Planning for Health Emergency Management

Planning for Health Emergency

Management

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


Learning Objectives

By the end of this module, the participant should be able to:

Describe the steps of emergency response planning process in terms of inputs, outputs and outcomes

Create flowcharts for emergency response planning

To identify the various plans that must be developed and the harmonization between them


Quick brain storming……

What is an emergency response plan?

Why to develop emergency response and recovery plans?

How are emergency response planning processes different from routine planning processes for the health sector?


An integrated set of long-term, multi-sectoral development activities

Emergency Preparedness Program –

Reminder


Goal: to achieve an increasing level of “readiness” within communities to cope with any situation which demands an emergency response, using their own resources. This requires the development and maintenance of :

1. Political authority, policy for EM

2. Plans and Procedures for EM and Recovery training and education

3. Institutional and human resources for EM

4. Public awareness & education

5. System for the collection, analysis and distribution of information related to emergencies

Emergency Preparedness Program


Just remember the overall context…….

Public Safety

Risk Management Emergency ManagementHazard Reduction

Vulnerability Reduction

Emergency Preparedness

Damage Assessment & Needs Analysis

Epidemiology and Reporting

Mass Casualty ManagementHospital Planning

Curative CareShelter and Security

Water and SanitationControl of Communicable Disease

Food and NutritionReproductive HealthPsychosocial Needs

Medical Supplies and Logisics

Media and Public Information

Recovery and Rehabilitation

safer communities

+

Response plans


Difference between Emergency Response Planning and Routine PlanningERP focuses on:

Coordination and management systems of resources from several sectorsemergency management and incident management systemsManagement of information

arrangements for intra-sectoral and inter-sectoral coordination of activities and mobilization of resources (surge capacity)

What are the characteristics of routine planning in your field of activity?

Quick brain storming……

What may be the different activities, situations and risks….that the Health Sector must think of when developing response plan and contingency plans ?

With what the response plan of the Health Sector must deal with ?


Health Sector Response Plan must deal with…..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)

Continuity of delivery of critical services for emergency patientsManagement of the dead and missing

Management of information (public information; support activities; health info system)

Mental healthEnvironmental healthReproductive healthPublic health programs (continuity of essential programs)


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 + recovery period)

What are the strategies to respond and recover


Disaster Management is:80% generic 15% specific 5% unique

to all disasters to the hazard to the event1. OrganizationEOC earthquake timecoordination large numbers of trapped and injured placecommunications large numbers of homeless and displaced weathertransport large numbers of dead and missinglogistics and supplies geographyinformation and media dead, injured and missing staff climatereporting and surveillance damaged critical infrastructure / resources (hospitals, vehicles)

loss of water, gas, electricity, phone, transport, fuel networks security2. Response loss of road, sea, air, rail infrastructure / accesssearch and rescue politics

evacuation long period of SAR, victim extraction economymass casualty management high demand for FA, stretchers, triage, medical transport governancemanagement of dead and missing high demand for beds, surgery, blood products, referral

security wound infections, amputations, tetanus, dust inhalation emergency management capacitytemporary shelter, clothing and utensils high demand for orthotics, prosthetics, disability, dental logistics capacityemergency water, sanitation and energy demand for specialized spinal and head injury care disposal of inappropriate donations

emergency food supplies high demand for temporary shelter, food, utensils, stoves,emergency public and environmental health water, energy, clothing, tents, blankets leadershipemergency engineering and public works high demand for psychosocial support of victims and staff solidaritymanagement of donated supplies / foreign teams morale

3. Recovery few outbreaks of communicable diseases corruptionvariable demand for medicines and equipment crime

curative and public health care (acute / chronic injury care - high, infectious disease - low, lootingeducation potentially unstable chronic disease - medium)agriculture compensation claimstrade and commerce contamination of water, air and soil insurance claims

toxic chemical, sewerage and gas leaks / spills4. Rehabilitation and Reconstruction urban fires, explosions ownership disputes

people contaminated, infested and unsafe foods property disputesproperty increased vector breedingserviceslivelihoods loss of livelihoods, markets, distribution networksenvironment

THIS IS WHAT WE PLAN FOR ….


Key characteristics of an ERP

Emergency Response Plan and Recovery Plan

an agreed set of arrangements forresponding to, andrecovering from emergencies

plans involve the description ofresponsibilitiesmanagement structuresresource and information managementLogistics managementTraining and exercises

plans focus on protecting life, property and environmentoutcomes


A response plan will define and discuss :

• a line of authority and clear responsibilities of all

the stakeholders involved

• the management systems: ICP; EOC; EEC

• the communications system

• alert and warning mechanisms

• public information arrangements

• resource management (human, financial and material)

• Monitoring, reporting and accounting arrangements

Core Elements of an Emergency Response Plan


Main characteristics Clear responsibilities (who, what, when, how, with whom, where) All key stakeholders need to be involved in the planning process, including:

agencies with disaster responsibilitiescommunity members / groupsInstitutions and legal authorities

Relevant to emergency events: large scale; complex; relatively rare; hard to predict

Consequences of poor decisions can be acute Scrutiny of mistakes is often in detail and in public


Community Risk Management Plan

Provincial EmergencyDisaster Plans

National Emergency Disaster Plan

HazardSpecific

Plans AgenciesSpecific Plans

(hospitals)

SectoralPlans

Intersectoral in nature

Context of emergency plans for a community


The following sectors are involved in the emergency planning process:

How these sectors can contribute to the development of the health sector response plan?

Essential Services

• communications• police• relief and rescue• health• social welfare

• transport• public works• also agriculture, media,

education, fire, ambulance, engineering, meteorology


Policy, guidelines, standards

Nationallevel

Nationallevel

CommunitiesShould be

allowed

CommunitiesShould be

allowed

Develop and implement

Preparedness activities

Vulnerability reduction plans

Emergency response plans

National & provincial levels = support communities in their work

Mobilise extra-resources

International org & assistance

Provinciallevel

Provinciallevel

Emergency Preparedness Program

Mitigation plans

Rehabilitation and recovery plans

Policy - Guidelines – Standards – Community Plans and Role of the MOH


The Roles of National Government (1)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 implementation of the policy (contents of the plans, etc.)

developing national plans (multi-sectoral; sectoral; contingency) for those situations that are not under the direct responsibility of local authorities


The Roles of National Government (2)

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. Security

international cooperation and assistance

WHAT ARE THE PRESENT CONSTRAINTS IN YOUR COUNTRY ?


Main responsibilities of MOH in emergency planning

Reduce the vulnerabilities of its own infrastructures andsystems: hospital mitigation; EMS System; etc.

Raise awareness first of the health staff then of the general public (in collaboration with other sectors)

Reduce health consequences of crisis and major emergencies (core function of the health sector). A “health emergency management program/unit” should be institutionalised within the MOH; development of emergency response plans

Assume its normative role and lead function (guidance) in health (emergency preparedness and risk management)


Overall strategy of the MOH

Integration strategy Vulnerability reduction and hazard mitigation Community risk management framework Inter-sectoral cooperation Planning based on existing resources (all types) Decentralization of the response capacity Community participation (and end-users) Institutionalization of an emergency/disaster Unit within the MOH


THE EMERGENCY PLANNING PROCESS


The Process


The Planning Process

Determine the authority responsible for the process Establish a planning committee and objectives; management structure of the process Conduct a risk assessment - hazards and community vulnerabilities (core elements) Assign responsibilities Identify and analyse capacities and resources Develop the emergency management systems and arrangements Document the plan Test the plan; Review and update the plan on a regular basis


Outputs of the intersectoral emergency planning process

A set of emergency response plans – who does what when using existing capacity:

search and rescue planevacuation / temporary shelter planmass casualty plan / hospital planssectoral relief plans (food, water, health, lifelines etc.)security plansMitigation; EWS (MCM: all hazards)

A disaster recovery and reconstruction plan (education, agriculture, public works etc.)


Outcomes of the emergency planning processThe planning process is a sequence of steps whereby a planning entity (e.g. government, community) agrees on ways to enhance and protect its 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, mitigation, and response greater awareness of risk reduction in the community higher levels of readiness to respond and to recover an emergency response plan and a recovery plan (and contingency plans when relevant) increased public safety (including for the health sector such as safer hospitals, etc.)


Evaluate the PlanHow do we know a plan is a functional plan?

it meets the national planning criteria and policy ? it conforms to the national planning format ? it has been developed through a true emergency planning process (from vulnerability analysis up to participation of end-users) ? it is tested, validated and regularly exercised ? all key staff are familiar with the details of the plan and know their responsibilities ?

WHAT DO YOU WANT TO ADD?


After the Plan has been developed

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 conduct regular exercises


Common Planning Mistakes

the plan (paper document) is given more importance than the planning process itself not key community members (or staff of the institutional plan) are aware of the existence of a plan revision is overlooked emergency planning is not integrated into normal activities (integration strategy) whenever possible different plans are developed for different hazards by different agencies – the all hazards approach should be preferred (no synergy; no compatibility) no or weak training programs what do you want to add?


Common Planning Mistakes

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


Organizational Capacity

implemented selectively by those agencies which have been delegated that responsibility by the Government or by the community

it is vital that…..agencies…… professionally managed adequately resourced highly trained demonstrated competence emergency management family


Emergency Risk Management – Principles for Agencies

goal :

to increase efficiency, effectiveness, readiness and integration of the agency into the overall organization of the emergency management process and system


Principles for Agencies and emergency planning needs

Objectives :

to improve the decision making process at all levels (within agency) to facilitate the choice of the most suitable strategies to rely on specific decision making procedures to ensure efficient communication :–internal and external

to ensure safety and well being of staff /community to promote and preserve the activities efficiency : synergy, complementarities, adaptability, cooperation to promote adequate training : personnel / exercises….


Define the ERM policy of the Agency

Enter the planning process (ERM)

Allocation of required resources of all kind

Implementation: activities – role - functions

Monitoring – reevaluation process

ERM process for an Agency

Risk management and Planning - Principles for Agencies


Group Work Activity……20 minutes

As part of an overall emergency response plan for the Asian Games, you are requested to prepare the Health Sector Response Plan…….Instructions as follows:

1. to identify a city in one country of your choice

2. to discuss potential problems, which can impact on health in this city

3. to identify the stakeholders who will be involved to contribute to the management of these health problems

4. to identify the key headings of the components of your Emergency Response Plan (for Health Sector in this city)


Updating the information on hazard and vulnerabilities...

Why Emergency Response Plans must be regularly revised ? update the current political, social and economic situation

update hazard reduction, emergency preparedness and vulnerability reduction activities in all sectors and by all organisations

update changes in resources, systems and procedures

update early warning information system


Assessment of Response Capacity of the Health Sectormandate and authority to deliver relief (scope of responsibility)

management and command structure (coordination among stakeholders)

competencies of staff (knowledge and skills and ability)

the availability and accessibility of information

the existence and relevance of plans

the existence and relevance of procedures

the networking of the plans of the Health Sector with the plans of the other sectors


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Early warning information...links with Response Plans

The emergency response plans are useful only:when they are activated they are relevant and functionalThey are efficiently used

So the early activation of the response plans is essential. In many emergencies there is a time frame which allows for early activation (floods; displacement of populations; anticipated cold wave, start of an outbreak, etc.) and for developing further mitigation measures (early warning is critical)


THE STEPS ONE BY ONE


Step 1: Define Project

Determine the aim, objectives and scope of the

planning process Identify the tasks to be performed, and the resources needed Identification of the framework in which emergencies will be managed legislation policy and guidelines must be considered and the resources that will be required:

stakeholders / agencies, etc.


Step 2: Review Planning Group

Key Stake-holders to be represented

multi-disciplinary teams are essential to ensure

sufficient expertise

must have appropriate authority

political and economic circumstances may

influence choice of members

social and cultural issues must be considered

there must be an efficient reporting system


Step 3: Potential Problem Analysis

planning group should know result of vulnerability analysis (at least core elements)

technique for identifying preventive and mitigation strategies; response and recovery strategies for identified problems

systematic breakdown of the problem into its components

techniques involves:

o hazard analysis / vulnerability assessment / developing response and recovery strategies / mitigation


Step 4: Resource Analysis

why?

to ensure that PRR strategies can be supported

to ensure that preparedness is coordinated

to ensure cooperation between agencies

to know who is responsible for supplying


Step 5: Roles and Responsibilities

should be defined & described to ensure that each organization knows precisely what is expected of it and that everyone is aware of the general roles of all relevant organizations

multi-sectoral approach for national disaster plan

key issues:o Information managemento resource managemento evacuationo specific situation such as hazardous material…


THANK YOU

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Planning for Health Emergency Management

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