Table of Contents
1.0 Introduction
1.1.1 Scope
1.1.2 Purpose
1.1.3 Strategy
1.2 Acknowledgements
1.3.1 Emergency Management Program Checklist
2.0 Emergency Management (EM) Concepts for Health Care Systems
2.1 Introduction
2.2 The Emergency Management Context
Figure 2.1: The Four Phases of a Comprehensive Emergency Management
2.3 Developing the Emergency Management Program
2.4 Structuring the Emergency Management Program
Figure 2.2: Structure of the All Hazards Emergency Operations Plan (EOP)
Figure 2.3: IEMS Program Development Process
2.5 Implementing the Emergency Operations Plan (EOP)
Figure 2.4: Principles of ICS
Figure 2.5: Integrating Functions and Annexes Under ICS
2.6 Understanding Crisis Behavior
2.7 Summary
3.0 Nine-Steps to Establish a Successful Emergency Management Plan
Figure 3.1: Nine Steps to Establish a Successful EMP
3.1 - Step 1 - Designate the Emergency Management Committee (EMC), Identify Operating Unit Roles
and Assign Responsibilities
3.1.1 Emergency Management Committee (EMC)
3.1.1.1 EMC Membership
3.1.1.2 EMC Reports to Facility Safety Committee
3.1.1.3 Functions of the EMC
3.2 - Step 2 - Conduct a Hazard Vulnerability Analysis (HVA) and Complete Operating Unit Templates
for Mission-Critical Systems
3.3 - Step 3 - Review Hazard Vulnerability Analysis (HVA) and Determine Priorities
for Developing Standard Operating Procedures (SOPs)
3.4 - Step 4 - Implement Mitigation and Preparedness Strategies
3.5 - Step 5 - Report Results of Mitigation and Preparedness Activities
to the Emergency Management Committee (EMC)
3.6 - Step 6 - Develop, Publish and Distribute the Emergency Operations Plan (EOP)
3.7 - Step 7 - Train Staff on the Emergency Operations Plan (EOP)
3.8 - Step 8 - Test and Evaluate the Emergency Operations Plan (EOP)
in Response to a Drill or Actual Event
3.9 - Step 9 - Conduct an Annual Review of the Effectiveness of the Emergency Management Program
3.10 - Emergency Management Program Tools
3.10.1 Key Personnel Resource Matrix (Blank Form)
Key Personnel Resource Matrix (Completed Form)
3.10.2 Sample Timeline for Development of Emergency Management Program (Blank Form)
Sample Timeline for Development of Emergency Management Program (Completed Form)
3.10.3 Hazard Vulnerability Analysis (HVA) Instructions
Hazard Vulnerability Analysis (Blank Form)
Hazard Vulnerability Analysis (Completed Form)
3.10.4 Sample Standard Operating Procedure (SOP)
Sample Key Activity Management Tool
Sample Key Activity Management Structure
3.10.5 Sample Operating Unit Assignment Matrix (Blank Form)
Sample Operating Unit Assignment Matrix (Completed Form)
3.10.6 Employee Training
3.10.7 "Emergency Management Program" (VAMC Handout)
*3.10.8 "Emergency Management Program" (PowerPoint Presentation)
4.0 Sample Operating Unit Templates
4.1 Introduction
4.1.1 Other Critical Services not Conducive to the Operating Unit Templates
4.1.2 Guidelines for Completing the Templates
4.1.3 Operating Unit Template Instructions
4.1.3.1 Emergency Management Program (EMP) Operating Unit Template (Blank Form)
4.2 Administrative Templates
Table of Contents
4.2.1 Fiscal Service
4.2.2 Human Resources
4.2.3 Police and Security Service
4.2.4 Purchasing, Contracting and Warehouse
4.2.5 Quality Management (Performance Improvement)
4.3 Ancillary Templates
Table of Contents
4.3.1 Canteen Service
4.3.2 Food and Nutrition
4.3.3 Clinical Laboratory Service
4.3.4 Pharmacy (Inpatient)
4.3.5 Pharmacy (Outpatient)
4.3.6 Prosthetics
4.3.7 Radiology
4.3.8 Social Work Service
4.4 Patient Care Service Templates
Table of Contents
4.4.1 Cardiac Cath Laboratory
4.4.2 Dialysis
4.4.3 GI Procedures
4.4.4 Intensive Care Unit
4.4.5 Inpatient Wards
4.4.6 Outpatient Clinic (CBOC)
4.4.7 Outpatient Clinic (On-Site)
4.4.8 Operating Rooms
4.4.9 Rehabilitation Medicine
4.5 Patient Care Support Templates
Table of Contents
4.5.1 Eligibility
4.5.2 Medical Records
4.5.3 Patient Travel and Funds
4.5.4 Scheduling
4.5.5 Supply, Processing and Distribution
5.0 Developing the Emergency Operations Plan (EOP)
5.1 Components
5.1.1 Relationship between the Emergency Management Program, EOP,
Incident Command System (ICS) and Standard Operating Procedures
5.1.2 Purpose
5.1.3 Scope
5.1.4 Policies
5.1.5 Situation: Emergency
5.1.6 Assumptions
5.1.7 Concept of Operations: General
5.1.8 Implementation of the Emergency Operations Plan (EOP)
5.1.8.1 The Incident Command System (ICS)
5.1.8.2 Incident With Warning (EOC Response)
5.1.8.3 Incident Without Warning (Field Response)
5.2 Organization of an EOP
5.2.1 EOP Structure
5.2.1.1 Basic Plan
5.2.1.2 Functional Annexes
5.2.2 Management and Planning
5.2.3 Logistics and Finance
5.2.4 Operations Section
5.2.4.1 Business Continuity Operations
5.2.4.2 Equipment, Plant and Utilities Operations
5.2.4.3 Safety and Security Operations
5.2.4.4 Health and Medical Operations
5.3 Sample - VA Medical Center Emergency Operations Plan (EOP)
Attachment A: Mobilization Checklist
Attachment B: Key Activity Management Structure (Blank Form)
5.4 Sample - VA Medical Center Community Based Outpatient Clinic (CBOC)
Emergency Operations Plan (EOP)
Attachment A: Hazard Vulnerability Analysis (Blank Form)
Attachment B: CBOC Hazards Analysis
Attachment B-1: Bomb Threat Checklist
5.5 ICS Position Descriptions and Forms
Table of Contents
ICS Position Descriptions and Forms Chart
Attachment: Mobilization Checklist
Attachment: Public Affairs Checklist
Attachment: Incident Action Planning Checklist
Form IMS 202 - Incident Objectives
Form IMS 203 - Organization List
Form IMS 204 - Assignment List
Form IMS 201 - Incident Briefing
Form IMS 213 - General Message
Attachment 1-A: EMP Incident Report (Sample)
Attachment 1-B: Situation Report (SITREP) (Sample)
Attachment 1-C: Operating Status Checklist and Report (Sample)
Attachment 1-D: After-Action Report (AAR) (Sample)
Compensation and Claims Unit/Officer
Business Continuity Group Leader
Equipment, Plant and Utilities Group Leader
Safety and Security Group Leader
Health and Medical Group Leader
6.0 External Support
6.1 Introduction
6.3 National Disaster Medical System (NDMS)
6.3.1 Federal Coordinating Centers
Attachment: VA Federal Coordinating Centers by VISN
6.4.1 FRP Organization
6.4.2 FRP Provisions
6.4.3 Mission Tasking
Figure 6.1: Request For and Furnishing Support Under FRP
6.4.4 Reimbursement Under the FRP
6.6 Developing Local Agreements
7.0 Sample Standard Operating Procedures (SOPs)
7.1 Introduction
Figure 7.1: Operations Section of the VAMC’s ICS
Key Activity Management Tool (Blank)
Key Activity Management Structure (Blank)
7.2 Table of Contents - Threats and Events
(Documents highlighted with an asterisk "*" can be found on the CD and Web Site)
7.2.1 Naturally Occurring Events
*7.2.1.1 Drought/Dust Storm
Key Activity Management Structure
7.2.1.2 Earthquake
Attachment: Earthquake Emergency Supply Inventory
Key Activity Management Structure
*7.2.1.3 Fire Response
Key Activity Management Structure
*7.2.1.4 Flood
Key Activity Management Structure
*7.2.1.5 Hurricane
Key Activity Management Structure
*7.2.1.6 Thunderstorm/Lightning
Key Activity Management Structure
*7.2.1.7 Tornado
Key Activity Management Structure
*7.2.1.8 Tsunami
Key Activity Management Structure
*7.2.1.9 Volcanic Eruption
Key Activity Management Structure
*7.2.1.10 Winter Storm
Key Activity Management Structure
7.2.2 Human Related Events
7.2.2.1 Bomb Threat
Key Activity Management Structure
7.2.2.2 Civil Disturbance
Key Activity Management Structure
7.2.2.3 Cyber Attack
Key Activity Management Structure
7.2.2.4 Hostage/Barricade Situation
Key Activity Management Structure
7.2.2.5 Terrorist Threat
Attachment A: Release of Information
Attachment B: Security Alert Levels and Taskings
Attachment C: Exterior Door and Duress Alarm Test Sheet
Attachment D: Biological and Chemical Substances Checklist
Key Activity Management Structure
7.2.2.6 Violence in the Workplace
Key Activity Management Structure
7.2.3 Hazardous Materials Events
7.2.3.1 Biological Agents (CDC Category A Agents)
7.2.3.1.1 "Generic" Biological Event
Attachment A: Sample Biologic Surveillance Plan (Symptomatic Patient)
Attachment B: Sample Biologic Event Plan
Attachment C: Veterans Health Administration Pharmaceutical Cache Program
Infection Control Bio-terrorism Checklist
Key Activity Management Structure
7.2.3.1.2 Anthrax
Key Activity Management Structure
7.2.3.1.3 Smallpox
Key Activity Management Structure
7.2.3.2 Other Hazardous Materials
7.2.3.2.1 Chemical Event (External)
Attachment: External Hazmat Response Plan
Key Activity Management Structure
7.2.3.2.2 Chemical Event (Internal)
Attachment: Internal Hazmat Response Plan
Key Activity Management Structure
7.2.3.2.3 Explosion
Key Activity Management Structure
7.2.3.2.4 Radiation Event
Attachment A: Goals of Contamination Control
Attachment B: Treatment for Selected Internal Contaminants
Attachment C: Acute Radiation Syndrome
7.3 Table of Contents - Key Operational Events and Activities
*7.3.1 Business Continuity
*7.3.1.1 Business Relocation
*7.3.1.2 Communications Disruption
Key Activity Management Structure
*7.3.1.3 Critical Supplies
*7.3.1.4 Patient Access to Services
*7.3.1.5 Records Preservation
*7.3.1.6 Staffing Shortage
Key Activity Management Structure
*7.3.1.7 VISTA and Other Computer Systems Disruption
Key Activity Management Structure
*7.3.2 Equipment, Plant & Utilities
*7.3.2.1 Alarm Systems Failure
Key Activity Management Structure
*7.3.2.2 Electrical Power Failure
Key Activity Management Structure
*7.3.2.3 Elevators/Vertical Transport Failure
Key Activity Management Structure
*7.3.2.4 Heating, Ventilation, Air Conditioning (HVAC)
*7.3.2.4.1 HVAC Failure
Key Activity Management Structure
*7.3.2.4.2 Room or Hood Exhaust Failure
Key Activity Management Structure
*7.3.2.4.3 Steam Distribution Failure
Key Activity Management Structure
*7.3.2.5 Internal Transport Systems Failure
Key Activity Management Structure
*7.3.2.6 Medical Gases System Failure
Key Activity Management Structure
*7.3.2.7 Roads and Grounds Blocked
Key Activity Management Structure
*7.3.2.8 Waste and Debris Removal
Key Activity Management Structure
*7.3.2.9 Water Delivery/Potability
Key Activity Management Structure
7.3.3 Health and Medical
7.3.3.1 Alternate Care Site
Attachment: Sample Memorandum of Understanding (MOU)
7.3.3.2 Evacuation (Total)
Key Activity Management Structure
7.3.3.3 Fatality Management
7.3.3.4 Mass Casualty Incident
Key Activity Management Structure
7.3.3.5 Outreach
7.3.4 Safety and Security
7.3.4.1 Alerting and Warning Systems
7.3.4.2 Facility Access Control
7.3.4.3 Fire Suppression Systems
Key Activity Management Structure
8.0 Acronyms, Terms and Definitions
9.0 Index of Tools
11.0 Topic Index