Tuesday, January 29, 2013

Hospital and Health Facility Emergency Exercises

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Preface

Practice is crucial to prepare for emergencies. Health organizations may have preparedness and contingency plans yet only when these plans are put to a test through drills can managers determine gaps and areas that needed strengthening. Emergency exercises are one of the best ways to test emergency plans. Hospital drills are essential components to ensure that health professionals are prepared to face emergencies and disasters.

This resource aims to guide hospital management in preparing for and conducting exercises for emergencies and disasters . After introducing basic principles in emergency exercises, it proceeds into describing the process of planning for and conducting them . It presents five exercise types: orientation, drill, tabletop, functional and full-scale. Emergency exercises are not just one time annual events but must be an essential component of a comprehensive emergency response plan.

The document was developed through a review of relevant literature and consultation with hospital directors and emergency exercise managers. A draft was presented before emergency preparedness and response experts at the regional office. Resource materials, examples and forms were included to provide a comprehensive overview of the emergency exercise process.

Hospital managers and supervisors will find this document useful in preparing for their emergency drills and preparedness plans. The document will also provide good information to disaster preparedness and risk reduction advocates and trainers especially those who are working within the health sector.

This publication is a part of a series of tools and guides for safe hospitals campaign that focus on health facility preparedness, risk reduction, emergency planning and management. The regional implementation of the global safe hospitals campaign was supported by the European Commission Humanitarian Aid department.

Executive summary

As part of the World Health Organization’s Hospitals Safe from Disasters campaign, Guidance Materials: Hospital and Health Facility Emergency Exercises was written with the goal of aiding hospital and health facility emergency management committees in preparing for and conducting exercises for emergencies and disasters. It was developed through a review of relevant literature and consultation with emergency exercise managers. The discussed materials, examples and forms adapted were selected with the hope of providing a brief but comprehensive overview of the emergency exercise process. Although there are common guiding principles in the execution of hospital emergency exercises, this document takes into consideration that each institution has unique circumstances. Thus, this document is not intended to serve as definitive guidelines—rather, it is meant to provide a starting point for hospital emergency management committees in developing emergency exercise plans customized to their particular needs and setting.

Emergency exercises are activities done to practise, develop, test and improve plans and procedures on how a hospital or health facility will respond to emergencies and disasters . This collection of plans and procedures is also known as the hospital or health facility emergency response plan. The emergency response plan is a prerequisite for conducting emergency exercises—for without the plan, there would be nothing to exercise.

There are five commonly used types of exercises: (1) orientation, (2) drill, (3) tabletop, (4) functional and (5) full-scale.

Each exercise type has its own strengths and limitations. More complex exercises more closely simulate reality; however, they also are more difficult to organize and require more resources. The choice of exercise type to be used will depend on the objectives for conducting the exercise.

A general emergency exercise process is provided to outline the four phases of preparing for and conducting exercises, and lists individual steps for each activity. Tool guides and example forms are provided at the end of each section. The four phases of the process are (1) pre-planning, (2) planning, (3) exercising and (4) post-exercise.

After going through the general exercise process, each type of exercise is discussed. Briefly, (1) an orientation is an informal seminar discussion on the emergency response plan or its particular parts; (2) a drill is an operational activity for maintaining and developing skills in a single-response procedure; (3) a tabletop exercise is an informal dialogue in which simulated emergency situations are discussed by officials with emergency management responsibilities to resolve problems based on the emergency plans; (4) a functional exercise is a real-time, interactive emergency simulation conducted in the emergency operations centre, coming just short of deploying personnel to an emergency site; and (5) a full-scale exercise, also known as a field exercise, is an interactive activity that includes real-time conduction and actual deployment of resources in response to a fully simulated emergency. Exercise type-specific tool guides are also provided at the end of each section.

These different exercise types are then discussed with reference to their potential use in the context of a comprehensive exercise programme. This is a process that makes use of the five exercise types in a progressively complex fashion until mastery of the emergency response is achieved.

At the end of the document, annexes attached include a discussion listing several elements of a hospital emergency response plan (Annex 1), as well as a listing of key definitions (Annex 2), which are useful to review for this guide.