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Is your center ready to manage a disaster and its aftermath? Practical tools to prepare you and your staff to manage an

Is your center ready to manage a disaster and its aftermath? Practical tools to prepare you and your staff to manage an emergency event. Amelia Muccio Director of Disaster Planning NEW JERSEY PRIMARY CARE ASSOCIATION. Learning Objectives. Explain the “ings” of disaster preparedness

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Is your center ready to manage a disaster and its aftermath? Practical tools to prepare you and your staff to manage an

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  1. Is your center ready to manage a disaster and its aftermath? Practical tools to prepare you and your staff to manage an emergency event. Amelia Muccio Director of Disaster Planning NEW JERSEY PRIMARY CARE ASSOCIATION

  2. Learning Objectives • Explain the “ings” of disaster preparedness • Review personal and professional preparedness • Demystify “NIMS Compliancy” • Identify next steps for CHC leadership

  3. Top Answer on the BoardMost Frequent Thing Said About Disasters? Survey Says • IT WILL NOT HAPPEN TO ME!

  4. In Review: Twenty Five Years of Disasters • A disaster is a natural or man-made event that negatively affects life, property, livelihood or industry, often resulting in permanent changes to human societies, ecosystems and environment.

  5. Beirut Barracks Suicide Bombing:Lebanon (1983) • American and French troops sent over to stabilize Lebanese civil war • 2 truck bombs • 241 American servicemen were killed

  6. Industrial Accident:Bhopal, India (1984) • Union Carbide plant • 40 tons of toxic methyl isocyanate gas leaked out • 20,000+ deaths • World’s worst industrial disaster

  7. Extreme Famine:Ethiopia (1985) • Drought and political instability contributed to the severity of the famine • one million people died between 1984-1985

  8. Nuclear Accident:Chernobyl, Ukraine (1986) • Nuclear power plant • Fourth reactor exploded • 200,000 additional deaths in the period between 1990 and 2004 • World’s worst nuclear accident

  9. Super Typhoon Nina:Philippines (1987) • Between 540-687 people were killed and between 80,000 and 100,000 people were left homeless. • The damage in the Philippines was at $26 million (1987 USD).

  10. Terrorist Air Disaster, Pan Am 103:Lockerbie, Scotland (1988) • Plastic explosive in forward cargo hold • The 270 fatalities (259 on the plane, 11 in Lockerbie) were citizens of 21 nations. Of them, 189 were Americans.

  11. Accidental Air Disaster, UA 232:Sioux City, Iowa (1989) • Uncontained failure of the DC-10’s number 2 engine • All 3 of the aircraft's hydraulic systems were destroyed • 111 killed • 185 survived

  12. Political Disaster, Land Mines:Jammu-Kashmir Region (1990) • 1990-2001 conflict • Over 1,000 Jammu-Kashmir civilians were killed by land mines over this period along with nearly 9,000 injuries.

  13. Civil War:Sierra Leone (1991) • Revolutionary United Front (RUF) • 11 year civil war • Tens of thousands killed • 2 million displaced • Tactics of decapitation, mutilation, rape, and murder • Used child soldiers

  14. Infrastructure Disaster:Guadalajara, Mexico (1992) • Numerous gasoline explosions in the sewer system under streets • 206 killed • 500 injured and 15,000 were left homeless • Monetary damage $1 billion • Mayor was informed of gas smell but did not order evacuation.

  15. Severe Flooding:Iowa (1993) • Extensive flood damage occurred in all 99 counties. • 7/93, IDPH calls in CDC • 5 of the 99 counties, reported closures of primary-care physician offices. • Persons hospitalized for carbon monoxide poisoning, hypothermia, electrocution, wound infections, and exacerbation of chronic illnesses.

  16. Northridge Earthquake:California (1994) • Damage was wide-spread, sections of major freeways collapsed, parking structures and office buildings collapsed, and numerous apartment buildings suffered irreparable damage.

  17. Heat Wave:Chicago (1995) • 5 day period in July • Temps reached 106 F degrees • 600 heat related deaths • Deaths were mainly poor, elderly residents

  18. North American Blizzard:East Coast (1996) • The Blizzard of 1996 was a nor'easter that paralyzed the U.S. East Coast with up to four feet over a three-day period. • New Jersey: All roads in the state were closed, including the entire length of the New Jersey Turnpike for the first time in that road's history.

  19. Soufriere Hills Volcanic Eruption: Montserrat, West Indies (1997) • 3 pyroclastic flows • 23 deaths • Exclusion zone still in effect • 14,000 permanently displaced

  20. Eschede Train Accident:Germany (1998) • 101 died • 88 injured • World's worst high-speed train disaster • Surpassed the 1971 Dahlerau train disaster as the deadliest accident in Germany’s history

  21. The Erika Maritime Oil Spill:Coast of France (1999) • In heavy storm, the tanker broke into two pieces and sank. • Thousands of tons of oil were released into the sea, killing marine life and polluting shores. • One of the greatest environmental disasters in the world.

  22. Ebola Hemorrhagic Fever Outbreak:Uganda (2000) • Gulu, Masindi, and Mbarara Districts • Approx. 500 infected • Highly lethal hemorrhagic virus (50-90%) • No vaccine or treatment • Animal reservoir unknown

  23. 9/11 Terrorist Attack:USA (2001) • 19 hijackers • 4 airplanes • 2,974 deaths • Victims were civilians • Rescue workers falling ill from contaminated air at WTC site

  24. MV Joola Ferry Disaster:Senegal (2002) • The disaster resulted in the deaths of at least 1,863 people, making it the deadliest maritime disaster in African history and one of the deadliest of all time.

  25. Space Shuttle Columbia Disaster:USA (2003) • Disintegrated over Texas during re-entry into the Earth's atmosphere. • All seven crew lost, shortly before concluding its 28th mission.

  26. Indian Ocean Tsunami: South East Asia (2004) • 9.1 earthquake triggered tsunami • 230,000 killed • Devastating toll on Indonesia, Sri Lanka, India, and Thailand • Second largest earthquake ever reported

  27. Hurricane Katrina: Gulf Coast (2005) • 1,300+ killed (most deadly U.S. storm since 1928) • Costliest natural disaster in U.S. history • Criticism remains over delayed response efforts and lack of recovery plans

  28. Sago Mine Disaster:West Virginia (2006) • Sago Mine disaster in Tallmansville, West Virginia, USA, 13 miners trapped for nearly two days, • Only one survivor Randall McCloy

  29. Kansas Tornado: Greensburg (2007) • All that remains of Greensburg, Kansas (right). • Tornado destroyed more than 90% of the town, which about 1400 people called home.

  30. Megatsunami:East Coast, USA (Future?) • Cumbre Vieja is a volcanic ridge on the island of La Palma in Spain's Canary Islands. • Landslide of CV during volcanic eruption could trigger Megatsunami. • Megatsunami could destroy NYC, Boston, and Miami.

  31. The “ings” of Disaster Preparedness Leadership • How do you PREPARE? • Planning • Partnering • Training • Exercising

  32. Disaster Planning—Where Do We Start? • Overwhelming • Impossible • Lack of communication • Lack of clear guidance • Time consuming • Resource constraint • No EP on staff

  33. Disaster Needs Mimic Everyday Needs • Organizational agility • Plans, drills, and evaluations • Training and education • Staff protection and support • Communications and reporting • Supplies and equipment • Security • Joint Commission & HRSA PIN*

  34. Four Phases of Disaster Planning

  35. Expect the Unexpected:Planning Activities • Start with Needs Assessment/Gap Analysis • Avoid wasting resources • Clear picture of needs and expectations • Jumping off point • HVAs-What are our hazards? • Risk assessment for potential emergencies • Prioritized by likelihood of occurrence and severity

  36. Example of HVA

  37. Different Types of Disaster Plans • HVA (Hazard Vulnerability Analysis) • EOP (Emergency Operating Plan) • EMP (Emergency Management Program) • CEM (Comprehensive Emergency Plan) • SOP (Standard Operating Procedure) • IAP (Incident Action Plan) • Business Continuity (Continuity of Operations) • Corrective Action (Lessons Learned/Hindsight

  38. Continuity of Operations Communication Staffing Surge Capacity Supplies Security Evacuation Decontamination Isolation Power Supply Transportation Water Sanitation Medical Records EMP-HRSA PIN

  39. Perpetual Preparedness Vs. “Times of Crisis” Preparedness If you jump out the window at the 42nd floor and you're still doing fine as you pass the 27th floor, that does not mean you don't have a serious problem. - Charles Munger

  40. M+P>R+RSuccessful Disaster Planning Equation • CHC’s are planning for events (pandemic, hurricane, power outage, outbreak, terrorism) that require highlevels of pre-disaster preparedness (prevention, and mitigation activities). • Disaster is reasonably expected and preparedness initiatives have been undertaken. • Example of low level, economic depression, long-term civil war

  41. Basic Disaster Planning Curriculum for CHCs(Personal) PLANNING TOOLS Resources are Available FEMA American Red Cross Ready.Gov 72hours.org ASPCA HSUS AARP • Family Preparedness Plan • Children • Elderly/Disabled • Pets • Emergency Communication Plan • Evacuation & Sheltering • How to Construct a Go-Bag (supplies)

  42. Thanks for the Lovely Brochure—Now What? • A ton of information on disaster preparedness exists already. • What good is it to us if we do not put it into action?

  43. First (Initial) Steps are the Hardest!

  44. Family Disaster Plan (FDP) • Find out what disasters are mostly likely to occur (local OEM, fire, police) • Call a family meeting (dinner) • Discuss why you (as a family) need to prepare for a disaster • Plan for “vulnerable populations” first

  45. Special Planning Considerations Children Elderly/Disabled/Pets

  46. Child Disaster Psych Basics • Disasters are extremely traumatic for children • We reduce this fear/anxiety by providing children with information to help them cope and understand disasters (FEMA coloring books) • We teach them to stay calm and listen to the directions of adults (teachers/parents)

  47. Child PlanningCommunication and School • Make sure your child and child’s school have all your updated contact info • Know school disaster plan to avoid confusion (dismiss or shelter) • Find out if school requires authorization to release child to designated alternate if you cannot pick them up

  48. Children Internet Planning • Check out: http://www.ready.gov/kids/step3/index.html • Website is interactive, educational and fun!

  49. Disaster Stats:The Elderly/Disabled • Of the more than 1,300+ people who died because of Hurricane Katrina, more than 70% were over age 60. • New Orleans has one of the largest diabetic populations in South • People fled without shoes • Medicare allows only one pair per year • Many patients with diabetes developed wounds (skin ulcers to limb amputations)

  50. The Elderly/Disabled • High risk of mortality/morbidity during disaster due to mobility, transportation, social network, and illness (O2 dependent) issues. • Get input from family member first • Reach out to police, fire, OEM • Special needs registry • Create a redundant plan (plan B) • When in doubt, bring the kitchen sink (medications)

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