business continuity plan - mackay hospital and health service...the aim of the mackay hospital and...

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Mackay Hospital and HealthService

Business Continuity Plan

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Table of ContentsIntroduction................................................................................................................... 3Purpose ........................................................................................................................ 3Support / Interface with other plans .............................................................................. 3Geographical Area........................................................................................................ 3Types of Hazards ......................................................................................................... 4Pandemic Influenza ...................................................................................................... 5

Reducing the likelihood of staff becoming exposed to the virus ............................ 5Management of illness and absenteeism .............................................................. 5Maintaining service/business delivery with specific reference to the maintenanceof essential services .............................................................................................. 6Staffing .................................................................................................................. 6Staff accommodation............................................................................................. 6

General Operations ...................................................................................................... 6Communications........................................................................................................... 7Activation and Relocation ............................................................................................. 7Risk Management......................................................................................................... 8Business Restoration.................................................................................................. 11Conclusion.................................................................................................................. 11Contingency Plans For the Mackay Hospital and Health Service ............................... 12

Occupational Health and Safety Unit ...................................................................... 13Medical Ward.......................................................................................................... 15Rehabilitation Unit................................................................................................... 22Operating Theatre Services .................................................................................... 25Intensive Care Unit ................................................................................................. 34Coronary Care Unit ................................................................................................. 37Womens Health Unit ............................................................................................... 40

Special Care Neonatal Intensive Care Nursery ................................................... 42Womens Health Unit – Ward & Clinics ................................................................ 45Birth Centre ......................................................................................................... 50

Child & Adolescent Health Unit............................................................................... 51Specialist Outpatients ............................................................................................. 60Renal Dialysis Unit.................................................................................................. 65Mental Health Unit .................................................................................................. 67Community Mental Health....................................................................................... 70Alcohol Tobacco & Other Drugs Service................................................................. 73Early Discharge Surgery Unit.................................................................................. 75Mackay Breastscreen ............................................................................................. 84CSSD...................................................................................................................... 85Health Information Division ..................................................................................... 87Corporate Services Travel ...................................................................................... 89Information Division ................................................................................................ 90Medical Imaging...................................................................................................... 92Pathology Services. ................................................................................................ 95Pharmacy................................................................................................................ 97Bowen Hospital – General & Clinical Services........................................................ 99

Bowen Hospital – Utilities Services ................................................................... 106Clermont Hospital - General ................................................................................. 110

Clermont Hospital – Utilities Services................................................................ 117

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Monash Lodge – General .................................................................................. 122Monash Lodge – Utilities Services .................................................................... 128

Collinsville Hospital - General ............................................................................... 133Collinsville Hospital – Utilities Services ............................................................. 141

Dysart Hospital – Clinical & General ..................................................................... 146Dysart Hospital – Utilities Services.................................................................... 153

Moranbah Hospital................................................................................................ 157Proserpine Hospital – Clinical & General .............................................................. 162

Proserpine Hospital – Utilities Services ............................................................. 172Sarina Hospital – Clinical & General ..................................................................... 183

Sarina Hospital – Utilities Services.................................................................... 186Environmental Services............................................................................................ 190Catering Services ..................................................................................................... 194Linen Services .......................................................................................................... 196Emergency Call Directory ......................................................................................... 198

Contact List – Internal ........................................................................................... 198Contact List – External.......................................................................................... 198

Operational Checklist ............................................................................................... 199Glossary ................................................................................................................... 200Amendment register and version control .................................................................. 200APPENDIX 1 ............................................................................................................ 201

Terms of Reference - Emergency Preparedness and Continuity Management Sub-Committee ............................................................................................................ 201

APPENDIX 2 ............................................................................................................ 202MODEL HEALTH INCIDENT MANAGEMENT CHECKLISTS.............................. 202

State Health Coordinator ................................................................................... 202Health Incident Controller .................................................................................. 202Site Medical Commander .................................................................................. 203Planning Officer................................................................................................. 203Logistics Officer................................................................................................. 204Liaison Officer ................................................................................................... 204Media and Communication Officer .................................................................... 204

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Introduction

The aim of the Mackay Hospital and Health Service (MHHS) Business Continuity Plan (BCP) is to promotecontinuity and rapid recovery of critical services or functions required to support the core business of the HealthService. It is a continuous improvement process of establishing and maintaining Business Continuity Plans andother measures in order to respond to and recover from disruptions that threaten key resources, locations andfunctions. Major disruptions can arise from both dramatic crises and from the escalation of routine managementand business failures within an organisation, and poor decision making.

In this plan, business continuity is an all embracing term which addresses organisational recovery following adisaster. It assumes that prevention arrangements have failed and that an incident has occurred which hasinterrupted normal business to the extent that corrective action is required. It aims to provide the availability ofprocesses and resources in order to ensure the continued achievement of critical objectives.

Purpose

The plan will outline the arrangement guidelines for Business Continuity within the MHHS in accordance withGovernment Agency Preparedness for Government for Queensland Government Departments. It will detail thekey people, the responses and actions needed to enable the MHHS to continue essential functions in the event ofa disaster.

Individual areas within the MHHS will be required to have a Business Continuity Plan that clearly identifies thefollowing;

Processes carried out within the section Impact of possible events Contingency plan Tasks and allocated responsibilities Approximate time frame they can survive without the service

The Emergency Planning committee (EPC) is responsible for establishing and implementing emergency plans andprocedures that include prevention, preparedness, response and recovery strategies.

The EPC for the MHHS is a sub group of the Safe practice & Environment Committee (SP&E) and is convened asnecessary with members being coopted for an advisory capacity. This committee is responsible for theidentification of internal and external stakeholders obtaining input from local emergency services to ensure acoordinated response.

Support / Interface with other plans

This plan has been developed in accordance with the Qld Health Disaster Plan 2008 and supports / interfaces with: Queensland Health Policy Statement 28028 Emergency Preparedness & Continuity Management,

September 2006 Occupational Health & Safety Management and Emergency Preparedness and Continuity Management:

Implementation Standard 1-28#21 MHHS Emergency Manual, NC-WPI161 - V1.0 July 2009 Standards Australia and New Zealand - HB292:2006 & HB293:2006 Business Continuity Management Standards Australia and New Zealand AS/NZS4360:2004 Risk Management

Geographical Area

This plan has been developed to cover the Mackay Hospital and Health Service which encompasses the followingshires Mackay, Whitsunday and Isaac Region with total population 163,060. Health facilities include:

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The Mackay Hospital and Health Service

Bowen Hospitalo 27 beds

Clermont Multipurpose Centreo 10 bedso 6 aged careMonash Lodgeo 16 Aged Care

Collinsville Hospitalo 8 bedso 7 aged careo Population (2007) 13,370

(Includes Bowen & Collinsville) Dysart Hospital

o 7 beds Mackay Base Hospital

o 162 beds Mackay Community Health Centre Moranbah Hospital

o 12 bedso Population (2012) 12,000

Proserpine Hospital & WhitsundayCommunity Health Centre


Sarina Hospital & Primary Health CareCentre


Population data extracted fromhttp://qheps.health.qld.gov.au/hic/infobank/POPPROJ/proj_lga_medium2006v.xls

Types of Hazards

A disaster, event or hazard will cause stress and extra load for the MHHS health care facilities. Hazards are oftenassociated with injuries and death. The aftermath of a hazard may lead to an increase or a perception that therewill be an increase in disease, placing stress on the MHHS to maintain continuity in health care provision andrecovery.

Far North Queensland's diverse climate conditions give rise to a number of hazards. During the Wet Season,flooding can occur over large areas of the MHHS cutting communication, causing landslides and damaginginfrastructure. Cyclonic conditions from November to April further compound this hazard with the risk of stormsurge.

Hazards and associated risks include:

earthquakes—deaths and injuries, mainly due to building collapse; flooding—drowning and injuries; storms and cyclones—deaths and injuries due to debris impact or building collapse, drowning; fire—deaths and injuries due to burns, smoke-inhalation or respiratory failure in vulnerable people:

explosions—deaths and injuries due to building collapse, burns; chemical spills or leaks may cause a range of injuries from burns to respiratory problems; the perceived risk of epidemics will place significant extra load on health-care facilities; primary health-care services must be maintained while the stress levels associated with an emergency or

disaster may actually increase normal rates of heart attacks, strokes, childbirths (as hyperbaric pressuredecreases during cyclones), psychological effects and availability of medication; eg. Methadone etc.immediately after the event; and

lack of power may increase loads on health systems by:

the general public using naked flames for heating or lighting, with increased fire risk andrespiratory problems;

use of generators with inadequate ventilation may cause suffocation or respiratory problems.Handling generator fuel may cause fire risks;

eating contaminated foods or out-of-date foods may lead to gastric disorders; Injuries to persons trying to navigate flooded areas and lack of power for in-home care of disabled or ill people may lead to these people seeking in-

hospital care.

As well as increased loading on the MHHS, the hazard itself may impact on Queensland Health’s ability to providea health care service. This could be due to the following:

damage to health infrastructure housing the facilities that may make them unsafe for continuing service; water damage (mould), cladding damage or smoke damage that may make the facility unserviceable.

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Equipment may have been damaged, records lost or cleanliness compromised;

Some facilities within the MHHS; such as Community Health and Victoria Street facilities may not haveemergency power or their premises may be inundated or damaged and may be unable to provideservices.

Staff shortages may occur following hazards, as casualties elsewhere in the community, damage totransportation and general community disruption may mean that staff rostered on cannot come to work.

Some equipment may have been affected by the hazard itself. Mobile or portable equipment is vulnerableto damage in cyclones & earthquakes. Equipment that makes use of gas or gases (critical services inparticular) may be compromised by leaks in pipes or damage to reticulation system or lack of supply, andgas storage areas could be compromised.

Many of the above effects have the added complication that the staff and patients of these facilities mayneed to be evacuated, placing extra load on surrounding facilities, and also risking the safety of peoplewho require continuous care or specialised equipment.

Pandemic Influenza

The MHHS must work with other health related agencies to determine how best to assist in responding to thehealth and wellbeing needs of the community during a pandemic, as well as minimising the impact of a pandemicon the service.

In order to reduce the impact of a pandemic on core business and maintain business continuity, absenteeismneeds to be effectively managed. Items to be considered are:

Reducing the likelihood of staff becoming exposed to the virus

Education can reduce fear through understanding and help protect through knowledge. Basic information that staffshould be made aware of includes:

What is pandemic influenza and how is it spread? What are the signs & symptoms? When are people considered infectious? What can be done to reduce the risk?

Note: Under the Workplace Health and Safety Act 1995 the obligations that an organisation has under this Act continue to apply in the event ofpandemic influenza. An organisation must continue to manage everyday risks to the workplace health and safety of workers and others, as well asmanage risks unique to pandemic influenza.

Management of illness and absenteeism

Well developed workplace policies are integral to the protection of the workforce and the organisation’s operationsduring a pandemic. Policies that can be considered include, but are not limited to the following topics:

Hygiene and cleaning practices Social distancing strategies incorporating - working from home, using company vehicles, restricting

access to the workplace, change to working rosters / hours of operation Work related restrictions on travel to affected areas

Maintaining service/business delivery with specific reference to the

maintenance of essential services

A Pandemic may create the need for staff members to remain at home to care for their dependants, and mayreduce the numbers of staff that attend work due to fear of the disease, or as an unwillingness to place themselvesat a risk of infection.

Key tasks to be undertaken are: Identify the core people required to keep the essential functions of the business running Identify opportunities for cross training/multi skilling of staff where appropriate with the intent of creating a

larger internal resource base from which to draw on Identify retired staff that may be employed for knowledge as opposed to physicality Identify critical resources and projected quantities (required to maintain functioning of key areas) over the

peak period of the pandemic. This can be used to assess the feasibility of bulk purchases/stockpiling Discuss preparedness planning with key suppliers/contractors. Identify all suppliers of the required resources beyond current contractual arrangements.

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Identify temporary alternatives and suppliers Identify the Critical Breaking Point.

Staffing

The effects of a pandemic on staffing numbers can only be estimated before the actual occurrence. It is notunreasonable to assume that at various times during a Pandemic the MHHS will experience significant levels ofabsenteeism whether directly related to influenza infection, family care responsibilities or fear and fatigue. This maybe as high as 30 - 40% absenteeism at the height of an outbreak.

It is important to note that an influenza pandemic will not be ‘business as usual’ for health services in Australia.Staff will be required to work flexibly to meet increased demands; usual clinical and infection control practices mayneed to be altered to accommodate the exceptional circumstances.

Depending on the epidemiology and virulence of the virus the MHHS may have to rationalise certain services inorder to maintain the ability to provide services directly related to a Pandemic Influenza outbreak.

Historically Pandemics have come in waves of between 6-12 weeks; changes to service provision will benecessary but temporary.

Staff should be discouraged from presenting to work with flu like symptoms, especially in the early stages whereprevention of spread will be paramount to the governments’ containment strategies. As the stages of a Pandemicwave progress the staff who have recovered will have immunity and be able to work in the front line of theresponse with little risk of further infection from pandemic influenza.

Staff accommodation

During some stages of a critical incident or pandemic there may be a need for staff accommodation within or closeto the Hospital. The reasons include:

Reduced staff available, increasing the need for overtime and extra shifts Staff wishing to remain at hospital rather than risk transmission to family.

If the Hospital staffing is hit hard then it may be that many staff will be required to work extended hours and extrashifts, all possible measures should be taken to ensure safe practice and to keep fatigue to a minimum.

For more information see: MHHS Pandemic Influenza Plan, C-WPI242 – V2.0 May 2009

General Operations

Strategies that may be required to be utilized(These will vary depending upon the type and severity of the Incident)

Temporary Cessation of all elective admissions and procedures at Mackay Base Hospital Temporary closure of Medical and Surgical Clinics, Deployment of staff to areas of greater need and to cover absenteeism will be common, Some staff will be required to perform their roles in new environments Multiskilling in areas of the same job stream but different roles

All wards and departments within the MHHS should develop an area specific contingency plan that givesconsideration to how they may function in any given incident that may arise. Work requirements should beprioritised.Consideration should be given to:

Patient Flows patients to and from units Succession planning, Mulitskilling where appropriate Changes to work practices that may occur Preparation for “knock-on” effects from other departments that may affect your departments functionality

Some departments within the Mackay Health Service will have to maintain elements of their core business,possibly at a reduced level because their service may not be able to be completely absorbed by other hospitals in

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the MHHS. These may include Emergency Department, Intensive Care Unit, Coronary Care Unit, Theatres,Maternity, Renal, & Mental Health.

Communications

Locally, where an incident threatens to disrupt normal operations, immediate decisions are required to minimise theimpact of the incident and to resolve issues where possible.

In the event of a crisis, the delegated Health Incident Controller will initiate the Emergency Operation Centre tomanage immediate response activities—for example, authorising and releasing communications with staff andstakeholders, authorising the activation of business continuity and information disaster recovery arrangements,standing down staff, declaring the crisis over.

The Emergency Operation Centre would normally include relevant senior and functional managers, or theirdelegates, who can provide leadership and who understand agency operations. Sub-groups can also be identifiedto support the crisis management team.

The State Disaster Management Group meet and manage disaster arrangements. Queensland’s DisasterManagement arrangements are managed by the Department of Emergency Services (seewww.disaster.qld.gov.au).

Activation and Relocation

The MHHS will be activated and deployed in an appropriate authorised manner according to procedures set out inthe MHHS Emergency Manual

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Risk ManagementPossible Types of Exposure and the Risk Assessment:(According to the Queensland Health Risk Management Matrix (Integrated Risk Management ImplementationStandard 3)It is assumed that any major loss of hospital/facility global essential resources (eg. Power, fuel, gases, water,communications etc) will be addressed and co-ordinated through the MHHS Disaster Coordination Centre.

Risk Description Likelihood Consequence Risk RatingEarthquake (deaths & injuries dueto building collapse)

Rare Extreme High 15

Storms & Cyclones Rare Extreme High 15

Flooding (drowning & injuries) Unlikely Major High 14

Fire (deaths & injuries due to burns,smoke inhalation or respiratory failurein vulnerable people)

Rare Major Medium 11

Fire Alarm Failure Rare Extreme High 15

Water Failure Rare Extreme High 15

Electricity Failure (public or staffmay use a naked flame for heating orlighting with an increased fire &respiratory problems)

Possible Moderate High 13

Gas Supply failure Rare Moderate Low 5

Medical Gas Failure Rare Extreme High 15

Damage to Infrastructure(following an event – impact uponability to provide health service)


Water Damage making thefacility unserviceable

Unlikely Major High 14

Capacity of the Hospital isexceeded

Likely Major Very High 20

Industrial Disputes Possible Major Very High 19

Epidemic/Pandemic Possible Major Very High 19

Computer system failure –greater than 1 day

Possible Moderate High 13

Bomb or Explosions (deaths &injuries due to building collapse &burns)


Chemical Spills & Leaks (rangeof injuries from burns to respiratoryproblems)


Biological Incident – escape,spillage or contamination


Radiological incident Rare Major Medium 11

Adverse Public interest Possible Major Very High 19

Major engineering failures -burst water mains, electrical sub-station failure, generator failure etc. Impact upon buildings - helicopter or aircraft Chemical spill in vicinity of hospital - road tanker Communication Systems failure

Medical Gas Reticulated Systems failure - oxygen, suction

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Integrated Risk Management Analysis MatrixThe use of integrated Risk Management Analysis Matrix is mandatory when communicating risks (risk Ratings) to Executive andSenior Management throughout the Department.The Integrated Risk Management Analysis Matrix is used to assess Consequence(s) should the risk occur and Likelihood(Probability) of the Risk occurring. Together, the Likelihood and Consequences(s) determines an overall Risk Rating or Level of risk.

CONSEQUENCE TABLE (Consequence Table for types of consequences and degrees of severity)

Degree of SeverityType of Consequence NEGLIGIBLE MINOR MODERATE MAJOR EXTREME

Adverse ClinicalEvent

C No injury or harmcaused, minoradjustment tooperational routine

Minimal harmcaused, minorinterruption toroutine

Loss of function,major harm caused

Permanent loss offunction or disability

A loss of life

Outrage/Damage toReputation

O Minimal adverselocal publicity

Significant adverselocal publicity

Significant adverseStatewide publicity

Significant andsustained Statewideadverse publicity

Sustained nationaladverse publicity,Queensland Health’sreputation significantlydamaged

Litigation L Potential exposure toQueensland Health

Minor exposure toQueensland Health

Exposure will resultin a single claim

Claims greater than$500,000 or multipleclaims resulting fromsingle exposure

Claims greater than$1M or multiple claimsresulting from multiplesimilar exposures

Disruption toEstablishedRoutines/Operational Delivery

D No interruption toservice

Some disruptionmanageable byaltered operationalroutine

Disruption to anumber of areaswithin a location orMHHS, possible flowon to other locations

All operational areas ofa location or MHHScompromised, otherlocations or MHHSs areaffected

Total systemdysfunction and/or totalshutdown of operations

Staff Morale(may includeabsenteeism,establishment)

SM Staff dissatisfactionwithin local unit. Noeffect on services orprograms

Alteration to routinepractice required inlocal area or MHHS

Disruption spreadsacross services orprograms

Disruption spreads toroutine practiceStatewide

Statewide cessation ofservice or programs

Workplace Health &Safety

H No injury/illness – notime lost, minoradjustment tooperational routine

No lost time injuryFirst aid or medicaltreatment required

Lost time injuryinvolving atemporary loss offunction or anotifiable event

Permanent loss offunction or disability

A loss of life

Security(may includefraud/theft.Unauthorised accessand areas ofsuspected officialmisconduct)

S Event noted by localstaff/management,no change to routineoperations

Monitored by localstaff, some effect onroutine operations

A security event thatmay threaten aprogram /service. Anevent requiringinternal investigation

Major event thatthreatens a program/service across thewider organisation.Events requiringreferral to Police / CMC

Extreme event affectinga program / serviceareas ability to continueits operation resulting intotal shutdown

EnvironmentalImpact(may includedischarge ofhazardous ordangeroussubstances, carbonfootprint etc)

E No lastingdetrimental effect onthe environment

Local detrimentaleffect on theenvironment

Short term localdetrimental effectcontained withoutside assistance(i.e.QFRS, EPA)

Long term detrimentaleffect contained withoutside assistance(i.e.QFRS, EPA)

Having a long lastingeffect on theenvironment

Workforce Issues(may includerecruitment andretention, capability

W No effect on servicesor programs

Some effect onspecific service orprogram – alterationsto routine practicerequired

Restrictions toservice/programavailability within alocation or MHHS,with possible flow onto other locations

Cessation ofservice/program of alocation or MHHS,which could impactother locations orMHHSs

Statewide cessation ofa program or multiplrprograms

OperationalManagement

OM No impact on localoperations

Minor impact on localoperations

Moderate to longterm impact on wideroperations

Major impact onoperations across otherareas of organisation

Cessation of someoperations

CorporateManagement

M Local managementreview

Local managementreview on a broaderbasis

Senior Managementreview orintervention

Directorate/MHHS/Health ServiceExecutive Managementreview or intervention

Statewide managementreview or interventionby EMT / D-G

Financial(anything that has afinancial impact

F ~ 1% of monthly /cost centre budget

~ 2% of monthly /cost centre budget

~ 5% of monthly /cost centre budget

~ 10% of monthly / costcentre budget

~ 15% of monthly / costcentre budget

Please note that the severity for each consequence type is to be considered separately and not relative to each other

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Likelihood (probability) Table

This table defines the likelihood or probability of the risk occurring, based on the information available at the time of assessment.

Rare May occur in exceptional circumstances only / May occur at least once in a period of 5 years or moreUnlikely Might occur sometime but not expected / Might occur at least once during a period of five years or lessPossible Could occur, capable of happening, foreseeable / Could occur at least once in 12 monthsLikely Is expected to occur occasionally / Is expected occur at least once per monthAlmost Certain Is expected to occur frequently, in most circumstances / Is expected occur at least once per week

Integrated Risk Management Analysis Matrix

←Consequences→Likelihood ↓ Negligible Minor Moderate Major Extreme

Rare Low (1) Low (4) Low (5) Medium (11) High (15)Unlikely Low (2) Medium (8) Medium (10) High (14) Very High (21)Possible Low (3) Medium (9) High (13) Very High (19) Very High (22)Likely Medium (6) High (12) Very High (17) Very High (20) Extreme (24)Almost Certain Medium (7) Very High (16) Very High (18) Extreme (23) Extreme (25)

LegendLow risk (1-5) Manage by routine procedures, unlikely to need specific application of resources

Medium Risk (6-11) Manage by specific monitoring or response procedures locally

High Risk (12-15) Management attention needed and management responsibility specified to controlthe risk

Very high risk (16-22) Detailed research and management planning required at a senior management /executive level

Extreme risk (23-25) Immediate action and involvement required at a senior management /executive levelto control the risk

Actions required in response to the level of risk:

Risks with a residual risk rating of Very High (16-22) and Extreme (23-25) must be reported.The management must consider the need for legal advice or guidance. If legal advice or guidance is required itmust be reported to Corporate Counsel (or delegate)All notifiable events (as per the local policy or procedure) must be reported as directed.All incidents including near misses must be reported.The risk assessment process is applicable to all processes and levels within the Department.

SourceIntegrated Risk Management Implementation standard 3 – Risk Analysis Matrix:htpp://qheps.health.qld.gov.au/audit/RM_Stream/RM_Policy/31237_ 08_ 2.0.pdf

(September 08)

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Business Restoration

Following the activation of business recovery arrangements to re-establish all core services, arrangements will beinitiated to restore normal operations to pre-crisis capacity.

The extent and duration of business restoration planning will depend on the impact and nature of the crisis.Business restoration might require, for example, sourcing new accommodation and equipment, re-establishing non-core or strategic processes or projects, transitioning temporary service delivery arrangements established underbusiness recovery to a permanent status or relocating staff and resources to new permanent accommodation.

Pre-planning for business restoration is difficult due to its circumstantial nature and the inherent number ofunknowns.

In the event of a major incident, Queensland’s disaster management arrangements would be activated tocoordinate recovery activities across the affected area and this may impact on the Mackay Health Service businessrestoration planning.

Conclusion

Business continuity arrangements are the MHHS’s last line of defence in risk management arrangements. Theyaddress the immediate crisis, re-establishment of the delivery of core services and essential business operations,and the restoration of the facilities to normal operations following a major interruption.

Business continuity thinking will commence as soon as an abnormal incident occurs even if not considered a majorincident, as this could herald the impending need to activate business continuity arrangements.

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Contingency Plans For the Mackay Hospital and Health Service

1. Contingency Plans for the Mackay Hospital and Health Service

Air Conditioning Failure Boilers Building Management System Gas Supply Human Resource management Mains Electrical Power (See Emergency Manual) Medical Gases, Air and Suction Occupational Health & Safety services Safety and Security Sewerage Telecommunications (See Emergency Manual) Vehicles and Transport (including fuel supply) Water Supply

2. Contingency Plans for Hospital Clinical Services General Surgical Unit/Medical Ward/Rehabilitation Ward Emergency Department Operating Theatre Intensive Care Unit Coronary Care Unit Womens Health Unit

Special Care/Neonatal Care Nursery Ward & Clinic Birth Centre

Child & Adolescent Unit Renal Dialysis Unit Specialist Outpatients Mental Health Community Mental Health

Alcohol & Other Drug Service Early Discharge Day Surgery Unit

3. Contingency Plans for Hospital Support Services

Breastscreen Catering Central Sterile Supply Department Cleaning Health Information Records Information Department Linen Medical Imaging Mortuary Pharmacy Pathology Stores/Supples

4. Contingency Plans for Rural facilities

Bowen Hospital General & Clinical Bowen Utilities Clermont hospital Collinsville Hospital General & Clinical Collinsville Utilities Dysart Hospital Moranbah Hospital Proserpine Hospital Sarina Hospital General & Clinical Sarina Utilities

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Business Continuity Planning

Occupational Health and Safety Unit

The Unit has ten (10) staff, including AO5 OHS Unit Manager (Hinterland) and is based at 73 Victoria Street, Mackay.Note: The Action Cards, Pandemic Influenza Plan 2009, for corporate services and all Managers are to be used in conjunction with the specific procedures detailed below.Key contact: Wendy Macfarlane, MHHS OHS ManagerDelegated as necessary in the following order: Gail Cameron, Susie Maddox, Wayne Vidler

OCCUPATIONAL HEALTH AND SAFETY UNITA = Up to 24hrs B = Up to 5 DaysC = Indefinitely D = Cannot Operate

Problem Impact Contingency Task ResponsibilityHow long can you function without this

service?

Insufficientstaff

Unable to provide promptor timely response for riskassessment, advice,records management orW/Comp casemanagement

Prioritize to addresshighest risk/s first

Undertake Executive Membersdirections / negotiatealternatives

MHHS OHS Mgr Indefinitely, but with a limited service

Identify tasks to be postponeduntil disaster subsides; cancelall unnecessary commitmentsaway from baseAssign tasks to existing staff,monitor progress / wellbeingthroughout dayDetermine staff availability ifshifts needed in addition to8:00-17:00 Mon-Fri.Availability may change daily.

Engage admin supportfrom MHHS units

An unlikely option - other units will be experiencing insufficientstaffing also

Engage expertise fromother Health Servicesand/or corporate

Arrange travel to Mackay ifnecessary

Coordinate scheduled dailybriefing time / place

Confirm primary andsecondary contact detailswhether in Mackay or otherlocation

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OCCUPATIONAL HEALTH AND SAFETY UNITA = Up to 24hrs B = Up to 5 DaysC = Indefinitely D = Cannot Operate

Problem Impact Contingency Task ResponsibilityHow long can you function without this

service?

Staff working from home ifpracticable

Provide laptops and mobilephones / chargers

Determine infection control,task assignment and scheduleam/pm briefing to MgrLiaise with agencies for extracritical care staff

Call staff in when possible

Pool Vehiclesunavailable

Delay in attending toissues needing face-to-face away from Victoria Stcampus; delay transportingill staff to their residences

Use taxi service, ifavailable, or privatevehicles

Identify which staff accept touse their private vehicles

Equip each staff spraydisinfectant and tissues forvehicleEnsure mobile phones arecharged and taken on alltransfers; ensure Mackaystreet maps for all cars

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Medical & Surgical Wards

The following Standard Operating Procedures have been generated for application across clinical units where common processes exist and are grouped thus to avoid replication oftasks for contingency planning for individual wards.

MEDICAL AND SURGICAL WARDSA = Up to 24hrsB = Up to 5 DaysC = IndefinitelyD = Cannot Operate

PROBLEM IMPACT CONTINGENCY TASK RESPONSIBILITY HOW LONG CAN YOUFUNCTION WITHOUT

THIS SERVICEComputerfailure

Unable to generate IDLabels

Record patient details manually Ensure supply of HBISCUS downtimeforms

Pre print labels on existing patients Hand write on blank labels for new

admissions

Administrative and nursingstaff

B

B

B

Unable to track patientlocation and bed status

Revert to the manual process Update patient location and bed statusat regular intervals

Notify after hours manager of all patientmovements

Develop a process for disseminatingpatient updates as part of the facilitycommunication plan


Nursing staff

Nursing Staff TeamLeader

B

B

B

Unable to provide patientdietary requirements

Revert to manual process Update patient diet lists and haveavailable for collection by cateringservices

NUM and Team LeaderB

Unable to recordinformation relating topatient nursedependency

Revert to manual process Ensure supply of downtime formsavailable to record information

Administrative StaffB

Unable to accesscomputerisedpathology/radiologyresults

Revert to manual process

Use portable phones if working

Ensure supply of Medical Imaging &pathology result forms

Develop means for notification ofMedical Imaging & laboratory testresults

Manual ordering of tests

Administrative staff

NUM, Medical Imaging &Laboratory Staff

B

B

B

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THIS SERVICEEnter data when system is fixed Ensure retrospective data entry when

computer services resume Backup any non centralised data or

ward specific computer programs

Medical & Nursing StaffUnit Manager, MedicalImaging & Laboratory staff

Administrative Staff

B

B

Power Failure Mains power notavailable

Refer to mains power failure plan Inform and Educate staff NUM & Nurse Educator Depends upon thegenerator

LightingFailure

Difficulties in patientobservation & care

Increased risk forpatients and staff

Utilise the emergency lighting

Maximise natural lighting

Utilise alternate lighting

Maintain WH&S precautions

Refer to facility wide power failureplan

Identify provision for emergency lighting Relocate immobile patients to the best

lit areas Ensure there are NO mobile patients

because of increased risk of injury ifthey move about in poorly lit areas

Clean & maintain windows & fittings Ensure blinds & curtains are open Ensure adequate supply of torches &

Battery operated lights & batteries Clear patient areas, work areas &

corridors of all hazards Inform and Educate staff

Engineering staff

Nursing Staff

Nursing Staff

Cleaning Staff

All staff

NUM

NUM & All staff

Educator

B

B

B

B

B

B

B

BAirConditioningFailure

Unable to regulate thetemperature &environment

Use alternate cooling devices egElectrical or manual fan

Refer to facility wide failure plan

Position fans for maximum benefit Identify patients requiring cooling Inform & Educate staff

Nursing Staff

Nursing StaffEducator

Depends upon theweather season in

Mackay

TelephoneFailure

No internal or externaltelephonecommunications

Refer to facility widetelecommunications failure plan

Inform & Educate staff NUMTeam LeaderEducator

A

Wall Oxygensupply failure

Wall oxygen notavailable

Use Oxygen cylinder Identify anticipated requirements ofcylinder oxygen for ward patients

NUMA – B

Page - 17 28/08/2013



THIS SERVICE

Provide emergency oxygen/suction

Order required cylinders from centralstorage area

Ensure all oxygen cylinders are full Ensure a corresponding number of

oxygen fittings available at ward level Consider co-locating high oxygen users

(run on the same bi-connectors) Ensure small oxygen cylinder with twin-

o-vac suction on resuscitation trolley Educate staff on use of alternate

devices

NUM

Wards person

Wards person

Nursing & Medical staff

Nursing Staff

NUMEducator

A – B

A – B

A – B

A – B

A – B

A – B

Digital Scalesfail

Unable to record weight Use alternative scales Purchase bathroom scales Use weighted scales if available

NUM

NUM

C

CFailure ofTymphanicThermometer

Potential for inaccuracyof temperature readings

NUM

Failure of non-invasive BloodPressuremonitors

Unable to electronicallymeasure blood pressurereadings

Use manual sphygmomanometer Ensure adequate number ofsphygmomanometers

NUM A

Page - 18 28/08/2013



THIS SERVICEFailure ofglucometer

Potential for decreasedaccuracy in bloodglucose readings

Visual readings

Utilise from CNS Stock fromCommunity Health

Formal laboratory blood glucoseanalysis for abnormal results

Ensure adequate stock of batteries Inform & educate staff

Develop policy for formal laboratory test

NUMNursing staffNUMEducator

Medical staffNursing staff

Failure of 12Lead ECGmachine

Unable to diagnose lifethreatening conditions

Ensure access to emergencypower

Use on battery power

Identify access to emergency poweroutlet

Keep batteries fully charged onemergency power

Identify location of alternative ECGmachines

Inform and educate staff

NUMEngineering staff

NUMNursing Staff

Nursing staff

NUM /Educator

A

A

A

A

Failure ofPulseoximeters

Unable to determineoxygen saturation

Increase nursing observationAccess other portable units fromfacility /Health Services ifavailable

Ensure staff to act as a runner areavailable

NUMEducator

B

Failure ofEmergencyAlarms

Unable to provide safeand secure environment

Increased staff vigilance

Refer to security plan

Schedule regular patient rounds

Direct notification via phone switch orrunner to Communication Centre tocontact fire services, security & police

Inform and Educate Staff

Nursing staff

All Staff

NUM

B

Failure of Patients unable to Refer to safety and security plan Have hand bells available NUM B

Page - 19 28/08/2013



THIS SERVICEPatient callbuttons

summon assistance

Failure ofinfusionPumps/SyringeDrivers

Staff unable to titratemedications and fluidsaccurately

Use battery power if available

Use burettes

Consider alternate administrationroutes

Charge on generator power if able Charge batteries fully Ensure adequate stock of burettes Protocols for alternative administration Manually titrate drip rate if necessary

All StaffNursing Staff

Nursing Staff

NUMMedical staff

A

AB

B

Failure ofEnteral feedpumps

Difficulty in maintainingpatient nutrition

Use alternate feeding methods Develop a procedure for bolus/gravityfeeding

Ensure adequate supply of tubes andfeeds

Manually titrate drip rate if necessary


NUMEducator/Nursing staff

NUM

Educator

B

Failure ofSequentialCompressionDevices

Potential increased riskof DVT/Embolus

Use alternate methods ofdeterring thromboembolus

Identify at risk patients

Consider compression stockings/drugtherapy

Develop Policy Ensure adequate supplies of stockings

NUMMedical staff

NUM/EducatorMedical StaffNUM/EducatorMedical StaffNursing staff

C

Refrigeration Drugs and medicalsupplies requiringrefrigeration maybecome unusable

Place drugs in refrigerators whichare connected to emergencypower supply

Use eskies and ice

Review emergency power outlets Monitor refrigerator temperature with

thermometer

Consider purchase of eskies and supplyof ice

Inform and Educate Staff Consult with Pharmacy

NUMEngineering Staff

Nursing staffInfection Control Staff

NUM/Educator

A - B

Failure of Difficulties with lifting Identify alternate lifting devices Use hydraulic lifting devices if available C

Page - 20 28/08/2013



THIS SERVICELifting Devices heavy patients – manual

handling injuries Mobile power pack Use of ski sheets, bed sheets etc Ensure staff trained in manual handling

All Staff

Pan RoomHopper

Unable to clean bedpans/urinals correctly

Rinse with ‘grey/waste” water anddisinfect with chemical solution

Reinforce Infection Control Policy

All Staff

Infection Control CNCEducator

B

B

Lift Failure Unable to transportpatients to differentlevels within the facility

Ensure one lift operates onemergency power

Utilise alternate methods oftransporting patients

Consider utilising ground floorfacilities

Minimise patient transfers

Review existing supply of emergencypower

Walk patients

Consider scoop stretchers, fireblankets, stair walkers, cardboardstretchers

Develop facility plan for locating newadmissions

Critical transfers only

Ensure all staff aware of facilityFire/Evacuation plan

Engineering StaffDisaster Committee

WardspersonNursing staffMHHS Executive

MHHS Executive

Medical Staff

NUM

A

A

A

A

A

A

Failure ofVideo & TV

Negative Impact onpatienteducation/enjoyment

Verbal education

Alternative recreational activities

Develop alternate packages for patients Prepare mobile library Consider hand held games for children

NUMEducatorVolunteersMHHS ExecutiveNUM

C

Failure of Fax Unable to receive orsend patient information

Utilise alternate lines ofcommunicationScan and email

Send patient information via courier orrunner

Delay the transfer of information untilservices have resumed

NUM

Medical StaffAdministration staff

B

B

Failure ofcopier

Unable to copydocuments

Utilise alternate lines ofcommunication

Telephone information

Send the original documents with thepatient and document in the chart

Nursing staffMedical staff

Page - 21 28/08/2013



THIS SERVICEDelay the transfer of information untilservices have resumed

Staffing Increased manual tasksmay increase theworkload

Roster extra staff on duty

Place staff on call

Estimate staffing numbers for 24 hourperiod

Prepare rosters Liaise with agencies for extra staff Call in staff if possible

All Managers

EquipmentFunction

Unable to guaranteeequipment accuracy

Check all equipment forfunctionality as soon as possibleafter disruption of power

Identify all equipment to be checked

Inform and Educate staff

NUMAll Staff

Educator

Page - 22 28/08/2013


Rehabilitation UnitThe Unit is connected to the emergency generator

REHABILITATION UNIT

A = Up to 24hrsB = Up to 5 DaysC = IndefinitelyD = Cannot Operate

Problem Impact Contingency Task ResponsibilityHow long can you

function without thisservice?

Failure ofinpatientelectric bedsmechanics

Unable to adjust heightof beds for safeexit/entry by patient

Utilise emergency generatorpower within 10 seconds ofpower failureIdentify alternative batterypower pack to operate bedmechanics

Identify emergency poweroutlets

Confer with engineering reavailability of portablebattery back-up equipment

All Nursing & Unit OperationalstaffNUM

D

Failure of VitalSigns Monitors& pulseoximetry

Nursing staff can utilisemanual equipment –minimal impact onnursing resources/time

Utilise emergency generatorpower within 10 seconds ofpower failureUtilise battery back upEnsure that nursing andmedical staff have access tomanual vital signsequipmentEnsure solid stock ofalkaline batteries forportable pulse oximetry unit

Identify emergency poweroutletsEnsure batteries are fullychargedEquipment nurse to ensurethat there is a sufficientsupply of correct sizedbatteries for equipment inunit storage.

All Nursing &Unit Operational staff

C*NB- Battery life of

Monitor is 30 mins to 2hours

ComputerSystem

Unable to access patientinformation systems andRehab Unitdocumentation if systemfails

D

Paging System Unable to contacttreating medical officerTeams if system fails-patient care mix at risk

D

Page - 23 28/08/2013

REHABILITATION UNIT




Failure ofDefibrillator

Unable to defibrillatepatients

Utilise emergency generatorpower within 10 seconds ofpower failureUtilise battery back up

Utilise other availableDefibrillators


Ensure batteries are fullychargedIdentify location of alternatedevices

All Nursing and Medical staffUtilise battery back up

Utilise other availableDefibrillators

Internal phonesystem

Unable to communicatewith others internally andexternally

Utilise personal mobilephones or ? available MBHmobile phone

Nurse CallAlarm System

Patients unable to buzzfor assistanceUnable to raise alarm foremergency and lifethreatening situations

Supply of hand bells

Use of phones if main phonesystem operational

Equipment nurse to ensuresupply and storageUse 222

Equipment Nurse & NUM

StaffingResources

Unable to provide safelevel of care in the eventof reduced nursingresources 24/7

Use Unit base staffing modelwhere possible.Seek support of thevolunteer services to assistwith tasks such as bed-makingConsider “outlieing” patientsto other departments if noteffected or transfer to otherfacilities/hospitals

Calculate individual patientstaffing requirements

Identify care staff able to beon call and redeployed in thefacilityEstimate staffing numbersrequired for 24 hour periodIdentify nursing staff able tobe on call and redeployed inthe facilityEstimate staffing numbersrequired for 24 hour periodEstimate staffing numbersrequired for 24 hour periodLiaise with other

Nurse Unit ManagerNurse ManagerNursing Director

Nurse Unit ManagerNurse ManagerNursing Director

Indefiantly but with alimited service

Page - 24 28/08/2013

REHABILITATION UNIT




facilities/units for extra carestaffLiaise with agencies forextra staffCall staff in when required

Essentialequipmenti.e.HoistsDressings andstore supplies

Unable to maintaincontinuity of caremanagement

Ensure adequate supply instoresAccess from otherdepartments

Equipment Nurse & NUM A

Linen SuppliesUnable to maintainadequate linenmanagement if Laundryeffected - potentialinfection control risk

B

Food Supplies Unable to maintainadequate dietaryrequirements ofindividual patients ifkitchen area effected

Outsource food supplies andcateringTransfer patients to otherwards/units

A

Oxygendelivery system

Would have to rely oncylinder supply

Maintain adequate supply ofcylinder O2 and deliverydevices

Confer with engineering reavailability of additionalsupply in emergency event

NUMEquipment NurseEngineering Rep B

InadequateWasteCollection &Disposal

Build up of clinical andgeneral waste productsin unitInfection Control Issue

Page - 25 28/08/2013


Operating Theatre ServicesContinuity Plan based on having Emergency generator power to the unit. If no power at all operating would cease and cases would have to be transferred.Emergency phone Number if no power 6392

OPERATING THEATRE SERVICES


Problem Impact Contingency Task ResponsibilityHow long can youfunction without thisservice?

Failure ofcomputerisedbooking system

Unable to schedule /cancelpatients for surgery

Revert to manual process Utilise downtime forms

Consider use of Theatre logbook.

Administration staffC

Failure ofanaestheticmachines &ventilators

Loss of power to machine

Inaccurate delivery ofanaesthetic gases

Unable to ventilate patients

Run on emergencygenerator power .Run on gases if no powerOxygen driven) for 90minutes only. Monitor ptfor 40 minutes on batteryfrom PACU monitorsUse backup cylindersupplies of oxygen, nitrousoxide & airHand ventilate

Check access to emergencypower outlets.Manually ventilate.Manually physically assess

Ensure supplies of cylindergasses available

Ensure adequate supply ofhand operated ventilationequipment - Disposablemanual resuscitatorLocate and provide air /oxygen driven ventilator(oxylog)Cancel elective surgery

Nurse Unit ManagerAnaesthetic staff

Unit ManagerWards person

Unit ManagerAnaesthetic staff

Director of AnaestheticsDirector of SurgeryNurse Unit ManagerESC &DMS/DON/ND/EDMS

A

Failure of Monitors –cardiac oximetry,end tidal CO2

Unable to identify arrhythmias /oxygen saturation andproblems with ventilation

Run on emergencygenerator power Batteypower 40 minutes- One UPSwill operate for 5 hrs

Check access to emergencypower outlets

Identify & ensure adequatemedical & nursing staffcoverage


Director of AnaestheticsCNC

A

Page - 26 28/08/2013




Defibrillator doesnot function

Unable to defibrillate patients Use on emergencygenerator power or batterypower.Use battery back up ifavailable

Check access to emergencypower outlets

Have batteries fully charged

Unit Manager

All staff

A

Failure oflaparoscopic camera/ light lead

Unable to performlaparoscopic surgery (may bedone if generator onemergency power).

Revert to non laparoscopicmethods

Postpone all non urgentsurgery

Notify surgeons, medical,nursing and booking office

Contact non urgent patientsand inform re need toreschedule at later dateensure list of proceduresunable to be under takenavailable at theatre frontdesk

Unit Manager

Bookings/OR Manager

Unit ManagerMedical staff

A

Failure of diathermymachine

Unable to perform electricalcoagulation (may be done ifgenerator on emergencypower).

Revert to ties/sutures Ensure adequate supply ofties and sutures

Unit Manager A

Failure of operatingtable.

Unable to position patient Revert to manual processes Adjust bed to optimal heightprior to critical datesPurchase manual overridefor table.Deleted all electric bed

Nursing staff

Nursing staffWards persons

A

Failure of Sterilisingequipment forscopes (ONEMERGENCYPOWER).

Unable to sterilise endoscopic/ laparoscopic and orthoscopicequipment

Consider open procedureswhere clinically indicated

Notify surgeons, medical,nursing and booking officeIdentify suitable patientsContact non urgent patientsand inform re need toreschedule at later dateStaff education – availabilityof types of cases able to bedoneList of procedures unable tobe under taken available attheatre desk


Bookings/OR Manager

Unit ManagerOR Educator


A

Page - 27 28/08/2013




Failure of Turbinetool outlets

Unable to use orthopaedicpower equipment:, Drills, Saw,Phaco Machine, Tourniquet

Use Tool air cylindersUse battery tools.

Ensure three full cylindersavailableEnsure CSSD rechargebatteries. In theatre poweroutlets

Wards personNUM

B

Failure of patientwarming devices

Unable to maintain patientthermal regulation

Revert to manual processes • Ensure supply of spaceblankets, warmingboots/gloves etc.

Nursing staffB

Failure of transportmonitors

Unable to monitor critically illor unstable patients

Aim to have at least onecompliant transport monitor

PACU Monitors portable &have battery powerCharge batteries

Biomedical staffUnit ManagerDuty staff

B

Failure of lift Unable to transport patientto/from theatre


Review existing supply ofemergency power

Manager Engineering A

Relocate services Consider relocating onetheatre on ground floor (eg)in ED

MHHS Executive

Consider locating all surgicalpatients on same level asOperating Theatre.

MHHS ExecutiveDirector of Surgery

A

Staffing Unable to provide safe level ofcare in the event of equipmentfailure

Centralise surgical servicesat one site in MHHS overcritical periodsRoster additional staff

Develop a staffing plan forMHHS.

Calculate individual unitstaffing requirementsIdentify need to maintainstaff on site as opposed toon call.Identify human resourcesable to be on call andredeployed in the facilityAssess competence of oncall staff

Unit Manager Director ofSurgery

Unit ManagerDirector of Surgery

Unit ManagerNurse manager

Unit Manager

A

Equipment Function Unable to guaranteeequipment accuracy

Check all equipment forfunctionality as soon aspossible after disruption ofpower

Identify all equipment tochecked


Unit ManagerAll staff

A

Recovery Monitoring equipment not onpower.

Monitors have battery power Nurse Unit Manager A

Page - 28 28/08/2013




Staff unable tocome to work.

No available Staff to performlists.

Disaster Plan has allavailable phone numbers upto date.

NUM to ensure DisasterPlan is current

Nurse Unit Manager A

No lights in changerooms

Staff are unable to change toscrubs Staffmay not feel safe.

Torches are available in theunit.Security to inspect all areasbefore staff enter.

Ensure batteries are in unit.Arrange security inspection.

NUM C

Computer failure Unable to generate ID labels

Unable to track patient locationand bed status

Unable to accesscomputerisedpathology/radiology results


Enter data when systemfixed

Ensure supply of HBCISdowntime formsPre –print labels on existingpatientsHand write on blank labelsfor new admissionsUpdate patient location andbed status at regularintervalsNotify after-hours managerof all patient movementsDevelop a process fordisseminating patientupdates as part of the facilitycommunication planEnsure supply of pathologyresult formsDevelop means fornotification of lab & testresultsManual ordering testsEnsure retrospective dataentry when computerservices resumeBackup any non centraliseddata or ward specificcomputer programs

Administrative and nursing staff

Nursing staff

Nursing Staff Team Leader

Medical & nursing staffUnit Manager & Lab staff


Power failure Mains power not available Refer to mains power failureplan

Inform and educate staff Unit Manager /Nurse Educator

Lighting failure Difficulties in patientobservation and care.

Utilise emergency lighting .Torches in all anaestheticmachines.

Identify provision foremergency lighting

Engineering staffNurse Unit Manager

Page - 29 28/08/2013




Increased risk for patients andstaff



Maintain WH&S precautionsRefer to Facility wide powerfailure plan

Relocate immobile patientsto best lit areasClean and maintain windowsand fittingsEnsure blinds/curtains openEnsure adequate supplytorches / battery operatedlights and batteriesClear patient areas, workareas and corridors of allhazardsEducate staff

Nursing staff

Cleaning staff

Unit Manager

Air conditioningfailure

Unable to regulatetemperature and environmentUnable to perform surgery dueto risk of infectionPossible loss of sterile stockdue to high temps.

Open Windows wherepossible.Electrical or manual fan

Refer to facility wide plan

Position fans for maximumbenefitIdentify patients requiringcoolingInform and educate staff

Nursing staff

Telephone failure No internal / externaltelephone communications.

Refer to facility widetelecommunications plan

Inform and educate staff Unit ManagerShift Team Leader /Educator

Wall oxygen supplyfailure.

Wall oxygen not available Use cylinder oxygen Identify anticipatedrequirements of cylinderoxygen for ward patientsOrder required cylindersfrom central storage areaEnsure correspondingnumber of oxygen fittingsavailable at ward level.Ensure all staff educated incylinder changeoverConsider co-locating highoxygen users

Unit Manager

Wards person

Wards personUnit Manager /EducatorNursing staffMedical Staff

Page - 30 28/08/2013




Wall suction failure Wall suction not available Use alternate suctiondevices

Provide emergencyoxygen/suction

Assess need for and numberof portable suction unitsrequired (There is twoportable suction unit in thetheatre).Consider co-locating suctiondependent patientsEnsure adequate supplyalternate drainage systemsReplace drain suction withmanual vacuum or drainagebottlesEnsure small oxygencylinder with twin-o-vacsuction on resuscitationtrolleyEducate staff on use ofalternate devicesUse weighted scales ifavailable

Unit Manager

Nursing staff

Nursing staff

Unit ManagerEducator

Unit Manager

Failure of Tympanicthermometer

Potential for inaccuracy oftemperature readings

Use digital thermometer Ensure stock digitalthermometers

Unit Manager

Failure of non-invasive bloodpressure (NIBP)monitors

Unable to electronicallymeasure blood pressurerecordings

Use manualsphygmomanometer

Ensure adequate number ofmanualsphygmomanometers

Unit Manager

Failure ofGlucometer

Potential for decreasedaccuracy in blood glucosereadings

Visual readings

Formal laboratory bloodglucose analysis forabnormal results

Ensure adequate stock ofbatteries.Inform and educate staffDevelop policy for formallaboratory test

Nursing staffUnit ManagerEducatorMedical staff

Failure of 12 leadECG machine

Unable to diagnose potentiallife-threatening conditions

Ensure access toemergency powerUse on battery power

Identify access toemergency power outletKeep batteries fully chargedon emergency powerIdentify location ofalternative ECG machinesInform and educate staff

Unit ManagerEngineering staffNursing StaffEducator

Page - 31 28/08/2013




Failure of Pulseoximeters

Unable to determine oxygensaturation

Increase nursingobservation

Educate staff re basicphysical assessment ofpatient


Failure of LamsonSystem

Unable to transport specimens Revert to manual process Inform and educate staff Unit ManagerEducator

Failure ofEmergency Alarms

Unable to provide safe andsecure environment

Increased staff vigilance Schedule regular patientroundsDirect notification via phoneto switch or runner toCommunication Centre tocontact fire services,security, police

Nursing staff

Refer to safety and securityplan.

Inform and educate Staff Unit Manager

Failure of Patientcall buttons

Patients unable to summonassistance


Inform and educate staff Unit Manager

Failure of InfusionPumps/SyringeDrivers


Use on battery power ifavailableUse burettes

Consider alternateadministration routes

Charge on generator powerif able Charge batteries fullyEnsure adequate stockburettesProtocols for alternativeadministration

All staff Nursing staff

Medical staff

A

Failure of Enteralfeed pumps

Difficulty in maintaining patientnutrition

Use alternate enteralfeeding methods.

Develop procedure for bolus/ gravity feedingEnsure adequate supplytubes & bags & feedsInform and educate staff

Unit ManagerEducatorNursing Staff

Failure of SequentialCompressionDevices

Potential increased risk of DVT/Embolus

Use alternative methods ofdeterring thrombo-embolus


Consider compressionstockings/ drug therapyDevelop policyEnsure adequate supplies ofstockings

Unit ManagerMedical staffEducator

Page - 32 28/08/2013




Refrigeration(Connected toEmergency power).Alert staff if noemergency power tomake plans forrefrigerated drugs.

Drugs and medical suppliesrequiring refrigeration maybecome unusable

Place drugs in refrigeratorswhich are connected toemergency power supply

Use Eskies and ice

Review emergency poweroutletsMonitor refrigeratortemperature withthermometerConsider purchase of eskiesand supply of iceConsider purchase of eskiesand supply of iceInform and educate staffConsult with Pharmacy

Unit ManagerEngineering staffNursing staffInfection Control Staff

Failure of liftingdevices

Difficulties with lifting heavypatients – manual handlinginjuries

Identify alternate liftingdevices

Use hydraulic lifting devicesif availableUse of ski sheets, bedsheets, etc.Ensure staff trained inmanual handling

All staff


Pan room hopper Unable to clean bed pans /urinals adequately

Single patient use bedpans/urinals

Purchase sufficient forimmobile patientsRinse with “grey/waste”water and disinfect withchemical solution• Rinsewith “grey/waste” water anddisinfect with chemicalsolutionInform staff of InfectionControl policy

Unit Manager

All staff

Unit ManagerInfection Control CNC

Lift failure Unable to transport patients todifferent levels within facility

Ensure one lift operates onemergency powerUtilise alternate methods oftransporting patients

Consider utilising groundfloor facilitiesMinimise patient transfers

Review existing supply ofemergency powerWalk patients

Consider scoop stretchers,fire blankets, stair walkers,cardboard stretchersDevelop facility plan forlocating new admissionsCritical transfers onlyEnsure all staff aware offacility Fire / Evacuation plan

Engineering staffDisaster CommitteeWards person

MHHS Executive

Medical staffUnit Manager

Page - 33 28/08/2013




Failure of Fax Unable to receive or sendpatient information


Send patient information byrunner/courierDelay transfer of informationuntil services resumed.

Unit Manager

Medical staffAdmin. staff

Failure of Copier Unable to copy documents Utilise alternate lines ofcommunication

Telephone informationSend original documentswith patient and document inchartDelay transfer of informationuntil services resumed


Staffing Increased manual tasks mayinfluence workload


Place staff "on call"

Estimate staffing numbersrequired for 24 hour periodPrepare rostersLiaise with agencies forextra staffCall in staff

All managers

Duty managers



Identify all equipment to bechecked



DMHHS ExecutiveUnit Manager /Educator

Page - 34 28/08/2013


Intensive Care UnitThe Unit is connected to the emergency generatorNote: The Standard Operating Procedures for the general wards and the MHHS Essential Services are to be used in conjunction with thespecific procedures detailed below.

INTENSIVE CARE UNITA = Up to 24hrs B = Up to 5 DaysC = Indefinitely D = Cannot Operate

Problem Impact Contingency Task Responsibility How long can you function without this service?

Failure ofCentralMonitoringSystem

Unable to closelymonitor patientsfrom centralstation

Utiliseemergencygenerator powerwithin 10seconds ofpower failure

Identifyemergencypower outlets

All Nursing and Medical staff

Use bedsidemonitors

Ensure alarmsfunctional andturned "on" on allmonitors

Nursing staff

Initiate closeobservation ofpatients


Unable toprovideTelemetry togeneral wards

Assess need forward patients tobe on Telemetry

Use portablemonitoringdevices on thewards

Director ICU, Medical Consultants and Nurse Unit Mangers

Transfer at riskpatients toICU/CCU

Medical Staff, NUM and team Leader

Failure ofMonitorsincludingcardiac &oximetry

Unable toidentifyarrhythmia’s /oxygensaturation




Utilise batteryback up

Ensure batteriesare fully charged

Nursing staff Battery life of Monitor is 30 mins to 2 hours

Locatefunctioningportablemonitors

Prioritise patientsfor monitoring

Director of ICU and ICU Consultants

Page - 35 28/08/2013



Increasednursing &medicalobservation

Inform staff All Nursing and Medical staff

Increasedrostered staffingnumbers

NUM Depening on staff availability

Utiliseemergencysupply ofporatble SpO2monitors

PurchaseportableemergencySpO2 monitorsfor eachICU/CCU bed

NUM

Note: Monitors work on emergency power. There are three portable Lifepacks and two transport monitor in the unit if emergency power does not work.

Failure ofTransportmonitors

Unable tomonitor criticallyill or unstablepatients

Utilise batterypower

Ensurebatteriesare fullycharged andoperational


Limit anymovement ofthese patients toessential testsonly

Liaise withMedical Officerregarding needfor patienttransfer

All Nursing and medical staff


Identify locationof emergencysupply



Unable todefibrillatepatients






All nursing and Medical staff

Utilise otheravailable

Identify locationof alternate


Page - 36 28/08/2013



Defibrillators devices

Insufficientstaff

Unable toprovide safelevel of care inthe event ofequipment failure

Use Unit basestaffing modelwhere possible.

Calculateindividual patientstaffingrequirements

Director of ICU,ICU Consultants,NUM and TeamLeader

Indefiantly but with a limited service

Identify criticalcare staff able tobe on call andredeployed in thefacility

NUM and Team Leader

Estimate staffingnumbersrequired for 24hour period

NUM and Team Leader

Liaise with otherfacilities for extracritical care staff

NUM

Liaise withagencies forextra critical carestaff

NUM

Call staff in whenrequired

NUM, Nurse Manager and Team Leader

Transfer patientsto other facilities

NUM and Clinical Director

Page - 37 28/08/2013


Coronary Care UnitThe Unit is connected to the emergency generatorNote: The Standard Operating Procedures for the general wards and the MHHS Essential Services are to be used in conjunction with thespecific procedures detailed below.

CORONARY CARE UNITA = Up to 24hrs B = Up to 5 DaysC = Indefinitely D = Cannot Operate


Failure ofCentralMonitoringSystem

Unable to closelymonitor patientsfrom centralstation




Use bedsidemonitors

Ensure alarmsfunctional andturned "on" on allmonitors

Nursing staff

Initiate closeobservation ofpatients


Unable toprovideTelemetry togeneral wards

Assess need forward patients tobe on Telemetry

Use portablemonitoringdevices on thewards

Director ICU, Medical Consultants and Nurse Unit Mangers

Transfer at riskpatients toICU/CCU

Medical Staff, NUM and team Leader


Unable toidentifyarrhythmia’s /oxygensaturation







Locatefunctioningportablemonitors

Prioritise patientsfor monitoring

Director of ICU and ICU Consultants

Page - 38 28/08/2013



Increasednursing &medicalobservation

Inform staff All Nursing and Medical staff

Increasedrostered staffingnumbers

NUM Depening on staff availability


PurchaseportableemergencySpO2 monitorsfor eachICU/CCU bed

NUM

Note: Monitors work on emergency power. There are three portable Lifepacks and two transport monitor in the unit if emergency power does not work.

Failure ofTransportmonitors

Unable tomonitor criticallyill or unstablepatients

Utilise batterypower

Ensure batteriesare fully chargedand operational


Limit anymovement ofthese patients toessential testsonly

Liaise withMedical Officerregarding needfor patienttransfer

All Nursing and medical staff

Utiliseemergencysupply ofportable SpO2monitors

Identify locationof emergencysupply



Unable todefibrillatepatients







Utilise otheravailableDefibrillators

Identify locationof alternatedevices


Page - 39 28/08/2013



Insufficientstaff

Unable toprovide safelevel of care inthe event ofequipment failure

Use Unit basestaffing modelwhere possible.

Calculateindividual patientstaffingrequirements

Director of ICU,ICU Consultants,NUM and TeamLeader

Indefinite but with a limited service

Identify criticalcare staff able tobe on call andredeployed in thefacility

NUM and Team Leader

Estimate staffingnumbersrequired for 24hour period

NUM and Team Leader

Liaise with otherfacilities for extracritical care staff

NUM

Liaise withagencies forextra critical carestaff

NUM

Call staff in whenrequired

NUM, Nurse Manager and Team Leader

Page - 40 28/08/2013


Women’s HealthThe Birth Suites are connected to the Emergency Generator

WOMENS HEALTH UNIT


Problem Impact Contingency Task Responsibility How long can youfunction without thisservice?

Failure of Infantresuscitation trolleys

Suction and oxygen notimmediately available

Unable to maintain infantwarming

Use portable gases

Use emergency generatorpower

Ensure alternate warmingdevices availableFill Blanket warmer withblankets and linen andplugged into generatorDry babies well. Wrap &dress warmlyPlace baby in bed withmother

Ensure twin-o-vac available

Ensure oxygen and ircylinders on resus cots arefull and additional bottles areavailableEnsure trolleys are pluggedinto red emergency powerpoints.Ensure supply of linen,blankets and bubble wrap

Consider bubbie wrap,space blankets, gladwrap

Clinicians

Unit Manager

Clinicians

Unit ManagerWardsperson

Nursing staff

Nursing staff

A

Failure of electric deliverybeds

Positioning for anassisted birth moredifficult


Revert to manualpositioningInform staff & patients

Ensure trolleys are pluggedinto red emergency powerpoints.Adjust bed to optimal heightprior to critical dates

Clinicians

Nursing staffWardspersons

C

Failure ofCardiotocograph (CTG)/pH scalp monitoring

Unable to performcontinuous foetal heartmonitoring on high riskwomen


Use battery-poweredultrasound doppler.

Use Pinard stethoscope

Ensure trolleys are pluggedinto red emergency powerpoints.Identify at risk patients &instigate intermittentmonitoringEnsure adequate supply ofbattery operated dopplersand gel.Ensure access to Pinard

Clinicians


Unit Manager

C

D

Page - 41 28/08/2013

WOMENS HEALTH UNIT



stethoscopeEducate staff in use

Medical staff

Failure of Monitorsincluding cardiac &oximetry

Unable to identifyarrhythmias / oxygensaturation

Utilise emergencygenerator power

Utilise battery back up

Locate functioning monitors

Increased nursing &medical observation


Ensure batteries fullychargedPrioritise patients formonitoringInform and educate staff&patients

Unit ManagerEngineering staff

Nursing staff


A

Potential for complicateddelivery

Unable to provideappropriate level of carein the intrapartum period

Transfer to other centres

Discuss options withpatient.Transfer patient beforecritical period

Early assessment andidentification of at risk clients

Medical staff


D

Staffing Unable to provide safelevel of care.

Utilise staff available withinthe facilityPlan staffing availability

Calculate individual unitstaffing requirementsIdentify pool of appropriatelyskilled staff to be on calland/or redeployed in thefacility

Unit ManagerMedical Director


D

Lift failure Unable to transportpatient to theatre orlabour ward


Consider alternate area forCaesarean section

Review exisitng supply ofemergency power.

Designate an area

Develop unit policies forprocedure, personnel, andequipmentInform and educate staff &patients

MHHS ExecutiveEngineering staff

MHHS ExecutiveMedical staffNursing staff

Unit ManagerMedical DirectorEducator

A

A





Unit Manager

MHHS ExecutiveMedical staffNursing staff

ADEPENDS ONEQUIPMENT

Page - 42 28/08/2013

Business Continuity PlanSpecial Care Neonatal Intensive Care Nursery

Special Care Nursery is connected to Emergency PowerRisk Management regular checks of emergency equipment and processes

SPECIAL CARE – NEONATAL INTENSIVE CARE NURSERY



Failure of ventilators Deterioration / possibledeath of critically illventilated neonates

Run ventilators onemergency power

Run ventilators on batteryback up (limited backup life)

Use alternative respiratorysupport methods eg BubbleCPAP

Hand bagging

Check emergency poweroutlets

Ensure batteries arecharged at all times.Discuss with paediatrician rereview of critically ill patientsand ventilation options theneed to transfer at riskbabies where possible.In-service all staff onoperation of respiratorysupportYearly competency.Ensure rostered staff arecompetent


Clinical StaffMedical Staff

Unit ManagerMedical DirectorEducator

A

Failure of Humidicrib Difficulty in regulatingneonate's environment


Review of ambienttemperatureUse warm blankets and/orjump suitsUse bubble wrap

Use water bed ifemergency power

Ensure cribs are pluggedinto red emergency powerpoints.Adjust bedding and clothingto meet neonatal needsEnsure adequate supply ofblankets/jump suitsEnsure supply of bubblewrapClinician to plan best optionrelative to clinical needs ofbaby.Inform and educate staff

All Clinicians


A

A

Failure of phototherapyunit

Unable to correctjaundice

Utilise emergency power

Monitor Bilirubin levels

Ensure access toemergency powerTransfer to another centre ifclinical care requires

Unit ManagerEngineering staffNursing StaffMedical staff

Aas long as contingency

available

Page - 43 28/08/2013




Exchange transfusioninterventionTransfer to another centre ifclinical care requiresintervention that cannot besafely performed in the SCNat the time.

Nursing StaffMedical staff



Utilise emergencygenerator powerUtilise battery back up

Locate functioning monitors


Identify emergency poweroutletsEnsure batteries fullychargedPrioritise patients formonitoringInform and educate staff



A

Staffing Unable to provide safelevel of care in the eventof critical event

Utilise staff available withinthe facility

Plan staffing availability

Calculate individual unitstaffing requirements

Identify pool of appropriatelyskilled staff to be on calland/or redeployed in thefacility


D





Unit Manager A

Failure of InfusionPumps/Syringe Drivers




Consider alternateadministration routes.

Ensure pumps are pluggedinto red emergency powerpoints.Charge on generator powerif able Charge batteries fullyEnsure adequate stockburettesProtocols for alternativeadministration


Nursing staff Medical staff

C

Failure of Breast Pump(Minimal significance)

Unable to express breastmilk

Use emergency generatorpowerExpress by hand or manualpumps

Ensure pumps are pluggedinto red emergency powerpoints.Adequate supplies ofmanual breast pumps

Nursing staff

Unit Manager

C

Page - 44 28/08/2013




Inform and educate staffInform and educate patients


Refrigeration of formula &expressed breast milk(EBM)

EBM & formula maybecome contaminated


Use fresh EBM

Use frozen EBM

Ensure date and time ofdefrosting is marked on anyEBMUse of formula instead offrozen EBM as a last resortonly.Use pre packed formulathat does not requirerefrigeration

.Ensure fridge is pluggedinto emergency supplyObtain EBM as close to feedas possibleDiscard any defrosted EBMafter 24hrs.Discard unused EBM after24hrs

Discuss options with motherEnsure adequate stocks ofbottled sterile water andformula (powder & prepared)Formula made and used asrequiredDiscard unused formulaDevelop unit policy andeducate staffConsult with Pharmacy

Nursing staff

Nursing staffMothers

Nursing staffInfection Control Staff


C

Page - 45 28/08/2013

Business Continuity PlanWomens Health Unit – Ward & Clinics

WOMENS HEALTH UNIT - WARD & CLINICS



Computer failure Unable to generate IDlabels



Unable to recordinformation relating topatient nursedependencyUnable to accesscomputerisedpathology/radiologyresults

Record patient detailsmanually






Ensure supply of HBCISdowntime formsPre –print labels on existingpatientsHand write on blank labelsfor new admissionsUpdate patient location andbed status at regularintervalsNotify after-hours managerof all patient movementsDevelop a process fordisseminating patientupdates as part of the facilitycommunication planUpdate patient diet lists andhave available for collectionby catering servicesEnsure supply of downtimeforms available to recordinformation

Ensure supply of pathologyresult forms

Develop means fornotification of lab & testresultsManual ordering testsEnsure retrospective dataentry when computerservices resumeBackup any non centraliseddata or ward specific

Administrative StaffNursing Staff


Unit Manager



Unit Manager & Lab staff

Medical & nursing staffUnit Manager & Lab staff


A

A

A

A

Page - 46 28/08/2013




computer programs

Power failure Mains power notavailable

Refer to mains powerfailure plan

Inform and educate staff Unit Manager /Nurse Educator A

Lighting failure Difficulties in patientobservation and care


Utilise emergency lighting


Ensure blinds/curtains openUtilise alternate lighting

Maintain WH&Sprecautions

Refer to Facility wide powerfailure plan

Identify provision foremergency lightingRelocate immobile patientsto best lit areasClean and maintain windowsand fittingsEnsure adequate supplytorches / battery operatedlights and batteriesClear patient areas, workareas and corridors of allhazardsEducate staff

Engineering staff

Nursing staff

Cleaning staff

All staffUnit Manager

D

Air conditioning failure Unable to regulatetemperature andenvironment

Use alternate coolingdevices (eg.) Electrical ormanual fan


Position fans for maximumbenefitIdentify patients requiringcoolingInform and educate staff

Nursing staff

A

Telephone failure No internal / externaltelephonecommunications


Inform and educate staff Unit ManagerShift Team LeaderEducator

A

Wall oxygen supply failure Wall oxygen notavailable

Use cylinder oxygen Identify anticipatedrequirements of cylinderoxygen for ward patientsOrder required cylindersfrom central storage area.Ensure all oxygen cylindersfullEnsure correspondingnumber of oxygen fittingsavailable at ward level.Ensure all staff educated incylinder changeover.

Unit Manager

Wardsperson

WardspersonUnit ManagerEducator

A

Page - 47 28/08/2013




Consider co-locating highoxygen users

Wall suction failure Wall suction notavailable

Use alternate suctiondevices


Assess need for and numberof portable suction unitsrequiredConsider co-locating suctiondependent patientsEnsure adequate supplyalternate drainage systemsReplace drain suction withmanual vacuum or drainagebottlesEnsure small oxygencylinder with twin-o-vacsuction on resuscitationtrolleyEducate staff on use ofalternate devicesUse weighted scales ifavailable

Nursing staffMedical Staff


A

Failure of noninvasiveblood pressure (NIBP)monitors


Run on emergency powerif loads permit.Use manualsphygmomanometer

Check emergency poweroutletsEnsure adequate number ofmanualsphygmomanometers

Unit ManagerEngineering staffUnit Manager

C

Failure of Pulse oximeters Unable to determineoxygen saturation



EducatorA

Failure of Lamson System Unable to transportspecimens

Revert to manual process Inform and educate staff Unit ManagerEducator

C

Failure of EmergencyAlarms


Refer to safety and

Increased staff vigilance Schedule regular patientroundsDirect notification via phoneto switch or runner toCommunication Centre tocontact fire services,security, policeInform and educate Staff

Nursing staff

All staff

D

Page - 48 28/08/2013




security plan.

Failure of Patient callbuttons

Patients unable tosummon assistance

Refer to safety and securityplan

Inform and educate staff Unit Manager A


Use on battery power ifavailable

Use burettes

Consider alternateadministration routes

Charge on generator powerif able Charge batteries fully

Ensure adequate stockburettesProtocols for alternativeadministration


Nursing Staff


C



Use Eskies and ice

Review emergency poweroutlets

Monitor refrigeratortemperature withthermometer as per InfectionControl Guidelines.Consider purchase of eskiesand supply of iceInform and educate staffConsult with Pharmacy


Nursing staffInfection Control Consultant

Unit Manager


A

Pan room hopper Unable to clean bedpans / urinals adequately


Purchase sufficient forimmobile patientsRinse with “grey/waste”water and disinfect withchemical solutionInform staff of InfectionControl policy

Unit Manager

Infection Control CNC

C

Lift failure Unable to transportpatients to differentlevels within facility




Walk patients

Consider scoop stretchers,fire blankets, stair walkers,cardboard stretchers

Engineering staffDisaster Committee

Wardsperson

MHHS ExecutiveD

Page - 49 28/08/2013




Consider utilising groundfloor facilitiesMinimise patient transfers

Develop facility plan forlocating new admissionsCritical transfers onlyEnsure all staff aware offacility Fire / Evacuation plan

MHHS Executive

Medical staff

Unit ManagerFailure of Fax Unable to receive or

send patient informationUtilise alternate lines ofcommunication

Send patient information byrunner/courierDelay transfer of informationuntil services resumed

Unit Manager

Medical staffAdministration staff

B

Failure of Copier Unable to copydocuments



Send original documentswith patient and document inchartDelay transfer of informationuntil services resumed



B

B

Staffing Increased manual tasksmay influence workload




All managers

Duty managers

D






MHHS ExecutiveUnit ManagerEducator

ADEPENDS ONEQUIPMENT

Page - 50 28/08/2013

Business Continuity PlanBirth Centre

The Birth Centre has no emergency power connected.The lighting is not suitable for operation without power

BIRTH CENTRE



No emergency power No electrical oremergency equipmentwill work.Poor lighting

Unable to provide infantwarming

Transfer all women to theWomen's health Unit

Transfer all women to theWomen's Health Unit

Transfer all women to theWomen's Health Unit

Arrange transfer of allwomen who require ongoingcare.Arrange transfer of allwomen who require ongoingcare.Arrange transfer of allwomen who require ongoingcare.

Unit ManagerBirth Centre Midwives

D

Isolation and Safety ofbuilding

Unable to maintaincommunication or safetyof staff

Transfer program to WHU Send P/N women home.Transfer to WHUB/C Midwives to providecare for BC women wherepossible.Inform all women that theservice is being conductedfrom the WHU for theduration of the disaster.Inform switchInform After HoursCoordinators

Unit ManagerBirth Centre Midwives

D

Outside furniture and toys Flying objects Refer to cyclonepreparation policy

Ensure all flying objects aresecure

Wards persons

Page - 51 28/08/2013


Child & Adolescent Health Unit

The following Standard Operating Procedures have been generated for application across clinical units where common processes exist and aregrouped thus to avoid replication of tasks for contingency planning for individual wards.

CHILD & ADOLESCENT HEALTH UNITA = Up to 24hrs B = Up to 5 DaysC = Indefinitely D = Cannot Operate

PROBLEM IMPACT CONTINGENCY TASK RESPONSIBILITYHOW LONG CAN YOUFUNCTION WITHOUT

THIS SERVICE?

Computerfailure

Unable to generate IDlabels

Record patient details manually Ensure supply of HBCIS downtime forms Administrative and nursing staff

CCan function but verytime consuming

Pre –print labels on existing patients Administrative and nursing staff


Hand write on blank labels for new admissions




Revert to manual process Update patient location and bed status at regular intervals


CCan function

Notify after-hours manager of all patient movements

Nursing staff

C Can function

Develop a process for disseminating patient updates as part of the facility communicationplan


C Can functionUnable to provide patientdietary requirements

Revert to manual process Update patient diet lists and have available for collection by catering services

Unit Manager


Page - 52 28/08/2013



THIS SERVICE?

Unable to recordinformation relating topatient nurse dependency

Revert to manual process Ensure supply of downtime forms available to record informationNursing staff to feedback to NUM/BedManager




Revert to manual process Ensure supply of pathology result forms Administrative staff


Develop means for notification of lab & test results

Unit Manager & Lab staff CCan function but verytime consuming

Manual ordering tests Medical & nursing staff CMO Currently write out

pathology forms Enter data when system fixed Ensure retrospective data entry when

computer services resumeUnit Manager & Lab staff

C Will be very timeconsuming

Backup any non centralised data or wardspecific computer programs


C Will be very timeconsuming

Power failure Mains power not available Refer to mains power failure plan Inform and educate staff Unit Manager /Nurse Educator

BCan function in mostareas, dependent onpatient acuity

Lightingfailure

Difficulties in patientobservation and care.

Utilise emergency lighting Identify provision for emergency lighting Engineering staff BCan function in mostareas.

Relocate immobile patients to best lit areas Nursing staff BCan function in mostareas.

Maximise natural lighting Clean and maintain windows and fittings Cleaning staff BCan function in mostareas.

Ensure blinds/curtains open All staff BCan function in most

Page - 53 28/08/2013



THIS SERVICE?

areas.

Utilise alternate lighting Ensure adequate supply torches / battery operated lights and batteries

Unit Manager

B Can function in mostareas.

Increased risk for patientsand staff

Maintain WH&S precautions Clear patient areas, work areas andcorridors of all hazards

Unit Manager /All staff B Can function in mostareas.


Educate staff Educator B Can function in mostareas.

Airconditioningfailure

Unable to regulatetemperature andenvironment

Use alternate cooling devices(eg.)

Position fans for maximum benefit Nursing staff A Especially in summerLimited where nowindow.

Electrical or manual fan AEspecially in summerLimited where nowindow.

Identify patients requiring cooling Nursing staff AEspecially in summerLimited where nowindow.

Refer to facility wide plan Inform and educate staff Unit Manager AEspecially in summerLimited where nowindow.

Telephonefailure

No internal / externaltelephonecommunications .


Inform and educate staff Unit Manager /Shift Team Leader /Educator

AOnly for a limited time.Major impact onemergencycommunication from/toCAU in current position

Wall oxygensupply failure.

Wall oxygen not available Use cylinder oxygen Identify anticipated requirements of cylinder oxygen for ward patients

Unit Manager BNeed to increase to fourcylinders

Page - 54 28/08/2013



THIS SERVICE?

Order required cylinders from central storage area.

Unit Manager

B Ensure all oxygen cylinders full Wards person

B Ensure corresponding number of oxygen

fittings available at ward level.Wards person B

Ensure all staff educated in cylinderchangeover.

Wards person/UnitManager /Educator

B

Consider co-locating high oxygen users Nursing staff /medical Staff

BPaediatric patients needto stay where there arepaediatric nurses

Wall suctionfailure

Wall suction not available Use alternate suction devices Assess need for and number of portablesuction units required

Unit Manager BNot safe for high riskpatients. Area only hasone manual suction.Post operative patientsnot able to cared forsafely.

Consider co-locating suction dependentpatients

Nursing staff BPaediatrict patientsneed to stay wherethere are paediatricnurses

Ensure adequate supply alternate drainagesystems

Nursing staff BLimited supply inhospital

Replace drain suction with manual vacuumor drainage bottles


BLimited supply inhospital

Page - 55 28/08/2013



THIS SERVICE?


Ensure small oxygen cylinder with twin-o-vac suction on resuscitation trolley

Nursing staff BLimited supply inhospital Only one inCAU.3x twin-o-vacs in CAU

Educate staff on use of alternate devices Unit Manager Educator

Digital scalesfail

Unable to record weight Use alternative scales Purchase bathroom scales Unit Manager C

Use weighted scales if available Unit Manager C

Failure ofWelsh Allenthermometer

Potential for inaccuracy oftemperature readings

Use digital thermometer Ensure stock digital thermometers Unit Manager C

Failure ofnon-invasivebloodpressure(NIBP)monitors


Use manual sphygmomanometer Ensure adequate number of manualsphygmomanometers

Unit Manager C


Potential for decreasedaccuracy in blood glucosereadings

Change battery in Glucometer. Ensure adequate supply of batteries andtest strips.

Nursing staff /UnitManager

C

Inform and educate staff Unit Manager Educator C

Formal laboratory blood glucoseanalysis for abnormal results

Develop policy for formal laboratory test Medical staffNursing staff

A.A potential treatmentproblem.

Failure of 12lead ECGmachine

Unable to diagnosepotential life-threateningconditions


Identify access to emergency power outlet Unit ManagerEngineering staff

ANo problem ifemergency power pointkept for use.

Use on battery power Keep batteries fully charged on emergencypower

Unit Manager /NursingStaff

Alimited battery life

Page - 56 28/08/2013



THIS SERVICE?


Nursing staff

Inform and educate staff Unit Manager /Educator

Failure ofPulseoximeters


Increase nursing observation Educate staff re basic physical assessmentof patient

Educator CStaff trained in physicalassessment

Failure ofLamsonSystem

Unable to transportspecimens

Revert to manual process Inform and educate staff Unit Manager /Educator CCan function but verytime consuming



Increased staff vigilance Schedule regular patient rounds Nursing staff BCan function but timeconsuming and canlead to decreasedpatient safety.

Direct notification via phone to switch orrunner to Communication Centre to contactfire services, security, police

All staff BCan function.

Refer to safety and security plan. Inform and educate Staff Unit Manager BCan function.

Failure ofPatient callbuttons


Refer to safety and security plan. Inform and educate staff Unit Manager CCan function

Failure ofInfusionPumps/Syringe Drivers


Use on battery power if available.

Charge on generator power if able Chargebatteries fully

All staff Nursing staff ABatteries can last up to12 hours.

Use burettes Ensure adequate stock burettes Nursing Staff AExtra staff will berequired.

Consider alternate administrationroutes.

Protocols for alternative administration Nursing staff Medical staff

Failure ofEnteral feedpumps

Difficulty in maintainingpatient nutrition

Use alternate enteral feedingmethods.

Develop procedure for bolus / gravityfeeding

Unit Manager/EducatorNursing Staff

CExtra staff required.

Page - 57 28/08/2013



THIS SERVICE?

Ensure adequate supply tubes & bags &feeds

Unit Manager

Inform and educate staff Educator


Potential increased risk ofDVT /Embolus

Use alternative methods ofdeterring thrombo-embolus

Identify at risk patients Unit Manager Medicalstaff

CNot common inpaediatrics

Consider compression stockings/ drugtherapy

Unit Manager /Educator/Medical Staff


Develop policy Unit Manager /Educator/Medical Staff


Ensure adequate supplies of stockings Nursing staff CNot common inpaediatrics

Refrigeration Drugs and medicalsupplies requiringrefrigeration may becomeunusable


Review emergency power outletsConsult with Pharmacy

Unit ManagerEngineering staffInfection Control staff

A

Monitor refrigerator temperature with thermometer

Nursing staff BAreas will need topurchase monitors.

Use Eskies and ice Consider purchase of eskies and supply ofice

Unit Manager Awith eskies.

Inform and educate staff Unit Manager Educator

Failure oflifting devices

Difficulties with liftingheavy patients – manualhandling injuries

Identify alternate lifting devices Use hydraulic lifting devices if available All staff B

Use of ski sheets, bed sheets, etc. All staff C

Ensure staff trained in manual handling Unit Manager Educator C

Page - 58 28/08/2013



THIS SERVICE?

Pan roomhopper

Unable to clean bed pans/ urinals adequately


Purchase sufficient for immobile patients Unit Manager B

Rinse with “grey/waste” water and disinfect with chemical solution

All staff B

Inform staff of Infection Control policy Unit Manager Infection Control CNC Educator

Lift failure Unable to transportpatients to different levelswithin facility


Review existing supply of emergency power Engineering staff Disaster Committee


Walk patients Wards person

Consider scoop stretchers, fire blankets, stair walkers, cardboard stretchers

MHHS Executive ANeed increased staff.


Develop facility plan for locating new admissions

MHHS Executive A

Minimise patient transfers Critical transfers only Medical staff A

Ensure all staff aware of facility Fire / Evacuation plan

Unit Manager A

Unit Manager Educator CCan still operate.

Failure ofVideo/TV

Negative impact onpatient educationenjoyment

Verbal education Develop alternate education packages forpatients

Medical Staff. CCan still operate.

Alternative recreational facilities Prepare mobile library Volunteers CCan still operate.

Page - 59 28/08/2013



THIS SERVICE?

Consider hand held computer games forchildren

MHHS Executive UnitManager

C Can still operate.



Send patient information by runner/courier Unit Manager ACan still operate buttime consuming.

Delay transfer of information until services resumed.


ACan still operate buttime consuming.

Failure ofCopier

Unable to copydocuments


Telephone information Nursing staffMedical staff

CWill be very timeconsuming

Send original documents with patient anddocument in chart

Nursing staff Medical staff

CWill be very timeconsuming

Delay transfer of information until servicesresumed


BStaffing Increased manual tasks

may influence workloadRoster extra staff on duty Estimate staffing numbers required for 24

hour periodAll managers

BPlace staff "on call" Prepare rosters All managers

BLiaise with agencies for extra staff All managers

CCall in staff Duty managers

BEquipmentFunction



Identify all equipment to be checked Unit Manager All staff

B Inform and educate staff MHHS Executive

Unit Manager Educator

Page - 60 28/08/2013


Specialist Outpatients

SPECIALIST OUTPATIENTS










Ensure supply of HBCISdowntime forms

Pre –print labels on existingpatientsHand write on blank labelsfor new admissionsUpdate patient location andbed status at regularintervalsNotify after-hours managerof all patient movementsDevelop a process fordisseminating patientupdates as part of the facilitycommunication planEnsure supply of pathologyresult formsDevelop means fornotification of lab & testresultsManual ordering tests

Ensure retrospective dataentry when computerservices resumeBackup any non centraliseddata or ward specificcomputer programs

Administrative StaffNursing staff


Unit ManagerLaboratory staff

Medical StaffNursing staffUnit ManagerLaboratory staff


CCan function but very time

consumingInformation may not be

accurate

C

B

C

C



Inform and educate staff Unit ManagerNurse Educator

Dunable to function due todarkness of area and

Page - 61 28/08/2013




unavailability of Pathologyresults etc.







Identify provision foremergency lightingRelocate immobile patientsto best lit areasClean and maintain windowsand fittingsEnsure blinds/curtains openEnsure adequate supplytorches / battery operatedlights and batteriesClear patient areas, workareas and corridors of allhazardsEducate staff

Engineering staff

Nursing staff

Cleaning staff

Unit Manager

Dunable to function due todarkness of area andunavailability of Pathologyresults etc.

CAir conditioning failure Unable to regulate

temperature andenvironment

Use alternate coolingdevices (eg.)

Electrical or manual fan


Position fans for maximumbenefit and open doors andwindowsIdentify patients requiringcoolingInform and educate staff

Nursing staff

Unit Manager

C

Telephone failure No internal / externaltelephonecommunications .





Use cylinder oxygen Identify anticipatedrequirements of cylinderoxygen for ward patientsOrder required cylindersfrom central storage areaEnsure all oxygen cylindersfullEnsure correspondingnumber of oxygen fittingsavailable at ward level.Ensure all staff educated incylinder changeoverConsider co-locating high

Unit Manager

Wards person

C

C

Page - 62 28/08/2013




oxygen users

Digital scales fail Unable to record weight Use alternative scales Purchase bathroom scalesUse weighted scales ifavailable

Unit Manager C

Failure of Welsh Allenthermometer


Use digital thermometer Ensure stock mercurythermometers

Unit Manager C

Failure of non-invasiveblood pressure (NIBP)monitors



Ensure adequate number ofmanualsphygmomanometers

Unit Manager C

Failure of Glucometer Potential for decreasedaccuracy in bloodglucose readings

battery change

Formal laboratory bloodglucose analysis forabnormal results

Ensure adequate stock ofblood glucose sticksInform and educate staffDevelop policy for formallaboratory test

Nursing staffUnit Manager


C

Failure of 12 lead ECGmachine


Ensure access toemergency power


Identify access toemergency power outlet

Keep batteries fully chargedon emergency powerIdentify location ofalternative ECG machines

Nursing staffUnit Manager

Brequired for medical

clinics

Failure of Pulse oximeters Unable to determineoxygen saturation

Use battery operatedoximeter.


Educator C





Schedule regular patientroundsDirect notification via phoneto switch or runner toCommunication Centre tocontact fire services,security, police

Nursing staff

All staff C

Refrigeration Drugs and medicalsupplies requiringrefrigeration may


Review emergency poweroutlets

Unit ManagerEngineering staffInfection Control Staff

ADrugs kept in fridge

Page - 63 28/08/2013




become unusable

Use Eskies and ice

Monitor refrigeratortemperature withthermometerConsider purchase of eskiesand supply of iceConsult with Pharmacy

Nursing staff

Failure of lifting devices Difficulties with liftingheavy patients – manualhandling injuries


Use hydraulic lifting devicesif availableUse of ski sheets, bedsheets, etc.Ensure staff trained inmanual handling

All staff


C




Unit Manager C

Failure of Video/TV Negative impact onpatient education /enjoyment

Verbal education

Alternative recreationalfacilities

Develop alternate educationpackages for patients

Prepare mobile libraryConsider hand heldcomputer games for children


Medical StaffVolunteers

c

Failure of Fax Unable to receive orsend patient information


Send patient information byrunner/courierDelay transfer of informationuntil services resumed.

Unit Manager

Medical staffAdministration staff

Anecessary for core

businessFailure of Copier Unable to copy

documentsUtilise alternate lines ofcommunication




Anecessary for core

business




Estimate staffing numbersrequired for 24 hour periodPrepare rosters

All managersB

no extra staff for area.

Page - 64 28/08/2013




Liaise with agencies forextra staffCall in staff Duty managers





Unit ManagerAll staffMHHS ExecutiveUnit Manager /Educator

Bnecessary for most clinics,

eg ECG's

Page - 65 28/08/2013


Renal Dialysis Unit

RENAL DIALYSIS UNITA = Up to 24hrs B = Up to 5 DaysC = Indefinitely D = Cannot Operate


THIS SERVICE?

Most Haemodialysis patients can survive 3-4 days before the situation becomes life threatening. However with the volume of people on haemodialysis they all cannot bedialysed at once and one day without a means to dialyse patients will become critical for the group that has been dialysed 2-3 days prior.

Loss of Water Will result in inability todialyse patients.Severe medical impact onpatients

Delay dialysis until treated wateris available

Identify volume of water available & numberof patients able to e treated

Failure ofDialysisMachines

Will result in inability todialyse patients.Severe medical impact onpatients.Life threatening.

Delay Dialysis until machineavailable

Consider dialysis of all patients beforecritical periods.Check Urea & Electrolytes to establishclinical status

Failure ofElectricalPower

Will result in inability todialyse patients.Severe medical impact onpatients.Life threatening.

Equipment will not operatewithout electricity

Educate patient re alternativeshort term plans

Relocate patients to otherdialysis centres

Relocate patients to other Dialysis centres

Discuss options with the patientConsider dialysis of patients after hoursRoster staff to cover out of hours if requiredCall in staffCheck machinery function before attachingthe patientProvide dietary advice regarding fluidrestrictions and avoidance of high potassiumfood & beveragesLiaise with Infection Control re potential forcross infectionDiscuss options with patient

Ensure agreements exist for temporary




Nursing StaffMHHS ExecutiveUnit ManagerMedical Director

Nursing Staff

Nurse Unit Manager

Nursing Staff

Nurse Unit ManagerMedical Director

Page - 66 28/08/2013

RENAL DIALYSIS UNITA = Up to 24hrs B = Up to 5 DaysC = Indefinitely D = Cannot Operate


THIS SERVICE?

referral of patients to nearest dialysis centre

EquipmentFunction


Check all equipment forfunctionality as soon as possibleafter disruption of power/failureof machines



Nurse Unit Manager

Nurse Unit Manager

Inability toContactDialysisPatients

Unable to discuss witheducate or managerelocation of patient fordialysis

Have radio contact phonenumbers of the Unit, ensure allpatients address and contactdetails are correct

Contact radio stations & utilise the police tocontact patients if needed

Nurse Unit ManagerMedical Director

Home PatientDialysis

Water or Power outage inthe community may resultin inability to operate themachine

Delay dialysis for 1-2 daysdependant on the patient needs

Educate the patient re potentialproblems

Hospital Dialysis

Discuss options with the patient

Provide dietary advice regarding fluidrestrictions and avoidance of high potassiumand beveragesIdentify High risk patientsAssess amount of battery time available andadvise patientsDevelop alternative treatment plans,including hospitalisation of conditiondeteriorates.

Nurse Unit Manager

Nursing Staff

Nursing Staff

HomePeritonealDialysis

Power outage incommunity may result inability to operate themachine

If peritoneal fluid available domanual PD exchanges

Educate patients re fluid andpotassium intakeHospital dialysis if poweravailable

Discuss options with the patient

Provide dietary advice

Identify high risk patients

Develop alternative treatment plansincluding hospitalisation if conditiondeteriorates

Nursing StaffCCan function but very time consuming

Page - 67 28/08/2013


Mental Health UnitNote: The Standard Operating Procedures for the general wards and the MHHS Essential Services are to be used in conjunction with the specific procedures detailed below.

MENTAL HEALTH UNIT


Problem Impact Contingency Task ResponsibilityHow long can you function

without this service?Loss of Power Decrease in service

delivery

No access tocomputerprograms/lab resultsfor patientsKeys – access tobuilding – will shutdown security accessto building

Refer to mains power failure planAccess to charts denied.Base some admin staff at MBHwith laptops and limit usage tochart search. Unit uses papercharts for everyday recording.Medical record charts can beaccessed manually from medicalrecords.UPS limited hours battery

Have keys available to staffmembers


Admin staff to ensure batteriesof laptop charged duringwarning phase of disaster.

Ensure batteries are chargedand investigate possibility ofhaving portable generator torun some services.Ensure staff are available toassist with staff access to workunits

Team Leader

Business Manager andAdministration staff

Business Manager andAdministration staff

Business Manager

D

B

A

D

Loss ofCommunication

Staff/patient safety

Communication withstaff post event toassess availability for

Ensure staff safety on home visitsEnsure staff safety on ward

Staff contact list available. Policiesreflect staff protocols for returningto work post event.

Amend protocol for home visitsDevelop protocol for wardConsider staffing increase forstaff to work in pairs and/ oruse security servicesRationalise services considerdiverting all but seriously illpatients to community on atemporary basis. Increaseresources at Community todeal withInform patients and health careproviders/community servicesManager to keep staff recordsup to date.

Team LeaderCNCNurse Unit Manager

Nurse Unit Manager

Nurse Unit Manager

A

D

A

A

Page - 68 28/08/2013

MENTAL HEALTH UNIT



without this service?

work to provideservices or assistMHHS with recoveryStaff unable tocontact the centre orcommunicate withinthe centrePatients unable tocontact or becontacted

Ensure staff have mobile phonescharged and ready for use.

Use media to communicate currentsituation and advice.

Rationalise services. Chargemobile phones .Engagevolunteers or operational staffas runners.Manager to contact media

Business Manager B

A

B

ComputerFailure


Unable to enterCIMHA dataUnable to enterclinical incidentsDifficulty inadministration ofMental Health Actpaperwork/forms

Unable to trackpatients location andbed status

Inability to accesselectronic records -relevant client infounable to beaccessed.

Record patient details manually

Record information manually –draft extra admin staff to supportRecord information manually- draftextra admin staff to supportRecord information manually- draftextra admin staff to support


Access client record UR numberfrom MBH utilising mobile phone

Ensure supply of HBCISdowntime formsPre-print labels for existingpatientsHand write on blank labels fornew admissionsEnsure supply of CIMHAdowntime formsEnsure supply of PRIMEdowntime formsPossible extra support for theMHA Delegate to ensure allconsumers are correctlycategorised and that the legalduty for paperwork ismaintained.Update patient location andbed status at regular intervals

Notify after-hours manager ofall patient movementsDevelop a process fordisseminating patient updatesas part of the facilitycommunication planStaff education re procedure inevent of power/communication loss


MHA DelegateNUM


A

B

A

A

Page - 69 28/08/2013

MENTAL HEALTH UNIT



without this service?Availability andreadiness ofgovernmentcars

Inability to serviceclients in anemergency

Ensure all vehicles are fuelled upand garaged safely once warningsare issued

Allocate cars to program areasonce event is over

Business Manager A

Cars No fuel Decrease in servicedelivery to clients

Ensure that cars where practicalare adequately fuelled during anywarning phase.

All staff made aware of theneed to keep cars fuelled at alltimes.

Business Manager andteam Leaders

B

Failure ofDuress Alarmsystem

Increased risk to staffand other consumers

Keep only the most ill/high riskpatients and divert the rest tohome/community. Use extrasecurity and put resources tocommunity and or other wards tomanage outliers.

Identify emergency poweroutlets. Contacted theMaintenance Dept. They areconfident the system willcontinue to work.

All Nursing and Medicalstaff

DCANNOT OPERATE

SAFELY


Unable to identifyarrhythmia’s / oxygensaturation. Low riskin the Mental HealthUnit

Utilise emergency generator powerwithin 10 seconds of power failure

Utilise battery back up

Locate functioning portablemonitorsIncreased nursing & medicalobservation

Identify emergency poweroutlets Have ECG machinecharged. Use manualSphygmomanometers. Pulseoximeter available which isbattery powered. Ensure allare charged and have sparebatteries availableEnsure batteries are fullychargedPrioritise patients formonitoringInform staff



Director of ICU and ICUConsultantsAll Nursing and Medicalstaff

A

ABattery life of Monitor is 30

mins to 2 hoursA

Insufficient staff Unable to providesafe level of care inthe event ofequipment failure

Use Unit base staffing model wherepossible.

Calculate individual patientstaffing requirementsIdentify critical care staff ableto be on call and redeployed inthe facilityEstimate staffing numbersrequired for 24 hour periodLiaise with other facilities forextra critical care staffLiaise with agencies for extracritical care staffCall staff in when required

NUMTeam Leader

Indefinitely but with a limitedservice

Page - 70 28/08/2013


Community Mental HealthNote: The Standard Operating Procedures for the general wards and the MHHS Essential Services are to be used in conjunction with the specific procedures detailed below.

COMMUNITY MENTAL HEALTH




Loss of Power Decrease in servicedelivery

No access tocomputer programs

Keys – access tobuilding – will shutdown security accessto building

Refer to mains powerfailure planAccess to charts denied.Base some admin staff atMBH with laptops and limitusage to chart search.UPS limited hours battery

Have keys available tostaff members


Admin staff to ensurebatteries of laptop chargedduring warning phase ofdisaster.Ensure batteries arecharged and investigatepossibility of having portablegenerator to run someservices.Ensure staff are available toassist with staff access towork units

Team Leader

Business Manager and Admin staff



Communication withstaff post event toassess availability forwork to provideservices or assistMHHS with recoveryStaff unable tocontact the centre orcommunicate within

Ensure staff safety onhome visits

Staff contact list available.Policies reflect staffprotocols for returning towork post event

Ensure staff have mobilephones charged andready for use.

Amend protocol for homevisitsConsider staffing increasefor staff to work in pairsRationalise servicesInform patients and healthcare providers/communityservicesManager to keep staffrecords up to date.

Rationalise services. Chargemobile phones .Engagevolunteers or operational

Team Leader

Service Integration Coordinator

Business Manager

Business Manager

Page - 71 28/08/2013





the centrePatients unable tocontact or becontacted

Use media tocommunicate currentsituation and advice

staff as runners.Manager to contact media

ComputerFailure


Unable to enterCIMHA dataUnable to enterclinical incidentsInability to accesselectronic records -relevant client infounable to beaccessed.


Record informationmanually

Access client record URnumber from MBH utilisingmobile phone.

Ensure supply of HBCISdowntime formsPre-print labels for existingpatientsHand write on blank labelsfor new admissionsEnsure supply of CIMHAdowntime formsEnsure supply of PRIMEdowntime formsStaff education re procedurein event of power/communication loss

Develop a process fordisseminating patientupdates as part of the facilitycommunication plan


Availability andreadiness ofgovernmentcars


Ensure all vehicles arefuelled up and garagedsafely once warnings areissued

Allocate cars to programareas once event is over

Business Manager


Ensure that cars wherepractical are adequatelyfuelled during any warningphase.

All staff made aware of theneed to keep cars fuelled atall times.

Business Manager and team Leaders


Use Unit base staffingmodel where possible.

Calculate individual patientstaffing requirements

Identify critical care staffable to be on call andredeployed in the facilityEstimate staffing numbers

NUM and Team Leader

NUM and Team Leader

Indefinitely but with alimited service

Page - 72 28/08/2013





required for 24 hour periodLiaise with other facilities forextra critical care staffLiaise with agencies forextra critical care staffCall staff in when required

Page - 73 28/08/2013


Alcohol Tobacco & Other Drugs ServiceNote: The Standard Operating Procedures for the general wards and the MHHS Essential Services are to be used in conjunction with the specific procedures detailed below.

A.T.O.D.S



without this service?Loss of Power Decrease in service

delivery

No access tocomputer programs

Keys – access tobuilding – will shutdown security accessto building

Refer to mains powerfailure planAccess to charts denied.Base some admin staff atMBH with laptops and limitusage to chart search.UPS limited hours battery

Have keys available tostaff members


Admin staff to ensurebatteries of laptop chargedduring warning phase ofdisaster.Ensure batteries arecharged and investigatepossibility of having portablegenerator to run someservices.Ensure staff are available toassist with staff access towork units

Team Leader

Business Manager and Admin staff



Communication withstaff post event toassess availability forwork to provideservices or assistMHHS with recoveryStaff unable tocontact the centre orcommunicate withinthe centre

Ensure staff safety onhome visits

Staff contact list available.Policies reflect staffprotocols for returning towork post event.

Ensure staff have mobilephones charged andready for use.

Amend protocol for homevisitsConsider staffing increasefor staff to work in pairsRationalise servicesInform patients and healthcare providers/communityservicesManager to keep staffrecords up to date.

Rationalise services. Chargemobile phones .Engagevolunteers or operationalstaff as runners.

Team Leader

Service Integration Coordinator

Business Manager

Business Manager

Page - 74 28/08/2013

A.T.O.D.S



without this service?Patients unable tocontact or becontacted

Use media tocommunicate currentsituation and advice

Manager to contact media

ComputerFailure


Unable to enterCIMHA dataUnable to enterclinical incidentsInability to accesselectronic records -relevant client infounable to beaccessed.


Record informationmanuallyAccess client record URnumber from MBH utilisingmobile phone.

Ensure supply of HBCISdowntime formsPre-print labels for existingpatientsHand write on blank labelsfor new admissionsEnsure supply of CIMHAdowntime formsEnsure supply of PRIMEdowntime formsStaff education re procedurein event of power/communication lossDevelop a process fordisseminating patientupdates as part of the facilitycommunication plan


Availability andreadiness ofgovernmentcars


Ensure all vehicles arefuelled up and garagedsafely once warnings areissued

Allocate cars to programareas once event is over

Business Manager


Ensure that cars wherepractical are adequatelyfuelled during any warningphase.

All staff made aware of theneed to keep cars fuelled atall times.

Business Manager and team Leaders

Page - 75 28/08/2013


Early DischargeGeneral EDSU Contingencies:This Continuity Plan is based on having Emergency Power to the Unit. If there is no power all procedures would cease and cases would have to betransferred

EARLY DISCHARGE SURGERY UNITA = Up to 24hrs B = Up to 5 DaysC = Indefinitely D = Cannot Operate

PROBLEM IMPACT CONTINGENCY TASK RESPONSIBILITY HOW LONG CAN YOUFUNCTION WITHOUTTHIS SERVICE?

Failure ofanaestheticmachines &ventilators

Loss of power to machine

Inaccurate delivery ofanaesthetic gases

Unable to ventilatepatients

Run on emergency generatorpower . Runon gases if no power Oxygendriven) for 90 minutes only.Use backup cylinder supplies ofoxygen, nitrous oxide & airHand ventilate

Check access to emergency poweroutlets.Manually ventilate.Manually physically assess

Ensure supplies of cylinder gassesavailable

Ensure adequate supply of handoperated ventilation equipment - blackbag, bag - valve device

Locate and provide air / oxygen drivenventilator (oxylog / birds)

Cancel elective surgery


Unit ManagerWards person



Director of AnaestheticsDirector of SurgeryNurse Unit Manager

ESC & DMS/DON/ND

D

Failure ofMonitors –cardiac oximetry,end tidal CO2

Unable to identifyarrhythmias / oxygensaturation and problemswith ventilation

Run on emergency generatorpower

Check access to emergency poweroutlets

Identify & ensure adequate medical &nursing staff coverage

Unit ManagerAnaesthetic Staff

Director of AnaestheticsCNC

D

Defibrillator doesnot function

Unable to defibrillatepatients

Use on emergency generatorpower or battery power.Use battery back up if available


Have batteries fully charged

Unit Manager

All staff

D

Page - 76 28/08/2013



Failure ofEndoscopicEquipment

Unable to performendoscopic procedures(may be done ifgenerator on emergencypower)

Use on emergency generatorpower or battery power.

Postpone all non urgent surgery

Notify surgeons, medical, nursing andbooking office

Contact non urgent patients and informre need to reschedule at later date

Ensure list of procedures unable to beunder taken available at theatre frontdesk

Unit Manager

BookingsTheatre Manager

Unit ManagerMedical Staff

D

Failure ofdiathermymachine

Unable to performelectrical coagulation(may be done if generatoron emergency power).



Unit Manager

Failure ofFibredryer(NOT ONEMERGENCYPOWER).

Unable to store processedscopes

Arrange for use on emergencypower

Notify surgeons, medical, nursing andbooking office D

Failure ofSterilisingequipment forscopes (ONEMERGENCYPOWER)

Unable to steriliseendoscopic equipment

Arrange for use on emergencypower


Identify suitable patients

Contact non urgent patients and informre need to reschedule at later date

Staff education – availability of types ofcases able to be done

List of procedures unable to be undertaken available at theatre desk

Medical staff


Unit Manager


D

Page - 77 28/08/2013



ContaminatedWater supply ordamage to waterfilters

Unable to perform/cleanand sterilise proceduresand equipment accordingto Australian Standards

Arrange for supply of sterilewater

Rationalise service to emergencyuse only

Ensure large supply of water availablebefore restarting procedures

Identify and prioritise critical services


MHHS ExecutiveUnit Manager

D

Failure of lift Unable to transport patientto/from DPU



Consider locating all surgical patientson same level as Surgical Services

Manager Engineering

MHHS ExecutiveDirector of Surgery

C

Staffing Unable to provide safelevel of care in the eventof equipment failure

No available Staff toprovide care

Increased manual tasksmay influence workload

Centralise surgical services atone site in MHHS over criticalperiods

Roster additional staff

Disaster Plan has all availablephone numbers up to date.Roster extra staff on dutyPlace staff "on call"

Develop a staffing plan for MHHS.

Calculate individual unit staffingrequirements

Identify need to maintain staff on site asopposed to on call.

Identify human resources able to be oncall and redeployed in the facility

Assess competence of on call staff

NUM to ensure Disaster Plan is current

Estimate staffing numbers required for24 hour periodPrepare rostersLiaise with agencies for extra staffCall in staff




Unit ManagerNurse manager

Unit Manager

NUM

All Managers

All ManagersAll ManagersDuty Managers

C

Page - 78 28/08/2013



EquipmentFunction







A

No lights inchange rooms

Staff may not feel safe. Torches are available in the unit.Security to inspect all areasbefore staff enter.

Ensure batteries are in unit. Arrangesecurity inspection.

NUMA

Computer failure Unable to generatemaitain data base, printpatient ID & paperwork



Unable to recordinformation relating topatient nurse dependency







Ensure supply of HBCIS downtimeforms

Pre –print labels on existing patients

Hand write on blank labels for newadmissions

Update patient location and bed statusat regular intervals

Notify after-hours manager of all patientmovements

Develop a process for disseminatingpatient updates as part of the facilitycommunication plan

Update patient diet lists and haveavailable for collection by cateringservices

Ensure supply of downtime formsavailable to record information

Ensure supply of pathology result forms


Administrative and nursingstaffAdministrative and nursingstaff


Nursing staff


Unit Manager




C

C

C

C

Page - 79 28/08/2013



Enter data when system fixed

Develop means for notification of lab &test results

Manual ordering tests

Ensure retrospective data entry whencomputer services resume

Backup any non centralised data orward specific computer programs

Medical & nursing staff


Administrative staff C

Power failure Mains power not available Refer to mains power failure plan Inform and educate staff Unit Manager /NurseEducator

D



Utilise emergency lighting .Torches in all areas.





Identify provision for emergency lighting

Relocate immobile patients to best litareas

Clean and maintain windows andfittings

Ensure blinds/curtains open

Ensure adequate supply torches /battery operated lights and batteries

Clear patient areas, work areas andcorridors of all hazards

Educate staff

Engineering staffNUMNursing staff

Cleaning staff

All staff

Unit Manager

Unit Manager /All staff

Educator

C

C

Air conditioningfailure

Unable to regulatetemperature andenvironmentUnable to perform surgerydue to risk of infectionPossible loss of sterile

Open Windows where possible.

Electrical or manual fan


Position fans for maximum benefit

Identify patients requiring coolingInform and educate staffInform and educate staff

Nursing staff

Nursing staffUnit ManagerShift Team Leader

C

Page - 80 28/08/2013



stock due to high temps. Educator



Inform and educate staff Unit ManagerA

Wall oxygensupply failure.

Wall oxygen not available Use cylinder oxygen Order required cylinders from centralstorage area.

Ensure all oxygen cylinders full

Ensure corresponding number ofoxygen fittings available at ward level.

Ensure all staff educated in cylinderchangeover.

Consider co-locating high oxygen users

Wards person

Wards person

Wards person

Wards personUnit ManagerEducatorNursing staffmedical Staff

C

Wall suctionfailure

Wall suction not available Use alternate suction devices


Assess need for and number of portablesuction units required as there is notone within the department.There is one located in theatres

Consider co-locating suction dependentpatients

Ensure adequate supply alternatedrainage systems

Replace drain suction with manualvacuum or drainage bottles

Ensure small oxygen cylinder with twin-o-vac suction on resuscitation trolley

Educate staff on use of alternatedevices

Unit Manager

Nursing staff

Nursing staff


Nursing staff


D

Page - 81 28/08/2013



Failure of WelchAllen monitors

Unable to electronicallymeasure pt observations

Use manual sphygmomanometer


Ensure adequate number of manualsphygmomanometers


Unit Manager

Unit Manager

D










Unit ManagerNursing Staff

Nursing staff


D

Failure of LamsonSystem

Unable to transportspecimens

Revert to manual process Inform and educate staff Unit ManagerEducator D




Refer to safety and security plan.


Direct notification via phone to switch orrunner to Communication Centre tocontact fire services, security, police

Inform and educate Staff

Nursing staff

All staff

Unit Manager

D



Refer to safety and security plan. Inform and educate staff Unit ManagerD



Use on battery power if available

Use burettes

Consider alternate administrationroutes.

Charge on generator power if ableCharge batteries fully

Ensure adequate stock burettes

Protocols for alternative administration

All staffNursing staff

Nursing StaffNursing staffMedical staff

D

Page - 82 28/08/2013



Refrigeration(Connected toEmergencypower). Alert staffif no emergencypower to makeplans forrefrigerateddrugs.

Drugs and medicalsupplies requiringrefrigeration may becomeunusable


Use Eskies and ice

Review emergency power outlets

Monitor refrigerator temperature withthermometer

Consider purchase of eskies and supplyof iceInform and educate staffConsult with Pharmacy


Nursing staff

Unit ManagerInfection Control Staff


D

Pan roommacerator

Unable to dispose of bedpans / urinals adequately


Purchase sufficient for immobilepatients

Rinse with “grey/waste” water anddisinfect with chemical solution

Inform staff of Infection Control policy

Unit Manager

All staff

Unit ManagerInfection Control CNCEducator

A

Lift failure Unable to transportpatients to different levelswithin facility






Walk patients

Consider scoop stretchers, fireblankets, stair walkers, cardboardstretchersDevelop facility plan for locating newadmissions


Ensure all staff aware of facility Fire /Evacuation plan


Wards person

MHHS Executive

MHHS Executive

Medical staff

Unit Manager

D

Page - 83 28/08/2013





Send patient information byrunner/courier

Delay transfer of information untilservices resumed.

Unit Manager


D




Send original documents with patientand document in chart

Delay transfer of information untilservices resumed




D

Page - 84 28/08/2013


Mackay Breastscreen

MACKAY BREASTSCREENA = Up to 24hrsB = Up to 5 DaysC = IndefinitelyD = Cannot Operate


THIS SERVICELoss of Power Complete loss of

service deliveryAdvise public of servicecommunication problems throughthe media

Inform & Educate staff ManagerD


Unable to communicatewith clients to bookappointments

Advise the Public of servicecommunication problems throughthe Media

Administration staff to make clientappointments in person

ManagerD

EquipmentFailure

Failure ofMammographyUltrasound machinewould unable service toperform core businessof screening andassessment.Failure of IT equipmentwould unable service touse State wide database to access clientrecords

Service has 2 MammographyMachines and can continue toscreen with 1 machine down. IfUltrasound machine failed clientswould be booked for nextassessment clinic. If data basefailed bookings and data entrycan be entered at a later time.

If problem occurred at the time of taking amammogram radiographer is able tomanually release client from compression.BETS would be contacted to fix equipment.Client requiring ultrasound would berebooked when machine operational.Client info can be entered into data base ata later time

RadiographerData ManagerService Manager

A

Page - 85 28/08/2013


CSSDBased on emergency generator functioning. No emergency power to CSSD, lighting only No air-conditioning to CSSD when on generator.

CSSD DEPARTMENT


Problem Impact Contingency Task Responsibility

Failure of steamsteriliser. UseSterrad steriliseronly.

Unable to processtheatre/ward linen bundles.

Use disposable linen for allprocedures. Transport Sterrad totheatre to emergency power

Equipment nurse to facilitatepurchase costingsimplementation of disposablelinen.

NUMMHHS Executive.

Nowasher/disinfectorconnected toemergency power.

Unable to processreusable medicalequipment/instruments.

Manually wash all equipment. Explore the possibility ofconnecting of one machine toemergency power.

NUMEngineer

No dryersconnected toemergency power.

Difficulty drying adequatequantities of equipment toSterrad sterilisers.

Manually dry all equipment. Explore the possibility ofconnecting of one machine toemergency power.

NUMEngineer

Ward instrumentshortage.

Ward/A&E/ICU/shortage ofsterile instruments.

Purchase pre-prepared instruments Equipment nurse to facilitatepurchase/costings/implementation/ofinstrument packs.

Unit Manager

No red emergencypower points in thedepartment.

Unable to use anyequipment

Take equipment to theatre to use. Explore the possibility ofconnecting emergency power.

NUMEngineer

Failure of steriliser Unable to process wardand theatre instrumentsUnable to provide dentalservices

Ensure one steriliser on emergencypowerAlternative sterilisation methods

Rationalise service to emergency useonly

Identify emergency power supplyto sterilisersInvestigate alternativesterilisation methods eg ,chemical sterilisationEnsure full stock levels of sterileequipment available prior tocritical periodsIdentify and prioritise criticalservices


Unit Manager


Failure ofinstrument / tubewasher

Unable to cleaninstruments / tubes

Utilise disposable consumables usemanual methodRevert to manual process

Ensure stock at maximum levels

Manually wash instruments &tubes

Manager

Nursing staff

Page - 86 28/08/2013

CSSD DEPARTMENTA = Up to 24hrsB = Up to 5 DaysC = IndefinitelyD = Cannot Operate

Problem Impact Contingency Task Responsibility

Unable to disinfectanaesthetic ventilationtubing

Utilise disposable consumables Ensure stock at maximum levels Unit Manager

Failure ofinstrument / tubedryers

Unable to dry instrumentsand tubing effectively

Alternative strategies for drying

Sterilise instruments just in time foruse

Manually dry instruments & tubes

Air dry

Set up trays for immediate useand ‘flash sterilise’ as required

Nursing staff

Nursing staff

Nursing staff

Ward instrumentshortage

Shortage of sterileinstruments available towards

Have all available instrumentsprepacked in peel packs

Use disposable instruments andpacks

Purchase any additionalequipment if required

Purchase disposablesIdentify storage area for extrapacksNotify wards/units of contingency


Failure of sterilisedlinen service

No Sterile Linen bundles Have maximum stores available

Rationalise use of linenAlternative supplierUse disposable linen

Prepacked and ensure maximumstore of sterile linenDevelop a plan for rationingConsider alternative supplierOrder extra supplies ofdisposable linen

Unit Manager

Equipment function Unable to guaranteeequipment accuracy

Check all equipment for functionalityas soon as possible after disruption ofpower/failure of machines


Inform and educate staffUnit Manager

Page - 87 28/08/2013


Health Information Division

HEALTH INFORMATION UNIT



Failure HBCIS Medical Records& Request Tracking System

Unable to locate & sendmedical records

Ensure all records in fileprior to critical dates -presumes there is advancenoticeRun location by location forcharts not returned -providing power sufficient torun HBCISRevert to manualcommunication systems forrequesting medical recordsUse manual tracing system

Notify all MO’s/wards/deptsto return outstanding records(Antenatal excluded)

Manager to arrangeappropriate staff to completetask.

Notify hospital departmentsabout manual system

�Implement manual system

� (eg) tracer cards

Update system with changes& new registrations

Manager / Supervisor

HBCIS Data Manager



Administrative staff & WardClerks

Depends on the severity ofthe disaster

Manual allocation of URN’s Check backup PMI file is upto date - may not besufficient notification to dothis

Use backup PMI to look upexisting URN’s - may not besufficient notification to dothis

Manually allocate & look upURN’sUpdate system when systemback online

Print hard copy of PMI priorto critical date - may not besufficient notification to dothis

Failure of HBCIS Patient MasterIndex (PMI)

Cannot allocate new URNumbers

Cannot search forexisting URN’s

Manual process

Use the block of unissueddowntime UR numbers

Allocate downtime URnumbers

HBCIS Data Manager


HBCIS Data Manager


Depends on the severity ofthe disaster

Failure HBCIS Admission,Transfer, Discharge (ADT)

Cannot search ADT totrack patients

Not critical, wait untilsystem returns

Update System Administrative staff & WardClerks

C:Weeks – Indefinitely

Page - 88 28/08/2013

HEALTH INFORMATION UNIT



Cannot run enquiryreports

Keep hard copy list inMedical RecordsDepartment - may not besufficient notification to dothis

Have register and down timeforms available. Updatepatient list as needed


Update system when systemback online

Failure of Coding System Unable to enter codes

Unable to access reports

Copy codes to front sheetand use manual tally sheet(label & codes)Access when systemreturns

Update system when systemback on line

Clinical Coders

Clinical Coders

C:Weeks – Indefinitely

Equipment function H machine not working

Dumb Waiter notworking

Use manual record requestsystem

Revert to physical chartdelivered to EmergencyDepartment

Check all equipment forfunctionality as soon aspossible after disruption ofpower/failure of machinery

Supervisor/Administrative staff C:Weeks – Indefinitely

HBCIS Appointment Scheduling Unable to print reportsfor patients attendingclinics

Print reports one week inadvance where possible(Laptop)

Manual list of attendees HBCIS Data Manager

No access to activity data Unable to access reports Access when ssytemreturns

Retrospective updating ofdata

Decision Support Coordinator C:Weeks – Indefinitely

Unable to fax dischargesummaries

Unable to respond torequests from GP's forfollow up dischargeinformation

Hand write dischargesummaries. Give patients acopy on discharge

Post copy handwrittendischarge summaries toGeneral Practitioners

ROI OfficerC:

Weeks – Indefinitely

Flooding of Medical recordDepartment

Destruction of charts If possible move charts tosafe area

Arrange for staffing to movecharts

Manager C:Weeks – Indefinitely

Flooding/destruction of InactiveRecords Shed

Destruction of charts If possible move charts tosafe areaPrioritise charts to save

Arrange for staffing to movecharts

Manager C:Weeks – Indefinitely

Page - 89 28/08/2013


Corporate Support Services –Travel Office

TRAVEL OFFICEA = Up to 24hrsB = Up to 5 DaysC = IndefinitelyD = Cannot Operate


THIS SERVICELoss of Power Complete loss of

service deliveryUnable to book travel PSA clients advising of situation

Contact main referral hospitals to adviseManager

D

Loss of Phones Unable to communicatewith clients to booktravel

PSA to advise clients to present inperson

Business as usual if clients present ManagerB

EquipmentFailureTravel ManagerMFD

Complete loss ofservice delivery

Delay to processingtravel

Manual data input with data to beput in later

Use MFD in another Department,need fax re-diverted

Urgent travel only able to be booked

Business as usual

Manager D

B

Page - 90 28/08/2013


Information Division

INFORMATION DIVISION




Failure of primarydatacommunications toData Centre

No impact to applicationaccess, communicationsautomatically switches tobackup data communicationservice

Automatic switch over to Optusbackup link.

Switch over backupautomatic

ID Team leader

Failure of all datacommunications toData Centre

Loss of corporately hostedEnterprise Applications: egAuslab, EDIS, FAMMIS,internet, iPharmacy, QHEPS.Access to Groupwise andHBCIS unaffected

Escalate issue with EnterpriseOperation Centre

Liaise with EOC todetermine possiblealternate connectionoptions

ID Team leader

Failure ofEnterprise DataCentre

Loss of corporately hostedEnterprise Applications: egAuslab, EDIS, FAMMIS,internet, iPharmacy, QHEPS.Access to Groupwise andHBCIS unaffected

Pathology and Finance systemsdown – Departments revert tomanual system no availablecontingency.

Determine minimal levelof function

MHHS ExecutiveID Team leader

Failure ofHBCIS primaryserver

No access to HBCIS Revert to HBCIS standby server Switch over to standbyserverRestore normaloperation of HBCISPrimary server

ID Team Leader

SIM1/ID Team Leader

Failure ofHBCISapplication

No access to HBCIS Medical Records use backupPMI

Revert to HBCISPrimary ServerMedical Records revertto manual look upsystem.Medical Records revertto manual look upsystem.Restore operation ofHBCIS application

SIM1/ID Team Leader

Health Information Manager

SIM1/ID Team Leader

Page - 91 28/08/2013

INFORMATION DIVISION




Switch to manual businessprocesses if required

Inform business units ofissues and timeframes

Failure ofMackay BaseHospital FileServer

No access to G:/H: drives,network printing, server basedlocal applications eg RIPS

Restore server operation


If hardware failureinitiate vendor support -Investigate availablehardware replacementoptions as requiredIf software failure - Techops Directories/Novellfor assistanceIf required restore datafrom backupInform business units ofissues and timeframes

ID Team Leader/Businessunits

Failure ofMackay BaseHospitalGroupwiseServer

No access to Groupwise Restore server operation


If hardware failureinitiate vendor support -Investigate availablehardware replacementoptions as requiredIf software failure - Techops Directories/Novellfor assistanceIf required restore datafrom backupInform business units ofissues and timeframes

ID Team LeaderTechnical OperationsSupport vendor

INFORMATION DIVISION – DESKTOP SERVICES

Failure of LocalArea Network

Loss of access toEnterpise/Local applications

Restore network operation


If possible reconfigurenetwork to re-establishoperationInform business units ofissues and timeframes

ID Team LeaderEnterpirse Operation Centre

ID Team LeaderBusiness units

Page - 92 28/08/2013


Medical ImagingSome areas within Medical Imaging are connected to the emergency generator

MEDICAL IMAGINGA = Up to 24hrs B = Up to 5 DaysC = Indefinitely D = Cannot Operate


Loss of Power No CT Service.

Use alternateinvestigation ifpossible.Outsource tolocal privatepractices.

CT is ongenerator powerwill function aslong asgenerator isoperational.

Director of Medical Imaging, radiographers and Engineering staff. Up to 24hrs, maybe extendedin consultation with local private practices ability to provide alternate service

No X-RayService.

Key equipmenton UPS.EmergencyPower.Mobile x-rayunits.

Test andmaintain UPS.AssessEmergencypower for x-ray

Director of Medical Imaging, radiographers, Engineering staff and BTS staff.Indefinitely with reduced capacity as long as generators are operational.

No UltrasoundService.

Equipment onemergencypower. Usealternate test

Test andmaintain UPS.AssessEmergencyPower forUltrasound

Director of Medical Imaging, sonographers and Engineering staff.Indefinitely with reduced capacity as long as generators are operational.

Key Equipmentfailure.

No CT Service. Use alternateinvestigation ifpossible.Outsource tolocal privatepractices.

Ensureequipment ismaintained ingood workingorder throughregularscheduledservicing.

Director of Medical Imaging, radiographers and servicing agent.Up to 24hrs, maybe extended in consultation with local private practices ability to providealternate service

No X-RayService.

Use alternateunit.Mobile x-ray

Ensureequipment is

Director of Medical Imaging, radiographers and BTS Director.Indefinitely with reduced capacity as long as other like equipment remains operational.

Page - 93 28/08/2013



units. maintained ingood workingorder throughregularscheduledservicing.


Use alternateinvestigation ifpossible.Use alternativeU/S unit.Outsource tolocal privatepractices.

Ensureequipment ismaintained ingood workingorder throughregularscheduledservicing.

Director of Medical Imaging, sonographers and servicing agent.Indefinitely with reduced capacity as long as other like equipment remains operational.

MedicalImagingenvironmentunsafe

Service cannotbe provided inMedical Imaging.

Relocateultrasound units.Relocate mobilex-ray units.Relocate CoreCR Equipment.

Alternate site tobe identified.Mobile shieldinginstalled.Necessaryconsumablesrelocated.Emergencynetwork to beestablished. CToutsourced toLocal PrivatePractice.

Director of Medical Imaging, Medical Imaging staff, BTS staff, Information Division staff andEngineering staff.Up to 5 days with reduced service reflective of the capacity of alternate site

No CT Service.

Use alternateinvestigation.Outsource tolocal privatepractices.

Outsource toLocal PrivatePractice. Noonsitealternative.

Director of Medical Imaging and Medical Imaging staff.Up to 24hrs, maybe extended in consultation with local private practices ability to provide theservice

Page - 94 28/08/2013



Insufficientstaff

Unable toprovide sufficientand safe level ofservice.

Recall of allavailable staff asrequired.

Calculateindividual staffingrequirements.

Director ofMedical ImagingorOn callRadiographer.

Indefinitely but with a limited service.

Estimate staffingnumbersrequired for 24hour period.

Director ofMedical Imaging


Liaise with otherHHSs/CASS forextra staff.



Liaise with locumagencies forextra staff.



Page - 95 28/08/2013


Pathology Services.

PATHOLOGY SERVICES



Failure of PowerSupply

Laboratory unable tofunction without power


Use alternate testing facilityoutside organisation

Use of the iSTAT for urgenttests

Confirm availability of emergencypowerEnsure all critical equipmentsupplied with emergency powerRationalise all services toemergency requests onlySource alternate testing facilityoutside organisationFor example- Private lab orTownsville/RBH labsensure all UPS are charged andserviced.Ensure all iSTATs are placed onbattery recharger when not in use.Stock spare batteries (6-12batteries)

Lab. ManagerEngineering staff

Lab. Manager

Lab managerNUM's or person incharge of iSTAT onthe wards

Can function indefinityon emergency power

Hours

Loss of Watersupply

Major impact relating tothe Major ChemistryAnalyserUnable to maintain staffhygiene

No alternates to water

Use alternate solutions

• Ensure adequate stock available

Ensure adequate supplies of HexolEnsure adequate supplies bottledwater

Lab manager

Lab. ManagerInfection Control CNC

Can not operate

Temperaturemonitoring fails.

Unable to determineaccurate temperature ofBlood Stock Fridge andReagent Fridge.

Manual monitoring of fridgetemperature using portableprobe.

Install portable probe . Policy willdirect procedure if time becomesan issue

Develop policy on frequency oftemperature checksInform and educate staff

Lab. Manager

Lab. Manager

weeks

Failure of BloodBank Fridge

Unable to preserveintegrity of blood.

Transfer blood storeselsewhere

Investigate alternative storagesolutions.Private laboratories and Red Cross

Lab. Manager weeks

Page - 96 28/08/2013

PATHOLOGY SERVICES



Equipment Failure Unable to process bloodsamples

Use alternate testing facilityoutside organisation

Source alternate testing facilityoutside organisationInform medical/nursing staff

Lab. Manager weeks

EquipmentFunction


Check all equipment forfunctionality as soon aspossible after disruption ofpower/failure of machines



Lab. Manager

Lab. Manager

Can not operate

Page - 97 28/08/2013


Pharmacy

PHARMACY



Failure of Refrigerators /Deep Freeze

Spoilage ofpharmaceuticalsrequiring refrigeration /freezing

Ensure fridges and freezersconnected to emergencypower

Ensure fridges monitoredfor temperature

Check access to emergencygenerator power

Ensure On call pharmacistroster to respond tofridge/freezer failure alarm

Relocate stock to workingrefrigerators, cold rooms andfreezers

Pharmacy DirectorEngineering

Pharmacy Director

Pharmacy DirectorEngineerInfection Control Staff

within 30 minutes

within 30 minutes

one hour

Failure of air conditioning Unable to maintain airtemperature below 25'C

Ensure air conditioning forpharmacy connected toemergency power

Consider portable airconditionerHighlight potential inventoryfor destruction iftemperature extremeHigher load on fridges

Check availability ofemergency generator powerEnsure pharmacy is apriority area when airconditioning load shedscheduledArrange access to portableair conditionerContact Central Pharmacyfor direction

Monitor fridges



Pharmacist

Director of Pharmacy


six hours

Failure of computer IPharmacy notaccessible but localapplications okay

network printers notavailableiPharmacy access not atworkable speedPDE not available forimprest

Use fred5 label fordispensing, use hard copyrecoding for issues ifneededrestrict data entry toimmediate needs

print manual sheets asrequired or record manualdistributions

Have label available on localdrive

Have some label printers aslocal printers

print manual sheets as




pharmacy staff

Indefinite, more thanthree days will needcomplete stock take

when available

Indefinitely

Indefinitely

Page - 98 28/08/2013

PHARMACY



required or documentmanually

Indefinite, more thanthree days will needcomplete stock take

when availableNo lighting Not safe to operate Torch light available for

URGENT supply onlyTorches available insidegoods delivery door, afterhours room and safe

Director of Pharmacy URGENT supply only

No drug deliveries fromBrisbane

May not have drugavailable when required

Maintain stock levels toallow for supply chaininterruption of three daysObtain stock from SymbionTownsville

May need to cancelchemotherapy

Maintain max mins monthly

Ensure on line ordering fromSymbion is available



up to five days

Lack of pharmaciststaffing

Long delays in supply.Potential for increase inerror rateFatigue risk

Build in capacity intopharmacy staffing. Uselocum pharmacist.

Monitor staffing levels.Monitor availability of locums

Monitor working hours andrecall



Lack of pharmacy supportstaffing

Long delays in supply.Potential increase inerror rateFatigue risk

Build in capacity intopharmacy staffing. Usecasual staff.

Monitor staffing levelsMonitor availability of locumsMonitor working hours


No ability to deliver bulk IVfluids to wards

IV fluid may not beavailable when required

Adequate supply in wards

Backup forklift operators

Director of Pharmacy IV fluids bulk storage isnow a supply function

No proximity card accessto pharmacy

No access to pharmacyby prox card

nil

No forklift access to IV fluidsrestricted

Set locations of IV fluids instorage racks

Set locations of IV fluids instorage racks

Director of Pharmacy andSupply services

IV fluids bulk storage isnow a supply function

Page - 99 28/08/2013

.


Bowen Hospital – General & Clinical ServicesNOTE: The Standard Operating Procedures for the general wards and the MHHS Essential Services are to be used in conjunction with the specific procedures detailed below.

BOWEN HOSPITAL – GENERAL & CLINICAL SERVICES


Problem Impact Contingency Task Responsibility How long can youfunction withoutthis service?

HBCIS access failure Unable to registerpatients

No Patient IDlabelsUnableUnable to accessUR numbers andexisting medicalrecords

Manual registration

Manual process

Good history taking

Adequate supply downtime formsData Entry at return of serviceHand write requests

Filing at return to service

Admin. staff

Admin and Clinicalstaff

Admin and Clinicalstaff

B

A&E Module failure Unable to utiliseTRIAGE, treatmentandadmission/discharge screens

Manual recording. Adequate Supply of downtime triageforms. Data Entry at return of service

Admin. Staff

C

Printing services Failure Unable to recordstatisticalrequirements

Retrospective data entry Check and update missing data Admin.& NursingStaff C

Computer failure Unable to printresults / labels etc.

Unable to generateID labels

Unable to trackpatient location andbed status

Manual recording - lead to adequate staffnumbersRecord patient details manually


Ensure adequate staffing to coverworkloadEnsure supply of HBCIS downtimeformsPre –print labels on existing patientsHand write on Medical record andspecimens as requiredUpdate patient location and bedstatus at regular intervals

BusinessManager/Admin.Staff

Administrative andnursing staff

Administrative andnursing staff

B

B

Page - 100 28/08/2013




Telephone failure No internal /external telephonecommunications .

Access hand held radios from SES. UtiliseFire Panel Communication for internalcommunication.

contact SES DON or Delegate C

Cardex System 5hr battery back-upWhen back-uppower failureoccurs for extendedperiod. Access withCardex will not bepossible. SecurityVideo Surveillancewill discontinue.

Use back-up keys for door access. Inform and educate staff BusinessManager/DONNurse Unit Manager/Shift Team Leader

C

FAX Failure Unable to receiveor send patientinformation

Utilise alternate lines of communication Send patient information by courierDelay transfer of information untilservices resumed

Nurse UnitManager

Medical StaffAdministration Staff

B

Photocopier Failure Unable to copydocuments

Utilise alternate lines of communication Telephone information

Send original documents with patientand document in chartDelay transfer of information untilservices resumed

Nursing staff/Medical staff

B

Oxygen supplydisrupted

Use cylinder oxygen Ensure adequate suppliesEnsure all staff educated in cylinderchangeover.Consider co-locating high oxygenusers

OperationalOfficers

Wardsperson/Nurse UnitManager /Educator

Nursing staff/medical Staff

D

D

Failure of Refrigeration /cool rooms

Food spoilage referto Food Safety Plan

Essential fridges on emergency powerSource food off campus perhaps

Assess availability of emergencypower

Develop plan for preparation andtransport of food from other

Cook/BusinessManager

C

Page - 101 28/08/2013




Consider long life shelf products appropriate sourcesPurchase dry / tinned foodConsider purchase of long life milkConsider purchase of bottled waterfor drinking Cook/Business

Manager

B

Refrigeration - Vaccine Drugs and medicalsupplies requiringrefrigeration maybecome unusable

Place drugs in refrigerators which areconnected to emergency power supply

Review emergency power outlets andmanage vaccines as per infectioncontrol/vaccine managementguidelines.Monitor refrigerator temperature withthermometerInform and educate staffConsider purchase of eskies andsupply of ice

Nurse Nurse UnitManager/Engineering staff

Nursing staff

Nurse UnitManagerNurse UnitManager

A -B

Failure of Dishwashers Refer to FoodSafety Plan

Use disposables Adequate supply disposables Cook/BusinessManager

C

Loss of communicationwith pre-hospital/transfer services andreferral centres

Unable tocommunicate withQAS

Unable tocommunicate withlocal GP’s

Use alternate communication channels

Develop an alternate referral/dischargeprocess

Use alternate communication strategy

Consider use of Mobile Phone ifnetwork is operational, use of 2-wayradio from community eg CouncilDevelop criteria for referral based onavailable services

Develop pro forma for requiredpatient informationLetter and pro forma sent with patientfor admissionDischarge summary sent with patientat dischargeUse QAS radio to contact ambulancecommunications

Use mobile phone if network isoperationalUse satellite phoneUse ambulance radio

Nursing Staff

Nursing Staff

B

C

Page - 102 28/08/2013




Unable tocommunicate withClinical Coordinatorvia AMCOM repatient advice/transfer/ retrieval(RFDS, helicopter)

Unable tocommunicate withreceiving/ referringhospital

Use alternate communication strategy Instigate close observation of at riskpatients

Nursing Staff

Nursing Staff

C

B

C

Transport monitorsmalfunction

Unable to monitorcritically ill orunstable cardiacpatients in transit

Aim to have at least one complianttransport monitor or list of compliantmachines.Assess patients prior to critical dates.

Ensure one compliant transportmonitor available in central location

Schedule tests prior to critical dates

Assess pt need for transportCharge batteries

Nurse UnitManager

Medical staff

Nursing staff

D

B

Defibrillator malfunction Unable todefibrillate patients

Have compliant defibrillator available

Connect to emergency power

Use battery backup

Identify non compliant equipment

Aim to replace non compliantequipmentIdentify & re allocate compliantdefibrillatorInform & Educate staffIdentify existing emergency poweroutletsHave batteries fully charged

Nurse UnitManager

Nurse UnitManager

D

D

Medical equipmentfailure

Unable to providespecialised medicalequipmentBi-PAP/CPAPVentilators


Manual processBattery back-up if availableManual ventilation

Manual processManual process

Check existing emergency poweroutlets

Fully charge batteriesEnsure adequate staff available formanual ventilationWarm water bathPerform visual examinationTreat prophylactically

Nurse UnitManager

A

Page - 103 28/08/2013




Blood warmersSlit lamp

Plaster saw

Manual process Refer to ophthalmologistUse plaster cuttersApply a back slab

Nursing staffMedical staff C


Unable to identifyarrhythmias /oxygen saturation

Use on emergency power

Use battery backup

Increased nursing & medical observation

Check existing emergency poweroutletsIdentify non compliant equipmentAim to replace non compliantequipmentIdentify & position compliant monitorsensuring access to emergency powerEnsure adequate supply of batteries•Have batteries fully chargedIdentify & ensure adequate medical &nursing staff coveragePrioritise patients for monitoringInform and educate staff

Nurse UnitManager

Nurse UnitManagerNursing staff

D

D

Unable to providetransport services

Pathology servicesnot available

Identify and rationalise use of availablevehicles

Discontinue non-essential services

Develop a plan for centralising vehicles

Prioritise useNotify clients of potential fordisruption to normal servicesRe–admit at risk patients if necessary

Business manager C

Failure of EFTPOS fuelcard service

Arrange credit facility Liaise with local fuel distributor for credit facilities for fleet vehicles

Business manager C

Overcrowding ofhospital campus

Spread of disease Planned areas for habitation Allocate areas for use by public DON C

Staff dislocated fromfamily

Distress to staff Plan for accommodation Allocate staff accommodation (work &living for staff)

DON/NUM/BM C

Disease outbreak Infected persons Vaccines Plan for vaccines, fact sheets DON/MBH/AHS/TPHU

C

Waste Disposal Vector BorneDisease Infections

Sprays for insects. Antiseptics Assign contractors for pest control TPHU C

Lack of PublicKnowledge

Suspicion -Concerned Public

Stockpile of HP Material Stockpile PH MaterialMedia person to duties

BM/NUM/DON/TPHU

C

Loss of ability to protectstaff and patients

Duress alarms Provide alternative alert system for nursesAim to have fire alarms compliant

Purchase hand held audible alarmsand/or whistles

Nursing staff B

Page - 104 28/08/2013




Fire alarmsProvide alternative power source foralarmsEnsure all staff have recent fire safetytraining

Check fire alarms

Ensure alarms are connected togenerator powerLiaise with Fire Department

BM/FSA



Unable to regulatetemperature andenvironment



Enter data when system fixed

Use alternate cooling devices (eg.)

Calculate individual unit staffingrequirements

Identify human resources able to beon call and redeployed in the facilityAssess competence of on call staffCourier to collect results

Develop means for notification of lab& test resultsManual ordering testsEnsure retrospective data entry whencomputer services resumePosition fans for maximum benefitOpen Windows as a requirement

Director Of NursingNurse UnitManagerBusiness Manager

Operational Staff

Nurse UnitManager & Labstaff

Medical & nursingstaff

Nursing staff

B

B

Air conditioning failure Electrical or manual fan Identify patients requiring cooling,Use windows. Notify and informpatients and staff. All staff B


Use alternate suction devices Assess need for and number ofportable suction units requiredConsider co-locating suctiondependent patientsEnsure adequate supply alternatedrainage systemsReplace drain suction with manualvacuum or drainage bottles

NUM

Nursing staff

B

Page - 105 28/08/2013





Bloods to path as transport available

Ensure small oxygen cylinder withtwin-o-vac suction on resuscitationtrolleyEducate staff on use of alternatedevicesDevelop policy for formal laboratorytest

Nursing staff

Unable to use ISTAT Unable to diagnosepotential life-threateningconditions

Ensure access to emergency power Identify access to emergency poweroutlet

Nurse UnitManager /Engineering staff

D

Failure of 12 lead ECG machine

Unable to provide safe and secureenvironment



Keep batteries fully charged onemergency powerInform and educate staffSchedule regular patient rounds

Nurse UnitManager /NursingStaff

D


Patients unable tosummonassistance

Utilise bells with capable patients Inform and educate Staff and Patients Nurse UnitManager

B



Refer to safety and security plan. More regular rounds of patients in thedepartment. Inform and educate staffand patients

Nurse UnitManager

B


Staff unable totitrate medicationsand fluidsaccurately

Difficulties withlifting heavypatients – manualhandling injuries

Use on battery power if available.

Use burettes

Consider alternate administration routes.Identify alternate lifting devices


Ensure adequate stock burettesProtocols for alternativeadministrationUse hydraulic lifting devices ifavailable

All staff Nursingstaff

C

Failure of lifting devices Use of slide sheets, pat slide, slidaperson etc.

All staff C

Macerators Unable to disposeof used pans andurinals

Utilise supply of washable pans andurinals. Manual Cleaning

Scrub and/or soak. Encourage use oftoilet as much as possible.

All clinical staff B

Page - 106 28/08/2013

Business Continuity PlanBowen Hospital – Utilities Services

BOWEN HOSPITAL - UTILITIES SERVICES



Loss of LPG supply

Unable to providecooking facilities

Secure LPG site and implementretrieval/disposal of hazardous material

Arrange urgent supply of portable LPGcylindersUse alternate energy source Gas Cook topor BBQ

Staff Education

Engineer to establish security of thesite and risk assess immediateneeds.Identify number of cylinders requiredand allocate as per priority listing.Arrange for supplier to fill storagetanks if not damagedIdentify alternate energy sources forcookingEducate staff on contingency plans

BM/Groundsman A

Oxygen supply disrupted Use cylinder oxygen Ensure adequate supplies BM/Groundsman A

Inability to supply mainspower to facilities

Unable to providehot water

Emergency power generation

Heat water with alternate energy sourceGas Quick heat water heater.Wash / clean with cold water

Ration use of emergency power

Identify existing supply of emergencypower generationRefer to power points/ outlets withemergency generation in each areaConfirm essential equipment onlyconnected to generator power outletsEnsure essential lights andequipment.Ensure access to extension leadsContact Contractor to ensureadequate fuel source for use ofgeneratorIdentify alternate energy sources forwater heatingIdentify cleaning processes that canuse cold water or use disposableware.Identify alternate washing regime forpatient hygiene Utilise "Bed Bath"productsEnsure fuel storage standards aremaintained.Identify generator load capacity

BM/Groundsman

Nurse UnitManager

BM/Groundsman

Nurse Unit

A

A

Page - 107 28/08/2013




Use alternate power sources

Supply additional lighting

Discharge/ relocate patients within facility

Consider activation of MHHS Disaster Plan

Close Facility

Staff Education

Fully charge batteries on all essentialequipmentLocate/purchase torches/ lanternsand batteriesUse natural lighting -open windowsand doorsIdentify patients for discharge orrelocationConsult current MHHS Disaster Planfor processInform and educate staffLiaise with alternative serviceprovider for care of patientsTransfer patients out & close facility

Educate staff on contingencyarrangements

Manager

MHHS Manager

MHHS Manager/MedicalSuperintendentMHHS ManageronlyEducate staff oncontingencyarrangements

Loss of water supply forgeneral use, e.g., toilets,patient hygiene

Liaise with LocalCouncil Authorityre supplies ofwater.

Loss of MaceratorfunctionLoss of drinkingwater

ContingencyFailure

Ration water usage

Identify alternative water sources

Identify alternative supplies of drinkingwaterSee Worksheet "General"



Use emergency supply

Close facility

Rationalise services and develop planfor water restriction

Source / cost alternate supplies, e.g. /Water tankers / Fire service supplyInitiate use of alternate supplyConsider purchase of bottled water

Unable to use.

Buy containers for storage ofdrinkable water

Identify patients for discharge orrelocationLiaise with local council / utilities reemergency water supplyLiaise with alternative serviceprovider for care of patient

MHHS Executive

ManagerEngineering

All clinical staff

MHHS Manager

A

D

A

Page - 108 28/08/2013




Staff education Transfer patients out and close facilityEducate staff on contingency

Sewerage Unable to disposeof waste productsdue to waterfailure

Ensure facility wide plan Develop facility plan for wastedisposal

MHHS Executive D

Ensure Local Council andPublic Health Unitinvolvement.

Failure ofcontingency

Utilise “grey/used” water

Designate toilets to be used

Alternate toilet facilities



Close facility

Staff education

Inform staff to save water after patienthygienePlace bucket for used water in eachtoilet cubicle for flushing purposesClose off toilets not for use and postsignsIdentify alternate toilet devices e.g.,porta loos, and number requiredSource supply / cost of alternatedevicesRinse with “grey/waste” water andchemical solutionInform staff of Infection Control policy

Identify patients for discharge orrelocationConsult current MHHS Disaster Planfor processLiaise with local council / utilities reemergency water supplyArrange for septic tank pumping truckto pump sewerage out of hospitalpipes

Liaise with alternative serviceprovider for care of patientTransfer patients out, close facilityEducate staff on contingency plans

Nurse UnitManagerOperationalServicesNUM

ManagerEngineering

Nurse UnitManager/ InfectionControl CNC

MHHS Manager /ManagerEngineering

MedicalSuperintendent

Nurse UnitManager /Managers

D

D

Power failure Mains power notavailable.Generator

Refer to mains power failure plan Inform and educate staff DON/NUM/BM/Engineering

B

Page - 109 28/08/2013




suppliesemergency power

Lighting failure Difficulties inpatientobservation andcare.


Nosafety/evacuationlighting available





Provide additional portable lighting

Identify provision for emergencylighting

Relocate immobile patients to best litareasClean and maintain windows andfittingsEnsure blinds/curtains openEnsure adequate supply torches /battery operated lights and batteries

Clear patient areas, work areas andcorridors of all hazardsIdentify and source alternative lighting

Staff member to place lighting instrategic areas for safetyIssue clinical staff with torches

Engineering staff

Nursing staff

Nurse UnitManager

Nurse UnitManager /All staffNurse UnitManager /All staff

B

Page - 110 28/08/2013


Clermont Hospital - General

Clermont HOSPITAL - GENERAL




Manual registration Adequate supply downtimeforms

Administration staff B

A&E Module failure No patient ID labels

Unable to utiliseTRIAGE, treatment andadmission/dischargescreensUnable to recordstatistical requirements

Manual process

Manual recording. Nowritten record of Ur nosmaintained on site

Retrospective data entry

Hand write requestsEnsure blank labels areavailableEnsure details are recordedin chart

Check and update missingdata

Administration staff

Administration StaffNursing Staff

B

C

Printing services Failure Unable to print results /labels etc.

Manual recording - lead toadequate staff numbers

Ensure adequate staffing tocover workload

Business ManagerAdministration staff

B






Ensure supply of HBCISdowntime formsPre –print labels on existingpatientsHand write on blank labelsfor new admissionsUpdate patient location andbed status at regularintervalsUpdate patient diet lists andhave available for collectionby catering services


Nursing staff

B

C

C



Inform and educate staff Nurse Unit MangerDirector of NursingNursing staff

C

FAX Failure Unable to receive orsend patient information


Send patient information bycourierDelay transfer of informationuntil services resumed.

Nurse Unit MangerDirector of NursingAdministrative StaffNursing staff

B

B

Page - 111 28/08/2013








Administrative StaffNursing staffNursing staffMedical staff

Medical staff

B

Oxygen supply disrupted Use cylinder oxygen Ensure adequate suppliesEnsure all staff educated incylinder changeover.Consider co-locating highoxygen users

Operational OfficersNurse Unit ManagerDirector of Nursing D


Food spoilage refer toFood Safety Plan

Essential fridges onemergency powerSource food off campusperhaps

Consider long life shelfproducts

Assess availability ofemergency powerDevelop plan for preparationand transport of food fromother appropriate sourcesPurchase dry / tinned foodConsider purchase of longlife milkConsider purchase of bottledwater for drinking

Cook/Business ManagerFacility Manager

B



Use Eskies and ice

Review emergency poweroutlets and managevaccines as per infectioncontrol/vaccine managementguidelines.Monitor refrigeratortemperature withthermometerUtilise SBVP EskyInform and educate staff

Nurse Unit ManagerDirector of NursingEngineering staff

Nurse Unit Manager

A

C

Failure of Dishwashers Refer to Food SafetyPlan

Use disposables Adequate supplydisposables

Cook/Business ManagerDirector of Nursing

C

Loss of communicationwith pre-hospital/ transferservices and referralcentres

Unable to communicatewith QAS

Use alternatecommunication channels

Consider use of MobilePhone if network isoperational, use of 2-wayradio from community egCouncil Nursing Staff

B

Page - 112 28/08/2013




Unable to communicatewith local GP’s

Unable to communicatewith Clinical Coordinatorvia AMCOM re patientadvice/ transfer/ retrieval(RFDS, helicopter)Unable to communicatewith receiving/ referringhospital

Develop an alternatereferral/discharge process

Use alternatecommunication strategy


Develop criteria for referralbased on available servicesDevelop pro forma forrequired patient informationLetter and pro forma sentwith patient for admissionDischarge summary sentwith patient at dischargeUse QAS radio to contactambulance communicationsUse mobile phone if networkis operationalUse satellite phoneUse ambulance radio

Instigate close observationof at risk patients

Nursing Staff

Nursing Staff

C

C

C


Unable to monitorcritically ill or unstablecardiac patients in transit

Aim to have at least onecompliant transport monitoror list of compliantmachines.Assess patients prior tocritical dates.

Ensure one complianttransport monitor availablein central location

Schedule tests prior tocritical datesAssess pt need for transportCharge batteries

Nurse Unit ManagerDirector of Nursing Medicalstaff

Medical staff

D

Defibrillator malfunction Unable to defibrillatepatients

Have compliant defibrillatoravailable

Connect to emergencypowerUse battery backup

Identify non compliantequipmentAim to replace noncompliant equipmentIdentify & re allocatecompliant defibrillatorInform & Educate staffIdentify existing emergencypower outletsHave batteries fully charged

Nurse Unit ManagerDirector of Nursing Medicalstaff

D

Medical equipment failure Unable to providespecialised medicalequipmentBi-PAP/CPAP


Manual process

Check existing emergencypower outlets

Use black bag closed circuit

Nurse Unit ManagerDirector of Nursing

Nurse Unit Manager

C

Page - 113 28/08/2013




Ventilators

SpirometerSlit lamp

Plaster saw

Battery back-up if available

Manual ventilation

Use alternate equipment

Manual process

with 100% oxygenFully charge batteriesUse alternate oxygen drivenventilator

Ensure adequate staffavailable for manualventilationEnsure equipment isavailableUse peak flow metersPerform visual examinationTreat prophylacticallyRefer to ophthalmologistUse plaster cuttersApply a back slab

Director of NursingMedical staff

Nurse Unit ManagerDirector of NursingNursing staff

Nursing staff

Nursing staff

C

A

A

C

C




Use battery backup



Identify non compliantequipmentAim to replace noncompliant equipmentIdentify & position compliantmonitors ensuring access toemergency powerEnsure adequate supply ofbatteries• Have batteriesfully chargedIdentify & ensure adequatemedical & nursing staffcoveragePrioritise patients formonitoringInform and educate staff



Nurse Unit ManagerDirector of NursingNurse Unit Manager Directorof Nursing


D

D

D

DD


Linen, pathologyservices not available

Identify and rationalise useof available vehicles

Develop a plan forcentralising vehicles

Business manager C

Page - 114 28/08/2013




Discontinue non-essentialservices

Prioritise useNotify clients of potential fordisruption to normal servicesRe–admit at risk patients ifnecessary

Medical staff C


Arrange credit facility Liaise with local fueldistributor for credit facilitiesfor fleet vehicles

Business managerDirector of Nursing

C

Unable to transportsupplies from/to facility

Use alternate methods fortransport of supplies

Identify and engage externalcontractors


C

Overcrowding of hospitalcampus

Spread of disease Planned areas forhabitation

Allocate areas for use bypublic

Director of Nursing C


Distress to staff Plan for accommodation Allocate staffaccommodation (work &living for staff)

Director of NursingNurse Unit Manager Businessmanager

C

Disease outbreak Infected persons Vaccines Plan for vaccines, factsheets

Public Health Unit C

Waste Disposal Vector Borne DiseaseInfections

Sprays for insects.Antiseptics

Assign contractors for pestcontrol


Lack of Public Knowledge Suspicion - ConcernedPublic


Director of NursingMHHSPublic Health Unit

C


Duress alarms

Fire alarms

Provide alternative alertsystem for nurses

Aim to have fire alarmscompliant

Provide alternative powersource for alarms

Ensure all staff have recentfire safety training

Purchase hand held audiblealarmsConsider purchase ofwhistlesCheck fire alarms

Ensure alarms areconnected to generatorpowerLiaise with Fire Department

Nursing staff

Nurse Unit ManagerEngineering staffBusiness Manager

Manager Engineering

Director of NursingNurse Unit Manager BusinessManager

CWith appropriate

security

CWith appropriate

security

C

Insufficient staff Unable to provide safelevel of care in the event

Roster additional staff Calculate individual unitstaffing requirements

Director of NursingNurse Unit Manager Business B

Page - 115 28/08/2013




of equipment failure




Identify human resourcesable to be on call andredeployed in the facilityAssess competence of oncall staffCourier to collect results

Develop means fornotification of lab & testresultsManual ordering tests

Ensure retrospective dataentry when computerservices resume

Manager

Operational Staff

Nurse Unit Manager & Labstaff

Medical StaffNursing staffNursing staff

B

B




Position fans for maximumbenefit

Identify patients requiringcoolingInform and educate staff

Nursing staff

Nursing staff

Nurse Unit Manager

B

B




Assess need for and numberof portable suction unitsrequiredConsider co-locating suctiondependent patientsEnsure adequate supplyalternate drainage systemsReplace drain suction withmanual vacuum or drainagebottlesEnsure small oxygencylinder with twin-o-vacsuction on resuscitationtrolleyEducate staff on use ofalternate devices

Nurse Unit Manager

Nursing staff

Nursing staff


B

B

D

Page - 116 28/08/2013




Unable to use ISTAT Bloods to path Develop policy for formallaboratory test

Medical staff C






Keep batteries fully chargedon emergency powerIdentify location ofalternative ECG machinesInform and educate staff

Nurse Unit ManagerDirector of NursingEngineering staff

Nursing staff

Nurse Unit Manager

D

D





Schedule regular patientroundsInform and educate Staff

Nursing staff


C




More regular rounds ofpatients in the department.Inform and educate staff


C





Charge on generator powerif ableCharge batteries fullyEnsure adequate stockburettesProtocols for alternativeadministration



C

C

CFailure of lifting devices Difficulties with lifting

heavy patients – manualhandling injuries


Use hydraulic lifting devicesif availableUse of slide sheets, patslide, slida person etc.Ensure staff trained inmanual handling

All staff

All staff

Nurse Unit Manager Back carefacilitator/Hinterland Educator

C




Nurse Unit ManagerAll staff

Nurse Unit Manager Directorof NursingInfection Control CNC forMHHS

C

C

Page - 117 28/08/2013

Business Continuity PlanClermont Hospital – Utilities Services

CLERMONT HOSPITAL - UTILITIES



Loss of LPG supply


Unable to provide hotwater

Secure LPG site andimplement retrieval/disposalof hazardous materialArrange urgent supply ofportable LPG cylinders

Use alternate energysource Gas Cook top orBBQHeat water with alternateenergy source Gas Quickheat water heater.Wash / clean with coldwater

Dishwasher heats ownwaterStaff Education

Engineer to establishsecurity of the site and riskassess immediate needs.Identify number of cylindersrequired and allocate as perpriority listingArrange for supplier to fillstorage tanks if notdamagedIdentify alternate energysources for cooking

Identify alternate energysources for water heating

Identify cleaning processesthat can use cold water oruse disposable ware

Identify alternate washingregime for patient hygieneNo remedial action required

Educate staff oncontingency plans

Manager Engineering/Director of Nursing

Manager Engineering

Manager Engineering

Business manager/Director ofNursing

Manager Engineering

Manager EngineeringBusiness ManagerDirector of NursingBusinessManager/Cook/Director ofNursing

A

A

A

A

B

B

Oxygen supply disrupted Use cylinder oxygen Ensure adequate supplies Operational Officers/ BusinessManager

A


Emergency powergeneration

Identify existing supply ofemergency powergenerationRefer to power points/outlets with emergencygeneration in each area

Manager Engineering

Manager EngineeringDirector of Nurse UnitManager

A

Page - 118 28/08/2013




Ration use of emergencypowerUse alternate powersourcesSupply additional lighting

Discharge/ relocate patientswithin facility

Confirm essential equipmentonly connected to generatorpower outletsEnsure essential lights andequipment supplied.Consider need to purchaseextension leadsDevelop a procedure for useof emergency power in eacharea and inform staffContactEngineering/Contractor toensure adequate fuel sourcefor use of generatorEnsure fuel storagestandards are maintainedIdentify generator loadcapacityFully charge batteries on allessential equipmentLocate/purchase torches/lanterns and batteriesInform and educate staff

Manager Engineering

Nurse Unit ManagerNurse Unit Manager

Manager Engineering

Manager Engineering

Nurse Unit Manager

Nurse Unit Manager

All Managers

A

A

A

A

A

A

Consider activation ofMHHS Disaster PlanClose Facility

Staff Education

Consult current MHHSDisaster Plan for processLiaise with alternativeservice provider for care ofpatientsTransfer patients out & closefacilityEducate staff oncontingency arrangements

MHHS Manager

MHHS ManagerMedical Superintendent

MHHS Manager only

Nurse Unit Manager

A

A


Liaise with LocalCouncil Authority resupplies of water.

Ration water usage

Identify alternative watersources

Rationalise services anddevelop plan for waterrestrictionSource / cost alternatesupplies, e.g. / Watertankers / Fire service supply

MHHS ExecutiveManager EngineeringDirector of Nursing

A

Page - 119 28/08/2013




Loss of drinking water

Contingency Failure

Identify alternative suppliesof drinking water


Consider activation ofMHHS Disaster PlanUse emergency supply

Close facility

Staff education

Initiate use of alternatesupplyConsider purchase of bottledwaterLiaise with Renal DialysisUnit to save empty dialysatecontainers for water storageBuy containers for storage ofdrinkable waterIdentify patients fordischarge or relocationConsult current MHHSDisaster Plan for processLiaise with local council /utilities re emergency watersupplyLiaise with alternativeservice provider for care ofpatientTransfer patients out andclose facilityEducate staff oncontingency

Manager Engineering

MHHS ExecutiveManager Stores

Business Manager

Medical Superintendent

MHHS Manager

MHHS Manager

MHHS Manager / MedicalSuperintendent

A

A

A

A

Sewerage Unable to dispose ofwaste products due towater failure

Ensure facility wide plan Develop facility plan forwaste disposal

MHHS Executive D

Ensure Local council andPublic Health Unitinvolvement.




Single patient use bedpans/

Inform staff to save waterafter patient hygienePlace bucket for used waterin each toilet cubicle forflushing purposesClose off toilets not for useand post signsIdentify alternate toiletdevices e.g., porta loos, andnumber requiredSource supply / cost ofalternate devicesPurchase sufficient for

Nurse Unit ManagerOperational Services


Manager Engineering

Manager Engineering

Nurse Unit Manager

D

D

D

D

Page - 120 28/08/2013




Failure of contingency

urinals

Discharge/ relocate patientswithin facilityConsider activation ofMHHS Disaster Plan

Close facility

Staff education

immobile patientsRinse with “grey/waste”water and chemical solutionInform staff of InfectionControl policyIdentify patients fordischarge or relocationConsult current MHHSDisaster Plan for processLiaise with local council /utilities re emergency watersupplyArrange for septic tankpumping truck to pumpsewerage out of hospitalpipesLiaise with alternativeservice provider for care ofpatientTransfer patients out, closefacilityEducate staff oncontingency plans

All staff


MHHS ManagerManager Engineering

Manager Engineering


Nurse Unit Manager/FacilityManager/ Managers

D

D

D

Power failure Mains power notavailable. Generatorsupplies emergencypower


Inform and educate staff DON/ NUM/BM/Engineering B







Identify provision foremergency lightingRelocate immobile patientsto best lit areasClean and maintain windowsand fittingsEnsure blinds/curtains openEnsure adequate supplytorches / battery operatedlights and batteriesClear patient areas, workareas and corridors of all

Engineering staff

Nursing staff

Operational Staff

All staffNurse Unit Manager/Directorof NursingNUM/ All staff

B

B

Page - 121 28/08/2013




No safety/evacuationlighting available

Provide additional portablelighting

hazardsIdentify and sourcealternative lightingStaff member to placelighting in strategic areas forsafetyIssue clinical staff withtorches

NUM/All staff

Page - 122 28/08/2013


Monash Lodge Clermont - General

Monash Lodge - GENERAL










B








Nursing staff

B

C

C



Inform and educate staff Clinical NurseNurse Unit ManagerDirector of NursingNursing staff

C



Send patient information bycourierDelay transfer of informationuntil services resumed.

Clinical NurseAdministrative StaffNursing staff

B

BPhotocopier Failure Unable to copy

documentsUtilise alternate lines ofcommunication




Medical staff

B

Oxygen supply disrupted Use cylinder oxygen Ensure adequate suppliesEnsure all staff educated in

Operational OfficersClinical Nurse

Page - 123 28/08/2013




cylinder changeover.Consider co-locating highoxygen users

Nurse Unit Manager D






Cook/Business Manager/Director of Nursing

B

Refrigeration - Drugs and medicalsupplies requiringrefrigeration maybecome unusable


Use Eskies and ice

Review emergency poweroutlets and manage as perinfection control/management guidelines.Monitor refrigeratortemperature withthermometerUtilise SBVP EskyInform and educate staff

Clinical NurseNurse UnitManager/Engineering staff

Clinical Nurse

A

C



Cook/Business Manager C

Loss of communicationwith pre-hospital/ transferservices and referralcentres



Unable to communicate



Use alternate

Consider use of MobilePhone if network isoperational, use of 2-wayradio from community egCouncilDevelop criteria for referralbased on available servicesDevelop pro forma forrequired patient informationLetter and pro forma sentwith patient for admissionDischarge summary sentwith patient at dischargeUse QAS radio to contact

Nursing Staff

Nursing Staff

B

C

C

Page - 124 28/08/2013




with receiving/ referringhospital

communication strategy


ambulance communicationsUse mobile phone if networkis operationalUse satellite phoneUse ambulance radio


Nursing Staff C






Clinical Nurse, Nurse UnitManager Medical staff

Medical staff

D

Medical equipment failure

Failure of Monitorsoximetry


Use on emergency powerUse battery backup



Identify non compliantequipmentAim to replace noncompliant equipmentIdentify & position compliantmonitors ensuring access toemergency powerEnsure adequate supply ofbatteries• Have batteriesfully chargedIdentify & ensure adequatemedical & nursing staffcoveragePrioritise patients formonitoringInform and educate staff

Clinical Nurse Consultant



Clinical Nurse ConsultantDirector of Nursing

Clinical Nurse ConsultantClinical Nurse Consultant

D

D

D

DD

Page - 125 28/08/2013








Develop a plan forcentralising vehiclesPrioritise useNotify clients of potential fordisruption to normal servicesRe–admit at risk patients ifnecessary


Medical staff

C

C



Business manager C




Business manager C

Overcrowding of MonashLodgecampus






Director of NursingClinical NurseBusiness manager

C


Public Health UnitDirector of Nursing

C




Public Health UnitDirector of Nursing

C




C


Duress alarms

Fire alarms






Ensure alarms areconnected to generatorpowerLiaise with Fire Department

Nursing staff

Clinical NurseNurse Unit ManagerDirector of Nursing

Engineering staffBusiness Manager

Manager Engineering

Director of NursingClinical Nurse /Business mgr

CWith appropriate

security

CWith appropriate

security

C

Page - 126 28/08/2013




Insufficient staff Unable to provide safelevel of care in the eventof equipment failure









Director of NursingClinical Nurse, Nurse UnitManager Business Manager

Operational Staff

Clinical Nurse & Lab staff


B

B

B






Nursing staff

Nursing staff

Clinical NurseNurse Unit Manager

B

B

Educate staff on use ofalternate devices


Medical staff C






Nursing staff

Clinical NurseC





Clinical Nurse C

Page - 127 28/08/2013






Use hydraulic lifting devicesif availableUse of slide sheets, patslide,slida person etc.Ensure staff trained inmanual handling

All staff

All staff

CNBack care facilitatorHinterland Educator

C




Clinical Nurse

All staff

CNInfection Control CNC

C

C

Page - 128 28/08/2013

Business Continuity PlanMonash Lodge Clermont – Utilities Services

MONASH LODGE - UTILITIES



Loss of LPG supply











Manager EngineeringDirector of Nursing

Manager EngineeringDirector of Nursing

Manager Engineering

Business manager

Manager Engineering

Manager EngineeringBusiness ManagerClinical NurseBusiness Manager/Cook

A

A

A

A

B

B

Oxygen supply disrupted Use cylinder oxygen Ensure adequate supplies Operational Officers/ BusinessManager/Director of Nursing

A




Manager Engineering

Manager EngineeringClinical NurseClinical Nurse

A

Page - 129 28/08/2013







Manager Engineering

Clinical NurseClinical Nurse

Manager Engineering

Manager Engineering

Nurse Unit Manager

Nurse Unit Manager

All Managers

A

A

A

A

A

A


Staff Education


MHHS Manager


MHHS Manager only

Clinical Nurse, Nurse UnitManager

A

A



Ration water usage



MHHS ExecutiveManager EngineeringDirector of Nursing

A

Page - 130 28/08/2013





Contingency Failure




Close facility

Staff education


Manager Engineering


Business Manager


MHHS Manager

MHHS Manager


A

A

A

A



MHHS Executive D








Operational Services

Clinical Nurse, Nurse UnitManagerDirector of Nursing

Manager Engineering

Manager Engineering

D

D

D

D

Page - 131 28/08/2013





urinals


Close facility

Staff education


Clinical Nurse, Nurse UnitManagerDirector of Nursing

All staff



Manager Engineering


Clinical Nurse / Managers

D

D

D



Inform and educate staff DON/ NUMBM/Engineering B





Identify provision foremergency lightingRelocate immobile patientsto best lit areasClean and maintain windowsand fittingsEnsure blinds/curtains openEnsure adequate supplytorches / battery operatedlights and batteries

Engineering staff

Nursing staff

Operational Staff

All staffClinical Nurse, Nurse UnitManagerDirector of Nursing

B

B

Page - 132 28/08/2013








Clear patient areas, workareas and corridors of allhazardsIdentify and sourcealternative lightingStaff member to placelighting in strategic areas forsafetyIssue clinical staff withtorches

CN / NUM/DON All staff

CN/NUM/DON/All staff

Page - 133 28/08/2013


Collinsville Hospital - General

COLLINSVILLE HOSPITAL - GENERAL






A&E Module failure No patient ID labels

Unable to utiliseTRIAGE, treatment andadmission/dischargescreensUnable to recordstatistical requirements

Manual process

Manual recording. Nowritten record of Ur nosmaintained on site


Hand write requestsEnsure blank labels areavailableEnsure details are recordedin chart

Check and update missingdata

Administration staff

Administration StaffNursing Staff

B

C





B









Nursing staff

B

C

C



Inform and educate staff NUM/DONNursing staff

C

Tape recorder failure Unable to pre-recordpatient handover

Revert to verbal handover Designate time, venue andprocedure for verbal hand-over

NUM/DON C



Send patient information bycourier

Nurse Unit ManagerAdministrative Staff

B

Page - 134 28/08/2013




Delay transfer of informationuntil services resumed.

Nursing staffB






Medical staff

B

Oxygen supply disrupted Use cylinder oxygen Ensure adequate suppliesEnsure all staff educated incylinder changeover.Consider co-locating highoxygen users

Operational OfficersClinical Nurse Consultant

D






Cook/Business Manager B



Use Eskies and ice

Review emergency poweroutlets and managevaccines as per infectioncontrol/vaccine managementguidelines.Monitor refrigeratortemperature withthermometerUtilise SBVP EskyInform and educate staff

Clinical NurseConsultant/Engineering staff

Nurse Unit Manager/DON

A

C



Cook/Business Manager C

Loss of communicationwith pre-hospital/ transfer



Consider use of MobilePhone if network is

B

Page - 135 28/08/2013




services and referralcentres


Unable to communicatewith Clinical Coordinatorvia AMCOM re patientadvice/ transfer/ retrieval(RFDS, helicopter)Unable to communicatewith receiving/ referringhospital




operational, use of 2-wayradio from community egCouncilDevelop criteria for referralbased on available servicesDevelop pro forma forrequired patient informationLetter and pro forma sentwith patient for admissionDischarge summary sentwith patient at dischargeUse QAS radio to contactambulance communicationsUse mobile phone if networkis operationalUse satellite phoneUse ambulance radio


Nursing Staff

Nursing Staff

Nursing Staff

C

C

C






NUM/DON Medical staff

Medical staff

D

Defibrillator malfunction Unable to defibrillatepatients

Have compliant defibrillatoravailable

Connect to emergencypowerUse battery backup

Identify non compliantequipmentAim to replace noncompliant equipmentIdentify & re allocatecompliant defibrillatorInform & Educate staffIdentify existing emergencypower outletsHave batteries fully charged

NUM/DON Medical staff D

Page - 136 28/08/2013




Medical equipment failure Unable to providespecialised medicalequipmentBi-PAP/CPAP

Ventilators

Blood warmersBiers machineLevel 1 transfuser

SpirometerSlit lamp

Plaster saw


Manual process


Manual ventilation


Manual processManual process

Manual process


Use black bag closed circuitwith 100% oxygenFully charge batteriesUse alternate oxygen drivenventilator

Ensure adequate staffavailable for manualventilationEnsure equipment isavailableWarm water bathDouble cuff tourniquetBlood pumping set andpressure bagUse peak flow metersPerform visual examinationTreat prophylacticallyRefer to ophthalmologistUse plaster cuttersApply a back slab

NUM/DON

NUM/DON Medical staff

NUM/DON

Nursing staff

Nursing staff

Nursing staff

C

C

A

A

C

C




Use battery backup



Identify non compliantequipmentAim to replace noncompliant equipmentIdentify & position compliantmonitors ensuring access toemergency powerEnsure adequate supply ofbatteries• Have batteriesfully chargedIdentify & ensure adequatemedical & nursing staff

DON/NUM

NUM/DON

NUM

Director of Nursing

D

D

D

Page - 137 28/08/2013




coveragePrioritise patients formonitoringInform and educate staff

NUM/DONNUM/DON

DD





Develop a plan forcentralising vehiclesPrioritise useNotify clients of potential fordisruption to normal servicesRe–admit at risk patients ifnecessary

Business manager

Medical staff

C

C



Business manager C




Business manager C







Director of NursingNUM

Business managerC










C


Duress alarms

Fire alarms





Ensure alarms areconnected to generator

Nursing staff

NUM

Engineering staffBusiness Manager

Manager Engineering

CWith appropriate

security

CWith appropriate

security

C

Page - 138 28/08/2013





powerLiaise with Fire Department Director of Nursing

NUMBusiness manager

Insufficient staff Unable to provide safelevel of care in the eventof equipment failure









Director of NursingNurse Unit Manager

Business manager

Operational Staff

Nurse Unit Manager & Labstaff


B

B

B






Nursing staff

Nursing staff

NUM/DON

B

B



Assess need for and numberof portable suction unitsrequiredConsider co-locating suctiondependent patientsEnsure adequate supplyalternate drainage systemsReplace drain suction withmanual vacuum or drainage

NUM/DON

Nursing staffB

B

Page - 139 28/08/2013





bottlesEnsure small oxygencylinder with twin-o-vacsuction on resuscitationtrolleyEducate staff on use ofalternate devices

Nursing staff

Nurse Unit Manager

D


Medical staff C






Keep batteries fully chargedon emergency powerIdentify location ofalternative ECG machinesInform and educate staff

Nurse Unit ManagerEngineering staff

Nursing staff

NUM/DON

D

DFailure of EmergencyAlarms





Nursing staff

NUM/DONC





NUM/DON C





Charge on generator powerif ableCharge batteries fullyEnsure adequate stockburettesProtocols for alternativeadministration



C

C

CFailure of lifting devices Difficulties with lifting

heavy patients – manualhandling injuries


Use hydraulic lifting devicesif availableUse of slide sheets, patslide,slida person etc.Ensure staff trained inmanual handling

All staff

All staff

NUM/DONBack care facilitator

C

Page - 140 28/08/2013







NUM/DON

All staff

NUMInfection Control CNC

C

C

Page - 141 28/08/2013

Business Continuity PlanCollinsville Hospital – Utilities Services

COLLINSVILLE HOSPITAL - UTILITIES



Loss of LPG supply











DON/BM/Engineering

DON/BM/Engineering

DON/BM/Engineering

Business manager

Manager Engineering

DON/BM/EngineeringBusiness ManagerNUM/DON

Business Manager/Cook

A

A

A

A

B

B

Oxygen supply disrupted Use cylinder oxygen Ensure adequate supplies Operational Officers/ BusinessManager

A




DON/BM/Engineering

DON/BM/Engineering

Nurse Unit Manager

A

Page - 142 28/08/2013







Manager Engineering

NUM/DON

NUM/DON

DON/BM/Engineering

DON/BM/Engineering

Nurse Unit Manager

Nurse Unit Manager

All Managers

A

A

A

A

A

A


Staff Education


MHHS Manager


MHHS Manager only

Nurse Unit Manager

A

A



Ration water usage



MHHS ExecutiveDON/BM/Engineering

A

Page - 143 28/08/2013





Contingency Failure




Close facility

Staff education


DON/BM/Engineering


Business Manager


MHHS Manager

MHHS Manager


A

A

A

A



MHHS Executive D







Nurse Unit Manager


Nurse Unit Manager

NUM/BM/DON/Engineering

DON/BM/Engineering

Nurse Unit Manager

D

D

D

D

Page - 144 28/08/2013





urinals


Close facility

Staff education


All staff



DON/BM/Engineering


NUM/DON/Managers

D

D

D



Inform and educate staff DON/NUMBM/Engineering B







Identify provision foremergency lightingRelocate immobile patientsto best lit areasClean and maintain windowsand fittingsEnsure blinds/curtains openEnsure adequate supplytorches / battery operatedlights and batteriesClear patient areas, workareas and corridors of all

Engineering staff

Nursing staff

Operational Staff

All staffNurse Unit Manager

NUM/DON/BM/ All staff

B

B

Page - 145 28/08/2013






hazardsIdentify and sourcealternative lightingStaff member to placelighting in strategic areas forsafetyIssue clinical staff withtorches

NUM/DON /All staff

Page - 146 28/08/2013


Dysart Hospital – Clinical & General

DYSART HOSPITAL – CLINICAL & GENERALA = Up to 24hrs B = Up to 5 DaysC = Indefinitely D = Cannot Operate

PROBLEM IMPACT CONTINGENCY TASK RESPONSIBILITY

HOW LONG CANYOU FUNCTIONWITHOUT THIS

SERVICE?

HBCISAccess Failure

Unable to registerpatients

No patient ID labels

Manual registration

Manual Process

Adequate supply downtime forms

Hand write requests

Ensure blank details are recorded inchart

Administration Staff



B

HBCISEmergency DepartmentModule failure

Unable to utiliseTRIAGE treatment,admission anddischarge

Unable to recordstatisticalrequirements

Manual recording.

No written record of UR Numbersmaintained on site


Ensure correct details are recorded inthe chart

Check and update missing data

Nursing Staff

Administration StaffNursing staff

C

Printing services Failure

Unable to printresults/labels

Manual recording of labels

Results can be obtained via phone orinternet

Ensure adequate staffing to coverworkloadList of relevant phone numbers e.g.pathology, x-ray etc.

Business ManagerAdministration StaffNursing Staff

B

Computer failure

Unable to generateID labels, trackpatient location,bed status, labresults, emails,online policies andprocedures

Record patient details manually Ensure supply of HBCIS downtimeformsPre-print labels on existing patientsHand write on blank labels for newadmissionsUpdate patient location and bedstatus at regular intervals


B

Page - 147 28/08/2013




SERVICE?

Unable to trackpatient location andbed statusUnable to providepatient dietaryrequirements

Revert to manual process Update patient diet lists and haveavailable for collection by cateringservices

Nursing StaffOperational Stream

C

Telephone Failure

No internal orexternalcommunications

Refer to facility wide telecommunicationsplan

Inform and Educate staffNUMRegistered NurseBusiness ManagerDON

C

FAX Failure

Unable to receiveor send patientinformation

Utilise alternate lines of communicationSend patient information by courier,registered post or scan and email


NUMAdministration StaffDON

B

B

Photocopy Failure

Unable to copy,scan or faxdocuments

Utilise alternate lines of communication Telephone CommunicationUtilise photocopier at Private SurgerySend original documents with thepatient in chart


All Staff

A

Oxygen Supply Disrupted

Piped oxygenfailure

Use oxygen cylinders Ensure adequate supply of cylinders

Ensure all staff educated in cylinderchangeoverConsider co-locating high oxygenusers

Operational StreamAdministrationNursing

All Staff

B


Use alternate suction devices


Assess need for and number ofportable suction units requiredConsider co-locating suctiondependent patientsEnsure adequate supply alternatedrainage systemsReplace drain suction with manualvacuum or drainage bottles

NUMDONNursing Staff

BLimited supply in

hospital

Page - 148 28/08/2013




SERVICE?Ensure small oxygen cylinder withtwin-o-vac suction on resuscitationtrolley

Failure of Welsh Allenthermometer

Potential forinaccuracy oftemperaturereadings

Use digital thermometer Ensure stock digital thermometers NUMDONNursing Staff

C

Failure of non-invasiveblood pressure (NIBP)monitors

Unable toelectronicallymeasure bloodpressurerecordings

Use manual sphygmomanometer Ensure adequate number of manualsphygmomanometers NUM

DONNursing Staff

C

Failure of Glucometer

Potential fordecreasedaccuracy in bloodglucose readings

Change battery in Glucometer

Formal laboratory blood glucose analysisfor abnormal results

Ensure adequate supply of batteriesand test strips

Inform and educate staffDevelop policy for formal laboratorytest

NUMDONNursing Staff

C

A



Ensure access to emergency power oraccess battery backupUse on battery power


Keep batteries fully charged onemergency powerIdentify location of alternative ECGmachinesInform and educate staff

NUMDONNursing Staff

A

limited battery life

Failure of Pulse oximeters Unable todetermine oxygensaturation

Increase nursing observationEducate staff re basic physicalassessment of patient

NUM / DONNursing Staff C




Use battery backup

Identify non compliant equipmentAim to replace non compliantequipmentIdentify & re allocate compliantdefibrillatorQAS on standbyInform & Educate staffIdentify existing emergency poweroutletsHave batteries fully charged

NUMDONNursing Staff

A

Page - 149 28/08/2013




SERVICE?Medical equipment failure Unable to provide

specialised medicalequipment

Ventilators

Blood warmers

Biers machine

Level 1 transfuser

Spirometer

Slit lamp

Plaster saw

Utilise emergency powerManual process


Manual ventilation


Manual process

Manual process

Manual process

Check existing emergency poweroutletsUse black bag closed circuit with100% oxygenFully charge batteries

Use alternate oxygen driven ventilatorEnsure adequate staff available formanual ventilationEnsure equipment is available

Warm water bath

Double cuff tourniquet

Blood pumping set and pressure bag

Use peak flow meters

Perform visual examinationTreat prophylacticallyRefer to ophthalmologist

Use plaster cuttersApply a back slab

NUMDONNursing Staff

C

C

A

A

C

C

Unable to use ISTAT Bloods to path Develop policy for formal laboratorytest

NUMDONNursing Staff

C


Unable to providesafe and secureenvironment


Refer to safety and security plan


Direct notification via phone to switchor runner to contact fire services,security, policeInform and educate Staff

All staff

BCan function but

time consuming andcan lead to

decreased patientsafety

BFailure of Patient callbuttons


Refer to safety and security plan. Use of hand bellsInform and educate staff

NUMDONBusiness ManagerNursing Staff

C

Page - 150 28/08/2013




SERVICE?

Refrigeration Vaccine

Drugs and medicalsupplies requiringrefrigeration maybecome unstable


Use eskies and ice

Review emergency power outlets andmanage vaccines as per infectioncontrol guidelines

Monitor refrigerator temperature withthermometerUtilise SBVP EskyInform & Educate staff

DONNUMNursing StaffChild & CommunityHealth Staff

A



Use on battery power if available .

Use burettesConsider alternate administration routes


Ensure adequate stock burettesProtocols for alternativeadministration

NUMDONNursing Staff

ABatteries can last up

to 12 hours.

Failure of SequentialCompression Devices

Potential increasedrisk of DVT/Embolus

Use alternative methods of deterringthrombo-embolus


Consider compression stockings/drug therapyDevelop policyEnsure adequate supplies ofstockings

NUMDONNursing Staff

C

Failure of lifting devices Difficulties withlifting heavypatients – manualhandling injuries

Access Battery back up of lifting devices Use hydraulic lifting devices ifavailableUse of ski sheets, bed sheets, hovermattress etc.Ensure staff trained in manualhandling

NUMDONNursing StaffNurse EducatorWH&S Officer

B


Verbal education

Alternative recreational facilities


Prepare mobile library

NUMDONBusiness Manager

C

Staffing Increased manualtasks may influenceworkload

Roster extra staff on dutyPlace staff "on call"

Estimate staffing numbers requiredfor 24 hour periodPrepare rosters


B

Telehealth Unable toguarantee liaisonwith Specialist

Source alternative conferencing unitCommunicate by telephoneInternet e.g. Skype etc.Mobile video calling

Communicate with ITEnsure availability of telephone,laptopEducate staff


C

Page - 151 28/08/2013




SERVICE?Equipment Function Unable to

guaranteeequipmentaccuracy

Check all equipment for functionality assoon as possible after disruption of power

Identify all equipment to be checked NUMDONBusiness ManagerNursing Staff

C

Failure of Dishwasher

Refer to FoodSafety Plan

Use Disposables Ensure adequate supply ofdisposables

CookOperational StreamBusiness ManagerDON

C

B

Loss of communicationwith pre Hospital transferservices and referralcentres


Unable tocommunicate withGP’s


Develop an alternate referral dischargeprocess

Consider the use of Mobile Phone ifnetwork is operationalUse 2 way radioDevelop criteria for referral based onavailable services

Develop pro forma for requiredpatient information

NUMDONNursing StaffBusiness Manager

C


Unable to obtainfuel

Arrange credit facility Liaise with local fuel distributor forcredit facilities for fleet vehicles /Generator fuel

DONBusiness Manager

C


Unable to receiveSupplies

Use alternate methods for transport ofsupplies



C


Spread of disease Planned areas for habitation Allocate areas for use by public NUMDONNursing StaffBusiness Manager

C



NUMDONNursing StaffBusiness Manager

C

Page - 152 28/08/2013




SERVICE?Disease outbreak Infected persons Vaccines Plan for vaccines, fact sheets Public Health Unit

Child HealthNursesDONNUMBusiness Manager

C

Waste Disposal Vector BorneDisease Infections


Assign contractors for pest control Public Health UnitBusiness ManagerDON

C

Page - 153 28/08/2013

Business Continuity PlanDysart Hospital – Utilities Services

DYSART HOSPITAL - UTILITIESA = Up to 24hrsB = Up to 5 DaysC = IndefinitelyD = Cannot Operate

Problem Impact Contingency Task Responsibility How long canyou functionwithout thisservice?

Loss of LPGsupply

Unable to provide cookingfacilities


Unable to utilise drier inlaundry

Secure LPG site and implementretrieval/disposal of hazardousmaterialArrange urgent supply ofportable LPG cylinders

Use alternate energy sourcee.g. Gas Cook top or BBQ

Wash / clean with cold water

Dishwasher heats own water

Utilise drier in staff quartersClothes line adequate to hangwashingOut source laundry – e.g.Moranbah Hospital, PrivateLaundry

Staff Education

Engineer to establish security of the site andrisk assess immediate needs.Arrange for supplier to fill storage tanks ifnot damagedIdentify alternate energy sources for cooking

Identify alternate energy sources for waterheatingIdentify cleaning processes that can usecold water or use disposable wareIdentify alternate washing regime for patienthygiene.

No remedial action required

Clothes trolley baskets and pegs availableWorkload Management

Educate staff on contingency plans

Manager EngineeringBusiness ManagerDONOperational Stream

C

B

B

Inability tosupply mainspower tofacilities

Emergency power generation Identify existing supply of emergency powergeneration

Refer to power points/ outlets withemergency generation in each areaConfirm essential equipment only connectedto generator power outlets

A

Page - 154 28/08/2013



Ration use of emergency powerUse alternate power sources



Consider activation of MHHSDisaster Plan

Close FacilityStaff Education

Ensure essential lights and equipmentsupplied.Consider need to purchase extension leadsDevelop a procedure for use of emergencypower in each area and inform staffEnsure adequate fuel for generator useEnsure fuel storage standards aremaintainedIdentify generator load capacity

Fully charge batteries on all essentialequipmentLocate/purchase torches/ lanterns andbatteriesUse natural lighting -open windows anddoorsIdentify patients for discharge or relocationConsult current MHHS Disaster Plan forprocessLiaise with alternative service provider forcare of patients

Transfer patients out & close facilityEducate staff on contingency arrangements

Manager EngineeringDirector of Rural ServicesDONNUMBusiness ManagerAll Staff

A

A

Loss of watersupply forgeneral use,e.g., toilets,patienthygiene


Contingency Failure

Ration water usage


Identify alternative supplies ofdrinking water

Discharge/ relocate patientswithin facilityConsider activation of MHHS

Rationalise services and develop plan forwater restriction

Source / cost alternate supplies, e.g. / Watertankers / Fire service supplyInitiate use of alternate supply

Consider purchase of bottled water

Identify patients for discharge or relocation

Consult current MHHS Disaster Plan for


A

Page - 155 28/08/2013



Disaster Plan

Local Emergency Water Supply

Close facility

Staff education

process

Liaise with local council / utilities reemergency water supplyLiaise with alternative service provider forcare of patientTransfer patients out and close facility

Educate staff on contingency

Sewerage

Unable to dispose ofwaste products due towater failure

Ensure facility wide plan Develop facility plan for waste disposal Manager EngineeringDirector of Rural ServicesDONBusiness Manager

D

Ensure LocalCouncil andPublic HealthUnitinvolvement. Failure of contingency


Source supply / cost of alternatedevices e.g. porta loos



Consider activation of MHHSDisaster Planfacility

Staff education

Place bucket for used water in each toiletcubicle for flushing purposesClose off toilets not for use and post signs

Identify alternate toilet devices e.g., portaloos, and number required

Purchase sufficient for immobile patientsInform staff of Infection Control policy

Identify patients for discharge or relocationConsult current MHHS Disaster Plan forprocessLiaise with local council / utilities reemergency water supply

Arrange for septic tank pumping truck topump sewerage out of hospital pipes

Liaise with alternative service provider forcare of patientTransfer patients outClose facility

Educate staff on contingency plans


D

Page - 156 28/08/2013



Power failure

Mains power notavailable. Generatorsupplies emergencypower

Refer to mains power failure plan Inform and educate staff Manager EngineeringDirector of Rural ServicesDONNUMBusiness ManagerAll Staff

A

Lightingfailure

Difficulties in patientobservation and care








Identify provision for emergency lightingRelocate immobile patients to best lit areas

Clean and maintain windows and fittingsEnsure blinds/curtains open

Ensure adequate supply torches / batteryoperated lights and batteries

Clear patient areas, work areas andcorridors of all hazards

Identify and source alternative lightingStaff member to place lighting in strategicareas for safetyIssue clinical staff with torches

DONNUMBusiness ManagerAll Staff

B

Page - 157 28/08/2013


Moranbah Hospital

MORANBAH HOSPITAL




Unable to track patientprogress notes location



Revert to manualprocess

Revert to manualprocess


Ensure supply of HBCIS downtimeformsPre –print labels on existing patientsHand write on blank labels for newadmissionsUpdate patient location and bedstatus at regular intervalsNotify after-hours On-Call of allpatient movementsDevelop a process for disseminatingpatient updates as part of the facilitycommunication planEnsure supply of pathology resultforms

Develop means for notification of lab& test resultsManual ordering testsEnsure retrospective data entry whencomputer services resumeBackup any non centralised data orward specific computer programs



Administrative and Nursingstaff

Nurse Unit Manager

Nurse Unit Manager / CN


CCan function but very

time consuming

C

C

C

C

Power failure Mains power not available Generator poweravailable

Inform and educate staff Nurse Unit Manager /DON BCan function in most

areas.

Lighting failure Difficulties in patientobservation and care

Utilise emergencygenerator lighting

Maximise naturallighting


Identify provision for emergencylightingRelocate immobile patients to best litareasClean and maintain windows andfittingsEnsure blinds/curtains openEnsure adequate supply torches /battery operated lights and batteries

Identify provision foremergency lightingEngineering staffNursing staffCleaning staff

All staffNurse Unit Manager / DON

BCan function in most

areas.

Page - 158 28/08/2013

MORANBAH HOSPITAL




Maintain WH&SprecautionsGenerator poweravailable

Clear patient areas, work areas andcorridors of all hazardsEducate staff

Nurse Unit Manager /All staff

Air conditioning failure Regulate temperature andenvironment withGenerator power

Use alternate coolingdevices and turn offunnecessary air-consElectrical or manual fan

Position fans for maximum benefit

Identify patients requiring cooling

Nursing staff AEspecially in summer

Limited where nowindow.


Refer to facility widetelecommunicationsplan

Inform and educate staff Nurse Unit Manager /ShiftTeam Leader /DON

AOnly for a limited time.

Wall oxygen supplyfailure

Wall oxygen not available Use cylinder oxygen Identify anticipated requirements ofcylinder oxygen for ward patientsOrder extra required cylindersEnsure all oxygen cylinders fullEnsure corresponding number ofoxygen fittings available at wardlevel.Ensure all staff educated in cylinderchangeover.


B

Wall suctionfailure

Wall suction notavailable



Assess need for and number ofportable suction units requiredConsider co-locating suctiondependent patientsEnsure adequate supply alternatedrainage systemsReplace drain suction with manualvacuum or drainage bottles

Ensure small oxygen cylinder withtwin-o-vac suction on resuscitationtrolley

Nurse Unit Manager


B

BLimited supply in

hospital

Digital scales fail Unable to record weight Use alternative scales Use bathroom scales

Use weighted scales if availableNurse Unit Manager

C

Failure of WelshAllenthermometer


Use digitalthermometer

Ensure stock digitalthermometers

Nurse Unit ManagerC

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MORANBAH HOSPITAL



Failure of non-invasive bloodpressure (NIBP)monitors

Unable to electronicallymeasure bloodpressure recordings


Ensure adequate number ofmanual sphygmomanometers

Nurse Unit ManagerC


Potential for decreasedaccuracy in bloodglucose readings

Change battery inGlucometer

Formal laboratoryblood glucoseanalysis for abnormalresults

Ensure adequate supply ofbatteries and test strips

Inform and educate staffDevelop policy for formallaboratory test

Nursing staff /Unit Manager

Nursing staff

C

A.A potential treatment

problem


Unable to diagnosepotential life-threatening conditions

Ensure access toemergency power oraccess batterybackupUse on battery power

Identify access to emergencypower outlet

Keep batteries fully charged onemergency powerIdentify location of alternativeECG machinesInform and educate staff

Nurse Unit Manager / DON

Nurse Unit Manager /NursingStaff

Nurse Unit Manager

ANo problem if

emergency powerpoint kept for use.

Alimited battery life

Failure of Pulseoximeters



Educate staff re basic physicalassessment of patient

Nurse Unit Manager CStaff trained in physical

assessment


Unable to provide safeand secureenvironment

Increased staffvigilance

Refer to safety andsecurity plan


Direct notification via phone toswitch or runner to contact fireservices, security, policeInform and educate Staff

Nursing staff

All staff

BCan function but time

consuming and can leadto decreased patient

safety

B



Refer to safety andsecurity plan.

Inform and educate staff Nurse Unit ManagerC

Page - 160 28/08/2013

MORANBAH HOSPITAL





Use on battery powerif available.

Use burettesConsider alternateadministration routes

Charge on generator power ifable Charge batteries fully

Ensure adequate stock burettesProtocols for alternativeadministration

Nursing Staff

ABatteries can last up

to 12 hours.


Potential increased riskof DVT /Embolus

Use alternativemethods of deterringthrombo-embolus


Consider compression stockings/drug therapyDevelop policyEnsure adequate supplies ofstockings

Unit Manager Medical staff

Unit Manager /Medical Staff

Nursing staff

C


Place drugs inrefrigerators whichare connected toemergency powersupply - as per ColdChain Protocol

Use Eskies withportable thermometersand ice as per ColdChain Protocol

Review emergency power outlets

Monitor refrigerator temperature withthermometerConsider purchase of eskies andsupply of ice

Unit Manager / DON

Nursing staff


A

Awith eskies


Access Battery back upof lifting devices

Use hydraulic lifting devices ifavailableUse of ski sheets, bed sheets, etc.Ensure staff trained in manualhandling

All staff

Unit ManagerWH&S Officer

B

Pan room hopper Unable to clean bed pans/ urinals adequately

Single patient usebedpans/ urinals

Purchase sufficient for immobilepatientsRinse with “grey/waste” water anddisinfect with chemical solutionInform staff of Infection Control policy

Unit Manager / DON

Nurse Unit ManagerNB “Hopper” has been

replaced with“Macerator” and

disposable urinals &bed pans

Page - 161 28/08/2013

MORANBAH HOSPITAL




Verbal education

Alternative recreationalfacilities


Prepare mobile library

Nurse Unit Manager

Volunteers

CCan still operate



Send patient information byrunner/courierDelay transfer of information untilservices resumed.

Unit Manager /BusinessManagerMedical staffAdmin. staff

ACan still operate but

time consuming




Send original documents with patientand document in chartDelay transfer of information untilservices resumed


C

B


Roster extra staff ondutyPlace staff "on call"

Estimate staffing numbers requiredfor 24 hour periodPrepare rosters

Nurse Unit Manager / DONB


Check all equipment forfunctionality as soon aspossible after disruptionof power

Identify all equipment to be checked Nurse Unit Manager/ DON

Page - 162 28/08/2013

Business Continuity PlanProserpine Hospital – General & Clinical Services

PROSERPINE HOSPITAL – CLINICAL & GENERALA = Up to 24hrs B = Up to 5 DaysC = Indefinitely D = Cannot Operate



SERVICE?Ensure all records in file • Notify all MO’s/ward/depts to return

outstanding recordsManager ofSupport Services B

Run location by location for charts notreturned.

Manager to arrange approp staff tocomplete task.

Manager ofSupport Services

Failure HBCIS MedicalRecords & TrackingSystem

Unable to locate &send medicalrecords

Use manual tracing system Implement manual system (eg)tracer cardsUpdate system with changes & newregistrations


Admin staff

Failure of HBCIS PatientMaster Index (PMI

Cannot allocatenew UR Numbers

Manual allocation of URN’s Check backup PMI file is up to date. Manager ofSupport Services

BCannot search forexisting URN’s

Use backup PMI to look up existingURN’s

• Manually allocate & look up URN’s

Update system


Manual process • Print hard copy of PMI prior tocritical date


Prepare a block of unissued downtime URnumbers

• Allocate downtime UR numbers Manager ofSupport Services

Failure HBCIS Admission,Transfer, Discharge (ADT)

Cannot search ADTto track patients

Not critical, wait until system returns • Update System Manager ofSupport Services

BCannot run enquiryreports

Keep hard copy list in Medical RecordsDepartment.

• Have register and down formsavailable. Update patient list asneeded.

Admin Staff

HBCIS AppointmentScheduling

Unable to printreports for patients

to attend clinics

Print reports one week in advance wherepossible.

Manual list of attendees. Business Manager

ANo access to activity data Unable to access

reports.Access when system returns Retrospective updating of data. Business Manager C

Page - 163 28/08/2013




SERVICE?No access to pathology /radiology results


Revert to manual process Ensure retrospective data entry whencomputer services resume

DON & FM /Business Managers

B

Unable to fax dischargesummaries.

Increased requestsfrom GP for followup dischargeinformation.

Hand write discharge summaries. Givepatients a copy on discharge.

Post copy handwritten dischargesummaries to General Practitioners.

Administrative staff C

Flooding of Medical recordDepartment.

Destruction ofcharts

Move charts if possible to safe area. Rollsof black plastic and tape to secure.

Arrange for staffing to move charts.Or Cover filings bays with plastic andsecure.


C

EDIS failure Inability to recordemergencypresentations

manual recording adequate supply of downtime formsand triage forms

NUM, admin staff C

Computer failure unable to printresults / labels etc

manual recording of patient details andresults.

ensure supply of downtime forms andmanually record information.

admin, nursing andmedical staff

C

FAX Failure unable to send orreceive patientinformation

utilise alternate communication lines ordelay transfer of information

Inform and educate staff. Delaytransfer of information or alternatemeans of communications

NUM / BM B

BMDF Failure unable to copy orscan documents

utilise alternate communication lines ordelay transfer of information

Telephone information. Send originaldocuments with patient anddocument in chart. Delay ofinformation until restored

Nursing / medicaland admin staff

Oxygen Supply Disrupted oxygen notavailable

use cylinder oxygen Ensure adequate supplies. Ensurestaff education on use. Consider co-locating high oxygen users.

NUM, nursing staff,operational staff

B

Failure ofRefrigeration/Cool Rooms

food spoilage referto food safety plan

Essential fridges on emergency power.Source food offsite if needed. Considerlong life options

Access Emergency power. Developplan for preparation and transport offood from other sources. Purchasedry / tinned food. Consider long lifemilk and bottled water if needed

operationalservices managerand BM

B

Failure of Dishwasher refer to food safetyplan

use disposables adequate supplies needed operationalservices managerand BM

C

Page - 164 28/08/2013




SERVICE?

Ensure one compliant transportmonitor available in central location

Schedule tests prior to critical dates

Nurse UnitManager

DTransport monitorsmalfunction

Unable to monitorcritically ill orunstable cardiacpatients in transit

Aim to have at least one complianttransport monitor or list of compliantmachines.Assess patients prior to critical dates.

Assess pt need for transportCharge batteries


C




Use battery backup

Identify non compliant equipmentAim to replace non compliantequipmentIdentify & re-allocate compliantdefibrillatorInform & educate staffIdentify existing emergency poweroutletsHave batteries fully charged

Nurse UnitManager

D

Medical equipment failure Unable to providespecialised medicalequipment

Bi-PAP/CPAP

Ventilators

Blood warmers

Slit lamp

Plaster saw


Manual processBattery back-up if availableManual ventilation

Manual process

Manual process

Manual process

Check existing emergency poweroutlets

Fully charge batteriesEnsure adequate staff available formanual ventilation

Warm water bath

Perform visual examination

Treat prophylacticallyRefer to ophthalmologist

Apply a back slab / plastic cutters

Nurse UnitManager

Nursing staff

Medical staff

A

C

C

Page - 165 28/08/2013




SERVICE?Failure of Monitorsincluding cardiac &oximetry

Unable to identifyarrhythmias /oxygen saturation

Use of emergency power

Use battery backup

Increased nursing & medical observation

Check existing emergency poweroutletsIdentify non compliant equipmentAim to replace non complaintequipmentIdentify & position compliant monitorsensuring access to emergency powerEnsure adequate supply of batteries.Have batteries fully charged.Identify & ensure adequate medical &nursing staff coveragePrioritise patients for monitoringInform and educate staff’

Nurse UnitManager

Nurse UnitManager

Nursing staff

D

D

C

Pathology servicesnot available

Identify and rationalise use of availablevehicles

Develop a plan for centralisingvehicles

DON & FM /Medical Staff

CUnable to providetransport services

Discontinue non-essential services Prioritise useNotify clients of potential fordisruption to normal servicesRe-admit at risk patients if necessary

Business manager C


Spread of disease Planned areas for habitation Allocate areas for use by public DON & FM C



DON/NUM/BM C

Disease outbreak Infected persons Vaccines Plan for vaccines, fact sheets DON/MBH/AHS/TPHU

C

Lack of Public Knowledge Suspicion -Concerned Public


BM/NUM/DON/TPHU

C


Roster additional staff Calculate individual unit staffingrequirements

All Line Managers B

Identify human resources able to beon call and redeployed in the facility

Director Of Nursing B

Page - 166 28/08/2013




SERVICE?

Assess competence of on call staff Nurse UnitManager

B

Wall suction notavailable

Use alternate suction devices Assess need for and number ofportable suction units required

NUMWall suction failure

Provide emergency oxygen/suction Consider co-locating suctiondependent patientsEnsure adequate supply alternatedrainage systemsReplace drain suction with manualvacuum or drainage bottlesEnsure small oxygen cylinder withtwin-o-vac suction on resuscitationtrolleyEducate staff on use of alternatedevices

Nursing staff

B

Unable to use ISTAT Unable to diagnosepotential life-threateningconditions

Ensure access to emergency power Identify access to emergency poweroutlet

Nurse UnitManager /Engineering staff

D

Failure of 12 lead ECGMachine

Unable to providesafe and secureenvironment




Inform and educate staffSchedule regular patient rounds

Nurse UnitManager/ Nursingstaff

D



Utilise bells with capable patients Inform and educate Staff and Patients Nurse UnitManager

B



Refer to safety and security plan. More regular rounds of patients in thedepartment. Inform and educate staffand patients

Nurse UnitManager

B

Use on battery power if available . Charge on generator power if ableCharge batteries fully

All staff Nursingstaff

Ensure adequate stock burettes

Use burettes Protocols for alternativeadministrationUse hydraulic lifting devices ifavailable



Consider alternate administration routes.

C

Page - 167 28/08/2013




SERVICE?Failure of lifting devices Difficulties with

lifting heavypatients – manualhandling injuries

Identify alternate lifting devices Use of slide sheets, pat slide,slidaperson etc.

All staff C

Macerators Unable to disposeof used pans andurinals

Utilise supply of washable pans andurinals. Manual Cleaning

Scrub and/or soak. Encourage use oftoilet as much as possible.

All clinical staff B

Failure of Blood /immunisation Fridges

Unable to preserveintegrity of blood.

Transfer blood and immunisations storeselsewhere

Investigate alternative storagesolutions.

NUM B

Spoilage ofpharmaceuticalsrequiringrefrigeration /freezing

Ensure fridges and freezers connected toemergency power

Check access to emergencygenerator power

Pharmacist within 30 minutes

Ensure fridges monitored for temperature Ensure On call pharmacist roster torespond to fridge/freezer failure alarm

Pharmacist /nursing staff

A

Failure of Refrigerators /Deep Freeze

If generator not managing loadarrange for portable eskies and orportable generators to maintainfridges and freezers

Ensure air conditioning for pharmacyconnected to emergency power

Check availability of emergencygenerator power


Ensure pharmacy is a priority areawhen air conditioning load shedscheduledArrange access to portable airconditioner


Contact Central Pharmacy fordirection

Consider portable air conditioner Pharmacist

Highlight potential inventory fordestruction if temperature extreme

Monitor fridges

Failure of air conditioning- pharmacy

Unable to maintainair temperaturebelow 25'C

Higher load on fridges Director ofPharmacy

A

No drug deliveries fromBrisbane

May not have drugavailable whenrequired

Maintain stock levels to allow for supplychain interruption of three daysObtain stock from Symbion Townsville

Maintain max mins monthly

Ensure on line ordering from Symbionis available

Director ofPharmacyDirector ofPharmacy

B

Page - 168 28/08/2013




SERVICE?Loss of Power / equipmentfailure

No CT Service.Use alternate investigation if possible.

Outsource to local private practices.Put CT Gantry onto emergencypower.

Medical ImagingStaff and DON &FM / Medical staff B

No Xray service

Key equipment on UPS.Emergency powerMobile x-ray units

Test and maintain UPS. AssessEmergency power for x-raygenerator.



Equipment on emergency power. Usealternate test

Test and maintain UPS. AssessEmergency Power.


Ensure one steriliser on emergency power Identify emergency power supply tosterilisers

NUMB

Alternative sterilisation methods Investigate alternative sterilisationmethods eg , chemical sterilisationEnsure full stock levels of sterileequipment available prior to criticalperiodsIdentify and prioritise critical services

NUM and Nursingstaff

B

Failure of steriliser Unable to processward and theatreinstruments

Rationalise service to emergency use only NUM/DON&FM

No washer/disinfectorconnected to emergencypower.

Unable to processreusable medicalequipment/instruments.

Manually wash all equipment. Explore the possibility of connectingof one machine to emergency power.

B

Have maximum stores available Prepacked and ensure maximumstore of sterile linen

Rationalise use of linen Consider alternative supplier

Alternative supplier Order extra supplies of disposablelinen

Failure of sterilised linenservice

No Sterile Linenbundles

Use disposable linen

NUM and Nursingstaff

B

Failure of Infantresuscitation trolleys

Suction and oxygennot immediatelyavailable

Use emergency generator power Ensure trolleys are plugged into redemergency power points.

Midwives A

Ensure twin-o-vac available

Ensure alternate supply eg portablegenerator

Ensure oxygen cylinders availableand full

CMC

Unable to maintaininfant warming

Ensure alternate warming devicesavailable

Consider bubble wrap, gladwrap Midwives / CMC

Fill Blanket warmer with blankets andlinen

Page - 169 28/08/2013




SERVICE?

Dry babies well. Wrap & dress warmly

Place baby in bed with mother


Midwives

Revert to manual positioning Adjust bed to optimal height prior tocritical dates

Midwives / CMC

Failure of electric deliverybeds

Positioning for birthmore difficult

Inform staff & patients CMC

B


Midwives

Identify at risk patients & instigateintermittent monitoringEnsure adequate supply of batteryoperated Doppler’s and gel.

Use battery-powered ultrasound Doppler. Ensure access to Pinard stethoscope CMC

Failure ofCardiotocograph (CTG)/pH scalp monitoring

Unable to performcontinuous foetalheart monitoring

Educate staff in use

B

Run on emergency generator power .Run on gases if no power Oxygendriven) for 90 minutes only. Monitor ptfor 40 minutes on battery from PACUmonitors

Check access to emergency poweroutlets. Manuallyventilate. Manually physicallyassess

Nurse UnitManagerAnaesthetic staff

Use backup cylinder supplies of oxygen,nitrous oxide & air

Ensure supplies of cylinder gassesavailable

Loss of power tomachine

Hand ventilate Ensure adequate supply of handoperated ventilation equipment -Disposable manual resuscitator

A

Inaccurate deliveryof anaestheticgases

Locate and provide air / oxygendriven ventilator (oxylog)

NUM A

Failure of anaestheticmachines & ventilators

Unable to ventilatepatients

Cancel elective surgery DON & FM / NUM B

Failure of laparoscopiccamera / light lead

Unable to performlaparoscopicsurgery (may be

Revert to non laparoscopic methods Notify surgeons, medical, nursing andbooking office

NUM and clinicalstaff

A

Page - 170 28/08/2013




SERVICE?

Postpone all non urgent surgery Contact non urgent patients andinform re need to reschedule at laterdate

NUM /Administrationsofficer bookings.

done if generatoron emergencypower).

ensure list of procedures unable to beunder taken available at theatre frontdesk

Bookings/ORManager

A

Failure of diathermymachine

Unable to performelectricalcoagulation (maybe done ifgenerator onemergency power).

Revert to ties/sutures Ensure adequate supply of ties andsutures

NUM andOperating theatreCN

A

Failure of operating table. Unable to positionpatient

Revert to manual processes Adjust bed to optimal height prior tocritical dates Purchasemanual override for table.

Nursing staff


NUM & DON / FM

Identify suitable patientsContact non urgent patients andinform re need to reschedule at laterdate

bookings officers

Staff education – availability of typesof cases able to be done

NUM

Failure of Sterilisingequipment for scopes (ONEMERGENCY POWER).

Unable to steriliseendoscopic /laparoscopic andorthoscopicequipment

Consider open procedures where clinicallyindicated

List of procedures unable to be undertaken available at theatre desk

A

Visual readings · Ensure adequate stock ofbatteries

Nursing Staff

· Inform & educate staff CNC

Failure of glucometer Potential fordecreasedaccuracy in bloodglucose readings Formal laboratory blood glucose analysis

for abnormal results· Develop policy for formal

laboratory testMedical Staff A

Ensure access to emergency power · Identify access to emergencypower outlet

NUM

Use on battery power · Keep batteries fully charged onemergency power

NUM

Failure of 12 Lead ECGmachine

Unable to diagnoselife threateningconditions

· Identify location of alternativeECG machines

Nursing Staff

A

Page - 171 28/08/2013




SERVICE?

· Inform and educate staff CNCFailure of Pulse oximeters Unable to

determine oxygensaturation

Increase nursing observationAccess other portable units from facility/Health Services if available

· Ensure staff to act as a runnerare available

NUM B

Use alternate feeding methods · Develop a procedure forbolus/gravity feeding

CNC / nursing Staff

· Ensure adequate supply oftubes and feeds

NUM

· Manually titrate drip rate ifnecessary

nursing staff B

Failure of Enteral feedpumps

Difficulty inmaintaining patientnutrition

· Inform and educate staff Educator

Failure of non-invasiveBlood Pressure monitors

Unable toelectronicallymeasure bloodpressure readings

Use manual sphygmomanometer · Ensure adequate number ofsphygmomanometers

NUM A

Page - 172 28/08/2013

Business Continuity PlanProserpine Hospital – Utilities Services

PROSERPINE HOSPITAL - UTILITIES



Loss of mains power tohospital.



Ensure emergencygenerator is supplying.

Business Manager,Operational ServicesSupervisor. A

Confirm essential equipmentconnected to generatorpower outlets

Staff each area.

A

Ensure essential lights andequipment supplied withuninterrupted power (UPS)battery (e.g.) theatre lights

Business Manager,Operational ServicesSupervisor.

A

Consider need to purchaseextension leads


Continue testing andmaintenance schedule forgenerators AS/NZS 3009-1998


A

Ascertain L/per hour fuel useof generator


Ensure fuel reservesavailable for generator forlong term use.


Ensure manual fuel pumpingcapability


Investigate legal/safe levelsof fuel storage on premises


Ration use of emergencypower

Identify generator loadcapacity

Hospital Executive

A

Identify potential for load-shedding and developprocedures


Page - 173 28/08/2013




Use alternate powersources

Fully charge batteries on allessential equipment

NUM

A

Supply additional lighting Locate/purchase torches/lanterns and batteries

NUM

A

Use natural lighting -openwindows and doors

All staff

A

Use alternate emergencygenerator

Identify alternate supplierseg SES, Local industries,mines/mills, Army, Hirecompany

Hospital Executive

A


Identify patients fordischarge or relocation


A

Inform and educate staff Hospital Executive

A

Consider activation ofDistrict Disaster Plan

Consult current DistrictDisaster Plan for process

District CEO, DON/FacilityManager A

Close Facility Liaise with alternativeservice provider for care ofpatients

District CEO, DON/FacilityManager, MedicalSuperintendent A

Transfer patients out & closefacility

Hospital Executive

A

Staff Education Educate staff oncontingency arrangements

Hospital Executive

ALoss of water supply forgeneral use, e.g., toilets,laundry, boilers, patienthygiene.

Diminished ability tocontinue clinical services

Ration water usage Rationalise services anddevelop plan for waterrestriction

DON/Facility Manager A


Source / cost alternatesupplies, e.g. On-site tankstorage, Bore water, Watertankers, Fire service supply


Initiate use of alternatesupply


Use emergency supply Liaise with local council /utilities re emergency watersupply

District CEO, DON/FacilityManager

A

Page - 174 28/08/2013




Loss of drinking water Identify alternative suppliesof drinking water

• Buy containers for storageof drinkable water

DON/Facility Manager,Business Manager

A

Source/cost supply ofbottled water

Supervisor OperationalServices

A



Medical Superintendent,DON/Facility Manager

A

Contingency Failure Consider activation ofDistrict Disaster Plan



A

Close facility Liaise with alternativeservice provider for care ofpatient

District CEO, DON/FacilityManager, MedicalSuperintendent

A

Transfer patients out andclose facility

District CEO, DON/FacilityManager, MedicalSuperintendent

A

Staff education Educate staff oncontingency

DON/Facility Manager,Medical Superintendent

A

Failure of seweragesystem

Unable to dispose ofwaste products due towater failure


Hospital Executive D

Utilise “grey/used” water Inform staff to save waterafter patient hygiene

DON/Facility Manager D

Place bucket for used waterin each toilet cubicle forflushing purposes

Cleaning Services D

Designate toilets to be used Close off toilets not for useand post signs

Business Manager, SupervisorOperational Services

D

Alternate toilet facilities Identify alternate toiletdevices e.g., porta loos, andnumber required and cost ofthese alternatives


D


Purchase sufficient forimmobile patients


D

Rinse with “grey/waste”water and chemical solution

Nursing staff D

Page - 175 28/08/2013




Inform staff of InfectionControl policy

NUM, Infection Control CNC D



Medical Superintendent D

Consider activation ofDistrict Disaster Plan



D

Liaise with local council /utilities re emergency watersupply

DON/Facility Manager D

Back up of effluent dueto council pump failure

Isolate hospital drainagesystem from main system

Liaise with council to closevalves

DON/Facility Manager ,Business Manager

D

Arrange for septic tankpumping truck to pumpsewerage out of hospitalpipes

DON/Facility Manager ,Business Manager

D

Failure of contingency Close facility Liaise with alternativeservice provider for care ofpatient

Medical Superintendent D

Transfer patients out, closefacility


D

Staff education Educate staff oncontingency plans

Hospital Executive D

Loss of LPG supply Unable to supply torelevant areas.

Establish security of the siteand risk assess immediateneeds.

Secure LPG site andimplement retrieval/disposalof hazardous material


B

Arrange urgent supply ofportable LPG cylinders

Identify number of cylindersrequired and allocate as perpriority listing.

Operational ServicesSupervisor.

B

Arrange for supplier to fillstorage tanks


B

Reduce use of LPG topriority areas

Identify priority areas for gasrationing


B


Use alternate energysource or BBQ

Identify alternate energysources for cooking.


B

Page - 176 28/08/2013




Identify alternate facility toprepare patients meals. egMOW Proserpine/ProserpineNursing Home


B


Heat water with alternateenergy source eg GasQuick heat water heater.



B

Wash / clean with coldwater

Identify cleaning processesthat can use cold water oruse disposable ware.


B

Develop procedure forlaundry processes


B

Develop procedure for wardcleaning

Operational Servicessupervisor, Infection ControlCNC

B

Staff Education Educate staff oncontingency plans

CNC B

Internal Telephone failureUnable to communicateinternally.

Establish extend of problemand likely time for re-establishment ofcommunication.

Urgently contactIT/communications DeptMBH.


A/B

Utilise 2 way Radio Locate and centraliseexisting 2 way radios tocommunication centre


A/B

Identify critical personneland reallocate 2 way radios(eg) Facility Manager, NUM,ED

DON/Facility Manager

A/B

Utilise mobile phones Locate and distribute mobilephones to key personnel.


A/B

Maintain and distributedirectory of re-allocatedphone unit numbers

Business Manager

A/B

Develop procedure foremergency phone use andeducate staff


A/B

Page - 177 28/08/2013




Runners Provide staffing and developa planned circuit

DON/Facility Manager,Business Manager A/B

Utilise alternate existingcommunication devices

Consider use of intercoms,nurse call system, WIPphones, PA system, E mail,message board


A/B

Inform and educate staff DON/Facility Manager

A/BExternal telephone failure(dial in )

Unable to communicateexternally.

Identify alternate means ofcommunication

Liaise with CEO & MediaRelations Officer re localmedia to inform community


A/BExternal telephone failure(dial out)

Unable to receivecommunication fromexternally.

Utilise mobile phones Distribute mobile phones tokey personnel


A/B

Limit outgoing calls DON/Facility Manager,Business Manager A/B

Inform and educate staff DON/Facility Manager,Business Manager A/B

Utilise existing radionetworks

Consider use of existingQAS radio phones

Hospital Executive, QAS

A/B

Consider access toemergency services radiosand negotiate for frequency.


A/B

Identify alternateemergency communicationnetworks

SES, Fire Services, Police,Shire Council vehicles


A/BEquipment function That ongoing issues

following restoration ofservice.


Identify all equipment to bechecked in liaison withIT/communications DeptMBH.


A/B

Inform and educate staff DON/Facility Manager,Business Manager A/B

Loss of ability to securesite

Hospital businessdisruption. Risks relatedto lack of security.

Provide onsite security Engage services of securityfirm as necessary over 24hour period.

DON/Facility Manager,Business Manager.

C

Page - 178 28/08/2013




Identify priority areas forsecurity

Hospital Executive C

Provide security presencein critical areas

Hospital Executive C

Closed circuit TV Manual operation of sitesecurity

Increase indoor and outdoorsecurity rounds

NUM, Business Manager C

Assess ability to operatesystem manually

NUM, Business Manager C

Self-opening doors frontentrance. Security locksall entrances.

Manual override of self-opening front entrance doorand unlock all otherentrance doors.

Ensure that doors kept inopen position.


C

Keypad locks / swipecard access

Manual override of keypadlocks

Use other means ofsecuring area, e.g., personalalarms for isolated staffmembers, lockablecupboards for medications/expensive equipment


C

Exterior lights Provide alternative exteriorlighting

Purchase battery-operatedlights and extra batteries


C

Parking Manual control of parking ifany of the car parks areflooded.

Place "No Parking" signs inthe appropriate areas.


C

Helicopter landing site Provide alternative lightingfor helicopter landing site

Purchase battery-operatedlights for landing site

Supervisor OperationalServices D

Staff education Educate staff oncontingency plan

DON/Facility Manager,Business Manager. D


Increased risk to staff Roster extra staff forescorts

Ensure availability of extrastaff

NUM & Hospital Executive

C

Review emergency call inroster

NUM & Hospital Executive

CLoss of ability to protectstaff and patients

Duress alarms Provide alternative alertsystem for nurses

Purchase hand held audiblealarms

DON/Facility Manager,Business Manager. C

Consider purchase ofwhistles

DON/Facility Manager,Business Manager. C

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Fire alarms Aim to have fire alarmscompliant.

Check fire alarms DON/Facility Manager,Business Manager. C


Ensure alarms areconnected to generatorpower


C

Messenger sent to all unitsin event of fire.

Appoint messenger DON/Facility Manager,Business Manager. C

Ensure fire evacuationprocedures in facilitydisaster manual.

Review fire procedures andpolicy


C

Sensor alarms formedical gases

Revert to manual process Visual check of gauges Operational Wards persons

C

Equipment function Check all equipment forfunctionality as soon aspossible after disruption ofpower


Hospital Executive, All staff

C

Inform and educate staff Hospital Executive

C



Identify and sourcealternative lighting

Supervisor OperationalServices C

Staff member to placelighting in strategic areas forsafety


C

Issue clinical staff withtorches

Supervisor OperationalServices C

Failure of hot watersystems

Loss of steam forsterilisation, laundry, andhot water

Arrange for laundrysterilisation and provision ofhot water from externalsources.

Access available services DON/Facility Manager,Supervisor OperationalServices

B

Equipment Function Check all equipment forfunctionality as soon aspossible after disruption ofpower



B

Inform and educate staff Supervisor OperationalServices

Page - 180 28/08/2013




Loss of vehicles or fuelsupply.



Develop a plan forcentralising vehicles withWhitsunday CommunityHealth

Business ManagersProserpine Hosp and WCHC

C

Prioritise use Hospital Executive C


Notify clients of potential fordisruption to normal services

Department staff C

Re–admit at risk patients ifnecessary

Medical staff Communityhealth staff

C




C



Identify and engageexternal contractors


C

Failure of File Server Loss of access todesktop applications

Inform IT and take directionfrom IT Dept, MBH.

Urgently contact IT DeptMBH.


D

Switch to backup fileserver.

• Flag PC to substitute asreplacement file server

• Information ServicesManager

D

Worst case – switch tomanual system.

• Conduct full backup of fileserver


D

• Reconfigure new file server • Information Services staff D

• Load backup data • Information Services staff D

• Revert back to originalserver

• Information Services staff D

• Copy amended data • Information Services staff D

Failure of Local AreaNetwork

Loss of access todesktop applications

Inform IT and take directionfrom IT Dept, MBH.

Urgently contact IT DeptMBH.


D

Switch to condensed LocalArea Network system.

Flag PC to substitute asreplacement


D

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Switch to stand aloneprocessing

• Conduct full backup if fileserver


D

• Switch to manualProcessing.

• Reconfigure new file server • Information Services staff D

• Load backup data • Information Services staff D

• Revert back to originalserver

• Information Services staff D

• Copy amended data • Information Services staff D

Air conditioning failure Electrical or manual fan Identify patients requiringcooling, Use windows. Notifyand inform patients andstaff.


Utilise emergency lighting Identify provision foremergency lighting

business manager /Operational Services Manager

B

Relocate immobile patientsto best lit areas

B

Maximise natural lighting Clean and maintain windowsand fittings

Nursing staff C

Ensure blinds/curtains open C

Ensure adequate supplytorches / battery operatedlights and batteries

C


Clear patient areas, workareas and corridors of allhazards

C

Utilise alternate lighting Identify and sourcealternative lighting

Nurse Unit Manager C



Staff member to placelighting in strategic areas forsafety

Nurse Unit Manager /All staff B

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Issue clinical staff withtorches

Nurse Unit Manager /All staff B


C

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Sarina Hospital – Clinical & General

SARINA HOSPITAL – CLINICAL & GENERALA = Up to 24hrs B = Up to 5 DaysC = Indefinitely D = Cannot Operate



SERVICE?HBCIS AccessFailure

Unable to registerpatients

No patient ID labels

Manual registration

Manual Process

Adequate supply downtime forms

Hand write requestsEnsure blank details are recorded inchart


Administration StaffAdministration Staff

B

Emergency DepartmentModule failure

Unable to utiliseTRIAGE treatmentandadmission/dischargeUnable to recordstatisticalrequirements

Manual recording.No written record of UR Numbersmaintained on siteRetrospective data entry

Ensure details are recorded in thechart

Check and update missing data



C

Printing services Failure Unable to printresults/labels

Manual recording – lead to adequate staffnumbers

Ensure adequate staffing to coverworkload

Business ManagerAdministration Staff B

BComputer failure Unable to generate

ID labels

Unable to trackpatient location andbed statusUnable to providepatient dietaryrequirements




Ensure supply of HBCIS downtimeformsPre-print labels on existing patientsHand write on blank labels for newadmissionsUpdate patient location and bedstatus at regular intervalsUpdate patient diet lists and haveavailable for collection by cateringservices


C

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SERVICE?Telephone Failure No internal or

externalcommunications

Refer to facility wide telecommunicationsplan

Inform and Educate staff Nurse UnitManagerShift Team Leader

C

FAX Failure Unable to receiveoe send patientinformation

Utilise alternate lines of communication Send patient information by courier


Nurse UnitManager

Medical &AdministrationStaff

B

BPhotocopy Failure Unable to copy

documentsUtilise alternate lines of communication Telephone Communication

Send original documents with thepatient in chartDelay transfer of information untilservices resumed

All Staff

A

Oxygen Supply Disrupted Use oxygen cylinders Ensure adequate supply of cylinders

Ensure all staff educated in cylinderchangeoverConsider co-locating high oxygenusers

OperationalOfficers

All Staff

D

Failure ofRefrigeration/Cool Rooms

Food spoilage referto Food Safety Plan

Essential Fridges on emergency powerSource Food off campus

Consider long shelf life food products

Assess availability of emergencypower

Develop a plan for preparation &transport of food from otherappropriate sourcesPurchase dry/tinned foodConsider purchase of long life milkConsider purchase of bottled waterfor drinking

CookBusiness Manager

B

Refrigeration Vaccine Drugs and medicalsupplies requiringrefrigeration maybecome unstable


Use eskies and ice

Review emergency power outlets andmanage vaccines as per infectioncontrol guidelines

Monitor refrigerator temperature withthermometerUtilise SBVP EskyInform & Educate staff

Nurse UnitManagerEngineering Staff

A

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SERVICE?Failure of Dishwasher Refer to Food

Safety PlanUse Disposables Ensure adequate supply of

disposablesCookBusiness Manager C

BLoss of communicationwith pre Hospital transferservices and referralcentres


Unable tocommunicate withGP’s


Develop an alternate referral dischargeprocess

Consider the use of Mobile Phone ifnetwork is operationalUse 2 way radio from Community e.g.CouncilDevelop criteria for referral based onavailable servicesDevelop pro forma for requiredpatient information

Nursing staff

C

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Business Continuity PlanSarina Hospital – Utilities Services

SARINA HOSPITAL - UTILITIESA = Up to 24hrsB = Up to 5 DaysC = IndefinitelyD = Cannot Operate


Loss of LPGsupply

Unable to provide cookingfacilitiesUnable to provide hotwate

Secure LPG site and implementretrieval/disposal of hazardousmaterialArrange urgent supply ofportable LPG cylinders

Use alternate energy sourceGas Cook top or BBQHeat water with alternate energysource Gas Quick heat waterheater.Wash / clean with cold water

Dishwasher heats own waterStaff Education

Engineer to establish security of the site andrisk assess immediate needs.Identify number of cylinders required andallocate as per priority listing.Arrange for supplier to fill storage tanks ifnot damagedIdentify alternate energy sources for cookingIdentify alternate energy sources for waterheatingIdentify cleaning processes that can usecold water or use disposable wareIdentify alternate washing regime for patienthygiene.No remedial action requiredEducate staff on contingency plans

Manager Engineering

Business manager

CNC/Managers

A

B

Oxygensupplydisrupted

Use cylinder oxygen Ensure adequate supplies Operational Officers/Business Manager A

Inability tosupply mainspower tofacilities

Emergency power generation Identify existing supply of emergency powergeneration

Refer to power points/ outlets withemergency generation in each areaConfirm essential equipment only connectedto generator power outletsEnsure essential lights and equipmentsupplied.Consider need to purchase extension leadsDevelop a procedure for use of emergencypower in each area and inform staff

Manager EngineeringNurse Unit Manager

Nurse Unit Manager

A

A

Page - 187 28/08/2013



Ration use of emergency powerUse alternate power sources



Consider activation of MHHSDisaster PlanClose Facility

Staff Education

Contact Engineering/Contractor to ensureadequate fuel source for use of generatorEnsure fuel storage standards aremaintainedIdentify generator load capacity

Fully charge batteries on all essentialequipmentLocate/purchase torches/ lanterns andbatteriesUse natural lighting -open windows anddoorsIdentify patients for discharge or relocationInform and educate staffConsult current MHHS Disaster Plan forprocessLiaise with alternative service provider forcare of patients

Transfer patients out & close facilityEducate staff on contingency arrangements

Manager Engineering

Nursing staff

All ManagersMHHS Manager

MHHS Manager /MedicalSuperintendent only

Nurse Unit Manager

A

A

ALoss of watersupply forgeneral use,e.g., toilets,patienthygiene

Ration water usage


Identify alternative supplies ofdrinking water

Rationalise services and develop plan forwater restriction

Source / cost alternate supplies, e.g. / Watertankers / Fire service supplyInitiate use of alternate supply

Consider purchase of bottled waterLiaise with Renal Dialysis Unit to saveempty dialysate containers for water storageBuy containers for storage of drinkablewater

MMHS Executive •Manager Engineering

Manager Engineering

MHHS Executive /Manager Engineering

MHHS Executive A

Page - 188 28/08/2013



Loss of drinking wate

Contingency Failure

Discharge/ relocate patientswithin facilityConsider activation of MHHSDisaster PlanUse emergency supply

Close facility

Staff education

Identify patients for discharge or relocationConsult current MHHS Disaster Plan forprocessLiaise with local council / utilities reemergency water supplyLiaise with alternative service provider forcare of patientTransfer patients out and close facilityEducate staff on contingency

MHHS Manager

Nurse Unit ManagersSewerage Unable to dispose of

waste products due towater failure

Ensure facility wide plan Develop facility plan for waste disposal MHHS ExecutiveD

Ensure Localcouncil andPublic HealthUnitinvolvement.





Discharge/ relocate patientswithin facilityConsider activation of MHHSDisaster Plan

Inform staff to save water after patienthygienePlace bucket for used water in each toiletcubicle for flushing purposesClose off toilets not for use and post signsIdentify alternate toilet devices e.g., portaloos, and number requiredSource supply / cost of alternate devicesPurchase sufficient for immobile patientsRinse with “grey/waste” water and chemicalsolutionInform staff of Infection Control policyIdentify patients for discharge or relocationConsult current MHHS Disaster Plan forprocessLiaise with local council / utilities reemergency water supplyArrange for septic tank pumping truck topump sewerage out of hospital pipesLiaise with alternative service provider forcare of patientTransfer patients out, close facilityEducate staff on contingency plans

Nurse Unit Manager


Nurse Unit Manager

All staff

MHHS Manager

Manager Engineering

D

Page - 189 28/08/2013



Failure of contingency Close facility

Staff education

Medical SuperintendentNurse Unit ManagerManagers

DPower failure Mains power not

available. Generatorsupplies emergencypower

Refer to mains power failure plan Inform and educate staff DON/NUM/BM/Engineering B

Lightingfailure

Difficulties in patientobservation and care

Increased risk for patientsand staffNo safety/evacuationlighting available






Identify provision for emergency lightingRelocate immobile patients to best lit areasClean and maintain windows and fittingsEnsure blinds/curtains openEnsure adequate supply torches / batteryoperated lights and batteriesClear patient areas, work areas andcorridors of all hazardsIdentify and source alternative lightingStaff member to place lighting in strategicareas for safetyIssue clinical staff with torches

Engineering staff

Nursing staff

Operational Staff

All staff

Nurse Unit Manager Allstaff

B

Page - 190 28/08/2013

Business Continuity PlanEnvironmental Services

Environmental Services



Lift Failure Unable to transportpatients to differentlevels within facility



Consider utilising groundfloor facilities



Walk patients

Consider scoop stretchers,fire blankets, stair walkers,cardboard stretchersDevelop facility plan forlocating new admissions


Ensure all staff aware offacility Fire / Evacuation plan


Wards person

MHHS Executive

MHHS Executive

Medical staff

Unit Manager

D



Use cylinder oxygen Order required cylindersfrom central storage area.

Ensure all oxygen cylindersfull

Ensure correspondingnumber of oxygen fittingsavailable at ward level.

Ensure all staff educated incylinder changeover.

Consider co-locating highoxygen users

Wards person

Wards person

Wards person

Wards personUnit ManagerEducatorNursing staffmedical Staff

C

Page - 191 28/08/2013









Inform and educate staff Unit Manager /Nurse Educator D



Utilise emergency lighting .Torches in all areas.





Identify provision foremergency lighting

Relocate immobile patientsto best lit areas

Clean and maintain windowsand fittings

Ensure blinds/curtains open

Ensure adequate supplytorches / battery operatedlights and batteries

Clear patient areas, workareas and corridors of allhazards

Educate staff

Engineering staffNUMNursing staffSecurity

Cleaning staffWards person

All staff

Unit Manager

Unit Manager /All staff

Educator

C

C

Outside furniture/objects Flying objects Refer to cyclonepreparation policy

Ensure all flying objects aresecure

Wards persons

Linen Supplies Unable to maintainadequate linenmanagement if Laundryeffected - potentialinfection control risk

Beds only to be changed ondischarge and infectiouspatients

Ensure spare linen prepared Disaster CommitteeCorporate Services

A

Page - 192 28/08/2013




Inadequate WasteCollection & Disposal

Build up of clinical andgeneral waste productsin unitInfection Control Issue

Use additional disposalmethods

Ensure where possible JJRichards has emptiedcompactus. Supplyadditional bins

Disaster CommitteeCorporate Services

C





All managers

Duty managers

D




Refer to security plan

Schedule regular patientrounds

Direct notification viaphone switch or runner toCommunication Centre tocontact fire services,security & police

Inform and Educate Staff

Disaster CommitteeCorporate ServicesSecurity

All staffB

Failure of Lamson System Unable to transportspecimens

Revert to manual process Inform and educate staff Unit ManagerEducator


Wards person

D

In addition:

Environmental Services Manager/Supervisors and Team Leaders to have contact details of all staff All management team to the hospital if safe to travel Environmental Services Manager attendance to Emergency Disaster Committee Meetings Create a ‘Disaster team’ within Environmental Services (or Corporate Services) If we have notice of the disaster:

o Ensure adequate supplies of chemicals for at least a week

Page - 193 28/08/2013

o Attendance at emergency meetingso Liaise with JJ Richards in regards to waste – empty compactus, additional large bins, additional pick up of sharps and clinical

wasteo Staff meetings – rostering, ensure contact details are correct, draft in from other areas ie gardenerso Wet weather protection – heli-pad, Kids/WHU/Labour wardo Enough torches/batterieso Continually update staffo All outdoor furnishings/objects removed/tied down/locked securelyo Liaise with NUMs/Bed Managers for early discharges – impact on wardies/cleanerso Enough buckets/bins for water

Page - 194 28/08/2013

BUSINESS CONTINUITY PLANCatering Services

Limited connections to the generator during power failure.Problem Impact Contingency Task Responsibility

How long can you functionwithout this service?

Failure ofcomputerised systems

Unable to accesselectronic forms androsters

Revert to manualsystems

• Ensure adequatesupply of forms.

• Catering ManagerCatering Supervisor

BFailure ofcomputerised systems

Unable to accessinpatient status anddietary requirements

Revert to manualsystems

• Allocate staff tomanually collectstats/menus from wards


AFailure of energysupply to ovens

No hot/cooked food Use the 1 oven withemergency capability

•Assess and ensureemergency power isworking.


AFailure of energysupply to cookingequipment

No hot/cooked food Cold menu • Ensure adequatesupplies of cold food


AFailure ofRefrigeration / coolrooms

Food spoilage Essential fridges onemergency power

• Coolrooms areconnected toemergency power

• Catering Manager• Engineering staffCatering Supervisor

CFailure ofRefrigeration / coolrooms

Food spoilage Restrict menu • Utilise cyclone menu • Catering ManagerCatering Supervisor

BFailure ofRefrigeration / coolrooms

Food spoilage Restrict menu • Purchase dry / tinnedfood


BFailure ofRefrigeration / coolrooms

Food spoilage Modify choices • Consider purchase oflong life milk


B

Water quality Patient & staff health Bottled water • Consider purchase ofbottled water fordrinking

• Catering Manager •Catering Supervisor

CFailure ofDishwashers

Unable to ware wash Use disposables • Adequate supplydisposables

• Catering ManagerCatering Supervisor B

Inability to transportmeals

Unable to deliver patientmeals to floors abovekitchen area

Utilise emergencypower

• Ensure at least one liftoperational onemergency power

• Engineering staff A

Page - 195 28/08/2013

Inability to transportmeals


Airline lunches(prepacked lunches)

• Develop simple menufor easy transport


AInability to transportmeals


• Consider use ofvolunteers to transportmeals

Coordinate volunteers • Catering ManagerCatering Supervisor

AInability to cater forfunctions

No catered functionsheld

Resume catering whenservice is available

• Inform staff • Catering ManagerCatering Supervisor C

Inability to maintainstaff hygiene

Risk of food bornedisease

• Refer to facility WideInfection Control Plan

• Inform and educatestaff


BPotential for foodspoilage

Potential for diseaseoutbreak

• Monitor refrigerationand temperature

• Increased staffvigilance

• Catering ManagerCatering Supervisor C

Potential for foodspoilage

Potential for diseaseoutbreak

• Monitor refrigerationand temperature

• Ensure supply of auditforms/ thermometers

• Catering ManagerCatering Supervisor B


Check all equipment forfunctionality as soon aspossible after disruptionof power/failure ofmachines

Identify all equipmentto be checked

• Catering Manager

A• Inform and educatestaff

• Catering Manager

C

Mode of Operation A: Hours up to 24hrs

B: Days up to 5C: Weeks –

Indefinitely

D: Cannot Operate

Page - 196 28/08/2013

BUSINESS CONTINUITY PLANLinen ServicesLaundry cannot function if there is no electricity as the generator is not connected.

Boiler function is critical to the laundry. If boiler not operating:- No laundry Service.


Emergency Power Reduced production Utilise emergency power Identify access toemergency power

Manager Linen ServicesSupervisor LinenServices

C

Emergency Power Reduced production Utilise available existinglinen

Identify minimum usagerequired


B

Emergency Power Reduced production Evaluate linen resources Rationalise the use oflinen


B

Emergency Power Reduced production Evaluate linen resources Develop procedures tominimise patient useincluding ‘top & tail’,change only whensoiled, patients to supplyown linen where able

Manager Linen ServicesCNC Infection ControlNUM

B

Equipment breakdown /emergency power problem

No production Utilise alternative linenservice.

Review existingarrangements withexternal provider andnegotiate forsupply/removal linen

•Manager Linen ServicesSupervisor LinenServices

D

Page - 197 28/08/2013

Lifts out of service Develop plan fortransport of soiled andclean linen andrelocation of staff

• Manager LinenServicesSupervisor LinenServices

A

Boiler not working Unable to process anylinen at all.

Outsource all linen toprivate provider.

Arrange for linentransport to privateservice.


D

No water Unable to process anylinen at all.

Outsource all linen toprivate provider.

Arrange for linentransport to privateservice.


D

Supplies of chemicals Reduced production Ensure chemical stocksare adequate

Order extra supplies incyclone season


C

Mode of Operation A: Hours up to 24hrs

B: Days up to 5C: Weeks –

IndefinitelyD: Cannot Operate

Page - 198 28/08/2013

Emergency Call Directory

Contact List – Internal

Person Responsibilities Contact Number Email

Kerry McGovern(MHHS ChiefExecutive Officer)

QH & Board Liaison 4885 6752 [email protected]

David Farlow(EmergencyDirector of MedicalServices)

Health IncidentController

48856755 [email protected]

Julie Rampton(District Directorof Nursing)

Operations Officer48856763 [email protected]

Rhonda Morton(Chief OperationsOfficer)

Logistics Officer48856753 [email protected]

Vicki Barrow(Pandemic ProjectOfficer)

Planning Officer48855640 [email protected]

Danielle Jesser(Public AffairsManager)

Media andCommunicationsOfficer

48855984 [email protected]

Contact List – External

Key contacts Name Contact number/s

Police 000Emergency Services 000Ambulance 000MedicalSecurityInsurance companySuppliersWater and SewerageGasElectricityTelephone

Page - 199 28/08/2013

Operational ChecklistImmediate Response Checklist

INCIDENT RESPONSE ACTIONS TAKEN

Have you:

assessed the severity of the incident?

evacuated the site if necessary?

accounted for everyone?

identified any injuries to persons?

contacted Emergency Services?

implemented your Incident Response Plan?

started an Event Log?

activated staff members and resources?

appointed a spokesperson?

gained more information as a priority?

briefed team members on incident?

allocated specific roles and responsibilities?

identified any damage?

identified critical business activities that havebeen disrupted?

kept staff informed?

contacted key stakeholders?

understood and complied with anyregulatory/compliance requirements?

initiated media/public relations response?

Page - 200 28/08/2013

Glossary

Business Continuity

Management

The framework of controls implemented and steps undertaken by

an organisation to manage its business continuity risks. The

primary objective of these controls is to ensure the uninterrupted

availability of its key business resources that support key (or

critical) business processes.

Business Continuity

Planning

A process that helps develop a plan document to manage the risks

to the Mackay Hospital and Health Service, ensuring that it can

operate to the extent required in the event of a crisis/disaster.

Business Continuity

Plan

A document containing all of the information required to ensure

that the Mackay Hospital and Health Service is able to resume

critical activities should a crisis/disaster occur.

Critical Infrastructure A service, facility or a group of services or facilities, the loss of

which will have severe effects on the physical, social, economic or

environmental wellbeing or safety of the community

Essential Service An indispensable supply or activity

Emergency Control

Organisation

A structured organisation that will initiate an appropriate response

to emergency situations. During emergencies instructions given by

the EOC personnel shall overrule the normal management

structure.

Incident Business interruption, adverse event, disaster – a series of events

beyond the capacity and resources of a unit or facility to manage

eg fire, flood, loss

Key activities Those activities essential to deliver outputs and achievement of

overall facility objectives.

Recovery Time

Objective (RTO)

the time from which you declare a crisis/disaster to the time that

the critical facility functions must be fully operational in order to

avoid serious financial loss.

Resources the means that support delivery of an identifiable output and/or

result. Resources may be money, physical assets, or most

importantly, people.

Risk Management is the process of defining and analysing risks, and then deciding on

the appropriate course of action in order to minimise these risks,

whilst still achieving facility goals.

Amendment register and version control

Version Date Prepared by Comments1 26/8/13 Raelene Burke Updated from 2009 version23

Page - 201 28/08/2013

APPENDIX 1

Terms of Reference - Emergency Preparedness andContinuity Management Sub-Committee

The Mackay Hospital and Health Service Emergency Preparedness and Continuity Management Sub-Committee will ensure the Mackay Hospital and Health Service is able to respond effectively to externaland internal potential and actual emergencies and disasters.

Aim:

The Committee will oversee the implementation of systems, policies and procedures that identify andmanage potential emergency situations that may arise, either internally or externally in terms ofconsequence, exposure, probability and preventative actions.The Committee will assess staff preparedness to deal with emergency situations and, where necessary,develop strategies to improve the preparedness.

Objectives:

The MHHS Emergency Preparedness & Continuity Management Sub-Committee will:

Ensure compliance with relevant standards and legislation. Standards Australia – AS 4083-1997: Planning for Emergencies – Health Care Facilities Standards Australia – HB221:2004 Business Continuity Management Develop and implement appropriate emergency response systems in consultation with relevant

external emergency response organisations. Develop strategies, plans, manuals, processes and procedures to manage internal and

external emergencies. Ensure appropriate training of staff in cooperation with the Liaise with external agencies to ensure responses to both external and internal emergencies

are optimised. Report any risks assessed as Very High or Extreme to the MHHS Executive Identify key internal and external stakeholders and develop strategies for ongoing

communication with these stakeholders.

Membership:

Chief Operations OfficerDistrict Director of Nursing (or delegate)Executive Director Emergency MedicineEnvironmental ServicesHealth Information ServicesManager Building Engineering and Maintenance ServicesOccupational Health & Safety OfficerBed ManagerFire Safety OfficerInformation DivisionClinician

Page - 202 28/08/2013

APPENDIX 2

MODEL HEALTH INCIDENT MANAGEMENT CHECKLISTS(Adapted from the Australian Inter-service Incident Management System)

State Health Coordinator

The State Health Coordinator’s role is to provide the leadership and support for an overall coordinatedhealth response to the health event and the liaison with other agencies to ensure a planned, effectiveand integrated health service response and recovery.

Responsibilities include: Obtain (or provide) briefing from/to the Health Incident Controller; Provide the high level support required by the Health Incident Controller in meeting the

objectives of the health event management plan; Set up the Health Event Management Team and where appropriate with the other agencies

involved in the health response; Activate the Health Emergency Coordination Centre - dependent on the nature of the health

event, this may be in conjunction with another agency(s); Establish a support management structure that is appropriate to the size, nature and

complexity of the health event; Brief and liaise with the SCC or SDCC through the QH Director General or Chief Health Officer; Access external resources and agencies to ensure that the human, physical, fiscal and

communication resources are identified and made available to the Health Event ManagementTeam; and

Maintain a log of all activities.

Health Incident Controller

The Health Incident Controller is responsible for incident management activities including thedevelopment and implementation of strategic decisions and approving the ordering andreleasing of resources.

Responsibilities include: Assume control and obtain incident briefing; Assess incident information; Conduct initial briefing; If required or appropriate activate the Incident Management Team; Ensure planning meetings are conducted; Brief and allocate operational personnel including the Site Medical Commander

(when not already determined) in accordance with the health event managementplan;

Approve and authorise implementation of the management plan Supervise the health response and operations within the health event Coordinate staff activities; Assemble and disassemble response teams and task forces assigned Approve requests for additional resources and requests for release of resources; In consultation with the Media Officer, approve release of information to the news

media; Regularly report to the ‘lead’ agency and upwards; Approve plan for stand-down activities; Ensure safety and welfare of all health personnel; and Maintain a log of activities.

Page - 203 28/08/2013

Site Medical Commander

The Site Medical Commander is responsible for the management and coordination of all public health ormedical resources at the scene of the health event. The Site Medical Commander coordinates theorganisational elements providing medical or public health care at the scene in accordance with the sitemanagement plan and directs its execution. The Site Medical Commander coordinates his/her activitieswith the Site Commanders from Ambulance, Police and Fire services. The relationship between the SiteMedical and Ambulance Commanders is particularly close.

The Site Medical Commander also liaises frequently with the Health Incident Controller (in a largeincident once the EOC has been established) or individual hospital emergency departments (in a smallincident where the EOC support is in effect provided by the facilitating hospital). This communication willensure an accurate flow of information from the scene and appropriate destinations for the patientsleaving the scene. Requests for the provision of additional medical or public health resources to thescene are also the responsibility of the Site Medical Commander.

Responsibilities include: Obtain briefing from the Health Incident Controller; Develop the medical and or public health operational objectives of the site management plan in

conjunction with the Health Incident Controller; Oversee the implementation of the site management plan; Coordinate with the site commanders from all other agencies especially ambulance; Provide overall control and coordination of the primary triage area(s) with particular respect to

triage, transport and dispersal ; Coordinate with other site commanders where necessary tovary the SOP’s to ensure optimum safety for both patients and emergency personnel;

Brief and allocate (according to the site management objectives) arriving medical or publichealth personnel within the triage, treatment and dispersal framework;

Determine needs and request additional medical or public health resources; Report information about special activities events and occurrences to the Health Incident

Controller; Liaise with the ambulance transport officer to ensure appropriate provision of transport

services; Determine the level of escort required for patients en route to hospital Liaise with the Health Incident Controller to ensure appropriate destinations are found for all

patients; Maintain frequent communications with hospitals either directly or via the Health Incident

Controller to ensure hospitals have accurate information with which to plan; and Maintain a log of all activities.

Planning Officer

The Planning Officer is responsible for the collection, evaluation, dissemination and use ofinformation about the incident and status of resources.

Responsibilities include: Obtain briefing from Health Incident Controller; Negotiate with Health Commander the allocation and deployment of initial response

personnel as appropriate; Establish information requirements and reporting schedules for all involved in the

management of the incident; Establish as required information gathering and planning elements – for example: Weather collection system; Organise specialist advice; and HR requirements to maintain continued services or response; Supervise/prepare incident management plan; Assemble information on alternate strategies; Identify use of specialised resource/s; Provide periodic predictions on incident potential; Provide management support to the Health Incident Controller; Consider safety and welfare implications for all personnel during and Maintain log of all activities

Page - 204 28/08/2013

Logistics Officer

The Logistics Officer is responsible for providing facilities, services and material in support of theincident management. The Logistics Officer participates in the development and implementation of themanagement plan and manages the functions within the logistics section.

Responsibilities include: Obtain briefing from Health Incident Controller Plan organisation of the logistics section; Allocate logistics work tasks; Participate in preparation of management plan Identify medical and support requirements for planned and expected operations; Coordinate

and process requests for resources; Estimate logistic needs for continuing operational response; Provide advice to IMT on current capabilities; and Maintain log of all activities with a particular emphasis on any logistic requirements that may

have financial/funding implications.

Liaison Officer

The Liaison Officer reports to the Health Incident Controller and is the point of contact for assisting andliaising with other agency representatives.

Responsibilities include: Obtain briefing from Health Incident Controller Provide a point of contact for assisting agency representatives Identify other agency liaison officers including their contact / communication link and location; Respond to requests from health incident personnel for inter-organisational support; Monitor

incident response and operations for potential inter-organisational problems; and Maintain log of activities.

Media and Communication Officer

The Media and Communication Officer is responsible for providing and coordinating media response,internal and external communication requirements, and stakeholder relations in support of the incidentmanagement. The Media and Communication Officer participates in development and implementation ofthe management plan.

Responsibilities include:

Media and communication response strategy in partnership with the incident management team,MHHSs, units and senior executives;

Develop the overall media and communication response category in partnership with the incidentmanagement team, MHHSs, units and executives;

Manage and coordinate all internal and external communication, media in and stakeholder relations outputs. Provide strategic internal and external communication and stakeholder relations advice to the

Director-General, senior executives and Incident Controller; Provide direction to media andcommunication support staff.

Act as media and communication liaison key conduit with the Ministers office.

business continuity plan - mackay hospital and health service...the aim of the mackay hospital and...

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