Certified Hospital Emergency Coordinator (CHEC) Training Program Emergency Operations Plan Basics

Objectives Discuss the purpose of planning Identify components of the emergency planning process Identify the basic components of an Emergency Operations Plan (EOP) Recognize characteristics incorporated into a quality plan Examine a sample outline of a state’s EOP and a large hospital’s EOP

Planning is more than just an EOP The Planning Process: Step 1. Identify the planning team (HEC + HEMC) Step 2. Develop the overarching Hospital Emergency Management Program (HEMP) Step 3. Conduct HVA Step 4. Develop EOP Step 5. Train, educate, and exercise staff Step 6. Conduct on-going reviews and revisions HEC plus key internal and external partners (HEMC) HVA conducted with all partners This is the overarching plan…it is what tells of planning all year long…it talks about who should be on the HEMC, what the HEMC must do, including the HVA and development of the EOP/COOP…it discusses drills and continuing staff education; it covers AARs and plan revisions, it provides for continuous communications with internal and external partners…in short, it cover all of disaster management and response, throughout the year EOP covers basic emergency management plan, functional operations/COOP plans, and hazards specific plans…it includes mitigation strategies THIS PROCESS IS CIRCULAR/CONTINUOUS. People may come and go, but they should be able to slip right into the process at any step. How Having an EOP Helps Ensures predictable behavior by staff immediately following an emergency Provides specific guidelines to be followed during an emergency Provides for a team to assess damage immediately, allowing for quick decision making Arranges for long term recovery efforts Again note that this is within the broader context of the entire hospital emergency management program. Once the EOP is written, it can’t be just placed on a shelf, waiting for the big incident to occur. Planning and preparing has to be always on everyone’s mind. The BASIC PLAN: should outline the facility wide strategy for responding to and recovering from any hazard or incident It should focus on providing overall direction, control and coordination structures and processes to be used by the facility To review an EOP is: Remind students that the EOP is never “done”…it is living…and that means that as times change, the plan changes…this might be as simple as updating phone lists, or as major as adding new sections for newly invented threats. Is a “living document” Assigns responsibilities to departments and individuals for carrying out specific actions when an emergency exceeds capability or routine responsibility Sets up lines of authority and organizational relationships, and shows how actions will be coordinated Describes how people and property will be protected in emergencies and disasters Identifies personnel, equipment, facilities, supplies, and other resources available within the hospital and among community partners Identifies steps for mitigation Cites the legal basis for its existence

Purpose of Emergency Planning To maximally prepare the facility to sustain operations while maintaining the safety of both the staff and facilities during an incident Reasons for Emergency Planning Healthcare facilities are some of the first institutions affected by: Accidents Spills, crashes, etc. Natural disasters Tornado, hurricane, ice storms, etc. Acts of Terrorism Chemical release, bombings, etc. Technological failures Power failures, water contamination, etc. Mention that this is why the facility needs a plan and needs to be prepared. Hospitals cannot expect towns/cities or fire/EMS to manage disasters for them. Hospitals must deal internally, with both internal and external disasters. Re-emphasize that it’s important to share the plan with external partners, and to receive input from them, but that it is essential that each hospital have it’s own plan.

EOP Basics Plans should address: Management and planning Logistics and finance Business continuity operations Equipment, plant and utilities operations Safety and security operations Health & medical operations Functional annexes as needed Evacuation Surge Pandemic Influenza, etc. Other functional annexes include mass care, isolation and quarantine, resource management, communications, family care plan The next several slides cover: HOW TO DEVELOP/WRITE an EOP…WHAT TO INCLUDE/COVER… The instructor should use this slide for a brief discussion. It will help assess how well the class grasps the subject. Ask the class their thoughts on what the purpose of the plan is and what should be written in this section of the EOP. They should say things to include something like: “The purpose of the plan is to provide the facility and surrounding community t “The purpose of the plan is to provide the facility and surrounding community that relies on a given facility with an effective and efficient emergency management operation which when activated will provide the levels of protection needed. hat relies on a given facility with an effective and efficient emergency management operation which when activated will provide the levels of protection needed” For situations and assumptions, suggest : “If possible, include the warning time, the degree of damage expected, or any specific situations particular to your community.” Statement of Purpose Describes the purpose of the EOP to the reader/user Situations and Assumptions Describes the types of disasters and emergency situations that have the possibility of occurring in the area of the facility Organization & Assignment of Responsibilities Defines the roles and specific assignments of officials in the emergency management structure The lines of authority between the various departments are specified Lines of authority should be similar to day-to-day operations. However, it should allow for the expansion and extension of duties. Administration and Logistics Addresses the management of resources, general support requirements, and availability of services and support for all phases of comprehensive emergency management Plan Development and Maintenance Establishes provisions for review, modification, acceptance, and approval of the plan Re: plan development and maintenance… Especially important will be the continuous review required to update the plan to reflect improvements needed as a result of experiences and changing emergency situations and assumptions. Refer to the current TJC requirements as well as others required by your facility. Authorities and References Cite the authorities and references providing the basis for the EOP Statutes Executive orders Regulations Formal agreements Emergency planning references general planning guidance tools plans from other agencies/hospitals Definition of Terms Broad glossary of terms enables improved communications and better understanding of the plan by all readers All acronyms used in the plan must be included Annexes and Appendices Included at the end of the plan Annexes are action oriented Appendices are attached to functional annexes Contain supplementary hazard specific information Contain details, methods, and technical information unique to specific hazards identified in the HVA Conducting Exercises (new regulation for ’09) Outlines the types of exercises preferred/required Delineates the number and frequency of exercises necessary annually Definition of terms…don’t assume your reader knows anything about disaster, disaster management, the lingo in your hospital, or about healthcare…It needs to be inclusive for the least educated member of the staff. Annexes: written for, and preferably by, the person responsible for controlling resources available in any large-scale emergency. Supporting documentation will be needed to help reinforce the plan. Attachments may include: Checklists Charts Maps Standard operating procedures Catalogues of resources Call up lists Contact lists Weather/ Almanac History

EOP Examples Sample State Public Health EOP Outline: Introduction General Operational Plan Purpose Situations and Assumptions Plan Organization Applicability Continuity of Operations Organization and Assignment of Responsibilities Emergency Response Procedures Response Personnel Organization Staff Mobilization INSTRUCTOR: have the class turn and you go through each section, discuss some of the highlights Ask them to consider what aspects of this plans subsections might be necessary for them to include in their hospital plans. This will prepare them to participate in this course’s practical exercises. Mention that there will be an entire unit on Annexes and appendices, and don’t spend too much time on these sections here. Section I: Base Plan consisting of 9 separate areas Introduction Purpose Situation and Assumptions Roles and Responsibilities Matrix of Roles and Responsibilities Concept of Operations Phase One Phase Two Phase Three Administration and Logistics Plan Development and Maintenance Authorities and References Section 2 Appendices Glossary of Terms List of Acronyms Public Health Districts (insert map of districts!)

EOP Examples Sample Large Hospital EOP Outline: Policy Purpose Scope Definitions Fundamentals Objectives

EOP Examples Sample Large Hospital EOP Outline: Organization & Assignment of Responsibilities HVA Emergency Response plan Management Plan Leadership and Medical Staff Involvement Processes for Mitigation, Preparedness, Response and Recovery Process for Implementing Plans & the Recovery Process Process to Notify Staff Notifying external Resources Assignment of Staff Management of Patient Care Relocation/Evacuation Alternate Care Sites Staff Identification Community Emergency Planning Back-up for Communication Equipment Alternate Role of Staff During an Emergency Utilities

EOP Examples, cont. Sample Large Hospital EOP Outline, cont: Decontamination Conducting drills Monitoring/improving environment of Care Collection of information Performance monitoring Annual program evaluation These things are in addition to the previous slides…some unique to Large Hospital's plan, and applicable to other hospital plans… INSTRUCTOR: have students begin to consider these sections in relation to their own facilities. Again, this will mentally prepare them to participate in the practical exercise. - identify various places to receive needed water, power and other necessary utilities for your facility. -will your facility use radios if the telephone lines go down? Who do you have to work the radios? Who will be on the other end? - the community should be considered both as a partner and a resource during a time of need. -What method will be used to identify and verify staff? Is your system technology based? What if it is down? -Alternate care sites: these should be checked into incase patients need to be moved to your facility or incase your facility needs to be move patients to an off site facility. -Evacuation-where will the patients go? How will they be transported? What routes will be taken? What staff will go with them?

EOP Basics Summary Gather the players Develop a strategy Conduct a HVA Develop an EOP Practice, practice, practice Origination date, review date, date changed Emphasize again that this is an ongoing process, and that buy in is needed at all levels. And, mention that even the greatest plan will fail if it’s not practiced and understood by all. Give a final plug for AARs and constant review and revision… Now, it’s on to practical exercise number 1.

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