1. Emerging Threats and Lessons Learned: Surviving in an era of Technology and Complexity Hawaii Director’s of Nursing Association January 30, 2015 Toby L. Clairmont, RN, CEM Director, Emergency Services Healthcare Association of Hawaii

2. Disclosure Title:Emerging Threats and Lessons Learned: Surviving in an era of Technology and Complexity Date:30 January 2015 Author:Toby L. Clairmont, RN, CEM 99-1450-C Koaha Place, Aiea, HI 96701 tclairmont@hah-emergency.net Security Classification:UNCLASSIFIED The information and views presented herein reflect the views and opinions of the presenter and may not constitute the views or policy of the United States Government or any other entity. Copyrighted images used under the provisions of the Copyright Act of 1976, 17 U.S.C §107 (fair use doctrine) and may not be further distributed without the consent of the copyright owner. The presenter does not endorse the products or services of any commercial entity.

5. Highlight societal trends and the impact they have on disaster response Outline key challenges facing emergency management in the near-term future Discuss meaningful preparedness and response strategies Objectives

6. Highlight societal trends and the impact they have on disaster response Outline key challenges facing emergency management in the near-term future Discuss meaningful preparedness and response strategies Objectives

7. 1. Disasters will continue to occur WHAT WE KNOW

8. 1. Disasters will continue to occur2. Often can predict location WHAT WE KNOW

9. 1. Disasters will continue to occur2. Often can predict location3. Rarely can predict timing WHAT WE KNOW

10. 1. Disasters will continue to occur2. Often can predict location3. Rarely can predict timing 4. Only the effects can be managed WHAT WE KNOW

11. 1. Disasters will continue to occur2. Often can predict location3. Rarely can predict timing4. Only the effects can be managed5. Management requires planning WHAT WE KNOW

14. Climate Change

15. Terrorism

16. Human Factors

17. Emerging Infectious Disease

18. Violent Crime

19. Political Change

20. Complex Cascading Events

22. 1. Individual empowerment MEGATRENDS

23. 1. Individual empowerment2. Diffusion of power MEGATRENDS

24. 1. Individual empowerment2. Diffusion of power3. Demographic shifts MEGATRENDS

25. 1. Individual empowerment2. Diffusion of power3. Demographic shifts 4. Demand food, water & energy MEGATRENDS

26. Cyber-Terrorism

28. Highlight societal trends and the impact they have on disaster response Outline key challenges facing emergency management in the near- term future Discuss meaningful preparedness and response strategies Objectives

29. TIPPING POINT AHEAD?

30. Extreme weather events more frequent Dependence on technology Political stress Increased demand for scare resources such as water, food & energy WHAT’S AHEAD

31. Disasters can become catastrophes WHAT’S AHEAD

32. Highlight societal trends and the impact they have on disaster response Outline key challenges facing emergency management in the near-term future Discuss meaningful preparedness and response strategies Objectives

33. INCREASE COMMUNITY RESILIENCY

34. ADAPT to NON-LINEAR ENVIRONMENT

35. DEVELOP ‘LAST MILE’ WARNING SYSTEMS

36. UTILIZE MULTIPLE, REDUNDANT COMMUNICATION PATHWAYS

37. DECENTRALIZE ESSENTIAL SUPPLIES & EQUIPMENT

38. FLEXIBLE, COMMUNITY-BASED RESPONSE TEAMS

39. BUILD INDUSTRY COALITIONS

40. HAH COALITION MEMBERSHIP 130 organizations Hospitals including critical access, specialty and government organizations Nursing Homes, Assisted Living facilities and Type II ARCH’s Home Care and Hospice providers Community Health Centers Dialysis providers Air and Ground Ambulance providers Hawaii Disaster Medical Assistance Team (Kalawao Rescue) Clinical Laboratories and Blood Banks Durable Medical Equipment suppliers

41. FIVE CORE MISSIONS 1.COORDINATE Health Care Response Operations 2.DEPLOY emergency response teams 3.MOBILIZE health care delivery systems 4.PROVIDE specialty logistical support 5.SUPPORT planning and preparedness

42. MISSION 1.0 COORDINATE HEALTH CARE RESPONSE OPERATIONS

43. MISSION 2.0 DEPLOY EMERGENCY RESPONSE TEAMS

44. MISSION 3.0 MOBILIZE HEALTH CARE DELIVERY SYSTEMS

45. MISSION 4.0 SUPPORT SPECIALITY LOGISTICAL SUPPORT

46. MISSION 5.0 SUPPORT PLANNING and PREPAREDNESS I.Awareness education: Prepare for Disaster video and supervisor-facilitated discussion II.National Incident Management System (NIMS): Hospital Incident Command System (HICS) and FEMA- equivalent courses III.Professional Development Series: Pediatric trauma, burn management, psychological first-aid, hospital evacuation…

47. Disasters events are increasing in terms of cost, frequency & complexity Only the effects can be managed Some changes in the way we prepare and plan for disasters are needed Patience and tenacity are needed TAKE HOME

48. QUESTIONS?