common planning mistakes • “National” plans have proven to be ineffective – planning is • a local activity • Plans are out of date as soon as they are published PLANS NEED REGULAR REVIEW • Procedures, policies and guidelines are needed to guide the • planning process at local level First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

20. “All Hazard Approach” plan: • 80% of what we do in emergencies is generic – we do it for every emergency – the all hazards approach • No need to wait for field information to do this • 15% is specific to the hazard • Much can be done before field data is available but an assessment is needed to provide the quantitative data • 5% is unique to the event – the people, the place and the time • The assessment will provide all of this data First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

22. A plan does not achieve results • The goal of the planning process is not to make a plan • – thegoal is use it • Results come from the actions defined in the plan – if • it’snot in the plan, no-one is responsible and it wont • be done • The time to start planning isnow First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

23. The role of government The role of national authorities is to support local planning processes by establishing the planning framework: • Setting national policies for risk reduction, emergency • preparedness, emergency response and disaster recovery • Issuing technical guidelines and administrative procedures for • the process of planning and for the contents of plans • Developing procedures for how national resources can be • deployed in an emergency • Allocating funds to support the development of new local • capacity and for local risk reduction • Planning for those hazards that are not the primary • responsibility of local government e.g. bio terrorism, war First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

24. The role of national authorities • Emergency Planning is a local responsibility • For most hazards, there should not be a “national plan” • for responding to the common hazards – ideally, the • national plan should simply be: • to support and resource local plans • National authorities must provide the laws, policies, • guidelines and procedures needed to make local plans for • risk reduction, emergency response and disaster • reconstruction First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

25. The planning hierarchy The levels of the planning hierarchy should be modelled on the existing administrative structure of the country. It should include: • national polices, guidelines and procedures (for the • planning process AND for the contents of plans) • Provincial/state plans to support local plans • local plans First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

26. Response planning Elements of a response plan A response plan will define : • a line of authority • responsibilities of all the stakeholders • the management of an Emergency Operations Centre • the communications system • alert and warning mechanisms • public information arrangements • resource management (human, financial and material) • reporting and accounting arrangements First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

27. Planning for the Phases reconstruction community PEOPLE relief PROPERTY First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman SERVICES recovery/ rehabilitation LIVELIHOODS ENVIRONMENT

28. Components of the plan The key components are: • the main plan which describes the goals, objectives and • overall arrangements • the functional plan which describes in detail how the • main plan is to be implemented • special plans e.g. airport, security • standard operating procedures • checklists • maps • hazard data • community data • staff data • records of key decisions taken in meetings First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

29. Essential services The following sectors are involved in the 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

30. Service plan For a hospital, the plan will describe: • activation mechanisms • chain of command • capacity assessment (casualty room, operating theatres, • beds, lab, blood bank, x-ray etc) • medical and technical staff;resources • communications • logistics • administration procedures – admin. staff,engineers, porters etc. • reception and triage • surgery, morgue, decontamination, psychiatry, forensicservices • other support services - nutrition, physiotherapy, orthotics etc • waiting area for families • arrangements for the media • arrangements for VIP visits First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

31. Capacity assessment In an emergency the following issues should be considered in assessing capacity to respond: • structural damage • staff availability • equipment failures • energy supply • water supply • access routes • additional workload First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

32. Elements of a good plan It is essential to: • simulate an emergency to test the plan • familiarise all staff with the plan • brief all new staff about the plan • familiarise local government, emergency services and • the community with the plan • train those staff with special roles and responsibilities in the • plan • review and update the plan after an emergency, after each • simulation and whenever new resources are acquired First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

33. Implement the plan • Plans will not be made or will lie unused unless the • responsible authorities actively provide: • Education and information on how to plan • Encouragement and incentives to plan • Enforcement of regulations to plan • Engineering and resource mobilisation solutions to • problems identified by the planning process First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

34. Evaluate the plan How do we know a plan is a good plan? • It meets the national planning criteria • It conforms to the national planning format • It is tested regularly • All staff are familiar with the details of the plan and • know their responsibilities First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

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