Essential Building Blocks of a Comprehensive Emergency Management Program April 28, 2015
Objectives 1. Overview of Planning Process and Requirements 2. Components of a comprehensive Emergency Management Program Incident Management System (IMS) All-hazards approach Hazard Identification and Risk Assessment (HIRA) 5 min 40 min 3. Q&A 10 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 the work for CSS, CMHA, CCAC organizations 3
Planning approach and time lines TC LHIN COMMUNITY SECTOR EMMERGENCY PLANNING Q4 FY14/15 Q1 FY15/16 Q2 FY15/16 Q3 FY15/16 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 [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] 4
TC LHIN System Emergency Planning Approach MCSCS - Emergency Management Ontario MOHLTC EMB Ministry Emergency Operations Centre (MERC) PHASE 3 GTA LHINs CE LHIN CW LHIN C LHIN MH LHIN TC LHIN HSPs Hospitals (17) LTC Homes (37) Addictions and Mental Health Providers (69) TC CCAC (1) Community Support Services (67) City of Toronto Office of Emergency Management (OEM) First Responders EMS Fire Police Toronto Public Health Unit Toronto Community Housing Community Health Centres (17) PHASE 1 PHASE 2 5
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. 6
COMPREHENSIVE EMERGENCY MANAGEMENT PROGRAM 7
32 people died at Résidence du Havre in L'Isle-Verte, Que., in January 2014 SOME KEY RECOMMENDATIONS MADE BY THE CORONER: 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 Recovery and Mitigation Prevention Response Preparedness 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
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 Communications Operations Planning Logistics Finance and Administration
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 Collaborate with partner organizations / broader system
Training / Plan Testing Source: City of Toronto Emergency Management Plan http://www1.toronto.ca/city%20of%20toronto/office%20of%20emergency%20management/files/pdf/e/emergency_plan.pdf
ALL-HAZARDS APPROACH AND HAZARD IDENTIFICATION AND RISK ASSESSMENT (HIRA) TOOL 14
All-Hazards Approach 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-faqeng.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 diagrams, floor plans and maps
Risk Assessment Scale 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
HIRA Grid TYPE OF HAZARD HAZARD DESCRIPTION PROBABILITY RATING - HOW LIKELY IS THIS TO SEVERITY RATING - WHAT IMPACT WOULD THIS HAVE ON ASSIGNED RISK (PROB. X SEV.) OCCUR? (SCALE OF 1-4) SAFETY OR OPERATIONS? (SCALE OF 1-4 NATURAL Extreme temperature - heat 4 2 8 TECHNOLOGICAL Loss of energy supply 4 3 12 HUMAN-CAUSED http://www.health.gov.on.ca/en/pro/programs/publichealth/oph_standards/docs/req13.pdf
Risk Assessment Matrix 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
Example 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 Risk Rating Low Moderate High
Next 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 VI. Mutual Aid/Assistance Agreements
Questions? Questions Could you repeat the name of the (IMS) course and where to access it? How do we find potential partners? Exactly what is it that we must have by September and do we have to submit it to the LHIN for approval? Is there a format that this Emergency Plan must follow? IT Business continuity planning can be quite technical and complex. Will there by any facilitation and, expertise available from the LHIN? Can organizations work through Health Links to create a unified emergency management plan? Hi, should we focus our EMP partnerships to TCLHIN area located organizations? Answers IMS 100 - Introduction to Incident Management System https://training.emergencymanagementontario.ca/tponline/tponline.dll/emo_public_course/courseno=cour20110704151 45004500149 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) 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. 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. 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. 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. 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.
TC LHIN Emergency Preparedness Resource Page: http://www.torontocentrallhin.on.ca/resources/emergencypreparedness.aspx Contact information: Olga Livshits, Consultant TC LHIN Performance Management Team Tel: 416.969.4923 Email: olga.livshits@lhins.on.ca