1. Hazard and Vulnerability Assessment
OSHA Training Institute – Region IX
University of California, San Diego (UCSD) - Extension
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Objectives
Discuss methods of conducting a hazard vulnerability analysis (HVA)
Identify how the HVA is applicable to preparedness and evacuation
Practice effective training techniques in conducting a HVA
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3. The HVA and the Relationship to Evacuation
The HVA is a tool used to evaluate the potential risks for a facility
It is not an evaluation of the potential for evacuation
However, risks identified in the process may focus the organization toward the need to mitigate and prepare for circumstances that could include evacuation
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The Purpose of the HVA
The purpose is a prioritization process that will result in a risk assessment for “all hazards”
The tool includes consideration of multiple factors
The focus is on organization planning and resources and /or the determine that no action may be required. This is an organization decision
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Is this required?
The Joint Commission, previously called the Joint Commission of Accreditation of Healthcare Organizations (JCAHO), requests an HVA for organizations to determine the focus of their emergency planning
There is no specific tool nor method defined
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6. HVA Categories for Evaluation
There are categories considered in a formal process of assessing an HVA
Most HVA tools include an assessment of the following factors:
Probability that an event will occur
The risk of disruption to the organization associated with the event scored as high, moderate or low or a similar description.
The level of preparedness
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7. Probability of Occurrence
The probability may be based on statistics and objective information but also may be intuitive and highly subjective.
The following factors are often considered:
Known risk
Historical data
Manufacturer or vendor statistics
American Society of Healthcare Engineering 2001
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Historical Data
Natural events
Hazardous material releases
Technological accidents
Infrastructure problems
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Risk Assessment
The risk of an event is assessed based on:
Threat to life and/or health
Disruption of services
Damage for failure possibilities
Loss of community trust
Financial impact and legal issues
American Society of Healthcare Engineering 2001
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Preparedness
Preparedness of the organization’s ability to manage risks, can include items such as:
Status of current plans
Training
Insurance
Back up systems
Community resources
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Models
There are a number of models for an HVA.
Two well known models are from
American Society of Healthcare Engineering (ASHE)
Kaiser Foundation
Both models can be adjusted to fit the organization
Security organizations and other vendors also market HVA tools
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12. Medical Center HVA Model
Kaiser model also includes:
Probability
Response factors
Human, property and business impacts, each considered as a separate issue
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13. A Comparison of Threat Events Considered in HVA Models
ASHE Model 2001
Human Events
Natural Events
Technological Events
Kaiser Foundation Model 2001
Human Events
Natural Events
Technological Events
Hazmat Events
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Natural Events
Risks common to the area or geography of the region, for example: storms, earthquakes, floods, and tornadoes, and other natural causes of damage
The impact may be able to be mitigated or may result in a partial or complete evacuation
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15. Mitigation Plans for Regions
Other models use sophisticated software to determine the hazards by cities, counties or regional areas
Are used for the development of mitigation plans for multi-jurisdictions
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Drill HVA
Grayville Hospital
Location: Grayville, CA; Eastern Sierras
Population: 150,000
Description: small town with general services, small businesses, surrounded by rural areas and ranches
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Grayville Hospital
70 Beds
Two story building; 50 years old
ED: 5 beds; in West Wing of hospital
West Wing is single story, recently renovated and structurally reinforced 5 yrs ago
ED connected to hospital by an enclosed corridor
Patient units on second floor of hospital
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Grayville Hospital
On the first floor:
Six bed ICU/CCU
Two room Labor and Delivery
Ten bed family unit
Small nursery
OR:
4 suites, 2 procedure rooms
5 gurney recovery room
Radiology and Laboratory
Five Administrative offices
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22. Why is this Important to Worker Well-being?
Preparedness efforts, plans and resources are directly related to the organization’s HVA
Engineering controls may occur as a result of HVA thus reducing risk for the work force
Safety factors are considered
Process promotes understanding of current resources that may not have been known beyond the “expert”
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23. Evacuation Implications
When a risk is identified in the HVA that would potentially result in an evacuation, the organization should focus on issues that could impact the need to evacuate or to mitigate the risk. Examples:
Routes
Locations
Personal Protective Equipment (PPE)
Communication to employees with special needs
Special situations - management of family on site
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What Does It All Mean?
HVA tools, used to prioritize specific and overall relative risks, are based on mathematical formulas that are either embedded in the document or managed manually
The factors considered in the assessment includes the assumption that the risk occurs at the worst possible time and with a full patient census
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25. Summary: What is the greatest risk?
The HVA process helps an organization prioritize in the order of criticality
The efforts to decrease the consequences of a possible event can be focused upon. This includes evacuation.
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Examples of HVA Tools
American Society for Healthcare Engineering of the American Hospital Association  
Kaiser  Permanente’s interactive HVA tool available at:  
Emergency Management Program Guidebook Published by VHA Center for Engineering & Occupational Safety and Health, St. Louis, MO vaww.ceosh.med.va.gov  
For review of an HVA sample go to: Click HVA under index link
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References
American Society of Healthcare Engineering
FEMA. Emergency Management Institute Hazard vulnerability analysis and risk assessment. Unit 2
Joint Commission Resources Hazard vulnerability analysis (HVA), May/Jun 2002, 2-3
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More References
Kaiser Permanente. Medical center hazard and vulnerability analysis Kaiser Foundation Health Plan, Inc.
Schwartz RB. Hospital preparedness for mass casualties in disasters. Institute of Disaster Medicine Medical College of Georgia slide set
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