Disaster Management in Healthcare

Disaster Management Overview

• Strategic planning should prepare hospitals and health organizations for emergencies and disasters.
• Strategic planning includes overall emergency plans, staff training, and facility protection.
• Contingency plans are sometimes appendices to strategic plans, providing actions to minimize challenges during specific emergencies.
• Forward planning occurs when an organization is alerted to an impending disaster, such as severe weather.
• Forward planning focuses on activating existing strategic and contingency plans.

Classifications of Disasters

• Internal disasters disrupt care environments within an organization or facility, related to the physical plant or personnel availability.
• The management goal for internal disasters is to maintain a safe environment, provide essential services, and restore normal services.
• External disasters strain facility resources when event consequences create service demands exceeding available resources.
• A combined external/internal disaster may occur when external conditions trigger internal disruptions within a health organization.

Three-Level Approach to Disaster Response

• Level 1: An organization can contain the event and effectively respond using its own resources.
• There must be adequate surge capacity within the organization, be competent in preparations.
• Level 2: The disaster requires assistance from external sources, obtained from nearby agencies or communities.
• Level 3: Exceeds local capacity and requires regional or national assistance; community linkages must be adequate.

Leadership in Disaster

• Activation of emergency operations plan triggers Incident Command System decision-making.

Phases of Disaster Management

• Non-Crisis Phase: Risk assessment and participative management styles are needed.
• Identification of vulnerabilities based on routine operations.
• Response Phase: Requires a more directive leadership style.
• Experienced managers who are confident in their knowledge of the institution and the plan should be given leadership tasks.
• Recovery and Evaluation Phase: A less commanding approach will encourage honest assessment by participating staff for future improvement.

Disaster Management Process

Preparedness/Risk Assessment

• Evaluation of the likelihood of emergencies or disasters.
• Issues to consider include weather patterns and geographical location.
• Expectations related to public events and gatherings.
• Age, condition, and location are important considerations.

Mitigation Strategies

• Mitigation includes prevention measures to lessen a disaster's impact should it occur.
• Examples include installing and testing backup generators or cross-training staff.
• Disaster management plans need staffing provisions to meet existing and incoming patient needs.

Infrastructure

• For internal disasters, the physical plant, utilities, staffing, and equipment must remain functional.
• If the disaster is external, facilities must care for current patients/relocate elsewhere and triage/care for new arrivals simultaneously.

Staff Competency

• Ensuring all levels of staff are competent is crucial to disaster management.
• Emergency preparedness competencies refer to staff ability to perform functional roles for emergency response.
• Competencies are complex; direct observation is the best method to evaluate competence.
• Regular participation in drills/exercises ensures a smooth response.

The Disaster Plan

• Staff should be conversant with agency's emergency response plan.
• Employees should know their most likely emergency response functional roles.
• This should be realistic to the expectations of the institution.

Relationship and Partnership

• Establishing mutual aid agreements, plans to share resources, and willingness to provide support are of paramount importance.

Hospital Incident Command System (HICS)

• Is an incident management framework to organize disaster plans and responses
• The HICS can be used in community health centers and long-term care facilities.
• Use of common nomenclature, and expandability are basic HICS principles.

Key Features of Incident Command System

• Predictable chain of command with one incident commander (IC) within the institution.
• Has overall responsibility for the management of an incident.
• Accountable to the people they report to.
• This person is responsible for instituting collaboration.

Use of Similar Titles

• All agencies use the same titles for each position.
• Common Terminology assists different agencies in communicating.

Flexible Mobilization of Resources

• Only the required portions of the system are activated.

Unified Command structure:

• Agencies coordinate their efforts in response by establishing a unified objective and strategy.

Incident Action Plan (IAP):

• The collaborative plan created at the Incident Command Center involving multiple agencies in disaster response.
• This plan ensures all agencies are working toward objectives.

Facility Actions Plan (FAP):

• A locally-developed plan for emergency management for internal event, when there are no other organizations involved in the response.

Unity of Command:

• All report to one individual.

Managing a Span of Control:

• A maximum number of people a manager is responsible for.

Job action sheets (JASS):

• Define specific functional role.

Republic Act(RA) 10121

• It requires to be prepared incase of a disaster.
• The country can prevent the loss of lives during disasters.

LGUs

• Under RA 1012, each region to establish a DRM for each region.

RDMMC

• RDMMC is responsible for maintainin and operating facility on a 24 hour basis
• Is responsible on implementing the new DRM LAW

DRMMC is powered to do the funtions, and national agenda

The NDRRMC has a 4 part system

• Preemptive measures
• Mitigation and precention
• Disaster response
• disaster, rehibilitation and recovery.

Doomsday Protocol

• Occurs in the metro of Manilla due to the impact of the earthquake that is based on the MMIRS

Level of disaster response

• level 1 team will react
• level 2 will respond to the even is there is 2 teams from code blue response
• lever 3 is more that 3 and would be Code RED

Disasters

• The quadrant for hospitals is, west south , North

Roles of NURSES DURING

• First to arrive
• Provide care

WHY

• Because they will know what needs to be done in this types of situations
• Should be there

Roles

• Member of the team
• Triage officer
• educator
• onsite coordinator

Phases

• mitigate- response , recover and prep

• Should plan the events

• Prepare well in this type of emergencies

PREPERATION:

• Is there a training plan, back up a plan, trained and train , supplies?

Act, mitigate , provide help.

• Know you and know what to.do.

Nurses roles and competencies.

• Provide the right care to the patient(s) involved.

Nurses levels and qualifications in times of disaster or situations.

• Should be prepared and know how to act during this event.