american college health association june 3, 2011 university disaster preparedness and mission...

American College Health AssociationJune 3, 2011

University Disaster Preparedness and Mission Continuity Plans

Session FRO30

John Andrews, MD, MPHAssistant Senior VP Academic Health Center

andDirector, University Health Services

University of Cincinnati

Disclosures

I have nothing to disclose.

Sources

University Health Services Mission Continuity Plan, University of Cincinnati, Cincinnati, OH

ACHA Guidelines. Emergency Planning Guidelines for Campus Health Services: An All-Hazards Approach, February 2011.

http://www.fema.gov/ http://www.bt.cdc.gov/cerc http://www.uc.edu/publicsafety/fire_emergency/e

mergency_preparedness.html

Objectives

Explain why an effective Mission Continuity Plan embraces an All-Hazards Approach to Disaster Preparedness

Describe the importance of an Effective Mission Continuity Plan for University Disaster Preparedness

Identify the university operational areas that must be included in an effective university Mission Continuity Plan

Outline of Today’s Presentation

I. Disaster Plans versus Mission Continuity Plans

II. A few Definitions and ConceptsIII. Four Main Steps in Disaster PreparednessIV. Practical Ideas for Mission Continuity Plans

(How we did them at the University of Cincinnati and How we Should Have Done them!)

V. Communication in DisastersVI. Psychological Impacts of DisastersVII. Conclusion

Why Plan?

The failure to plan is

a plan to fail.

Disaster Plans Versus Mission Continuity Plans

Disaster Plan: The plan that is used to respond to a disaster.

Mission Continuity Plan: The plan that is used to get your organization back to normal functioning - or what do you do after the fire department has left and all of the injured people have been removed from the scene.

Purpose of the National Response Framework (NRF)

The National Response Framework is used by federal agencies including the U.S. Department of Homeland Security to respond to disasters

Respond effectively to any type of incident with Immediate actions to save lives, protect

property and the environment, and meet basic human needs

Implementing emergency plans and actions to support short-term recovery

Reference: http://www.fema.gov/emergency/nrf

National Incident Management System (NIMS)

The National Incident Management System (NIMS) is a nationwide operations template that enables federal, state, tribal, and local governments, the private sector, and non-governmental organizations (NGOs) to work together regardless of cause, size, location, or complexity of a hazard in order to reduce the loss of life and property and harm to the environment.

Reference: http://www.fema.gov/emergency/nims/

Governance, Command and Control During Disasters

Identify individuals who will be responsible for declaring an emergency, determining the hazard level, and activating the Disaster Plan.

Identify the location of the Emergency Operations Center (EOC)

Assign Incident Command System (ICS) roles for individuals reporting to the EOC. (University Management will assign the Incident Commander. The Incident Commander will assign Section Chiefs and Liaison Officers)

Incident Command System (ICS)

A proven mechanism for the effective management of emergencies that involve either a multiple agency response or a single unit with a

Planned, Organized Structure Chain of Command Unity of Command Standardized terminology Facilities/Resources Management Communications and Information Management

Source: http://www.fema.gov

Set Up and Use the Incident Command System

Recommend that campuses and universities adopt the NIMS/ICS system on campuses for all emergencies

Incident Commander Safety Officer, Liaison Officer, Public Affairs

Officer, technical officers Planning, Logistics, Operations, and

Accounting/Finance Sections

Identify an Emergency Operations Center (EOC)

Identify personnel who will work in a Disaster. Identify a location for working in a Disaster. Identify equipment and information needed for

working in a Disaster. Identify a back-up location off-campus for

working in a Disaster (consider a local hotel. They have large rooms, telephones, bathrooms, copiers, fax machines)

Evacuation Plans

Set up Evacuation Plans for the relevant parts of your university

Inform employees as to who can decide to evacuate a work area

Set up an area for employees to meet (recommend finding a convenient place that is inside, that is away from heat or cold, that has food and water, and that is near bathrooms.

Shelter-In-Place Plans

Set up Shelter-in-Place Plans for situations in which work areas do not need to be evacuated.

Inform employees as to who can decide they need to shelter-in-place.

Areas of Rescue Assistance

Identify and placard Areas of Rescue Assistance for employees who are not able to leave work areas.

Inform local emergency personnel of who may need to be rescued and where the areas of rescue assistance are located.

Identify employees who can assist employees with disabilities in leaving the area.



II. A few Definitions and ConceptsIII. Four Main Steps in Disaster

PreparednessIV. Practical Ideas for Mission Continuity Plans



Four Main Parts of Disaster Preparedness

Mitigation/Prevention

Preparedness

Response

Recovery

Mitigation/Prevention

Campuses cannot prevent all disasters Campuses can identify risk reduction strategies

to prevent incidents and mitigate the impact of emergencies

The first strategy is to develop a preparedness plan

Create teams to decrease the risks due to acts of violence (Threat Assessment Team) and decrease exposure during public health outbreaks (School closure plan, immunization plan, etc.)

Preparedness

Interdepartmental project involving key individuals in various constituencies working on a plan with realistic deadlines.

Identify if the institution has policies, procedures, structures or templates to respond to an emergency

Determine if policies, procedures, structures or templates can be adapted to all hazards

Determine who is responsible for emergency preparedness on the campus.

Preparedness (cont)

If there is no plan, determine whom you need to engage in the conversation to get emergency planning on the agenda.

Determine if your school has participated in NIMS training/certification

Identify membership of the campus emergency management team. Include legal, risk management, human resources, and safety and security.

Identify the decision makers and a chain of command

Preparedness (cont)

Identify how essential groups will work together Define and explain roles and responsibilities for

the operational plans for each department. Identify the role of the campus health service Provide exercises and drills to rehearse the

response to a disaster. Coordinate drills with multiple departments.

Keep staff informed. Encourage staff participation in webcasts, disaster response training seminars and continuing education programs

Preparedness (cont)

Monitor CDC, World Health Organization, ACHA, and state health department information

Encourage staff to make personal and family emergency preparedness plans so they are better able to be responders in the event of an emergency

Fit test staff with N95 respirator protection. Consider positive air purifying respirators (PAPRs)

Identify staff roles and responsibilities for all types of critical incidents.

Preparedness (cont)

Compile a list of supplies that are needed Identify supply sources Identify storage area for supplies Maintain a stock supply of needed items Establish a plan for continued cleaning and

waste removal services Investigate the feasibility of establishing

negative pressure rooms in the campus health service

Coordinate with local hospitals

Preparedness (cont)

Consider cancelling classes and asking students to leave campus

Plan for a reduction in the campus health services workforce.

Consider volunteers to assist with answering phones, moving supplies, and providing bedside assistance to the ill.

Consider developed a clinic schedule based on 24/7 operation

Consider suspending nonemergency services.

Preparedness (cont)

Identify community resources that students could use.

Set up a system for reporting cases both on and off campus

Develop a plan for care of the deceased that considers storage until notification of the family and transfer

Develop plans for conducting mass immunization clinics.

Develop plans to provide food to students and staff

Preparedness (concl)

Plan for how to handle international students Determine how research activities will be

handled Establish a plan for care of laboratory animals

and cell cultures Establish a plan for specimen storage Set up an evaluation and continuous process

improvement plan

Response

Once an incident occurs, priorities shift from planning to saving lives and protecting property

Four actions in the response phase Obtain situational awareness Activate and deploy resources Coordinate response actions Demobilization

Response - Situational Awareness

Continuous monitoring of information regarding actual and developing incidents

Type of monitoring depends on the event

Response – Activate and Deploy Resources

Assess the situation Identify and prioritize requirements Activate available resources Develop an Incident Action Plan

Set up an Incident Command System Activate an Incident Management Team Activate specialized teams as needed Position resources based on need Request additional resources from state or

federal government.

Response – Coordinate Response Actions

Response operations are enhanced by full application of NIMS with its common principles, structures, and coordinating processes Coordinate actions with local authorities,

including law enforcement, firefighting, and emergency medical services

Continually assess operations and adapt existing plans to meet evolving circumstances

Coordinate public information strategies

Response – Specific Response Actions

Ensure responder safety and health Warning the public and providing information to the

public Implementing evacuation and sheltering plans that

includes provisions for special needs populations and household pets

Perform search and rescue Treat the injured Assist law enforcement and investigation Control hazards – extinguish fires, contain

hazardous spills

Response –Demobilization

Decide when to call an end to the crisis Set up a timeline for restoring normal operations Communicate with employees, students, and

others on the resumption of services Provide post-event resources for assisting those

who need psychological, financial, and social support

Evaluate the effectiveness of the emergency response including feedback from participants

Recovery

Actions to facilitate recovery (Mission Continuity) start almost as soon as the disaster occurs.

Recovery is getting the operation back to normal

Recommend not trying to “improve” the normal operation at this time. “Improvement” to the normal operation can occur after operations are back to normal



II. A few Definitions and ConceptsIII. Four Main Steps in Disaster PreparednessIV. Practical Ideas for Mission Continuity

Plans (How we did them at the University of Cincinnati and How we Should Have Done them!)


University Mission Continuity PlanUniversity of Cincinnati

A detailed plan of procedures for getting operations back to normal

Our experience at the University of CincinnatiHow we did it and how we should have done it!

Who needs to be involved?

All constituencies that will be involved in mitigation/prevention, preparedness, response, and recovery

Regularly scheduled meetings, written collaborative agreements, mutual aid planning, and/or memoranda of understanding

Frequent NIMS/ICS training, tabletop exercises, active drills, and specialized education for responders.

Mission Continuity Plans

Identify persons who will be in charge when a disaster occurs. Identify two back-up persons for each task (due to vacations, personnel being out-of-town or ill). Obtain addresses for these individuals

Identify persons who will be in charge when an emergency occurs. Indentify two back-up persons for each task

Identify who will document all activities during the emergency for legal, risk assessment, financial, and administrative purposes.

Mission Continuity Plans (contd.)

Identify who has access to any keys or equipment/forms/software/or data needed

Obtain contact information for other university personnel including the Biological Safety Office, Facilities Management, Construction Management, Risk Management, Public Safety, IT, Locksmith, Laboratory animals, Legal, Radiation, Supplies and Services, Work Control

Mission Continuity Plan Activities

List all activities in your areas as Critical (essential) or Non-Critical (non-essential).

It may be helpful to group activities into such categories as Education, Research, Patient Care, Business Support.

For both Critical and Non-Critical Functions, describe the processes/procedures/tasks that are required to carry out the function, the Recovery Time to have the activity operational, and the personnel (title/position) who will be needed to carry out the function.

Mission Continuity Plan Activities(contd.)

Identify the location of all equipment/forms that will be needed to carry about the function.

Indicate the space, software, connectivity, databases needed for the activity.

Set up teams for various areas of your university that will need to be operational in a disaster (Health Care, Environmental Health, Personnel, Legal, Public Relations, Finance, Administration, Executive, Liaison). Consider any technical experts that may be needed. Obtain contact information for these people.

Mission Continuity Plan Activities(contd.)

Inventory university equipment in enough detail that an underwriter will reimburse the university if the equipment is lost or damaged. Include band name, vendor, serial number, and purpose of the equipment, names of the equipment, and building and room number where equipment is kept.

Put a Mission Continuity Plan into Writing

Distribute Plans to key personnel Update Plans at least annually

Communication

Goal of Communication: Be first, Be right, Be credible.

Set up a Communication Plan for employees and students (beepers, cell phones, paging, enunciators, posters, bulletin boards, radio, television, Twitter, Facebook, Nixle)

Publicize the Communication Plan Update personnel on the plan Get staff cell phone and home phone numbers. Get

phone numbers of relatives and for places the staff member is likely to stay if they aren’t at home

http://www.bt.cdc.gov/cerc (CERC = Crisis and Emergency Risk Communication)

Communication (cont)

Discuss communication plan with communication and IT departments to be sure it is doable.

Identify who will be responsible for communications as well as at least two backups (Public Relations Officer)

Set up a central reporting plan for daily monitoring of illness or disease, employee and student absences, students in isolation, location and number of students transported to a hospital

Establish a plan for notifying essential personnel (calling tree ?)

Communication (cont)

Get appropriate approvals in advance so that messages can be disseminated quickly

On a regular schedule and as needed, provide information to the campus community on such topics as the disaster status on campus, travel advice, shelter-in-place, personal care, hand washing, cough etiquette, how/where/when to access healthcare services.

Consider crafting messages in advance Ensure that messages are easy to understand and

culturally appropriate.

Communication (concl)

Consider identifying translators and translating materials into different languages as appropriate.

Maintain communications with the local public health authorities, emergency preparedness groups, hospital systems regarding surveillance, case identification and reporting, control measures, and health care provisions. (Liaison Officer)

Maintain contact with other universities as appropriate (Liaison Officer)

Maintain up-to-date lists of key contacts (Liaison Officer)

Psychological Impact of Disasters

Most people (including disaster responders) will experience psychological distress in disasters (strong feelings of grief, sadness, fear, or anger)

Some individuals will need professional assistance to achieve the two primary goals of mental health crisis response Normalizing feelings Finding effective ways of coping with ongoing

stress

Psychological Impact of Disasters (cont)

There is not a single “normal” pattern of reaction to a disaster.

If symptoms of distress do not dissipate in a period of weeks if they become worse, affected individuals should seek professional help.

Strategies they may help individuals include identifying safe areas and behaviors, maximizing the individual’s ability to care for self and their family, teaching calming skills, encourage connectedness to family and other social supports.

Psychological Impact of Disasters (cont)

Important for primary health care clinicians to screen patients for stress related symptoms and emotional distress.

Identify positive methods of coping (social supports, self-care, structure to daily routine, continue “normal” rituals, continue exercise and recreational activities, gently facing feared situations.

Professional assistance if severe fatigue, easily startled or hyper-vigilant, headaches, gastrointestinal symptoms, problems with concentration, social isolation, blaming, unable to experience pleasure, outbursts of anger.

Psychological Impact of Disasters (concl)

Care-givers and emergency response personnel require Stress debriefing meetings Counseling and support options Educational in-services or workshops

regarding self-care Work rotation schedules and respite

Strategies most helpful focus on helping individuals to establish a feeling of being safe

Conclusion

Go Forthand

Plan Well

american college health association june 3, 2011 university disaster preparedness and mission...

Documents

conclusion slide

emergency plans

disaster preparedness

university operational

campus health services

practical ideas

type of incident

main steps