Presentation on theme: "Preparing for Internal and External Emergencies and Disasters"— Presentation transcript:
1Preparing for Internal and External Emergencies and Disasters Emergency ManagementPreparing for Internal and External Emergencies and Disasters
2Definition of an Emergency A sudden, unexpected event requiring immediate action due to a potential threat to health and safety.Joint Commission on Accreditation of Healthcare Organizations (JCAHO) defines an emergency as a natural or man-made event that suddenly or significantly:Disrupts the environment of careDisrupts care and treatment of patientsChanges or increases the demand for services
3Definition of a Disaster A sudden, unplanned event that makes it difficult, or impossible for a facility to carry out essential activities. During a disaster, the needed resources are greater than those availableA facility disaster is an event in which the demand for health services from the event or existing patients, exceeds the ability of the to provide those services.A disaster can occur at any level – local, state, regional, country or multiple countries.
4Classification of Facility Disasters Internal Disasters- events that result in loss of resources used for regular activities.Examples: fire, smoke, fumes, loss of utilities, worker strikes, release of chemicals or radiation, hostage situations, or bomb threatsExternal Disasters – events that occur in the community outside the hospital that may effect the facility’s ability to carry out regular activities.Examples: hurricanes, tornados, floods, storms, earthquakes, train derailments, plane crashes, power outages, terrorist attacks, and riots.
5Facility Emergency Preparedness Facilities must be prepared to respond to a wide range of emergencies. These events may include natural disasters, terrorist attacks or any other situation that dramatically increases the number of patients who come to the facility needing treatment.Facility emergency preparedness helps to reduce the impact of emergencies and disasters while continuing to provide essential day-to-day services.Preparedness phases include:PreventionResponseRecoveryMitigation
6Emergency Management Activities Prevention – activities aimed at avoiding or intervening to stop an emergency from occurringex. Examining the facility for potential dangers and correctingMitigation – lesson or eliminate the impactex. Back-up generator, Planning for likely eventsResponse – address the immediate effects of the emergencyex. Transferring of Patients to Alternate SiteRecovery – actions taken to restore normal operationsex. Clean-up operations
7Goals and Objectives Ensure safety of employees, staff, visitors Assure availability of dialysis careProtect PHIMitigate DamagePlanning, Sharing of Resources, Building/Equipment/System ChangesExpedite return to normal operationsComply with laws and regulations
8Emergency Management Plans Easy to understandFunctional, flexible and adaptiveConsider various viewsWritten and updated annuallyComprehensive, All-HazardEducation and TrainingAdhere to existing standards, requirementsInclude outside agencies
9Creating a Plan Planning Administrative Communications Preparation Record KeepingSecuritySuppliesTransportationPowerWater SystemsWaste DisposalRecoveryCreating a Plan
10Assumptions when Creating a Plan Dialysis facilities are not usually included in state or local disaster plansDisasters burden outside resourcesDisasters may interrupt utilities servicesCommunications may be impactedStaffing ShortagesImpractical to plan for all emergency types and sizesAcute renal services may be in need
11Risk Based Approach to Planning Hazard Vulnerability Analysis1) Identify Potential Risks/HazardsInternal/External2) Identify Possible Causes3) Assign Risk Level (Probability)
12Hazard Vulnerability Analysis Natural DisastersCriminalTerrorist ActionCivil DisastersAccidentInternal Disasters snowstorms hailstorms ice storms tornadoes floods earthquake bomb threat/incident nuclear, chemical or biological attack hostage incident with multiple victims demonstrations riots strikes buses planes multiple vehicle accidents explosions bridge collapse hazardous material spills/events Fire physical damage from natural disasters such as snow storms, ice storms etc utilities failure broken water mains hazardous material spills workplace violence hostage taking infant abduction acts of terrorism
13All Hazard PlanningAll-hazard planning, the foundation of preparedness, is a process that makes certain that each individual, each department and the entire facility is always ready for any type of emergency that might occur.Although each event has specific needs, many of the functions performed remain the same during any type of event.
14Plan Activation - Event Levels Alert PhaseMinor ImpactModerate ImpactMajor ImpactPre-disaster activation for alerting necessary staff to “stand by” in the event they are needed.Administration is immediately notified.Example:Storm WarningDelay in providing daily hemodialysis services.StormSuspension of services requiring temporary facility closer.Coordination with the Orleans/Genesee County Emergency Management Office is immediately enacted.NYS DOH and ESRD Network are immediately notified.Loss of Water, PowerThis would be an overwhelming disaster requiring immediate facility evacuation and indefinite suspension of services.911 call initiatedHospital Administration is immediately notified.Fire, Chemical, Radiological, Biological Event
15Problems in DisastersDuring disasters, problems often occur because hospital and management systems that work well on a day-to-day basis cannot effectively meet the additional needs of the disaster.Lack of clearly defined leadership and chain of commandLack of accurate facts and informationLack of, miscommunication, right amount
17Possible Emergencies and Associated Components Contaminated Water SupplyLoss of UtilitiesFire/Water DamageLoss of CommunicationsSupply ShortagesIncrease in Census/SurgeStaffingFinancial Concerns
18Contaminated Water Supply - May or May Not be Informed- Indicated by water system monitoring.Contact the municipal water supplier/County Health Department for present status of water supplyAdjustments may have to be made to your water treatment systemContact water system vendor or manufacturerWater meets EPA requirements or pre-existing quality prior to useIncreased Monitoring
19Loss of Utilities Generator Calculate Power Requirements Existing transfer switchPower Plan – full or partial loadFuel PlanMonitoringTest Emergency Power (Hospital Based)Bulk Water (could delay recovery phase)Calculate ConsumptionConnectionsSuspend ReuseShorten TreatmentsTesting/Monitoring
20Bulk/Tanker Water at the Facility Typical Water Treatment Systems designs based on EPA MCL’s.NYSDOH Certification of Approval for Distribution of Bottle or Bulk WaterVerification of compliance with EPA standards for drinking waterTesting Records for MCL’sDisinfection RecordsApproved Transportation Container
21Fire/Water Damage Damage Assessment Check List (Two Types) Survey Assessment – quick, briefWhat you HaveWhat you NeedWhat you Lost- Detailed AssessmentPhysical/Equipment/SuppliesCurrent Condition and Safety RiskCertified for use or service
22Communications Loss of Landline Cell Phones – Machine Interference Internet – HAN/HPNTwo Way RadioRunnersTV/MediaBattery Powered Radio
23Supply Shortages Days on Hand Dialysis Specific What is required Per/TreatmentEmergency Purchase Orders/Cash on hand
24Increase in Census/Surge Limited to C of ORationing of Treatments/Alternate SchedulesSupplies, Utilities ConsumptionPHITransportationStaffingNYS DOH Waivers?
25Staffing Availability Cross Credentialing Reserves and National Guard staff may be calledTravel – Driving BansTypes Needed – Professional, SupportWho can do what?Cross CredentialingProviding for staff in sustained operationsNutrition, Health, Rotation, Housekeeping, Family Issues,Incentives, CommunicationEducate Staff on Home Preparedness
27Summary Develop Emergency Management Plans Keep Plan readily available Train, Review, Update Plans to Changing EnvironmentBe active with your local Emergency Management agency (EMO)Mutual Aid Agreements (MOU’s)List of local vendors/suppliers/labs for assistancePreventative MaintenanceEstablish a Decision Making Tree/Center (EOC)Incident Command System
28Emergencies Stop Being One When You are Prepared for It