Emergency Management Programs for Health Care Systems: An Overview

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Emergency Management Programs for Health Care
Systems An Overview
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Behavioral Objectives

• Define the framework of Emergency Management
  Program (EMP) for hospitals and health care
  systems
• Define the role of the Joint Commission standards
  on the EMP
• Discuss the coordination of hospital and
  community planners in emergency management

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Context

• Emergency management standards for health care
  systems lacked a comprehensive approach until
  January, 2001.
• State of readiness of Americas health care
  industry were called into question after the
  events of 2001.
• Proliferation of new funding and groups eager to
  offer solutions to terrorism may overlook the
  enduring foundations of an all hazards program
  orientation.

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All-risk Concepts,Systems Knowledge

• Comprehensive Emergency Management (1979).
• Integrated Emergency Management System (1983).
• Incident Command System (1985).
• Standardized Emergency Management System (1994).
• National Incident Management System (NIMS)
• All hazards approach to emergency management

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Current DHS Initiatives

• Develop and maintain a risk-based, all-hazards
  national emergency management system that
  prevents, prepares for, responds to and recovers
  from major threats, including terrorism.
• Support emergency management standards-setting
  processes, particularly those relating to
  equipment and technology.
• Promote a national incident management system.

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Emergency Management Program (EMP)

• Organizes and address all activities related to
  emergency preparedness
• Development of relationships, policies and
  actions before the event occurs
• EMP Manager
• Operational understanding o f the hospital,
  local, state and federal response
• Responsibility and authority

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Emergency Management Program (EMP)

• Committee development
• Meetings with direction and strategy
• Components
• Mitigation
• Preparedness
• Response
• Recovery

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• Mitigation
• Pre-event planning and implementation actions
  that lessen the impact of the potential hazard
• System redundancy
• Mitigating structural hazards
• Preparedness
• Building capacity and capability to address the
  event and resulting patient care needs
• Builds from the Hazard Vulnerability Analysis

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• Response
• Activities in response to the incident or a
  potential incident
• Recovery
• Returning to normal operations, including
  personnel, supplies, equipment and the facility

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Comprehensive Emergency Management A Cycle
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Hospital Emergency Operations Plan (EOP)

• Hospital response to a event or potential event
• Event may be external, internal or a combination
  of both
• Guidance documents for initial response

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EOP Goals

• Protect staff, current patients and visitors
• Receive, evaluate, treat and disposition victims
  of the event
• Adhere to regulatory requirements and risk
  management issues
• Outline planning assumptions for consistency
  among all staff

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EOP Development and Maintenance

• Easy to train
• Easy to use
• Easy to update
• Maximize resources
• Minimize redundancy of actions
• Follow the mission of the hospital
• Play well with others

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Joint Commission on Accreditation of Healthcare
Organizations (JCAO)

• Management of the Environment of Care
• EC Standard 4.10 The hospital addresses
  emergency management

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JCAHO EC 4.10

• An emergency in the hospital or its community
  could suddenly and significantly affect the need
  for the hospital's services or its ability to
  provide those services. Therefore, a hospital
  needs to have an emergency management plan that
  comprehensively describes its approach to
  emergencies in the hospital or in its community.

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Key components of EC 4.10

• Hazard vulnerability analysis
• procedures that describe mitigation,
  preparedness, response and recovery strategies
• Development of an emergency management plan
• Notification of staff and external authorities
• Define the hospitals command structure

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EC 4.10 Key Concepts

• Adopted the broader context of comprehensive
  emergency management
• Included a hazards vulnerability assessment.
• Required use of an incident command system (ICS)
  that is consistent with the ICS in use by the
  local community.

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EC Standard 4.20

• The hospital conducts drills regularly to test
  emergency management
• The hospital tests the response phase of its
  emergency management
• Participation in at least one community wide
  practice drill a year relevant to the priority
  emergencies identifies in its HVA
  communication, coordination and effectiveness

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Foundation of ICS

• Common Terminology
• Integrated Communications
• Modular Organization
• Unified Management Structure
• Manageable Span of Control
• Integrated Plans
• Comprehensive Resource Management
• Pre-Designated Facilities

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NFPAEmergency Management Standards

• NFPA 99, Chapter 12 Health Care Emergency
  Management
• NFPA 1600 Standard for Business Continuity and
  Emergency Management

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NFPA 1600 Program Elements

• Laws Authorities
• Hazard Identification Risk Assessment
• Hazard Management (Mitigation)
• Resource Management
• Planning
• Direction, Control Coordination
• Communications Warning

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NFPA 1600Program Elements (cont)

• Operations Procedures
• Logistics Facilities
• Training
• Exercises, Evaluations Corrective Actions
• Public Education Information
• Finance Administration

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National Incident Management System

• Adopted in March 2004
• Calls for national system using the principles of
  incident command
• Defines the need for mitigation, preparedness,
  response and recovery
• Must be used for federal support of recovery

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Relationship

• JCAHO EC Standards provide detail on health
  system specifics.
• NFPA 1600 provides an overall emergency
  management program structure.
• NIMS outlines the national model that will
  facilitate all phases with emphasis on recovery

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What About HEICS?

• ICS model for health care organizations.
• Series of ICS position descriptions and
  checklists.
• Must be adapted to the organization and
  integrated with the EOP.
• Facilitates mutual aid with other hospitals and
  first responders
• Facilitates recovery and avoids confusion

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Establishing Leadership and Direction

• Adopting emergency preparedness as a mission of
  the facility
• Assigning Responsibilities
• Conducting a Program Assessment
• Developing the Strategic Administrative Plan
• Building Support
• Creating Opportunities for Interagency
  Coordination

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Emergency Management Program

• Identify Critical Operations and Infrastructure
• Perform Hazard Identification and Risk Assessment
  (HVA)
• Conduct Consequence Analyses
• Develop Recovery Priorities and strategies
• Create Mitigation Strategies and Take Action

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Preparedness and Response

• Resource Identification and Inventory
• Develop Agreements and Contracts
• Equipment Purchase and Maintenance
• Emergency operations planning
• Education and training
• Exercises and Real Events
• Evaluations Corrective Actions

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A Review4 Types of Planning

• Establishing goals, objectives and workplans.
• Developing priorities for recovering critical
  systems and equipment.
• Identifying actions for reducing the impact from
  hazards.
• Creating strategies for the initial response to
  emergencies.

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Disaster Planning Is...

• A continuous process.
• Reducing the unknowns.
• Evoking appropriate actions.
• Answering what is likely to happen?
• Based on valid knowledge

1 Quarantelli
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Disaster Planning Is

• Focused on general principles.
• An educational activity.
• Overcoming resistance.

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Key Activities

• Tasks common to all emergencies and disasters.
• Activated/de-activated based upon the needs of
  the situation.
• Basis for the development of position
  descriptions and checklists.

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Response Levels

• Field Response / first responders
• Hospital
• Local Government
• County (operational area)
• Region
• State
• Federal Region
• National

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Resources
Guidebook www.va.gov/emshg FRP/SLG
101/CAR www.fema.gov SEMS www.oes.ca.gov Disas
ter research www.colorado.edu/hazards JCAHO www
.jcaho.org NFPA www.nfpa.org HEICS www.emsa.
ca.gov