Essential Building Blocks of a
Comprehensive Emergency
Management Program
Objectives
1. Overview of Planning Process and
Requirements
5 min
2. Components of a comprehensive
Emergency Management Program
• Incident Management System (IMS)
• All-hazards approach
• Hazard Identification and Risk Assessment
(HIRA)
40 min
TC LHIN Community Sector Emergency
Planning Overview
•
LHIN funded a pilot project with our health service provider partners that
included emergency preparedness training and emergency preparedness
planning in the context of community. Outcome included consolidation of a
selection of best practices that can be tailored to the needs of individual
organizations. These resources (along with others) are available on the TC
LHIN’s internet site:
• A Guide to an Emergency Management Plan (October 2014)
• Emergency Management Supplemental Guide
•
Emergency preparedness and management obligation included in the Hospital
and Multi-Sector Service Accountability Agreements (M-SAAs) (deadline
extended to September, 2015).
•
Multi-sector working group struck in February 2015 to further support and guide
Planning approach and time lines
4
Level 1 preparedness:
Organizational EMP
following best practices
Level 2 preparedness:
Business continuity
planning (including
organizational asset
mapping)
Level 3 preparedness:
Organizational readiness
to participate in system
response
Q4 FY14/15 – Q1 FY15/16
Q2 FY15/16
Q3 FY15/16
[FY 14/15 M-SAA obligation for Organizational EMP deadline:
September 30, 2015]
[FY 15/16 M-SAA obligation for participation in initiatives to increase
emergency preparedness at organizational, sector and system levels]
MOHLTC – EMB
• Ministry Emergency Operations Centre (MERC)
MCSCS - Emergency Management Ontario
GTA LHINs
Hospitals (17)
LTC Homes (37)
TC LHIN HSPs
C LHIN
MH LHIN
CW LHIN
CE LHIN
Toronto Public Health Unit
PHASE 2
PHASE 3
First Responders
•
EMS
•
Fire
•
Police
Addictions and
Mental Health
Providers (69)
Community Support
Services (67)
TC CCAC (1)
Community Health
Centres (17)
PHASE 1
Toronto Community Housing
5
TC LHIN System Emergency Planning Approach
City of Toronto
• Office of Emergency
Management (OEM)
Pan Am / Parapan
Am Games
•
Anticipating 250,000 visitors over the course of the games, primarily residents of
southern Ontario
•
Based on the Hazard and Risk Identification Analysis (HIRA) that was performed
by the cross-functional emergency preparedness planning team, no specific
emergency risks and functions were identified affecting community-based health
service providers
•
There will be abnormal traffic during the Games. The Games emergency
management planning team has been working closely with the Ministry of
Transportation to outline traffic plans for the GTA. The TC LHIN is hosting a
webinar on May 8 @ 1 pm-2:30 pm
to share this information with health service
providers. Details to follow.
COMPREHENSIVE EMERGENCY
MANAGEMENT PROGRAM
“32 people died at Résidence du Havre in
L'Isle-Verte, Que., in January 2014”
S
OME
K
EY
R
ECOMMENDATIONS
M
ADE
BY
THE
C
ORONER
:
•
Creation of emergency response networks in both rural and urban environments to better organize a concerted and
simultaneous response to fires and other emergencies.
•
Need for properly trained staff in case of an emergency, as well as a sufficient number of staff members on duty,
particularly overnight.
Goals of emergency management planning
•
Protect lives, equipment, environment,
property
•
Build organizational resilience to return to
normal operations as soon as possible
FACT: Research has shown that workplaces that have developed effective
emergency management plans are capable of resuming normal operations six
times faster and suffer 70% fewer losses when facing natural or man-made
emergencies
Key Elements of Emergency
Management
Prevention:
Actions taken to prevent an emergency or disaster.
Strategies: Adopt a proactive risk management approach (tool: Hazard Identification and Risk Assessment)
Preparedness:
Includes actions that build organizational resiliency /capacity/ capabilities to respond
and recover from an emergency or disaster.
Strategies : Business Continuity Plan Policies/Procedures/Training/Tabletop Exercises (eg. evacuation plan,
shelter-in-place plan, lockdown plan, emergency supplies)
Response:
Actions taken in anticipation of an impending event and during/after the event has
occurred.
Strategies: Incident Management System (IMS) framework for standardized approach across the system
Recovery:
Restore activities to normal after a major incident.
Strategies: Clean up, return of evacuees, psychosocial support, emergency financial assistance
Prevention
Preparedness Response
Recovery and Mitigation
Incident Management System (IMS) -
Standardized organizational structure, functions, processes,
and terminology
•
Standardized processes - allow all who respond to the same incident to formulate a unified
plan to manage the incident.
•
Standardized language - use of plain-language terminology reduces the risk of
miscommunication among multiple responders.
•
Management by objective - incidents are managed by aiming towards specific objectives.
•
Flexible and modular organization – can expand and contract structure as needed by the
incident scope, resources and hazards.
•
Limited span of control - each individual participating in the operation reports to only one
supervisor; any single person's span of control should be between three and seven individuals.
•
Comprehensive resource management - all assets and personnel during an event are tracked
and accounted for.
Incident Command
Operations Planning Logistics Administration Finance and Communications
Pillars of Emergency Preparedness (prevention of injury / loss of life and business continuity)
Mitigation/ Prevention
Preparedness
Response
Recovery
Administrative /
Policies &
Procedures
• Organizational HIRA • Secure and protect your
location
• Preventative maintenance
• Emergency Planning Team • IMS chain of command
• Identification of critical services and resources to be maintained • Relocation strategy
• Human Resources: expertise/availability log
• Data: back-up
• Surge capacity analysis
• Patients prioritized by level of care needed
• Organizational capacity review
• Define circumstances for activating plan / IMS • Procedures for each
significant risk identified in HIRA • Emergency supplies • Transportation needs • Designated alternate assembly point • Shelter in place • Lockdown plan • Evacuation plan • Counseling • Time off for staff /
volunteers
Vulnerable
Persons
• Education
• Toronto Hydro Life Support Notification Program
• Registry/log
• Individualized emergency plans
• Assess for vulnerability
• Meet specialized needs in partnership with other orgs.
Training,
Evaluation,
Improvement
• Orientation / eLearning, etc. • Drills for staff / volunteers • Client education re: personal
preparedness
• Incident action plan • Operational debriefing / analysis of emergency response
• EMP adjustment as needed
Communication
• Crisis communication plan – clients / personnel / volunteers / local authorities / suppliers, etc.• Method for receiving official information • Designated call-in phone number • 24/7 fan out list
• Contact list for partners/suppliers • Up to date client contact information
System
Partnerships
• Protocols to coordinate agency response with system partners
• Mutual Aid Agreements
• Participation in system table top exercises
Training / Plan Testing
Source: City of Toronto Emergency Management Plan
ALL-HAZARDS APPROACH AND
HAZARD IDENTIFICATION AND RISK
ASSESSMENT (HIRA) TOOL
A systematic approach for concurrently identifying, analyzing and estimating all
natural, accidental and malicious threats and hazards
•
Shifts the focus to the causes of risk rather than emergencies that may result from
risk.
•
Informs all pillars of EM Planning – prevention/mitigation, preparedness, response,
recovery
•
Recognizes that the causes of emergencies can vary greatly, but many of the effects
do not.
•
Allows planners to address emergency functions common to all hazards in the basic
plan instead of having unique plans for every type of hazard.
•
Supports the identification of common tasks and who is responsible for
accomplishing those tasks
(Public Safety Canada :
http://www.publicsafety.gc.ca/cnt/mrgnc-mngmnt/mrgnc-prprdnss/mrgnc-mngmnt-plnnng-faq-eng.aspx
)
HIRA Process
1.
Identify all possible hazards that can impact your organization.
2.
For each of the hazards identified, consider the likelihood of it resulting in an
emergency situation and the impact such an emergency would have. The risks will
vary according to the size, location and nature of your operation.
3.
Validate with stakeholders. A HIRA can not be performed by a single individual –
diverse perspectives are important for this process.
4.
Create procedures for each hazard that poses a moderate or high risk. Procedures
need to be sufficiently detailed to allow staff to easily follow. Details to include:
–
explicit instructions about roles and responsibilities
–
actions that need to be taken
Probability Rating Description Definition
4
Highly Likely High chance of occurrence
3
Likely
Moderate chance of occurrence
2
Possible
Possible chance of occurrence
1
Unlikely
Minimal chance
Severity Rating
Description Definition
4
Catastrophic
Extremely harmful
Fatal injuries or major disabling injury/illness (resulting in permanent impairment)
Imminent danger and/or jeopardy to life
3
Critical
Harmful
Physical and/or psychological injury resulting in lost time > 5 days
Event resulted in major property/equipment damage
2
Serious
Slightly harmful
Physical and/or psychological injury resulting in lost time 1-5 days, medical aid or first aid
Event resulted in moderate property/equipment damage
1
Marginal
Peripheral
Observed hazard but has not caused harm
Evidence of minimal property damage
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YPEOFH
AZARDH
AZARDD
ESCRIPTIONP
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OWLIKELYISTHIS TOOCCUR
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EVERITYR
ATING-
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SSIGNEDR
ISK(P
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N
ATURALExtreme temperature - heat
4
2
8
T
ECHNOLOGICALLoss of energy supply
4
3
12
H
UMAN-C
AUSEDHIRA Grid
http://www.health.gov.on.ca/en/pro/programs/publichealth/oph_standards/docs/req13.pdf
Probability Rating
Severity Rating
4- Highly Likely
3-Likely
2-Possible
1-Unlikely
4- Catastrophic
High
High
Moderate
Low
3 -Critical
High
High
Moderate
Low
2- Serious
Moderate
Moderate
Moderate
Very Low
1- Marginal
Low
Low
Very Low
Very Low
Natural hazards
Human-caused hazards
Technological
System Risks
Earthquake
Chemical Incident
Building/Structural Collapse
Pandemic
Extreme Temperatures
- Cold
Biological Incident
Critical Infrastructure Failure
(internet, telephone, cell phone)
Health System co-ordination
and roles
Extreme Temperatures
- Heat
Radiological Incident
Loss of Water Supply
Inventory and supplies:
Materials Management
Flood
Nuclear Incident
Loss of energy supply (electricity,
natural gas, diesel)
Human Resources shortages:
Medical, Nursing and
Pharmacy
Extreme storms or
other weather incidents
Terrorist Incidents
Major Fire
Communication
Civil Disturbances
Transportation Accident (train,
air)
Building/Structural Collapse
Example
Risk Rating Low Moderate HighNext Steps
•
Continue to share helpful resources to support organizational
emergency plan preparation
•
For those who are ready, initiate system planning
•
Upcoming Webinars (May, 2015 – Fall, 2015):
I.
Step-by-step guide for creating an organizational EMP
II.
Primer on organizational asset mapping
III.
Risk-based patient/client coding and vulnerable persons protocol
IV.
Completing your organizational EMP and understanding roles of system
stakeholders
V.
Organizational roles in the context of system response
Questions?
Questions
Answers
“Could you repeat the name of the (IMS) course and where to access it?”
IMS 100 - Introduction to Incident Management System
https://training.emergencymanagementontario.ca/TPOnline/TPOnline.dll/EMO_Public_Course/COURSENO=COUR20110704151 45004500149
“How do we find potential partners?” We suggest building on any existing relationships with like providers as well as reaching out to organization in your proximity who may be willing to share complementary resources. They don’t have to be health services –you may partner with appropriate geographically based organizations (e.g. local church/community centre who could temporarily provide relocation space for some services)
“Exactly what is it that we must have by September and do we have to submit it to the LHIN for approval?”
The 2014/15 MSAA obligation states:
“By September 30th 2015, the ED/CEO of each organization with an M-SAA will be required to sign off that the organization has an HSP-specific emergency plan in place.”
“Is there a format that this Emergency Plan must follow?” There is no set format. The TC LHIN web site has some best practices & resources describing elements that plans should incorporate to be robust – but it also depends on the size of your organization and the services you provide .
“IT Business continuity planning can be quite technical and complex. Will there by any facilitation and, expertise available from the LHIN?”
This is an important topic to explore. We will take this question/request for discussion at our next working group meeting to see if we can provide any resources.
Can organizations work through Health Links to create a unified emergency management plan?
Organizations that are part of a Health Link can certainly bring emergency management planning for discussion at that table. Having a geographical approach makes sense for a system response, however it may not be the top priority for Health Links at this time in their evolution. It will be the decision of the Health Link governance to decide how this inititative fits with the Health Link’s work plan.
“Hi, should we focus our EMP partnerships to TCLHIN area
located organizations?” No – we encourage partnerships to be driven by your clients’ needs, existing working relationships and complementary organizations in your geographic proximity. TC LHIN is currently moving forward with this initiative – but other LHINs will also be doing something similar in the near future.
