Transcript Planning for Health Emergency Management

Planning for Health
Emergency Management
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Q&A
What is the difference between :
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Plans
Procedures
Guidelines
Regulations
Policies
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Policy
 a formal statement by a government, organisation or
institution that expresses a set of goals, the priorities
within those goals and the preferred strategies for
achieving those goals; policy is based on the
mandate of the institution (WHO)
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
The differences
Policy
– what must be done
Guidelines – how to implement the policy – technical how
Procedures – how to implement the policy – administrative
how
Internal Regulations – special procedures which often incur a
penalty if not followed
Plan –
who does what when to implement policy
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Characteristics of Plans
The information is volatile:
They lose relevance quickly because the information
in them decays over a short time
They need frequent revision
Are local and specific:
They are made by the end-users
They apply in specific circumstances
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
The relationship
Procedures, guidelines and authority are needed to
make plans
Policies are needed to define guidelines and set
procedures
Mandates are needed to set policies
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Procedures
Procedures are about allocating responsibility for
resources i.e.:
 Acquisition of new resources
 Access to existing resources
 Accounting for the use of resources
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Guidelines
Guidelines are about using resources:
 Appropriate resources
 Application of those resources
 Evaluation of the effectiveness of resources
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Emergency
One characteristic of an emergency is that normal procedures
are inappropriate or inadequate to deal with the situation
In an emergency, special emergency procedures are
needed to get the situation under control
In an emergency, institutions are given specific responsibilities
which require extraordinary powers to be given to specific
people for a limited time
Those specific people must have plans for how those
extraordinary powers will be used and for defining the
resources they will need to meet their responsibilities
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Planning for emergencies
Planning elements
Planning is a LOCAL activity, undertaken within a national
legal and policy framework:
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Define the planning objectives
Network with the stakeholders
Analyse the community and its risks
Plan for the priority risks
Resource the plan
Train and educate for the plan
Advocate for changing attitudes to the risks
Rehearse the plan
Review and revise the plan
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
The importance of planning
 lack of planning means that a failure comes as a
complete surprise
 a bad outcome is more often due to defective
planning, rather than lack of resources
 emergency response planning is about making the
best use of available resources
 Emergency preparedness planning is about getting
new resources
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Information is key to planning
bad or inadequate information
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wrong planning parameters
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bad plan
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Participatory planning
all those who are involved in implementation need to be
involved in the planning process
=
the stakeholders
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
The planning process
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Determine the authority responsible for the process
Establish a planning committee
Conduct risk analysis - hazards and community vulnerabilities
Set the planning objectives
Define the management structure for the process
Assign responsibilities
Identify and analyse capacities and resources
Develop emergency management systems and arrangements
Document the plan
Test the plan
Review and update the plan on a regular basis
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Outputs of the process
A set of risk reduction plans – how can we prevent
emergencies from occurring in our community
A set of emergency response plans – who does what
when using existing capacity:
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search and rescue plan
evacuation/temporary shelter plan
mass casualty management plan
restoration of lifelines plan
security plans
A set of disaster recovery plans (public health, education,
agriculture, transport, public works etc.)
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Outcomes of the process
Planing process is a sequence of steps whereby a community
agrees on ways to enhance and protect it’s own safety. It is an
interactive and iterative process that should lead to:
 better understanding of the roles and responsibilities of
all members of the community in prevention and response
 greater awareness of risk reduction in the community
 higher levels of readiness to respond
 A set of 3 basic plan sets – a risk reduction plan, an
emergency response plan a recovery plan (reconstruction
plans can only be made after a disaster but should be
based on existing policies and guidelines)
 increased public safety
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Planning for emergencies
Planning based on risk analysis is planning for any
emergency, by predicting:
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what might happen
when it might happen
where it might occur
how big it might be
what effect it might have
how long it might last (emergency period +
recovery period)
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Common planning mistakes
 Making a “national plan”: emergency plans only work for
institutions and communities – provinces and states need to
develop policies, procedures and guidelines to direct planning
process and support local response agencies in an emergency
 the plan is given more importance than planning process itself
 not all community members aware of the existence of a plan
 testing and revision is overlooked
 emergency planning is not integrated into normal activities
 different plans are developed for different hazards by different
agencies – the all hazards approach should be preferred
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Common planning mistakes
 “National” plans have proven to be ineffective – planning is
a local activity
 Plans are out of date as soon as they are published
PLANS NEED REGULAR REVIEW
 Procedures, policies and guidelines are needed to guide the
planning process at local level
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
“All Hazard Approach” plan:
 80% of what we do in emergencies is generic –
we do it for every emergency – the all hazards
approach
 No need to wait for field information to do this
 15% is specific to the hazard
 Much can be done before field data is available
but an assessment is needed to provide the
quantitative data
 5% is unique to the event – the people, the place
and the time
 The assessment will provide all of this data
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Disaster Management is:
80% generic
to all disasters
1. Operational Organisation
EOC/command and control systems
coordination mechanisms
communications systems
transport and traffic management systems
logistics and supplies systems
assessment and reporting systems
information systems and media management
resource mobilisation/tracking systems
donated supplies/foreign teams management systems
15% specific
5% unique
to the hazard
to the event
earthquake
time
place
weather
large numbers of trapped and injured
large numbers of homeless and displaced
large numbers of dead and missing
dead, injured and missing staff
damaged critical infrastruture/resources (hospitals, vehicles)
loss of water, gas, electricity, phone, transport, fuel networks
loss of road, sea, air, rail infrastructure / access
2. Response Operations
search and rescue
evacuation
mass casualty management
management of dead and missing
security and traffic control
temporary shelter, clothing and utensils
emergency water, sanitation and energy
emergency food / cooking supplies
emergency public and environmental health
emergency engineering and public works
long period of Search/Rescue, victim extraction
high demand for FA, stretchers, triage, medical transport
high demand for beds, surgery, blood products, referral
many wound infections, amputations, tetanus, dust inhalation
high demand for orthotics, prosthetics, disability, dental
demand for specialised spinal and head injury care
high demand for temporary shelter, food, utensils, stoves,
water, energy, clothing, tents, blankets
high demand for psychosocial support of victims and staff
severe disrupiton of public health services
3. Recovery Operations
low risk outbreaks of communicable diseases
variable demand for medicines and equipment
(acute/chronic injury care - high, infectious disease - low,
potentially unstable chronic disease - medium)
medium risk contamination of water and soil
medium risk fertiliser, chemical, sewerage and gas leaks/spills
lifelines
curative and public health care
education
agriculture
trade and commerce
4. Rehabilitation and Reconstruction
people
property
services
livelihoods
environment
urban fires, explosions
contaminated, infested and unsafe foods
increased vector breeding
high demand for debris clearance and disposal
loss of livelihoods, markets, distribution networks
THIS IS WHAT WE PLAN FOR ….
geography
climate
security
politics
economy
governance
emergency management capacity
logistics capacity
disposal of inappropriate donations
leadership
solidarity
morale
corruption
crime / looting
looting
compensation claims
insurance claims
ownership disputes
property disputes
foreign assistance
foreign teams
A plan does not achieve results
 The goal of the planning process is not to make a plan
– the goal is use it
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Results come from the actions defined in the plan – if
it’s not in the plan, no-one is responsible and it wont
be done
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The time to start planning is now
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
The role of government
The role of national authorities is to support local planning
processes by establishing the planning framework:
 Setting national policies for risk reduction, emergency
preparedness, emergency response and disaster recovery
 Issuing technical guidelines and administrative procedures for
the process of planning and for the contents of plans
 Developing procedures for how national resources can be
deployed in an emergency
 Allocating funds to support the development of new local
capacity and for local risk reduction
 Planning for those hazards that are not the primary
responsibility of local government e.g. bio terrorism, war
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
The role of national authorities
 Emergency Planning is a local responsibility
 For most hazards, there should not be a “national plan”
for responding to the common hazards – ideally, the
national plan should simply be:
 to support and resource local plans
 National authorities must provide the laws, policies,
guidelines and procedures needed to make local plans for
risk reduction, emergency response and disaster
reconstruction
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
The planning hierarchy
The levels of the planning hierarchy should be modelled
on the existing administrative structure of the country. It
should include:
 national polices, guidelines and procedures (for the
planning process AND for the contents of plans)
 Provincial/state plans to support local plans
 local plans
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Response planning
Elements of a response plan
A response plan will define :
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a line of authority
responsibilities of all the stakeholders
the management of an Emergency Operations Centre
the communications system
alert and warning mechanisms
public information arrangements
resource management (human, financial and material)
reporting and accounting arrangements
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Planning for the Phases
reconstruction
community
PEOPLE
relief
PROPERTY
SERVICES
LIVELIHOODS
recovery/
rehabilitation
ENVIRONMENT
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Components of the plan
The key components are:
 the main plan which describes the goals, objectives and
overall arrangements
 the functional plan which describes in detail how the
main plan is to be implemented
 special plans e.g. airport, security
 standard operating procedures
 checklists
 maps
 hazard data
 community data
 staff data
 records of key decisions taken in meetings
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Essential services
The following sectors are involved in the planning process:
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communications
police
relief and rescue
health
social welfare
transport
public works
also agriculture, media, education, fire, ambulance,
engineering, meteorology
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Service plan
For a hospital, the plan will describe:
 activation mechanisms
 chain of command
 capacity assessment (casualty room, operating theatres,
beds, lab, blood bank, x-ray etc)
medical and technical staff; resources
 communications
 logistics
 administration procedures – admin. staff, engineers, porters etc.
 reception and triage
 surgery, morgue, decontamination, psychiatry, forensic services
 other support services - nutrition, physiotherapy, orthotics etc
 waiting area for families
 arrangements for the media
 arrangements for VIP visits
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Capacity assessment
In an emergency the following issues should be
considered in assessing capacity to respond:
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structural damage
staff availability
equipment failures
energy supply
water supply
access routes
additional workload
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Elements of a good plan
It is essential to:
simulate an emergency to test the plan
familiarise all staff with the plan
brief all new staff about the plan
familiarise local government, emergency services and
the community with the plan
 train those staff with special roles and responsibilities in the
plan
 review and update the plan after an emergency, after each
simulation and whenever new resources are acquired
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First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Implement the plan
Plans will not be made or will lie unused unless the
responsible authorities actively provide:
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Education and information on how to plan
Encouragement and incentives to plan
Enforcement of regulations to plan
Engineering and resource mobilisation solutions to
problems identified by the planning process
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
Evaluate the plan
How do we know a plan is a good plan?
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It meets the national planning criteria
It conforms to the national planning format
It is tested regularly
All staff are familiar with the details of the plan and
know their responsibilities
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman
First National Course on Public Health Emergency Management
12 – 23 March 2011. Muscat, Oman