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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

Planning for Health Emergency Management

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

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

first national course on public health emergency management 12 23 march 2011 muscat oman1

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

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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

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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

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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

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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

quick brain storming
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 ?
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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

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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

first national course on public health emergency management 12 23 march 2011 muscat oman8

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 ….

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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

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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

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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

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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

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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

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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

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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

first national course on public health emergency management 12 23 march 2011 muscat oman16

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

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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

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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

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THE EMERGENCY PLANNING PROCESS

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman

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The Process

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

first national course on public health emergency management 12 23 march 2011 muscat oman32

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

first national course on public health emergency management 12 23 march 2011 muscat oman33

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

first national course on public health emergency management 12 23 march 2011 muscat oman34

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

first national course on public health emergency management 12 23 march 2011 muscat oman35

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

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THE STEPS ONE BY ONE

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 oman37

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

first national course on public health emergency management 12 23 march 2011 muscat oman38

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

first national course on public health emergency management 12 23 march 2011 muscat oman39

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

first national course on public health emergency management 12 23 march 2011 muscat oman40

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

first national course on public health emergency management 12 23 march 2011 muscat oman41

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

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THANK YOU

First National Course on Public Health Emergency Management

12 – 23 March 2011. Muscat, Oman