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Planning for Health Emergency Management

Planning for Health Emergency Management. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman. Learning Objectives. By the end of this module, the participant should be able to: Describe the steps of emergency response

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Planning for Health Emergency Management

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  1. Planning for Health Emergency Management First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  2. Learning Objectives • By the end of this module, the participant should be able to: • Describe the steps of emergency response • planning process in terms of inputs, • outputs and outcomes • Create flowcharts for emergency response • planning • To identify the various plans that must be • developed and the harmonization • between them First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  3. Quick brain storming…… • What is an emergency response plan? • Why to develop emergency response • and recovery plans? • How are emergency response planning • processes different from routine planning • processes for the health sector? First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  4. Emergency Preparedness Program – Reminder • An integrated set of long-term, multi-sectoral development activities First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  5. Emergency Preparedness Program Goal: to achieve an increasing level of “readiness” within communities to cope with any situation which demands an emergency response, using their own resources. This requires the development and maintenance of : Political authority, policy for EM Plans and Procedures for EM and Recovery training and education Institutional and human resources for EM Public awareness & education System for the collection, analysis and distribution of information related to emergencies First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  6. Just remember the overall context……. Public Safety Response plans Risk Management + Emergency Management Hazard Reduction Damage Assessment & Needs Analysis Vulnerability Reduction Epidemiology and Reporting Emergency Preparedness Mass Casualty Management Hospital Planning Curative Care Shelter and Security Water and Sanitation Control of Communicable Disease Food and Nutrition Reproductive Health Psychosocial Needs First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Medical Supplies and Logisics Media and Public Information Recovery and Rehabilitation safer communities

  7. Difference between Emergency Response Planning and Routine Planning • ERP focuses on: • Coordination and management systems of resources from several sectors • emergency management and incident management systems • Management of information • arrangements for intra-sectoral and inter-sectoral coordination of activities and mobilization of resources (surge capacity) • What are the characteristics of routine planning in your field of activity? First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  8. Quick brain storming…… • What may be the different activities, situations and risks….that the Health Sector must think of when developing response plan and contingency plans ? • With what the response plan of the Health Sector must deal with ?

  9. Health Sector Response Plan must deal with….. • Casualty management (first aid, triage, transport, pre-hospital care, in-patient care, out-patient care) • Communicable disease control (surveillance, tracking, treatment, prophylaxis, isolation and quarantine) • Continuity of delivery of critical services for emergency patients • Management of the dead and missing • Management of information (public information; support activities; health info system) • Mental health • Environmental health • Reproductive health • Public health programs (continuity of essential programs) First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  10. Planning for Emergencies • Planning based on risk analysis is planning for any emergency, by predicting: • 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 + recovery period) • What are the strategies to respond and recover First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  11. Disaster Management is: 80% generic 15% specific 5% unique to all disasters to the hazard to the event 1. Organization earthquake EOC time large numbers of trapped and injured coordination place large numbers of homeless and displaced communications weather large numbers of dead and missing transport logistics and supplies geography dead, injured and missing staff information and media climate damaged critical infrastructure / resources (hospitals, vehicles) reporting and surveillance loss of water, gas, electricity, phone, transport, fuel networks security 2. Response loss of road, sea, air, rail infrastructure / access search and rescue politics long period of SAR, victim extraction evacuation economy high demand for FA, stretchers, triage, medical transport mass casualty management governance high demand for beds, surgery, blood products, referral management of dead and missing wound infections, amputations, tetanus, dust inhalation security emergency management capacity high demand for orthotics, prosthetics, disability, dental temporary shelter, clothing and utensils logistics capacity demand for specialized spinal and head injury care emergency water, sanitation and energy disposal of inappropriate donations high demand for temporary shelter, food, utensils, stoves, emergency food supplies water, energy, clothing, tents, blankets emergency public and environmental health leadership high demand for psychosocial support of victims and staff emergency engineering and public works solidarity management of donated supplies / foreign teams morale First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman 3. Recovery few outbreaks of communicable diseases corruption variable demand for medicines and equipment crime (acute / chronic injury care - high, infectious disease - low, curative and public health care looting potentially unstable chronic disease - medium) education agriculture compensation claims contamination of water, air and soil trade and commerce insurance claims toxic chemical, sewerage and gas leaks / spills 4. Rehabilitation and Reconstruction urban fires, explosions ownership disputes contaminated, infested and unsafe foods people property disputes increased vector breeding property services loss of livelihoods, markets, distribution networks livelihoods environment THIS IS WHAT WE PLAN FOR ….

  12. Key characteristics of an ERP • Emergency Response Plan and Recovery Plan • an agreed set of arrangements for responding to, and recovering from emergencies • plans involve the description of responsibilities management structures resource and information management Logistics management Training and exercises • plans focus on protecting life, property and environment • outcomes First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  13. Core Elements of an Emergency Response Plan • A response plan will define and discuss : • a line of authority and clear responsibilities of all • the stakeholders involved • the management systems: ICP; EOC; EEC • the communications system • alert and warning mechanisms • public information arrangements • resource management (human, financial and material) • Monitoring, reporting and accounting arrangements First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  14. Main characteristics • Clear responsibilities (who, what, when, how, with • whom, where) • All key stakeholders need to be involved in the planning • process, including: agencies with disaster responsibilities community members / groups Institutions and legal authorities • Relevant to emergency events: large scale; complex; relatively rare; hard to predict • Consequences of poor decisions can be acute • Scrutiny of mistakes is often in detail and in public First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  15. Context of emergency plans for a community Community Risk Management Plan Sectoral Plans Hazard Specific Plans Provincial Emergency Disaster Plans Agencies Specific Plans (hospitals) First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman National Emergency Disaster Plan Intersectoral in nature

  16. Essential Services The following sectors are involved in the emergency planning process: How these sectors can contribute to the development of the health sector response plan? • 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

  17. Policy - Guidelines – Standards – Community Plans and Role of the MOH Policy, guidelines, standards National level Mobilise extra-resources International org & assistance Emergency Preparedness Program Provincial level Develop and implement Preparedness activities Communities Should be allowed First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Mitigation plans Vulnerability reduction plans Emergency response plans Rehabilitation and recovery plans National & provincial levels = support communities in their work

  18. The Roles of National Government (1) • 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 implementation of • the policy (contents of the plans, etc.) • developing national plans (multi-sectoral; sectoral; • contingency) for those situations that are not under the • direct responsibility of local authorities First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  19. The Roles of National Government (2) • 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. Security • international cooperation and assistance WHAT ARE THE PRESENT CONSTRAINTS IN YOUR COUNTRY ? First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  20. Main responsibilities of MOH in emergency planning • Reduce the vulnerabilities of its own infrastructures andsystems: hospital mitigation; EMS System; etc. • Raise awareness first of the health staff then of the general public (in collaboration with other sectors) • Reduce health consequences of crisis and major emergencies (core function of the health sector). A “health emergency management program/unit” should be institutionalised within the MOH; development of emergency response plans • Assume its normative role and lead function (guidance) in health (emergency preparedness and risk management) First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  21. Overall strategy of the MOH • Integration strategy • Vulnerability reduction and hazard mitigation • Community risk management framework • Inter-sectoral cooperation • Planning based on existing resources (all types) • Decentralization of the response capacity • Community participation (and end-users) • Institutionalization of an emergency/disaster Unit within • the MOH First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  22. THE EMERGENCY PLANNING PROCESS First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  23. The Process First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  24. The Planning Process • Determine the authority responsible for the process • Establish a planning committee and objectives; management structure of the process • Conduct a risk assessment - hazards and community vulnerabilities (core elements) • Assign responsibilities • Identify and analyse capacities and resources • Develop the 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

  25. Outputs of the intersectoral emergency planning process • A set of emergency response plans – who does what when usingexisting capacity: • search and rescue plan • evacuation / temporary shelter plan • mass casualty plan / hospital plans • sectoral relief plans (food, water, health, lifelines etc.) • security plans • Mitigation; EWS (MCM: all hazards) • A disaster recovery and reconstruction plan (education, agriculture, public works etc.) First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  26. Outcomes of the emergency planning process • The planning process is a sequence of steps whereby a planning entity (e.g. government, community) agrees on ways to enhance and protect its 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, mitigation, and response • greater awareness of risk reduction in the community • higher levels of readiness to respond and to recover • an emergency response plan and a recovery plan (and contingency plans when relevant) • increased public safety (including for the health sector such as safer hospitals, etc.) First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  27. Evaluate the Plan • How do we know a plan is a functional plan? • it meets the national planning criteria and policy ? • it conforms to the national planning format ? • it has been developed through a true emergency planning process (from vulnerability analysis up to participation of end-users) ? • it is tested, validated and regularly exercised ? • all key staff are familiar with the details of the plan and know their responsibilities ? • WHAT DO YOU WANT TO ADD? First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  28. After the Plan has been developed • 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 • conduct regular exercises First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  29. Common Planning Mistakes • the plan (paper document) is given more importance than the planning process itself • not key community members (or staff of the institutional plan) are aware of the existence of a plan • revision is overlooked • emergency planning is not integrated into normal activities (integration strategy) whenever possible • different plans are developed for different hazards by different agencies – the all hazards approach should be preferred (no synergy; no compatibility) • no or weak training programs • what do you want to add? First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  30. Common Planning Mistakes 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

  31. Organizational Capacity • implemented selectively by those agencies which have been delegated that responsibility by the Government or by the community • it is vital that…..agencies…… • professionally managed • adequately resourced • highly trained • demonstrated competence • emergency management family First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  32. Emergency Risk Management – Principles for Agencies goal : to increase efficiency, effectiveness, readiness and integration of the agency into the overall organization of the emergency management process and system First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  33. Principles for Agencies and emergency planning needs • Objectives : • to improve the decision making process at all levels (within agency) • to facilitate the choice of the most suitable strategies • to rely on specific decision making procedures • to ensure efficient communication : • internal and external • to ensure safety and well being of staff /community • to promote and preserve the activities efficiency : synergy, complementarities, adaptability, cooperation • to promote adequate training : personnel / exercises…. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  34. Risk management and Planning - Principles for Agencies Define the ERM policy of the Agency Enter the planning process (ERM) Allocation of required resources of all kind ERM process for an Agency First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Monitoring – reevaluation process Implementation: activities – role - functions

  35. Group Work Activity……20 minutes • As part of an overall emergency response plan for the Asian Games, you are requested to prepare the Health Sector Response Plan……. • Instructions as follows: • to identify a city in one country of your choice • to discuss potential problems, which can impact on health in this city • to identify the stakeholders who will be involved to contribute to the management of these health problems • to identify the key headings of the components of your Emergency Response Plan (for Health Sector in this city) First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  36. Updating the information on hazard and vulnerabilities... Why Emergency Response Plans must be regularly revised ? • update the current political, social and economic situation • update hazard reduction, emergency preparedness and vulnerability reduction activities in all sectors and by all organisations • update changes in resources, systems and procedures • update early warning information system First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  37. Assessment of Response Capacity of the Health Sector • mandate and authority to deliver relief (scope of responsibility) • management and command structure (coordination among stakeholders) • competencies of staff (knowledge and skills and ability) • the availability and accessibility of information • the existence and relevance of plans • the existence and relevance of procedures • the networking of the plans of the Health Sector with the plans of the other sectors First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  38. Early warning information...links with Response Plans The emergency response plans are useful only: • when they are activated • they are relevant and functional • They are efficiently used So the early activation of the response plans is essential. In many emergencies there is a time frame which allows for early activation (floods; displacement of populations; anticipated cold wave, start of an outbreak, etc.) and for developing further mitigation measures (early warning is critical) First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  39. THE STEPS ONE BY ONE First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  40. Step 1: Define Project • Determine the aim, objectives and scope of the • planning process • Identify the tasks to be performed, and the • resources needed • Identification of the framework in which • emergencies will be managed • legislation policy and guidelines must be • considered • and the resources that will be required: • stakeholders / agencies, etc. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  41. Step 2: Review Planning Group • Key Stake-holders to be represented • multi-disciplinary teams are essential to ensure • sufficient expertise • must have appropriate authority • political and economic circumstances may • influence choice of members • social and cultural issues must be considered • there must be an efficient reporting system First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  42. Step 3: Potential Problem Analysis • planning group should know result of vulnerability analysis (at least core elements) • technique for identifying preventive and mitigation strategies; response and recovery strategies for identified problems • systematic breakdown of the problem into its components • techniques involves: • hazard analysis / vulnerability assessment / developing response and recovery strategies / mitigation First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  43. Step 4: Resource Analysis • why? • to ensure that PRR strategies can be supported • to ensure that preparedness is coordinated • to ensure cooperation between agencies • to know who is responsible for supplying First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  44. Step 5: Roles and Responsibilities • should be defined & described to ensure that each organization knows precisely what is expected of it and that everyone is aware of the general roles of all relevant organizations • multi-sectoral approach for national disaster plan • key issues: • Information management • resource management • evacuation • specific situation such as hazardous material… First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

  45. THANK YOU First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

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