Planning for Hospital
Emergency Preparedness,
Response and Recovery
INTRODUCTION
Role of Hospitals in Emergency
Management (AO 6-B s. 1999)
Hospital shares the goal:
“To promote health emergency preparedness among
general public and to strengthen the health sector’s
capability to respond to emergencies, disasters or
calamities”
Role of Hospitals in Emergency
Management (AO 168 s, 2004)
The hospital shares the DOH mission:
“To lead in the formulation of comprehensive, integrated,
and coordinated health sector response to emergencies
and disasters”
Hyogo Framework for Action
(2005-2015)

World Conference on Disaster Reduction in in Kobe,
Japan in 2005

One of the key priorities for action “Promote the goal of
“hospitals safe from disasters”

Inter-agency Task Force of the ISDR made “Safe
Hospital” as the focus of the global risk reduction
campaign (2008 – 2009)
Significant Roles of a Hospital in
Emergency or Disaster

Receiving end of victims

Responders to emergencies/disasters

Direct life saving roles

Symbol of social progress

Prerequisite for social stability and
economic development
Role of Hospital in Management of
Emergencies
To protect public safety and public health, a
hospital and its emergency services need:
• Capacity to reduce vulnerabilities
• Capacity to respond
• Capacity to recover
From: WHO – PHEMAP Course
Bureau of Licensing and Regulation
“Submission of “Hospital Emergency Preparedness,
Response, and Recovery Plan” is a requirement prior
to the issuance of new hospital licenses to operate and
renewal of existing licenses”
Risk Management in Hospital
Planning
Disaster Management Cycle
Disaster Impact
Response
Preparedness
Recovery
Development
Mitigation
Prevention
Protect life, property,
environment
Promote
Cooperation
Among sectors
And agencies
Mitigate loss
of services
HEM Planning ?
Use efficiently
Available
resources
Create systems and networks for responding
To and recovering from emergencies
“Hospital Emergency Preparedness, Response
and Recovery Plan Development ‘08”
Preparedness

measures to build capacities to respond to, and recover
from emergencies
Capacity

ability to manage risks by:
•
reducing hazards
•
reducing vulnerabilities
•
reducing consequences by responding to, and
•
recovering from emergencies

In terms of:
•
Organization; systems; resources and partnership
Emergency Management Plan
An agreed set of arrangements for:

responding to, and

recovering from emergencies
Emergency Management Plan
A plan containing description of:






Responsibilities
Command & coordination mechanism
Management structures
Resource management
Information management and communication
Training and exercises
Risk Management

is a comprehensive strategy for reducing threats and
consequences to public health and safety of
communities by:

preventing exposure to hazards
(target = hazards)

reducing vulnerabilities
(target group = community)

developing response and recovery capacities
(target group = response agencies)
Hospital emergency Preparedness,
Response and Recovery Plan
1.
Emergency Preparedness Plan or A risk
reduction plan includes:

A hazard prevention plan

A vulnerability reduction plan

An emergency preparedness plan (or capacity
development plan)
Hazard Prevention Plan

plan to prevent exposure to hazards

not all hazards are predictable or preventable

Strategies/activities to prevent exposure to hazard
Vulnerability Reduction Plan

Plan to reduce consequences of exposure to hazards

Identify vulnerabilities specific to the five elements of
the community

Strategies/activities to reduce the vulnerabilities

Building resilience of the hospital to withstand impact
and consequences of hazard
Emergency Preparedness Plan

Plan to build response capacity of the hospital
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Policies, Protocols, Guidelines and Procedures
Plans
People
Promotion and Advocacy
Partnership Building
Physical (Facility Enhancement)
Program Development
Practices
Peso and Logistics
Package of Services
2. Emergency Response Plan

to use existing response capacity, includes :





Policies for direction and plans to be activated
Systems and Procedures to be activated/implemented
Organized team to respond to emergencies
Available logistics and funds for the operation
Established networks for emergency management
Emergency Response Plan

use existing capacities to deliver relief or response

mobilization of resources

use of developed systems for emergency management

actual implementation of guidelines/proedures for the
developed systems
3. Recovery and Reconstruction Plan
 A plan to restore services and replace damaged
elements of hospital for the better
Emergency Planning
Process
Analyze resources
Define the plan
Form Planning Group
Describe Roles and
Responsibilities
Hazard Analysis
Vulnerability Analysis
Describe Management
Structure
Risk Analysis
Problems/Gaps Analysis
Develop Strategies and
Systems
“Hospital Emergency Preparedness, Response
and Recovery Plan Development ‘08”
Elements of Hospital Preparedness,
Response and Recovery Plan
I.
II.
III.
IV.
V.
Background
Plan description
Goals and objectives
Planning Group
Emergency Preparedness Plan

Hazards prevention

Vulnerabilities reduction

Risk reduction
VI. Management Structures
VII. Roles and responsibilities
Elements of Hospital Preparedness,
Response and Recovery Plan
VIII.
Hospital Response Plan

IX.
X.
Policies, guidelines, protocols for the developed
systems
Recovery and Reconstruction Plan
Annexes





Glossary
Abbreviations
Directory of contact persons
Inventory of resources of hospital and partner
agencies
Hospital policies, guidelines, protocols, and other
issuances relevant to emergency or disaster
management
Hospital Emergency Planning
Process
I. Background

Write in narrative form the background of your
region or agency including the provinces,
municipalities/communities within your area of
jurisdiction.

Some data are better presented in tabular or
graph forms for faster and easier comprehension
of the reader or user.
Background
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Name of the Hospital and address (narrative)
Geographic description (location: Low lying area? Etc.)
Demographic profile of catchments communities
Hospital Profile
Health statistics of the hospital (IMR, MMR, etc.)
Health facilities found in the municipality/city (tabular)
Health services areas/departments of the hospital
Manpower complementation of the hospital
Disasters responded/managed
Legal issuances establishing its authority in HEM
Significance:
a.
b.
c.
d.
e.
f.
Picture of the site and location of the hospital
Catchments areas provided with hospital services
Health resources in and around the hospital
Existing capacity and capability of the hospital
Partner agencies around the hospital
Anticipated hazards as basis for hospitals’ capacity
and capability building
II.
Plan Definition

Aim, objectives, and scope

Tasks to be performed

Resources to be needed

Framework which emergencies will be managed
Plan Definition





Brief description of the content of the plan
Specific intentions relevant to set goals and objectives.
Include the coverage, scope and limitations.
Include the legal basis whereby the hospital is authorized
to act in disaster situations
Legal issuances detailing the roles and functions of
hospitals in managing all phases of emergencies or
disasters
Example:

PLAN DEFINITION
The JRMH Health Emergency Preparedness and
Response Plan defines the direction of the hospital in
preparing for an effective and efficient response in any
event of emergency or disaster. This embodies a set of
strategies and activities based on the hazards and
vulnerabilities or risk analysis of the hospital.
Example: Context of JRMH HEPRRP

The JRMH Preparedness Plan contains strategies & activities that
the hospital will carry out to build and enhance hospital capacity to
respond to emergency or disaster, whereas its Response Plan
includes strategies and activities in utilizing hospital resources for
effective and efficient response during emergency or disaster.
Likewise, this Response Plan includes policies, protocols,
guidelines and procedures pertaining to various emergency
management systems for more efficient response. The third set is
the Regional Recovery or Rehabilitation Plan which entails
strategies and activities in mainstreaming the hospital back to its
prepared position for any forthcoming eventuality.

The JRMH Emergency Preparedness and Response Plan includes
the inventory of its internal and external resources, in terms of
inventory lists and directories, in the context of human resources,
logistics, financial sources, existing systems and services. These
are all found in the annexes of the plan.
Scope of the Plan

This Plan shall be implemented, by the JRMH together,
(but not limited) with all other members of the regional
hospital network concerned with emergency or disaster
management.
Significance:
 Who will implement the plan
 Extent of implementation including limitations
III.

Goals and Objectives
Gives the purpose of the plan from a broader to more
specific perspectives.
Example :
Goal: To build the hospital capacity for effective and
efficient response to and recovery from emergency
Objectives:
 To strengthen the hospital HEPRRP
 To develop systems and guidelines for emergencies
 To develop human resource competencies
 To upgrade hospital facility for better services
 To ensure availability of funds and logistics in times of
emergency or disaster
IV. Planning Committee




Hospital Planning Committee include major
stakeholders
Permanent or “AD HOC Group” which convenes only
for hospital emergency planning purposes.
This group shall be created through a hospital order.
Roles and functions of the planning group/committee

Develops, reviews and updates the HEPRRP

Gathers required information and gain commitment
of key people and organizations

Initiates testing of the plan for its functionality and
adaptability to current situation
i.
Example: Planning Committee
Structure





Hospital Director/CMPS/HEMS Coordinator
Representative from Planning Division
Representative from Administrative Division (especially
finance and logistics officers)
Representative from areas of hospital operation
Representative from the community
Hospital Planning Committee Structure
Hospital Director/CMPS/
HEM Coordinator
Representative
from areas of
hospital
operation
Representative
from
Administrative
Division
Representative
from Planning
Division
Representative
from the
community
V. Emergency Preparedness Plan
Development
1. Hazard assessment


Identifying all the possible hazards that have the
potential to affect the hospital
Identify the possible areas to be affected
Hazards
Areas commonly affected
Translate into a Hospital Hazard Map
Example of Hospital Hazard Map
Legend:
Fire
Earthquake
Flood
Laboratory
OB Ward
OPD
Radiology
ER
Admitting Sect.
EENT Ward Urology Ward
Billing Sect.
Ortho Ward
OR
OR
Delivery Rm.
Pedia Ward
Medicine Ward Surgery Ward
Recovery/Rehabilitation Plan
Emergency
Hazard
Hospital
Risks
People
Property
Environment
Services
Livelihood
(Vulnerable)
People
Property
Environment
Services
Livelihood
(Damages
Needs)
Capacities used
To manage Risks
Disaster
Recovery/
Rehabilitation
Hazard Reduction/Prevention Plan
Hazard
Strategies/
Activities
Time
Frame
Resource Requirement
Req’d.
Avail.
Source
Person
Resp.
Indi
cators
Risk Analysis
Identified Hazards
Impact to hospital (Risks)
1. Property: Structural; Nonstructural; Funtional
Components
2. People
3. Services
4. Environment
5. Livelihood
Risk Assessment
Hazards
Vulnerabilities
People
Properties
Services
Environment
Livelihood
Risks
Probability of death
Probability of spread of the disease
Prob. Of disease or injury (mental,
physical)
Prob. Of contamination
Prob. Of displacement
Prob. Of loss of income or property
Prob. Of breakdown in security
Prob. Of breakdown in essential
services
Preparedness Plan
Capacity
(10P’s)
Hospital
Strategies/ Time
Resource Req’t.
weaknesses Activities Frame
Req’d
Avail
Person
Resp.
Indi
cators
Source
From the results of the self assessment of the hospital, list down
all the weaknesses based on the expected hospital capacities.
List down all the strategies and activities to be done for capacity
development.
Recovery/Rehabilitation Plan
Emergency
Hazard
Hospital
Risks
People
Property
Environment
Services
Livelihood
(Vulnerable)
People
Property
Environment
Services
Livelihood
(Damages
Needs)
Capacities used
To manage Risks
Disaster
Recovery/
Rehabilitation
Vulnerability Assessment
Impact to hospital
(Risks)
Why did Risks happen?
(Vulnerabilities)
1. Property:
Structural; Nonstructural; Funtional
Components
2. People
1. Property: Structural; Nonstructural; Funtional
Components
3. Services
3. Services
4. Environment
4. Environment
5. Livelihood
5. Livelihood
2. People
Vulnerability Reduction Plan
Hazard
Vulne
rability
Strategies/
Activities
Time
Frame
Resource Req’t.
Req’d
Avail
Person
Resp.
Source
Indi
cators
Activities during Response Phase

Utilization of capacities built

Activation of plans and systems developed

Activation of OPCEN

Mobilization of resources

Management of emergency cases

Validation and constant monitoring of the event
Hospital Emergency Management Policies, Guidelines,
Procedures and Protocols
1.
Available procedures, protocols, for emergency
management
a.
Security system
b.
Public Information System
c.
Incident Command System
d.
Information Management System
e.
MHPSS
f.
Blood and blood products mobilization
Hospital Emergency Management Policies, Guidelines,
Procedures and Protocols
1.
Available procedures, protocols, for emergency
management
g.
Code Alert System
h.
Infection Control
i.
System to expand services, spaces and beds in case
of surge of patients
j.
System on drills/simulation exercises
k.
Stockpiling of emergency medicines and supplies
Hospital Emergency Management Policies, Guidelines,
Procedures and Protocols
1.
Available procedures, protocols, for emergency
management
l.
SOP on Operation Center
m. Referral System Procedures
n.
Logistics management system
o.
Decontamination procedures
D.
Hospital Emergency Management Policies, Guidelines,
Procedures and Protocols
2.
Manual for the operation, preventive maintenance, and
restoration of critical services
a.
Electrical supply and back-up generators
b.
Drinking water supply and alternate sources
c.
Fuel reserves
d.
Medical gases
e.
Back-up communication system
f.
Wastewater and solid waste water treatment
g.
Fire suppression
D.
Hospital Emergency Management Policies,
Guidelines, Procedures and Protocols
3.
Hospital policies on emergency/disaster management
a.
Hospital policies related to disaster management
b.
Policy on managing volunteers during emergency
VI.
Response Plan
A. Management Structures
Incident Commander
Safety Officer
Public Info. Officer
Liaison Officer
Operations
Logistics
Planning
Administrative/
Finance
“Hospital Emergency Preparedness, Response
and Recovery Plan Development ‘08”
Response Plan
a.
Activation of Code Alert System
b.
Activation of the Plan
c.
Activation of the ICS
d.
Activation of the Operation Center
e.
Implementation of the RESPONSE Standard
Operating Procedures/ Protocols Emergencies
f.
Implementation of existing Standard Operating
Procedures/Guidelines for systems developed
g.
Initiation and Maintenance of Coordination and
networking for referrals of cases
Response Plan
h.
i
j.
k.
l.
Initiation and Maintenance of Mental Health and
Psychosocial Support Services for casualties, patients,
hospital staff and other responders, bereaved
Management of Information
Activation of plan in the event of complete isolation of
hospital/CHD/community for auxiliary power, water and
food rationing, medication/ dressing rationing, waste and
garbage disposal, staff and patient morale
Provision of the Public Health Services
Management of the Dead
Recovery/Rehabilitation Plan
Hazard
Hospital
Risks
People
Property
Environment
Services
Livelihood
(Vulnerable)
People
Property
Environment
Services
Livelihood
(Damages
Needs)
Capacities used to
manage Risks
Emergency
Disaster
Recovery/
Rehabilitation
Capacities
Utilized,
Damaged
Recovery/Rehabilitation Plan
Damages/
utilized
Resource
Req’t.
Resp.
Person
Time
Frame
Indicators
Next Actions
1. Write the Plan and have it approved by the head of the
agency. The Plan is not a plan until written and
approved by the head of agency
2. Disseminate the plan to all the stakeholders and staff.
Everyone needs to know the plan so that in emergency
no one would ever say, “he does nothing cause he
knows nothing”.
3. Test the plan. The plan is believed to be effective only
when it is tested, be able to know its functionality,
acceptability, and doability in the hands of the
implementers.Update the plan
4.
Implement the plan.
5. Monitor and evaluate the implementation of the plan
6. Review and update the plan regularly.
Thank You!