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

Emergency Response in Health Sector

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

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At the end of the session, the participants will be able to:

1. Define common terminologies in emergency management

2. Relate Emergency Response in the Emergency Management Framework

3. Describe Emergency Response Operation

4. Explain the roles of the health sector in managing the risks during response operations

5. Discuss the role of the Emergency Operation Center in managing the emergency

Learning Objectives:



Q & A

1. Define Emergency

2. Differentiate Emergency from Disaster

3. What is Emergency Response

4. What is Emergency Management

5. Define Health Sector



Emergency

a serious disruption of the functioning of a community or a society involving widespread human, material, economic or environmental losses and impacts which exceeds the ability of the affected community or society to cope using its own resources

Disaster

Actual threat to public health and safety is a threatening condition that requires urgent action


Emergency Response


the process of responding to any type of emergency situations that can threaten the human and safety of the public

These are dealt with differently based on the type of emergency

The main aim of emergency response is to mitigate the effect of an emergency on human life and property



Emergency Management Framework

Disaster Impact

Preparedness

Response

Recovery

Prevention

Mitigation



Emergency ManagementComprehensive strategy of building, utilizing and restoring capacities employed in addressing the actual threat to public health and safety

Organization and management of resources and responsibilities for addressing all aspects of emergencies, in particular preparedness, response and early recovery steps

Involves plans, structures and arrangements established to engage the normal endeavors of government, voluntary and private agencies in a comprehensive and coordinated way to respond to the whole spectrum of emergency needs.



In Emergency Response there are two basic concerns to be addressed:

1. Managing the risks

2. Managing the incident



1. Managing the Risks



What are the Risks?

Typhoon (Hazard) Community

People Properties

Environment

Livelihood

Services

What will be the impacts or risks to the community?



1. What are the risks?

Group the participants

Group 1: List the risks to people Group 2: List the risks to properties Group 3: List the risks to environment Group 4: List the risks to services Group 5: List the risks to livelihood

Exercise 1


Risks to people :


injuries like wounds, fractures, etc. drowning burns disabilities diseases psychological disorder displacement deaths

Risks to properties :


damaged buildings and structures damaged hospitals damaged schools damaged electric and telephone lines destroyed houses damaged transport vehicles damaged bridges damaged water sources and toilets

Risks to services :


disrupted health services disrupted education paralyzed transportation bogged down communication electrical brown outs or power shortage lack of water supply lack of food supply

Risks to environment :


poor sanitation air pollution water contamination poor sewage disposal etc.

Risks to livelihood : closure of business no work loss of job

2. Who will manage the risks?


Exercise 2 What are your response actions to manage the 5 categories of risks?

Who will be involved in the response?

The reporter must explain the roles of each listed involved persons, agencies, or organization

Risks Response Actions Responders

Q & A


What is Health Sector?


Definition: Health Sector


A part of the economy dealing with health-related issues in society

a division, or a collective aspect of a geographical area, an economy or a society dealing with health-related issues


Q & A


Who are the members ofthe Health Sector in Oman?



Emergency Response Operation

Measures undertaken in responding to emergencies

Includes operationalization of appropriate emergency management systems and procedures

Emergency Response Operation involves responsibilities management structures resource and information management SOPs

ERO focus on protecting life, property, essential services delivery and the environment



What are the services of the Health Sector in emergencies?

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) Management of the dead Environmental health measures (water, sanitation, environmental pollution) Psychosocial services Health information Management of health risks (risk assessment, mitigation, communication, preparedness and response leadership)


3. How will you manage

the risks?


Scenario: A destructive flood struck City X, what are the priority activities you have to organize as a health emergency manager on the first 24 to 72 hours?Priority Activities Services Needed Concerned Agencies

Exercise 3:


Exercise :


Scenario: A destructive flood struck City X, what are the priority activities you have to organize as a health emergency manager after the first week?

Priority Activities Services needed Concerned agencies


Exercise :


Scenario: A destructive flood struck City X, what are the priority activities you have to organize as a health emergency manager on the after one month?

Priority Activities Services needed Concerned Agencies



EMERGENCY AND HEALTH

EMERGENCY

COMMUNITY

VULNERABILITIES CAPACITIES

DIRECT IMPACT

INDIRECT IMPACT

ASSOCIATED FACTORS

Climate/ weather/ time of the day

Location

Security situation

Political environment

Economic environment

Socio-cultural environment

Morality, solidarity, spirit

Competence, corruption

DAMAGE AND

NEEDS

HEALTH RESPONSE

Search and rescue

First Aid

Triage

Medical evacuation

Primary care

Disease surveillance and control

Curative care

Blood banks

Laboratories

Referral system

Special units (burn, spinal)

Evacuation centers

Shelter and Water

Food and nutrition

Energy and Security

Environmental health

Primary Health Care

Care of the dead

Psychosocial care

Disability care

Recovery and Reconstruction


EPIDEMIC EMERGENCIES

OUTBREAK

Specific morbidity and mortality

- in the community

- in health facilities

- in health facilities

Risk for health and lab workers

Difficult access

Agent unknown

HEALTH RESPONSE

Case definition

Admission criteria

Case confirmation

Case management

Discharge criteria

Contact tracing

Vector control

Environmental controls

Surveillance system

Referral system

Professional education

Public Information and awareness

Laboratory plans

Hospital plans

Supplies and equipment

Borders control

Quarantine

Animal culling

Commerce/ trade

NEEDS


Health Roles in Managing Risks Over Time

stagetime-frame

general needs health needs

immediatefirst 24 hours

search and rescueevacuation / shelterfoodwaterpublic information system

first aid

triage

primary medical care

transport / ambulances

acute medical and surgical care

emergency communication, logistics and reporting systems (including injury and disability registers)

short-term

end of first week

securityenergy (fuel, heating, light, etc.)environmental health services for:•vector control•personal hygiene•sanitation, waste disposal etc.

emergency epidemiological surveillance for Vector Born Disease, Vaccine Preventable Disease, Diseases of Epidemic Potential

control of disease of public health significance

control of acute intestinal and respiratory disease

care of the dead

general curative services

nutritional surveillance and support (including micronutrient supplementation)

measles vaccination and Vitamin A


Health Roles in Managing Risksstage

time-frame

general needs health needs

medium term

end of first

month

protection (legal and physical)employmentpublic transportpublic communicationspsychosocial services

(re) establishment of the health information system

restoration of preventive health care services such as EPI, MCH, etc.

restoration of priority disease control programmes such as TB, malaria, etc.

restoration of services of non-communicable diseases / obstetrics

care of the disabled

long term end of 3 months

educationagricultureenvironmental protection

reconstruction and rehabilitation

specific training programmes

health information campaigns / health education programmes

disability and psychosocial care

conclusion compensation / reconstruction

evaluation of lessons learned

restitution / rehabilitation

revision of policies, guidelines, procedures and plans

prevention and preparedness

upgrade knowledge and skills, change attitudes

2. Managing the Emergency Operation

Center



Q & A


What is an Emergency Operation Center?

What are the roles of EOC in Incident Management?



Emergency Operation Center a place, activated for the duration of an emergency,

within which personnel responsible for planning, organizing, acquiring and allocating resources and providing direction and control can focus these activities on responses to the emergency

Purpose of EOC: to provide a place to manage the health sector’s contribution to an emergency


First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman 32

Roles of EOC

1. Support site (ICP): logistical support and policy direction to site-level2. Use standard functions - Protect

response personnel and resources 3. Mobilize extra resources and coordinate 4. Minimize loss of life, disability and suffering5. Protect public health6. Protect civil infrastructure, environmental and

economic assets, including property7. Reduce economic losses



Organizational Structure

Policy

Management

CommunicationsSafety/ risk mgmt

Liaison officer

Operations Planning Logistics Administration

Supports Management and Operations

Management Support staff

Develops goals and objectives

AccomplishesGoals and objectives



Elements are both functional and structural

Policy Management Operations Planning Logistics Administration



Draw personnel from appropriate agency operations

Policy group: Elected officials; chief medical officers; chairs of boards or board committees; legal advisors; chief executive, operating, administrative or financial officers; senior department heads

Management: Chief executive, operating or administrative officers; emergency program coordinators or planners; communications officers; safety officers; risk managers

Operations: Division and department heads with programmatic responsibility relevant to the emergency, who can work directly with the incident manager



Planning: program and emergency planners; analysts; subject matter experts

Logistics: staff from purchasing departments; information technology and systems support; human resources officers

Administration: financial officers, accounts and contracts processing personnel; financial analysts; administrative assistants; clerks

Draw personnel from



Competent staff

An EOC needs skilled people who will work together Functional familiarity through regular job Oriented and trained to the EOC role Good team players



EOC preparedness plan

purpose of the plan concept of operations, management structure, roles of personnel and how the components work togetherActivation procedures and levels, and who has authority Escalation and de-escalation plan Call-out list and notification proceduresProcedures /SOPs (resources mobilization and allocation, etc.)CommunicationsInformation management



EOC preparedness planChecklists of the roles and responsibilities of EOC functions

Checklists of standard operating procedures

floor plan, with inventory and locations of equipment and supplies

Electronic information management processes (including a layout plan of phone, fax, data lines, cables, switches and outlets)Communication resources and procedures, especially mobile phones and radiosPublic information and warning processes



EOC preparedness plan

Procedures for engaging levels of government and/or a superior jurisdictionStandard forms and instructions for documenting EOC activitiesMaps of the area of the eventGuidelines for worker care and safetyagency and position responsible for maintaining and updating the plan Training and exercise schedule to ensure staff and procedures are up-to-date.



Physical attributes of an EOC

Two primary considerations:

Location, including access, security, proximity to partners Facility, including size, amenities and configuration



Location

Is there an emergency management agency that could sponsor it?

Proximity to partners, stakeholders, donors and humanitarian agencies

Is some integration with the broader emergency management infrastructure of the jurisdiction possible.

Can the facility survive the hazards in the area?

Is it accessible in an emergency?



Facility a dedicated, purpose-built Health EOC is relatively rare except at the level of national governments a dual or multi-purpose EOC, where the space is routinely used for some other purpose is more common If contemplating dual use space, consider:

o convert and activate the space as an EOC in less than one hour,

o appropriate security measures can be put in place in the same time

o facility should meet the basic requirements of disaster survivability and access

o sufficient space for personnel and equipment required to run it.

o a mix of open and closed work space.



Size and configurationo There are no standards except for staff safetyo evaluate the scale of likely eventso size depends on people depends on event sizeo make form follow functiono Must provide space for:

• core functions (management, operations, planning, logistics and administration)

• Policy group intermittently when required

• A communications and message centre

• Break-out/meeting rooms

• Rest and eating areas

• Storage

• Media relations/public information. (may be off-site)



Useful considerations:

o the EOC Director should be positioned so that they can easily oversee operations.

o Functions that are interdependent should be co- located

o Locate functions adjacent to any displays that pertain to their activity

o A separate, quiet meeting room for priority setting discussions, management briefings, etc.

o If a high volume of incoming communication is anticipated, a separate message centre in the communications room is desirable

o All entrances and exits must be secure at all times. o Food and rest areas should be away from the main

area, and food handling practices and storage facilities should meet the highest public health standards



Building and resources:If staff sleep on site, segregated sleeping facilities will be required, along with enhanced facilities including water and sewage systemsHeating, ventilation and air conditioning and emergency power systems scaled for the extra burden of some crowding heat-producing office equipment. Furnishings may be fixed or movable, with movable, ergonomically suitable furniture offering greater flexibilityThe facility should support generous use of communications technologies, There should be a facility floor plan that identifies the workstations and maps the wiring and equipment at each station.



Office equipment and suppliesoffice equipment and supplies should, to the extent possible, be identical to that which the assigned personnel normally use in their daily work.

Where computers are used, there should be a back-up pen and paper system systems for documentation and reference, in the event of a system failure.

Information displays, if electronic or projected, should be backed up by manual systems (flipcharts, whiteboards)

Information is the lifeblood of an EOC. Use all the possible display space. At least one television and radio tuned to the local media



Redundancyhave back-up plans for technological failures within the EOC

have an alternate site for the EOC itself, in the event that circumstances make the designated facility uninhabitable.

the alternate site may not fully satisfy all the requirements

rely on moving some of the equipment, along with personnel from the primary site.



Learning Objectives:

At the end of the session, the participants will be able to:

1. Define common terminologies in emergency management

2. Relate emergency Response in the Emergency Management Framework

3. Describe Emergency Response Operation

4. Enhance their awareness on the roles of the health sector during response operations


“An effective emergency management will prevent the

escalation of the incident into a disaster”



Thank You



Documents

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