Conducting a Hazard and Vulnerability Analysis

1 Conducting a Hazard and Vulnerability AnalysisMitch SaruwatariDirector, emergency ManagementKaiser PermanenteObjectives2| Kaiser Permanente. All Rights Describe how to conduct a Hazard Vulnerability Analysis in the health care setting2. Highlight specific tools to mitigate risks once hazards have been identified and prioritized3. Discuss the use of the HVA to develop the annual emergency management program activities4. Demonstrate a new way to prioritize risks using actual incident informationAssessing Risk3| Kaiser Permanente. All Rights / ContaminationCatastrophic / Area Wide EventCivil Unrest (External)Civil Unrest (Internal)Compressed GasDialysis Department Response and RecoveryEarthquakeEvacuationExplosion ChecklistFacility ThreatFireFloodingHazmatHealth ConnectHVAC FailureInformation Technology Systems FailureLabor Action/Staff ShortageMass CasualtyMedical Gas FailureNatural Gas LeakPower FailureRadioactive InternalSewer System Failure Sexual AssaultShooting or WeaponsSuicideSurge CapacityTheftVOIP Telephony Failure BCPW ater Shortage/DroughtWater System FailureWeatherKey Components4| Kaiser Permanente.

2 All Rights ImpactPreparedness Risk Historical data Predictive data Human Property Business Plans Resources PartnershipsCalculating Probability5| Kaiser Permanente. All Rights Reserved. General Risk Flood plain, proximity to hazards or technology, aging infrastructure Hidden risks not previously identified FEMA data, emergency management data, local health department, USGS, internet, yellow Historical data History of flooding, drought, wild land fire FEMA, USGS, health department (local, state, federal), internet, emergency management (past activations), public safety agencies, EPA, DOT, FAA Predictive data Earthquake risk, hurricane season, terrorist targets USGS, NOAA, NWS, JTTF, law enforcement (crime statistics), DOT, local emergency management, local health departmentCalculating Impacts6| Kaiser Permanente.

3 All Rights Reserved. Human Direct injury or illness, exposure and surveillance, fatalities Personnel shortages Property Infrastructure, supplies and equipment, transportation resources Impact on provision of clinical services Business Occupancy, record keeping, loss of revenue, public perceptionCalculating Preparedness7| Kaiser Permanente. All Rights Reserved. Plans Existing EOP, SOPs, Response Guides, Task lists Identify what is missing: does lack of plan increase the impact? Resources Space, staff, stuff Community assets Agencies, military, federal response partners Partnerships Existing relationships, MOUs, consortiums Business and vendor supportDemo8| Kaiser Permanente. All Rights community, our hospital Located in the Midwest, hospital overlooks the Ohio River Community has high crime rate in some areas; moderate unemployment rate Bluegrass music festival held each spring along the water front, with camping available and houseboats docked along the water s edge Major employer is the OMG Nuclear Power Plant and its neighboring oil refinery 230 bed urban hospital, Level 2 trauma center No decontamination facilities Hospital built in 1985 75% of facility is on emergency power, including chillers, HVAC, main building Rehabilitation hospital on campus; 100% occupancy of 30 beds Recently hired part time emergency manager.

4 Collateral duties in Quality ManagementDemo9| Kaiser Permanente. All Rights AND Vulnerability ASSESSMENT TOOLTECHNOLOGIC EVENTSSEVERITY = (MAGNITUDE - MITIGATION)EVENTPROBABILITY HUMAN IMPACTPROPERTY IMPACTBUSINESS IMPACTPREPARED-NESSINTERNAL RESPONSEEXTERNAL RESPONSERISKL ikelihood this will occurPossibility of death or injuryPhysi cal losses and damagesInteruption of servicesPreplanningTime, effectivness, resoucesCommunity/ Mutual Aid staff and suppliesRelative threat*SCORE 0 = N / A 1 = Lo w 2 = M o derat e 3 = High 0 = N / A 1 = Lo w 2 = M o derat e 3 = High 0 = N / A 1 = Lo w 2 = M o derat e 3 = High 0 = N / A 1 = Lo w 2 = M o derat e 3 = High 0 = N / A 1 = H igh 2 = M o derat e 3 = Lo w o r no ne0 = N / A 1 = H igh 2 = M o derat e 3 = Lo w o r no ne0 = N / A 1 = H igh 2 = M o

5 Derat e 3 = Lo w o r no ne0 - 100%Electrical Failure0%Generator Failure0%Transportation Failure0%Fuel Shortage0%Natural Gas Failure0%Water Failure0%Sewer Failure0%Steam Failure0%Fire Alarm Failure0%Communications Failure0%Medical Gas Failure0%Medical Vacuum Failure0%HVAC Failure0%Information Systems Failure0%Fire, Internal0%Flood, Internal0%Hazmat Exposure, Internal0%Supply Shortage0%Structural Damage0%AVERAGE *Threat increases with = PROBABILITY * | Kaiser Permanente. All Rights Risks 2015 RegionAProbabilityImpact LevelPotential ImpactEarthquakeHighHighInjury and loss of life, significant structural damage, business and financial interruptionEpidemic or PandemicHighHighInjury and loss of life, business and financial interruptionCivil DisturbanceHighModerateInjury and loss of life, business and financial interruption, potential structural damageMedical SurgeHighHighInjury and loss of life, business and financial interruptionWork Stoppage/Labor Issue/StrikeHighModerateBusiness and financial interruptionRegion BProbabilityImpact LevelPotential ImpactEarthquakeHighHighInjury and loss of life, significant structural damage.

6 Business and financial interruptionEpidemic or PandemicHighHighLoss of life, business and financial interruptionMass CasualtyHighModerateInjury and loss of life, significant structural damage, business and financial interruptionWildfiresHighModerateLoss of life, business and financial interruptionTools11| Kaiser Permanente. All Rights Risks 201520062014 Tools12| Kaiser Permanente. All Rights Management Program Activities13| Kaiser Permanente. All Rights Reserved. Preparedness Resource identification and procurement, promotion of personal preparedness, development of an emergency management committee Planning Development of plans, policies, protocols, decision algorithms, response guides, SOPS Research best practices among partners Instructional Activity / Training All hazards training, personal preparedness, response specific training Organizational learning Exercises Drills, exercises, demonstrations Corrective Improvement Plan Evaluate the education and the exercises Identify and make improvements Organizational learning Test and evaluate the changesKP Model Risk ReductionKP Model Comprehensive ResponseBCPBCPBCPBCPBCPWhat if Real Incidents Are Tracked?

7 What is a Disaster Incident Log?17| Kaiser Permanente. All Rights :*A calamitous event, especially one that s sudden and causing great loss of life, damage, or hardship, as a flood, airplane crash, or business :*An event or occurrenceLog:*A record of performance, events, or day-to-day activitiesDisaster + Incident + Log:A record of performance for calamitous events or occurrences*The Oxford DictionaryInformation Tracked18| Kaiser Permanente. All Rights Reserved. All pertinent data as it relates to a disaster from start to finish Type of incident, when and where it occurred Response efforts - activation of plans and/or command center, resource support Impacts to patient care, business/operations, buildings/structuresKP Disaster Incident Log19| Kaiser Permanente.

8 All Rights Excel Binary WorksheetIncidents vs HVA20| Kaiser Permanente. All Rights Incidents vs 2014 HVAK aiser Permanente Southern California RegionHVAI ncidentsAnnual Analysis21| Kaiser Permanente. All Rights Programwide Alerts & ActivationsAlertsHCC ActivationsRCC ActivationsProgramwide Trends22| Kaiser Permanente. All Rights 2015 ProgramwideAlerts & ActivationsAlertsHCC ActivationsRCC ActivationsBenefits of an Incident Log23| Kaiser Permanente. All Rights from past experiencesFine-tune HVAA djust preparation and mitigation effortsRecord for reimbursementsAccreditation Definitions24| Kaiser Permanente. All Rights : ..can be either human made or natural (such as an electrical system failure or a tornado ), or a combination of both, and they exist on a continuum of severity.

9 Disaster: ..a type of emergency that, due to its complexity, scope, or duration, threatens the organization s capabilities and requires outside assistance to sustain patient and resident care, safety, or security functions. (EM )Meets Accreditation Requirements25| Kaiser Permanente. All Rights Reserved. The organization conducts a Hazard Vulnerability Analysis (HVA) to identify potential emergencies that could affect demand for the organization s services or its ability to provide those services, the likelihood of the potential emergencies occurring, and the consequences of those events. The findings of this Analysis are documented (EM EP2) The organization communicates its needs and vulnerabilities to community emergency response agencies and identifies the community s capability to meet its needs.

10 This communication and identification occur at the time of the organization's annual review of its emergency Operations Plan and whenever needs or vulnerabilities change (EM EP4)Meets Accreditation Requirements26| Kaiser Permanente. All Rights Reserved. The organization uses its Hazard Vulnerability Analysis as a basis for defining mitigation activities (that is, activities designed to reduce the risk of and potential damage from an emergency ) (EM EP5) The organization uses its Hazard Vulnerability Analysis as a basis for defining the preparedness activities that will organize and mobilize essential resources (EM EP6) The organization's incident command structure is integrated into its community s command structure(EM EP7)