1. Health and Safety in Emergency Management

2. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 2 Why prepare for emergencies Power blackout of 2003 Peterborough flood of 2004 SARS 2003 Pending pandemic Some health care and community care organizations are more ready than others to respond to emergencies.

3. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 3 Emergency Management Emergency Management is a cyclic approach Plan should be dynamic to adapt to change Faster recovery and fewer losses with a plan in place Prevention PreparednessResponse Recovery Mitigation

4. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 4 Natural hazards Emergencies caused by Natural hazards Windstorm Flood Tornado Landslide Hurricane Forest fire Winter/ice storm Epidemic/pandemic

5. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 5 Man-made hazards Emergencies caused by man-made hazards (human acts or omissions) Building fire Explosions Bomb threats Major transportation accident Power failure (black out or other system failure) CBRN disasters (chemical, biological, radiological, nuclear)

6. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 6 Injuries to People Burns, bleeding Injuries to muscles, joints, bones Concussion Emotional trauma Infection Poisoning Death

7. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 7 Property Damage Compromised building structure Building collapse Inoperable equipment or loss of equipment

8. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 8 Impact on the Environment Air contaminants Soil contamination Water contamination Destruction of wildlife and vegetation

9. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 9 Business Interruption Service disruption Loss of business Loss of customers/patrons Poor public image Financial loss

10. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 10 Emergency Management Plan ActsRegulationsCodesStandardsDirectives

11. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 11 Ontario Occupational Health and Safety Act, RSO 1990 Health Care and Residential Facilities Regulations Ontario Fire Code CSA Z731-03 Emergency Preparedness and Response

12. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 12 Directives MoHLTC Emergency Management Unit Health Canada Other (as applicable to the workplace)

13. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 13 Hazard Identification Risk Assessment (HIRA) Initial and ongoing risk assessment to refine safe work practices After each drill or incident, review the HIRA for accuracy and continuous quality improvement. Assessment ControlEvaluation Recognition

14. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 14 Identify Threats to Staff Health and Safety Complete a hazard identification and risk assessment. Use it to formulate the emergency management plan. Include: Likelihood and consequence of harm to staff health and safety Threats of both internal and external emergencies A risk rating to prioritize action plans and allocate resources Share the outcome with the JHSC/H&S representative.

15. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 15 Risk Management Steps Identify all loss exposures Evaluate the risk in each exposure Develop a Plan Implement the Plan Monitor the System Source: Frank Bird Practical Loss Control Leadership Revised Edition. Risk Inventories Tasks Analysis Inspections etc. Severity Frequency Probability Terminate Treat Train etc. Goals/objectives Responsibilities Accountabilities Follow-through Measure Evaluate Command/Correct I D I M E

16. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 16 Identify internal threats Floor plans Material Safety Data Sheets Job Safety Analysis Workplace inspection reports Accident investigation reports First Aid incident tracking Unusual occurrence reports Surveillance reports

17. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 17 Identify external hazards Aerial view Location of railways, airports/flight paths, water ways, industrial plants, etc Potential risks from local business operations

18. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 18 Risk Assessment What is the likelihood of an emergency if the hazard is not controlled? What is the severity of the outcome if the emergency occurs? Estimate the number of people or physical assets that are likely to be threatened, as well as probable consequences of the emergency.

19. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 19 Assess Resources and Capabilities facilities equipment and supplies capabilities of the workforce (expertise, experience) training

20. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 20 Emergency response equipment and personnel Appropriate and on-site emergency response equipment Current inventory of emergency equipment and supplies Maintenance and inspection program for equipment including personal protective equipment (PPE) Trained personnel available to provide on-site emergency response Contracted specialists available where required

21. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 21 Medical or first aid Medical or first-aid capabilities Agreements with neighboring facilities (mutual aid support) Capabilities of mutual aid partners to provide service

22. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 22 Evacuation Emergency evacuation of staff, clients/residents, family members, and the public, including casualties Staff are trained in evacuation procedures A procedure is in place to account for all personnel and clients/individuals supported

23. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 23 Communication Clearly defined internal and external lines of communication Strategies for communicating critical information to employees and their families, the joint health and safety committee, etc. Communication and back-up systems available Staff are educated in communication strategies and trained to use the equipment Fan out system established and tested

24. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 24 Liaison Community partners (healthcare and other service providers) have been identified and included in developing and testing emergency plans Mutual aid agreements identify available resources Established procedures for site representatives to co-ordinate activities with local government officials

25. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 25 Review Plans Review existing policies and procedures Use older plans only as a foundation Liaise with community partners in the development, implementation, review and revision of your emergency management plan After each drill or emergency, review the hazard identification and risk assessment for accuracy Identify any gaps and revise the assessment for continuous improvement Share the outcome of any H&S assessment with the JHSC/H&S representative(s).

26. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 26 Impact of the Emergency Human resources Food and water provisions Shelter provisions Health care/support services Transportation services Psychosocial support (elder care, child care, pet care etc.)

27. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 27 PEMEP Consider the impact on: People Equipment Materials Environment Process

28. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 28 Hazard Control The development, documentation and implementation of the emergency management plan are critical in controlling risks to staff, clients/individuals supported, other occupants/visitors and the workplace. With a common language and approach to emergency management a more cohesive and efficient response can occur particularly in a community wide or multi-organization response.

29. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 29 Incident Management System Framework Occupational Health and Safety All hazards approach IMS assumption

30. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 30 Hazard Control At the source Along the path At the worker Identify and implement these control strategies for specific hazards identified in the HIRA on which the plan is based.

31. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 31 Emergency Management Policy indicates a commitment to establishing an emergency management plan to eliminate or minimize risks includes the responsibilities and accountabilities of all workplace parties is signed by the most senior management level is communicated to all staff on an ongoing basis at orientation, during training, at staff meetings etc. is evaluated for operational expectations is reviewed and revised at least once a year in consultation with the JHSC/H&S representative(s)

32. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 32 Procedures Each organization should develop procedures for the types of emergencies identified in the hazard identification/risk assessment. Procedures provide details on the application of the policy. General procedures may be applicable to all hazards (“all hazards approach” to emergency management) (i.e. communications) Specific procedures for the type of hazard and resulting emergency (i.e. decontamination) Emergency codes should be supported by specific written procedures

33. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 33 Occupational Health and Safety in the Emergency Management Plan

34. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 34 Emergency Management Plan Identify threats to staff health and safety based on the hazard identification and risk assessment (HIRA) Use the HIRA in the writing of the plan In the plan, outline safe work practices Communicate your written policy on emergency management to all staff

35. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 35 Emergency Management Plan Determine the roles, responsibilities and accountabilities of all workplace parties in the Incident Management System (IMS) Communicate a written process for your Incident Manager to receive recommendations or directions from an external body Include in the plan a process for evacuating all or part to the workplace Evaluate all occupational health and safety aspects of the emergency management plan at least once per year

36. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 36 Safety Function Designate a Safety Officer in the IMS Involve the Safety Officer in an ongoing process of HIRA for occupational health and safety Have a written policy and procedure for workplace accident or incident investigation Have a written policy and procedure to deal with work refusal and work stop orders

37. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 37 Communications Clearly define internal and external lines of communication Establish strategies for communicating critical information to staff and their families Make sure that communication equipment is available for use Train staff in communication strategies and the operation of equipment Establish and test a written emergency fan-out system

38. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 38 Liaison Designate a Liaison Officer in the IMS Identify community partners and include them in the development and testing of the plan Develop written mutual aid agreements with community partners

39. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 39 Administration- Human Resources Designate a Human Resources Unit Leader to coordinate human resources Determine staffing levels needed to respond safely in an emergency Develop a contingency plan for increasing and relieving your workforce Maintain a data bank of information on available and reserve employees and volunteers

40. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 40 Administration- Psychosocial Support Services Set up psychosocial support services for staff or communicate availability of resources in the community Educate staff to recognize psychosocial stress in themselves and others Establish a critical incident stress management program to assist staff or source community service providers for this function

41. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 41 Planning Function- Drills, Exercises, Training Designate someone to coordinate training, education and mock drills Assess training needs for staff based on the HIRA and learning needs assessment Develop or access curriculum to meet identified needs Provide different modes of training, education and mock drills Provide general and specific training Clearly define the frequency of drills Conduct drills and training on all shifts Evaluate training needs annually and maintain all records

42. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 42 Logistics- Security Identify and assess all security threats to staff and the workplace Develop written policies and procedures for security measures; test the procedures Write procedures for the proper use, maintenance and operation of security systems

43. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 43 Logistics- PPE Assign someone to procure PPE for staff Use the HIRA to aid in the selection of type and quantity of PPE Train staff in the use, care and maintenance of PPE Write policies and procedures for the use of respirators (if required in an emergency)

44. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 44 Continuous Quality Improvement The annual evaluation reviews: The scope, functionality, execution and effectiveness of the plan as it affects staff health and safety The responsibilities of the workplace parties (employers, managers, charge person(s), and staff), volunteers and students, etc. In the IMS, and to whom they are accountable The hazard identification and risk assessment upon which the plan was originally developed An emergency management plan must be a dynamic tool.

45. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 45 Action Plan Review and revise existing emergency management policies and procedures for OHS Identify requirements for training and education to protect staff during an emergency Identify resources and support that staff will need before, during, and after an emergency Develop the plan in consultation with the JHSC

46. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 46 When the next emergency hits will you be ready? Group exercise: Identifying our strengths and opportunities for improvement.

47. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 47 Questions? Comments?