American College Health Association
June 3, 2011
University Disaster Preparedness and
Mission Continuity Plans
Session FRO30
John Andrews, MD, MPH
Assistant Senior VP Academic Health Center
and
Director, University Health Services
University of Cincinnati
Disclosures
I have nothing to disclose.
Sources
 University Health Services Mission Continuity
Plan, University of Cincinnati, Cincinnati, OH
 ACHA Guidelines. Emergency Planning
Guidelines for Campus Health Services: An AllHazards Approach, February 2011.
 http://www.fema.gov/
 http://www.bt.cdc.gov/cerc
 http://www.uc.edu/publicsafety/fire_emer
gency/emergency_preparedness.html
Objectives
 Explain why an effective Mission Continuity
Plan embraces an All-Hazards Approach to
Disaster Preparedness
 Describe the importance of an Effective Mission
Continuity Plan for University Disaster
Preparedness
 Identify the university operational areas that
must be included in an effective university
Mission Continuity Plan
Outline of Today’s Presentation
I.
Disaster Plans versus Mission Continuity
Plans
II. A few Definitions and Concepts
III. Four Main Steps in Disaster Preparedness
IV. Practical Ideas for Mission Continuity Plans
(How we did them at the University of
Cincinnati and How we Should Have Done
them!)
V. Communication in Disasters
VI. Psychological Impacts of Disasters
VII. Conclusion
Why Plan?
The failure to plan
is
a plan to fail.
Disaster Plans Versus Mission
Continuity Plans
Disaster Plan: The plan that is used to respond to
a disaster.
Mission Continuity Plan: The plan that is used to
get your organization back to normal
functioning - or what do you do after the fire
department has left and all of the injured
people have been removed from the scene.
Outline of Today’s Presentation
I.
Disaster Plans versus Mission Continuity
Plans
II. A few Definitions and Concepts
III. Four Main Steps in Disaster Preparedness
IV. Practical Ideas for Mission Continuity Plans
(How we did them at the University of
Cincinnati and How we Should Have Done
them!)
V. Communication in Disasters
VI. Psychological Impacts of Disasters
VII. Conclusion
Purpose of the
National Response Framework (NRF)
 The National Response Framework is used by
federal agencies including the U.S. Department
of Homeland Security to respond to disasters
 Respond effectively to any type of incident with
 Immediate actions to save lives, protect
property and the environment, and meet
basic human needs
 Implementing emergency plans and actions
to support short-term recovery
Reference: http://www.fema.gov/emergency/nrf
National Incident Management
System (NIMS)
 The National Incident Management System
(NIMS) is a nationwide operations template that
enables federal, state, tribal, and local
governments, the private sector, and nongovernmental organizations (NGOs) to work
together regardless of cause, size, location, or
complexity of a hazard in order to reduce the
loss of life and property and harm to the
environment.
Reference: http://www.fema.gov/emergency/nims/
Governance, Command and Control
During Disasters
 Identify individuals who will be responsible for
declaring an emergency, determining the hazard
level, and activating the Disaster Plan.
 Identify the location of the Emergency
Operations Center (EOC)
 Assign Incident Command System (ICS) roles for
individuals reporting to the EOC. (University
Management will assign the Incident
Commander. The Incident Commander will
assign Section Chiefs and Liaison Officers)
Incident Command System (ICS)
 A proven mechanism for the effective
management of emergencies that involve either a
multiple agency response or a single unit with a
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Planned, Organized Structure
Chain of Command
Unity of Command
Standardized terminology
Facilities/Resources Management
Communications and Information Management
Source: http://www.fema.gov
Set Up and Use the Incident
Command System
Recommend that campuses and universities
adopt the NIMS/ICS system on campuses for
all emergencies
 Incident Commander
 Safety Officer, Liaison Officer, Public Affairs
Officer, technical officers
 Planning, Logistics, Operations, and
Accounting/Finance Sections
Identify an Emergency Operations
Center (EOC)
 Identify personnel who will work in a Disaster.
 Identify a location for working in a Disaster.
 Identify equipment and information needed for
working in a Disaster.
 Identify a back-up location off-campus for
working in a Disaster (consider a local hotel.
They have large rooms, telephones,
bathrooms, copiers, fax machines)
Evacuation Plans
 Set up Evacuation Plans for the relevant parts
of your university
 Inform employees as to who can decide to
evacuate a work area
 Set up an area for employees to meet
(recommend finding a convenient place that is
inside, that is away from heat or cold, that has
food and water, and that is near bathrooms.
Shelter-In-Place Plans
 Set up Shelter-in-Place Plans for situations in
which work areas do not need to be evacuated.
 Inform employees as to who can decide they
need to shelter-in-place.
Areas of Rescue Assistance
 Identify and placard Areas of Rescue
Assistance for employees who are not able to
leave work areas.
 Inform local emergency personnel of who may
need to be rescued and where the areas of
rescue assistance are located.
 Identify employees who can assist employees
with disabilities in leaving the area.
Outline of Today’s Presentation
I.
Disaster Plans versus Mission Continuity
Plans
II. A few Definitions and Concepts
III. Four Main Steps in Disaster
Preparedness
IV. Practical Ideas for Mission Continuity Plans
(How we did them at the University of
Cincinnati and How we Should Have Done
them!)
V. Communication in Disasters
VI. Psychological Impacts of Disasters
VII. Conclusion
Four Main Parts of
Disaster Preparedness
 Mitigation/Prevention
 Preparedness
 Response
 Recovery
Mitigation/Prevention
 Campuses cannot prevent all disasters
 Campuses can identify risk reduction strategies
to prevent incidents and mitigate the impact of
emergencies
 The first strategy is to develop a preparedness
plan
 Create teams to decrease the risks due to acts
of violence (Threat Assessment Team) and
decrease exposure during public health
outbreaks (School closure plan, immunization
plan, etc.)
Preparedness
 Interdepartmental project involving key
individuals in various constituencies working on
a plan with realistic deadlines.
 Identify if the institution has policies,
procedures, structures or templates to respond
to an emergency
 Determine if policies, procedures, structures or
templates can be adapted to all hazards
 Determine who is responsible for emergency
preparedness on the campus.
Preparedness (cont)
 If there is no plan, determine whom you need
to engage in the conversation to get
emergency planning on the agenda.
 Determine if your school has participated in
NIMS training/certification
 Identify membership of the campus emergency
management team. Include legal, risk
management, human resources, and safety
and security.
 Identify the decision makers and a chain of
command
Preparedness (cont)
 Identify how essential groups will work together
 Define and explain roles and responsibilities for
the operational plans for each department.
 Identify the role of the campus health service
 Provide exercises and drills to rehearse the
response to a disaster. Coordinate drills with
multiple departments.
 Keep staff informed. Encourage staff
participation in webcasts, disaster response
training seminars and continuing education
programs
Preparedness (cont)
 Monitor CDC, World Health Organization, ACHA,
and state health department information
 Encourage staff to make personal and family
emergency preparedness plans so they are
better able to be responders in the event of an
emergency
 Fit test staff with N95 respirator protection.
Consider positive air purifying respirators
(PAPRs)
 Identify staff roles and responsibilities for all
types of critical incidents.
Preparedness (cont)
Compile a list of supplies that are needed
Identify supply sources
Identify storage area for supplies
Maintain a stock supply of needed items
Establish a plan for continued cleaning and
waste removal services
 Investigate the feasibility of establishing
negative pressure rooms in the campus health
service
 Coordinate with local hospitals
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Preparedness (cont)
 Consider cancelling classes and asking students
to leave campus
 Plan for a reduction in the campus health
services workforce.
 Consider volunteers to assist with answering
phones, moving supplies, and providing
bedside assistance to the ill.
 Consider developed a clinic schedule based on
24/7 operation
 Consider suspending nonemergency services.
Preparedness (cont)
 Identify community resources that students could
use.
 Set up a system for reporting cases both on and off
campus
 Develop a plan for care of the deceased that
considers storage until notification of the family and
transfer
 Develop plans for conducting mass immunization
clinics.
 Develop plans to provide food to students and staff
Preparedness (concl)
 Plan for how to handle international students
 Determine how research activities will be
handled
 Establish a plan for care of laboratory animals
and cell cultures
 Establish a plan for specimen storage
 Set up an evaluation and continuous process
improvement plan
Response
 Once an incident occurs, priorities shift from
planning to saving lives and protecting
property
 Four actions in the response phase
 Obtain situational awareness
 Activate and deploy resources
 Coordinate response actions
 Demobilization
Response Situational Awareness
 Continuous monitoring of information
regarding actual and developing incidents
 Type of monitoring depends on the event
Response –
Activate and Deploy Resources
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Assess the situation
Identify and prioritize requirements
Activate available resources
Develop an Incident Action Plan
 Set up an Incident Command System
 Activate an Incident Management Team
 Activate specialized teams as needed
 Position resources based on need
 Request additional resources from state or
federal government.
Response –
Coordinate Response Actions
 Response operations are enhanced by full
application of NIMS with its common principles,
structures, and coordinating processes
 Coordinate actions with local authorities,
including law enforcement, firefighting, and
emergency medical services
 Continually assess operations and adapt
existing plans to meet evolving circumstances
 Coordinate public information strategies
Response –
Specific Response Actions
 Ensure responder safety and health
 Warning the public and providing information to the
public
 Implementing evacuation and sheltering plans that
includes provisions for special needs populations
and household pets
 Perform search and rescue
 Treat the injured
 Assist law enforcement and investigation
 Control hazards – extinguish fires, contain
hazardous spills
Response –
Demobilization
 Decide when to call an end to the crisis
 Set up a timeline for restoring normal operations
 Communicate with employees, students, and
others on the resumption of services
 Provide post-event resources for assisting those
who need psychological, financial, and social
support
 Evaluate the effectiveness of the emergency
response including feedback from participants
Recovery
 Actions to facilitate recovery (Mission
Continuity) start almost as soon as the disaster
occurs.
 Recovery is getting the operation back to
normal
 Recommend not trying to “improve” the normal
operation at this time. “Improvement” to the
normal operation can occur after operations
are back to normal
Outline of Today’s Presentation
I.
Disaster Plans versus Mission Continuity
Plans
II. A few Definitions and Concepts
III. Four Main Steps in Disaster Preparedness
IV. Practical Ideas for Mission Continuity
Plans (How we did them at the
University of Cincinnati and How we
Should Have Done them!)
V. Communication in Disasters
VI. Psychological Impacts of Disasters
VII. Conclusion
University Mission Continuity Plan
University of Cincinnati
A detailed plan of procedures for getting
operations back to normal
Our experience at the University of Cincinnati
How we did it and how we should have done it!
Who needs to be involved?
 All constituencies that will be involved in
mitigation/prevention, preparedness, response,
and recovery
 Regularly scheduled meetings, written
collaborative agreements, mutual aid planning,
and/or memoranda of understanding
 Frequent NIMS/ICS training, tabletop
exercises, active drills, and specialized
education for responders.
Mission Continuity Plans
 Identify persons who will be in charge when a
disaster occurs. Identify two back-up persons for
each task (due to vacations, personnel being outof-town or ill). Obtain addresses for these
individuals
 Identify persons who will be in charge when an
emergency occurs. Indentify two back-up persons
for each task
 Identify who will document all activities during the
emergency for legal, risk assessment, financial,
and administrative purposes.
Mission Continuity Plans (contd.)
 Identify who has access to any keys or
equipment/forms/software/or data needed
 Obtain contact information for other university
personnel including the Biological Safety Office,
Facilities Management, Construction
Management, Risk Management, Public Safety,
IT, Locksmith, Laboratory animals, Legal,
Radiation, Supplies and Services, Work Control
Mission Continuity Plan Activities
 List all activities in your areas as Critical
(essential) or Non-Critical (non-essential).
 It may be helpful to group activities into such
categories as Education, Research, Patient Care,
Business Support.
 For both Critical and Non-Critical Functions,
describe the processes/procedures/tasks that are
required to carry out the function, the Recovery
Time to have the activity operational, and the
personnel (title/position) who will be needed to
carry out the function.
Mission Continuity Plan Activities
(contd.)
 Identify the location of all equipment/forms that
will be needed to carry about the function.
 Indicate the space, software, connectivity,
databases needed for the activity.
 Set up teams for various areas of your university
that will need to be operational in a disaster
(Health Care, Environmental Health, Personnel,
Legal, Public Relations, Finance, Administration,
Executive, Liaison). Consider any technical
experts that may be needed. Obtain contact
information for these people.
Mission Continuity Plan Activities
(contd.)
 Inventory university equipment in enough
detail that an underwriter will reimburse the
university if the equipment is lost or damaged.
Include band name, vendor, serial number, and
purpose of the equipment, names of the
equipment, and building and room number
where equipment is kept.
Put a Mission Continuity Plan
into Writing
 Distribute Plans to key personnel
 Update Plans at least annually
Outline of Today’s Presentation
I.
Disaster Plans versus Mission Continuity
Plans
II. A few Definitions and Concepts
III. Four Main Steps in Disaster Preparedness
IV. Practical Ideas for Mission Continuity Plans
(How we did them at the University of
Cincinnati and How we Should Have Done
them!)
V. Communication in Disasters
VI. Psychological Impacts of Disasters
VII. Conclusion
Communication
 Goal of Communication: Be first, Be right, Be
credible.
 Set up a Communication Plan for employees and
students (beepers, cell phones, paging, enunciators,
posters, bulletin boards, radio, television, Twitter,
Facebook, Nixle)
 Publicize the Communication Plan
 Update personnel on the plan
 Get staff cell phone and home phone numbers. Get
phone numbers of relatives and for places the staff
member is likely to stay if they aren’t at home
http://www.bt.cdc.gov/cerc (CERC = Crisis and Emergency Risk
Communication)
Communication (cont)
 Discuss communication plan with communication
and IT departments to be sure it is doable.
 Identify who will be responsible for
communications as well as at least two backups
(Public Relations Officer)
 Set up a central reporting plan for daily
monitoring of illness or disease, employee and
student absences, students in isolation, location
and number of students transported to a hospital
 Establish a plan for notifying essential personnel
(calling tree ?)
Communication (cont)
 Get appropriate approvals in advance so that
messages can be disseminated quickly
 On a regular schedule and as needed, provide
information to the campus community on such
topics as the disaster status on campus, travel
advice, shelter-in-place, personal care, hand
washing, cough etiquette, how/where/when to
access healthcare services.
 Consider crafting messages in advance
 Ensure that messages are easy to understand and
culturally appropriate.
Communication (concl)
 Consider identifying translators and translating
materials into different languages as appropriate.
 Maintain communications with the local public
health authorities, emergency preparedness
groups, hospital systems regarding surveillance,
case identification and reporting, control
measures, and health care provisions. (Liaison
Officer)
 Maintain contact with other universities as
appropriate (Liaison Officer)
 Maintain up-to-date lists of key contacts (Liaison
Officer)
Outline of Today’s Presentation
I.
Disaster Plans versus Mission Continuity
Plans
II. A few Definitions and Concepts
III. Four Main Steps in Disaster Preparedness
IV. Practical Ideas for Mission Continuity Plans
(How we did them at the University of
Cincinnati and How we Should Have Done
them!)
V. Communication in Disasters
VI. Psychological Impacts of Disasters
VII. Conclusion
Psychological Impact of Disasters
 Most people (including disaster responders) will
experience psychological distress in disasters
(strong feelings of grief, sadness, fear, or anger)
 Some individuals will need professional
assistance to achieve the two primary goals of
mental health crisis response
 Normalizing feelings
 Finding effective ways of coping with ongoing
stress
Psychological Impact of Disasters
(cont)
 There is not a single “normal” pattern of reaction
to a disaster.
 If symptoms of distress do not dissipate in a
period of weeks if they become worse, affected
individuals should seek professional help.
 Strategies they may help individuals include
identifying safe areas and behaviors, maximizing
the individual’s ability to care for self and their
family, teaching calming skills, encourage
connectedness to family and other social supports.
Psychological Impact of Disasters
(cont)
 Important for primary health care clinicians to
screen patients for stress related symptoms and
emotional distress.
 Identify positive methods of coping (social
supports, self-care, structure to daily routine,
continue “normal” rituals, continue exercise and
recreational activities, gently facing feared
situations.
 Professional assistance if severe fatigue, easily
startled or hyper-vigilant, headaches,
gastrointestinal symptoms, problems with
concentration, social isolation, blaming, unable to
experience pleasure, outbursts of anger.
Psychological Impact of Disasters
(concl)
 Care-givers and emergency response personnel
require
 Stress debriefing meetings
 Counseling and support options
 Educational in-services or workshops
regarding self-care
 Work rotation schedules and respite
 Strategies most helpful focus on helping
individuals to establish a feeling of being safe
Outline of Today’s Presentation
I.
Disaster Plans versus Mission Continuity
Plans
II. A few Definitions and Concepts
III. Four Main Steps in Disaster Preparedness
IV. Practical Ideas for Mission Continuity Plans
(How we did them at the University of
Cincinnati and How we Should Have Done
them!)
V. Communication in Disasters
VI. Psychological Impacts of Disasters
VII. Conclusion
Conclusion
Go Forth
and
Plan Well