Hazard and Vulnerability Assessment OSHA Training Institute – Region IX University of California, San Diego (UCSD) - Extension OSHA Training Institute

OSHA Training Institute Objectives Discuss methods of conducting a hazard vulnerability analysis (HVA) Identify how the HVA is applicable to preparedness and evacuation Practice effective training techniques in conducting a HVA OSHA Training Institute

The HVA and the Relationship to Evacuation The HVA is a tool used to evaluate the potential risks for a facility It is not an evaluation of the potential for evacuation However, risks identified in the process may focus the organization toward the need to mitigate and prepare for circumstances that could include evacuation OSHA Training Institute

OSHA Training Institute The Purpose of the HVA The purpose is a prioritization process that will result in a risk assessment for “all hazards” The tool includes consideration of multiple factors The focus is on organization planning and resources and /or the determine that no action may be required. This is an organization decision OSHA Training Institute

OSHA Training Institute Is this required? The Joint Commission, previously called the Joint Commission of Accreditation of Healthcare Organizations (JCAHO), requests an HVA for organizations to determine the focus of their emergency planning There is no specific tool nor method defined OSHA Training Institute

HVA Categories for Evaluation There are categories considered in a formal process of assessing an HVA Most HVA tools include an assessment of the following factors: Probability that an event will occur The risk of disruption to the organization associated with the event scored as high, moderate or low or a similar description. The level of preparedness OSHA Training Institute

Probability of Occurrence The probability may be based on statistics and objective information but also may be intuitive and highly subjective. The following factors are often considered: Known risk Historical data Manufacturer or vendor statistics American Society of Healthcare Engineering 2001 OSHA Training Institute

OSHA Training Institute Historical Data Natural events Hazardous material releases Technological accidents Infrastructure problems OSHA Training Institute

OSHA Training Institute Risk Assessment The risk of an event is assessed based on: Threat to life and/or health Disruption of services Damage for failure possibilities Loss of community trust Financial impact and legal issues American Society of Healthcare Engineering 2001 OSHA Training Institute

OSHA Training Institute Preparedness Preparedness of the organization’s ability to manage risks, can include items such as: Status of current plans Training Insurance Back up systems Community resources OSHA Training Institute

OSHA Training Institute Models There are a number of models for an HVA. Two well known models are from American Society of Healthcare Engineering (ASHE) Kaiser Foundation Both models can be adjusted to fit the organization Security organizations and other vendors also market HVA tools OSHA Training Institute

Medical Center HVA Model Kaiser model also includes: Probability Response factors Human, property and business impacts, each considered as a separate issue OSHA Training Institute

A Comparison of Threat Events Considered in HVA Models ASHE Model 2001 Human Events Natural Events Technological Events Kaiser Foundation Model 2001 Human Events Natural Events Technological Events Hazmat Events OSHA Training Institute

OSHA Training Institute Natural Events Risks common to the area or geography of the region, for example: storms, earthquakes, floods, and tornadoes, and other natural causes of damage The impact may be able to be mitigated or may result in a partial or complete evacuation OSHA Training Institute

Mitigation Plans for Regions Other models use sophisticated software to determine the hazards by cities, counties or regional areas Are used for the development of mitigation plans for multi-jurisdictions OSHA Training Institute

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OSHA Training Institute Drill HVA Grayville Hospital Location: Grayville, CA; Eastern Sierras Population: 150,000 Description: small town with general services, small businesses, surrounded by rural areas and ranches OSHA Training Institute

OSHA Training Institute Grayville Hospital 70 Beds Two story building; 50 years old ED: 5 beds; in West Wing of hospital West Wing is single story, recently renovated and structurally reinforced 5 yrs ago ED connected to hospital by an enclosed corridor Patient units on second floor of hospital OSHA Training Institute

OSHA Training Institute Grayville Hospital On the first floor: Six bed ICU/CCU Two room Labor and Delivery Ten bed family unit Small nursery OR: 4 suites, 2 procedure rooms 5 gurney recovery room Radiology and Laboratory Five Administrative offices OSHA Training Institute

Why is this Important to Worker Well-being? Preparedness efforts, plans and resources are directly related to the organization’s HVA Engineering controls may occur as a result of HVA thus reducing risk for the work force Safety factors are considered Process promotes understanding of current resources that may not have been known beyond the “expert” OSHA Training Institute

Evacuation Implications When a risk is identified in the HVA that would potentially result in an evacuation, the organization should focus on issues that could impact the need to evacuate or to mitigate the risk. Examples: Routes Locations Personal Protective Equipment (PPE) Communication to employees with special needs Special situations - management of family on site OSHA Training Institute

OSHA Training Institute What Does It All Mean? HVA tools, used to prioritize specific and overall relative risks, are based on mathematical formulas that are either embedded in the document or managed manually The factors considered in the assessment includes the assumption that the risk occurs at the worst possible time and with a full patient census OSHA Training Institute

Summary: What is the greatest risk? The HVA process helps an organization prioritize in the order of criticality The efforts to decrease the consequences of a possible event can be focused upon. This includes evacuation. OSHA Training Institute

OSHA Training Institute Examples of HVA Tools American Society for Healthcare Engineering of the American Hospital Association  www.ashe.org Kaiser  Permanente’s interactive HVA tool available at:  www.emsa.ca.gov/dms2/kp_hva.xls Emergency Management Program Guidebook Published by VHA Center for Engineering & Occupational Safety and Health, St. Louis, MO vaww.ceosh.med.va.gov   For review of an HVA sample go to: http://www1.va.gov/emshg/apps/emp/emp.htm Click HVA under index link OSHA Training Institute

OSHA Training Institute References American Society of Healthcare Engineering 2001 WWW.ashe.org FEMA. Emergency Management Institute Hazard vulnerability analysis and risk assessment. Unit 2 http://www.training.fema.gov/emiweb/EMICourses/E464CM/02%20Unit%202.pdf Joint Commission Resources Hazard vulnerability analysis (HVA), May/Jun 2002, 2-3 OSHA Training Institute

OSHA Training Institute More References Kaiser Permanente. Medical center hazard and vulnerability analysis. 2001 Kaiser Foundation Health Plan, Inc. Schwartz RB. Hospital preparedness for mass casualties in disasters. Institute of Disaster Medicine Medical College of Georgia slide set www.achd.net/swprjttf/pubs/pdf/hospitalprep.pdf OSHA Training Institute