Hospital Emergency Preparedness

Developing a Hazard Vulnerability Analysis

for Your Hospital

JCAHO Changes in 2001

Term changed to “Emergency Management”

Changes in alignment with NFPA 99, Chapter. 11 Community Response

Intent is to ensure more effective response to disasters (global).

Environment of CareEC 1.4 (a)

HVA Definition: “The identification of hazards and the direct and indirect effect these

hazards may have on the hospital.”

ASHE Definition of RiskRisk = Probability * Severity

Probability

Issues to consider for probability include, but are not limited to:

1 Known risk

2 Historical data

3 Manufacturer/vendor statistics

Score:

0 = N/A, 1 = Low, 2 = Moderate, 3 = High

Severity(Magnitude - Mitigation)

Magnitude (Impact)

Human Property Business

Severity(Magnitude - Mitigation)

Issues to consider for human impact include, but are not limited to:

1 Potential for staff death or injury

2 Potential for patient death or injury

Score:

0 = N/A, 1 = Low, 2 = Moderate, 3 = High

Severity(Magnitude - Mitigation)

Issues to consider for property impact include, but are not limited to:

1 Cost to replace

2 Cost to set up temporary replacement

3 Cost to repair

4 Time to recover

Score:

0 = N/A, 1 = Low, 2 = Moderate, 3 = High

Severity(Magnitude - Mitigation)

Issues to consider for business impact include, but are not limited to:

1 Business interruption

2 Employees unable to report to work

3 Customers unable to reach facility

4 Company in violation of contractual agreements

5 Imposition of fines and penalties or legal costs

6 Interruption of critical supplies

7 Interruption of product distribution

8 Reputation and public image

9 Financial impact/burden

Score:

0 = N/A, 1 = Low, 2 = Moderate, 3 = High

Severity(Magnitude - Mitigation)

Mitigation

Preparedness Internal Response External Response

Severity(Magnitude - Mitigation)

Issues to consider for preparedness include, but are not limited to:

1 Status of current plans

2 Frequency of drills

3 Training status

4 Insurance

5 Availability of alternate sources for critical

supplies/services

Score:

0 = N/A, 1 = High, 2 = Moderate, 3 = Low or none

Severity(Magnitude - Mitigation)

Issues to consider for internal resources include, but are not limited to:

1 Types of supplies on hand/will they meet need?

2 Volume of supplies on hand/will they meet need?

3 Staff availability

4 Coordination with Clinics's

5 Availability of back-up systems

6 Internal resources ability to withstand disasters/survivability

Score:

0 = N/A, 1 = High, 2 = Moderate, 3 = Low or none

Severity(Magnitude - Mitigation)

Issues to consider for external resources include, but are not limited to:

1 Types of agreements with community agencies/drills?

2 Coordination with local and state agencies

3 Coordination with proximal health care facilities

4 Coordination with treatment specific facilities

5 Community resources

Score:

0 = N/A, 1 = High, 2 = Moderate, 3 = Low or none

What To Review?Hospital Areas of Concern:

Natural Hazards

Technological Hazards

Human Hazards

Hazardous Materials

How to Start?Hospital Collaboration:FacilitiesEngineeringDesign and ConstructionSafetySecurityEmergency DepartmentLeadershipOthers

How to Start?External Collaboration:LEMSADHSHealth/HazMatFire DepartmentLaw EnforcementEnvironmental HealthOther HospitalsOthers

How to Start?SEVERITY = (MAGNITUDE - MITIGATION)

EVENT

PROBABILITY HUMAN IMPACT

PROPERTY IMPACT

BUSINESS IMPACT

PREPARED-NESS

INTERNAL RESPONSE

EXTERNAL RESPONSE

RISK

Likelihood this will occur

Possibility of death or injury

Physical losses and damages

Interuption of services

PreplanningTime,

effectivness, resouces

Community/ Mutual Aid staff

and suppliesRelative threat*

SCORE

0 = N/A 1 = Low 2 = Moderate 3 = High

0 = N/A 1 = Low 2 = Moderate 3 = High

0 = N/A 1 = Low 2 = Moderate 3 = High

0 = N/A 1 = Low 2 = Moderate 3 = High

0 = N/A 1 = High

2 = Moderate 3 = Low or none

0 = N/A 1 = High

2 = Moderate 3 = Low or none

0 = N/A 1 = High

2 = Moderate 3 = Low or none

0 - 100%

Hurricane 0 2 3 2 1 2 1 0%

Tornado 2 2 3 2 2 2 2 48%

Severe Thunderstorm

3 2 3 2 1 2 1 61%

Snow Fall 1 2 2 1 3 3 3 26%

Blizzard 1 2 2 1 3 3 3 26%

Ice Storm 1 2 2 1 3 3 3 26%

Earthquake 2 3 3 3 2 2 2 56%

Tidal Wave 0 3 3 3 3 0 3 0%

Temperature Extremes

3 2 1 1 1 1 1 39%

Drought 2 1 1 1 1 1 1 22%

Flood, External 2 3 3 3 1 2 1 48%

Wild Fire 1 2 3 2 1 3 1 22%

Landslide 0 2 3 2 2 0 2 0%

Dam Inundation 1 3 3 3 2 3 2

Volcano 1 3 3 2 2 3 2 28%

Epidemic 2 3 1 3 2 1 2 44%

AVERAGE SCORE 1.38 2.31 2.44 2.00 1.88 1.94 1.88 32%

*Threat increases with percentage.

22 RISK = PROBABILITY * SEVERITY

199 0.32 0.46 0.69

How to Summarize?

Hazard Specific Relative Risk to Medical Center

0.00

0.10

0.20

0.30

0.40

0.50

0.60

0.70

0.80

0.90

1.00

Natural Technological Human Hazmat

Rel

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e T

hre

at t

o F

acil

ity

How to Summarize?Operationalized Subjective Data:Areas of StrengthAreas WeaknessJustification for FundingJustification for TrainingJCAHO CompliantHospital AwarenessCommunity AwarenessOrganizational Awareness

Questions?Mitch SaruwatariKaiser PermanenteWestern EH&S100 South Los Robles, Suite 410Pasadena, CA 91188(626) 564-3817mitch.saruwatari@kp.org

Worksheet available at:

www.emsa.ca.gov