1. Emergency Management Program Development

2. Primary Reference Emergency Management Principles and Practices for Healthcare Systems, The Institute for Crisis, Disaster and Risk Management (ICDRM) at the George Washington University (GWU) for the Veterans Health Administration, Department of Veterans Affairs (VA), Washington, DC, June, 2006. Available at www.va.gov/emshg www.va.gov/emshg

3. Lesson Objectives Identify some of the concepts and systems that support a comprehensive emergency management (CEM) program. Describe the various standards and regulations that must be addressed by a health system’s CEM program. Explain how a nine-step process can be used to develop an effective program that meets regulatory requirements.

4. Concepts & Systems Disaster research (1940-present). Comprehensive Emergency Management (1979). Integrated Emergency Management System (1983). Incident Command System, National Interagency Incident Management System (NIIMS) (1985); National Incident Management System (NIMS) (2003). Standardized Emergency Management System (1994).

5. Comprehensive Emergency Management: 4 Phases Mitigation Preparedness Response Recovery

6. The Integrated Emergency Management System (IEMS) A philosophy of inclusiveness - the groups that will respond to disasters are brought into the planning process. A method of organization - around functions generic to all disasters, not around specific hazards, agencies or people. A set of program development steps tied to the four phases.

7. Maximum Capability Required Maximum Capability Required Optimally Integrated Plans Optimally Integrated Plans Continual Maintenance Continual Maintenance CAPABILITY ASSESSMENT CAPABILITY ASSESSMENT EMERGENCY OPERATIONS PLANS EMERGENCY OPERATIONS PLANS CAPABILITY MAINTENANCE CAPABILITY MAINTENANCE MITIGATION EFFORTS MITIGATION EFFORTS EMERGENCY OPERATIONS EMERGENCY OPERATIONS CAPABILITY SHORTFALL CAPABILITY SHORTFALL MULTI-YEAR DEVELOPMENT PLAN MULTI-YEAR DEVELOPMENT PLAN ANNUAL DEVELOPMENT INCREMENT ANNUAL DEVELOPMENT INCREMENT HAZARDS ANALYSIS HAZARDS ANALYSIS EVALUATION STATE/ LOCAL RESOURCES STATE/ LOCAL RESOURCES FEDERAL RESOURCES FEDERAL RESOURCES ANNUAL WORK INCREMENT ANNUAL WORK INCREMENT 1 234 5 67 8910 11 12 13

8. Disaster Research: Four Key Considerations Importance of organizing by functions, not agencies or hazards. Use of problem-solving model. Need to understand crisis behavior. The difference between disaster planning vs. disaster management.

9. Disaster Management Involves... Warning Pre-impact Preparations Search & Rescue Care of Injured & Dead Welfare Needs Restoration of Essential Services Protection against Continuing Threat Community Order Communication Continuing Assessment of Situation Mobilization & Utilization of Resources Coordination Exercise of Authority “Agent-Generated Demands” “Response-Generated Demands” Two Sets of Demands Occur Simultaneously! Quarantelli

10. Incident Command System & Standardized Emergency Management Systems ICS was developed as a result of a Congressional mandate to solve inter-agency coordination problems at the scene of major wildfires in the late 1970’s. SEMS was developed at the request of California’s Governor to solve inter-agency coordination problems in Emergency Operations Centers. Both use the same management functions and share system components.

11. Command Planning Logistics Finance Operations ICS/SEMS/NIMS Management Functions

12. ICS/SEMS System Components Common Terminology Integrated Communications Modular Organization Unified Command Structure Manageable Span of Control Consolidated Action Plans Comprehensive Resource Management Pre-Designated Incident Facilities

13. Standards and Regulations JCAHO OSHA EPA NFPA ASTM NIMS EMTALA HIPAA

14. Crosswalk Nine Steps NIMS Elements JCAHO indicators

15. Form Emergency Management Committee Leadership & Diirection, Establish Roles, Assign Responsibilities Implement Mitigation & Preparedness Activities Take Actions to Increase Resiliency and Medical Surge Capacity and Capability 1 Develop Emergency Operations Plan “All hazards” Concept of Operations Conduct Hazard Vulnerability Analysis Determine Threats and Impacts Develop Incident- specific Guidance Mitigation, Preparedness, Response & Recovery External Coordination Clarify Roles and Ensure Mutual-aid Conduct Staff Education & Training Understand Roles, Build Competencies and Confidence Implement Emergency Operations Plan Rehearsal or Actual Event Evaluation & Corrective Actions Review and Refine the Components of the Emergency Management Program 234 5 6789

16. Discussion Question: What are some of the biggest issues you have with developing the emergency management program in your organization?

17. Questions?