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Emergency Preparedness in Health Facilities . First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman. Q & A. Can you share us your idea on the following? Health facility Health care facility Hospital.

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Emergency preparedness in health facilities

Emergency Preparedness in Health Facilities

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

Q & A

  • Can you share us your idea on the following?

    • Health facility

    • Health care facility

    • Hospital

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 oman1

  • Health Facility

    • building where medicine is practiced

  • Health care facility

    • medical building

    • structure that has a roof and walls and stands

    • more or less permanently in one place

  • Hospital

    • a health facility where patients receive

    • treatment

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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  • Hospital - a health facility where patients receive

  • treatment

    • Physical structure

    • Health systems

    • health workforce and other resources

  • “Ensure the physical ad functional integrity of hospitals and health facilities to be accessible and functional at maximum capacity, immediately after a hazard strikes”

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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HYOGO FRAMEWORK FOR ACTION 2005 - 2015

Building the Resilience of Nations and Communities to Disasters

Expected Outcome

The substantial reduction of disaster losses, in lives and in the social, economic and environmental assets of communities and countries

Strategic Goals

The integration of disaster risk reduction into sustainable development policies and planning

The development and strengthening of institutions, mechanisms and capacities to build resilience to hazards

Systematic incorporation of risk reduction approaches into implementation of emergency preparedness, response and recovery programmes

Priorities for Action

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman

1. Ensure that disaster risk reduction (DRR) is a national and a local priority with a strong institutional basis for implementation

Identify, assess and monitor disaster risks and enhance early warning

Use knowledge, innovation and education to build a culture of safety and resilience at all levels

Reduce the underlying risk factors

Strengthen disaster preparedness for effective response at all levels

Cross Cutting Issues

Capacity building and technology transfer

Multi – hazard approach

Gender perspective and cultural diversity

Community and volunteers participation


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Hyogo Framework for Action

  • Strengthen disaster preparedness for effective response

  • at all levels

  • Key components:

  • strengthening institutional capacities and trainings and learning mechanisms to include risk reduction in all aspects of

  • disaster management

  • strengthening contingency and preparedness planning

  • Promoting community participation

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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Hyogo Framework for Action

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 International Strategy for Disaster Management (ISDR) made “Safe Hospital” as the focus of the global risk reduction campaign (2008 – 2009)

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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Operational point of view

  • Better prepared to mitigate and manage hospital

  • risks

  • Ready to respond properly and efficiently to

  • emergencies which create additional unexpected

  • demands on their services

    (Surge Capacity)

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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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

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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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

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman

From: WHO – PHEMAP Course


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Protect life, property,

environment

Mitigate loss

of services

HEM Planning ?

Promote

Cooperation

Among sectors

And agencies

Use efficiently

Available

resources

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman

Create systems and networks for responding

To and recovering from emergencies

“Hospital Emergency Preparedness, Response

and Recovery Plan Development ‘08”


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SUMMARY of Short-Term effects of Major Disasters

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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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; and resources

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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  • Capacityis directly associated to emergency preparedness

  • 10 elements of Emergency Preparedness:

    • Legal framework

    • Policies

    • Guidelines

    • Procedures

    • Plans

    • Knowledge

    • Attitude

    • Skills

    • Resources

Organizations

Systems

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman

People and other resources


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Emergency Management Plan

An agreed set of arrangements for:

responding to, and

recovering from emergencies

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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Emergency Management Plan

A plan containing description of:

  • Responsibilities

  • Command & coordination mechanism

  • Management structures

  • Resource management

  • Information management and communication

  • Training and exercises

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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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)

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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Hospital emergency Preparedness, Response and Recovery Plan

  • 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)

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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Hazard Prevention Plan

  • plan to prevent exposure to hazards

  • not all hazards are predictable or preventable

  • Strategies/activities to prevent exposure to hazard

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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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

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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Emergency Preparedness Plan

Plan to build response capacity of the hospital

  • Policies, Protocols, Guidelines and Procedures

  • Plans

  • People

  • Promotion and Advocacy

  • Partnership Building

  • Physical (Facility Enhancement)

  • Program Development

  • Practices

  • Peso and Logistics

  • Package of Services

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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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

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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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

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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Emergency Response Plan

  • Activation of Code Alert System

  • Activation of the Plan

  • Activation of the ICS

  • Activation of the Operation Center

  • Implementation of the RESPONSE Standard

  • Operating Procedures/ Protocols for Internal and

  • External Emergencies

  • Implementation of existing Standard Operating

  • Procedures

  • G. Initiation and Maintenance of Coordination and

  • networking for referrals of cases

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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Emergency Response Plan

  • 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 for auxiliary power, water and food rationing, medication/ dressing rationing, waste and garbage disposal, staff and patient morale

  • Provision of the Public Health Services of the Hospital

  • L. Management of the Dead

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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3. Recovery and Reconstruction Plan

  • A plan to restore services and replace damaged elements of hospital for the better

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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3. Recovery and Reconstruction Plan

  • Ex. of Recovery/Rehabilitation Planning Activities

  • Damage and needs assessment

  • Post Mortem Evaluation

  • Documentation of lessons learned

  • Research and development

  • Review and update of HEPRP

  • Psychosocial interventions

  • Repair of damaged health facilities and lifelines

  • Replenishment of utilized resources

  • Awarding and Recognition Rites for the major key players

  • Provision of overtime compensation to the responders

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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Emergency Planning

Process

Analyze resources

Define the plan

Describe Roles and

Responsibilities

Form Planning Group

Hazard Analysis

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman

Describe Management

Structure

Vulnerability Analysis

Risk Analysis

Develop Strategies and

Systems

Problems/Gaps Analysis

“Hospital Emergency Preparedness, Response

and Recovery Plan Development ‘08”


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Elements of Hospital Preparedness, Response and Recovery Plan

I. Background

II. Plan description

III. Goals and objectives

IV. Planning Group

V. Emergency Preparedness Plan

  • Hazards prevention

  • Vulnerabilities reduction

  • Risk reduction

    VI. Management Structures

    VII. Roles and responsibilities

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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Elements of Hospital Preparedness, Response and Recovery Plan

VIII. Hospital Response Plan

  • Policies, guidelines, protocols for the developed systems

    IX. Recovery and Reconstruction Plan

    X. 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

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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Response

Hospital

System

Health System

Epidemiology and

Surveillance

Prevention and Control of

Communicable Disease

Food and Water and

Nutrition Sanitation

Recovery

Preparedness

Health System

  • Service delivery

  • Health workforce

  • Information

  • Medical products and technologies

  • Health financing

  • Leadership/governance

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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The WHO Health Systems Framework

System building blocks

Goals/outcomes

Service delivery

Improved health

(level and quality)

Health workforce

Access coverage

Responsiveness

Information

Medical products & technologies

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman

Financial risk protection

Quality safety

Health financing

Improved efficiency

Leadership/ governance


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Health Emergency Preparedness Programme

NO PLAN

EXISTING PLAN

Prepare/

Review

HEPRRP

Operational

Needs

Assessment

Revise regulation,

Policies,

Guidelines,

Procedures,

Delegate authority

Emergency

Preparedness

Programme

Simulations

Drills

Trainings

Workshops

Revise

HEPRRP

Training

Needs

Assessment

Upgrade KAS

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman

Resource

Needs

Assessment

Acquire new

resources

Used in an

Emergency

Review

Revise


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Readiness Analysis

  • Mandates and authority

  • Institutional policies, procedures,

  • guidelines and plans

  • Financial and material resources

  • (availability, functionality)

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman

  • Human resources (Knowledge,

  • skills, attitude)

  • Coordination and management of

  • environment


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Ten Key Elements of Preparedness

Legal Framework

Policies

Procedures

Guidelines

Plans

Resources

Authority

Knowledge

Skills

Awareness

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman

National, provincial, local, agency and institutional level

Personal and community level


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Resource Analysis

  • What resources are required for

    response and recovery

  • Variation between requirement and

    availability

  • Who is responsible for the resources

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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What is Medical Surge Capacity

The ability to provide adequate medical evaluation and care during events that exceed the limits of the normal medical infrastructure of an affected community

Medical surge capacity

Evaluate and care for increased volume of patients

Extend beyond direct patient care

Medical surge capability

The ability to manage patients requiring unusual or very specialized / medical evaluation and care

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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What matters to enhance surge capacity ?

Strategy to promote integration of existing programs and management mechanisms into an overarching management system

Strategy to define basic requirements for health assets participation

A management system – functional relationships –systematic approach to organize and coordinate available health and medical resources

Mechanism for coordinating relationship between Hospitals and other services providers and the government response

Adoption of Emergency Planning Process principles and information management ( incorporating IMS)

Provision of platform for effective training

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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National Policy on Medical Surge Capacity

Assist Hospitals, other acute-care medical assets, emergency response services (EMS) / Establishing & integrating management systems

Provide concrete operational direction – guidance

Integrate the principles of IMS

Promote coordination between medical and other emergency services

Delineate information management system

Management system connected to Mitigation, Prevention, Response, Recovery + training efforts

Promote consistency with the national IMS

Strategies for resources mobilization

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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Why to Discuss Surge Capacity?

Management responsibilities in disasters

Medical care

Responder safety

Information management

Coordination diverse operating systems

Resolving intergovernmental issues

Medical assets support

Addressing time constraints

Incorporating health and medical assets into public safety response

First National Course on Public Health Emergency Management

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Overall strategy of the MOH for enhancing readiness (contribution to surge capacity)

Integration strategy (within the MOH)

scalability of the response

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

Promoting risk reduction activities

Why is integration strategy so important ?

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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“OPD” capacity …. a pre-established strategy

  • Intended to serve outpatient needs in events with sharp increase for medical care delivery

  • Functions can include:

    • distribution of self-help information and instruction for home care

    • triage for large numbers of people seeking care (lightly injured or for non urgent medical problems)

    • distribution of mass prophylaxis

  • During an infectious disease event, ill or infected individuals should not be in contact with individuals seeking information or coming to a mass prophylaxis centre

  • Example: Neighborhood Emergency Help Centre as a alternative to hospital based OPD

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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Community “acute care” centre (1)

  • Provides medical care in a community-based setting

  • Provides limited care to patients that generally would require short hospitalization (non emergency patients)

  • Designed to provide the most good for the greatest number of people when there are limited resources

  • Designed to care for patients until the healthcare system (mainly hospitals) can take care of the extended load

  • The ACC may provide mass isolation of individuals who cannot be isolated in their own homes

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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Community “acute care” centre (2)

  • Pre-established strategy for staffing; pre-positioning of equipment; logistics; communications; security

  • Importance of developing MOU with main stakeholders and surrounding HCF (provision of medical support / supplies / referral system / coordination / functional working relationships with hospital OPD and neighborhood emergency help centre / home care )

First National Course on Public Health Emergency Management

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Buildings opportunities for opening an community acute care centre

  • Large facilities, not normally used for health care services, but which have the basic utilities needed to support medical functions

  • Ideally have internal systems to handle medical oxygen and vacuum capability – but this is unlikely

  • Common buildings of opportunity include schools, gymnasiums, and community centers

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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Field Hospitals and mobile hubs as contribution to surge capacity

  • A mobile, self contained, self-sufficient health care facility capable of rapid deployment and expansion or contraction to meet immediate emergency requirements for a specified period of time (WHO)

  • Use of “local” Field Hospitals or mobile “hubs”

  • Possible use of Foreign Field Hospitals (in major disasters as offered by countries willing to assist)

    • Essential requirements

    • Optional criteria

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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Surge Capacity in pandemic

Efficient use of hospitals:

  • expanding the capacity

  • releasing capacity by prioritizing services

  • prioritizing patients and clinical interventions to control demand

    Reinforcement of out-of-hospital treatment capacity

  • triage and referral systems

  • alternative treatment sites

  • cooperation of all stakeholders

    Whole-health approach (vaccines; prophylaxis; etc.)

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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Urban Search and Rescue Teams contribute to surge capacity as an example

  • Integrated multi-agency response, which is beyond the capability of normal rescue arrangements to locate, provide initial medical care and remove entrapped persons from damaged structures and other environments in a safe and expeditious manner.

  • USAR is a specialized technical rescue capability for the location and rescue of entrapped people following a structural collapse : search component; rescue component; medical component; technical component.

  • Health Sector must actively contribute to the development of this capacity

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman


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First National Course on Public Health Emergency Management

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