Guide for Establishing, Operating and Evaluating an Emergency Operations Centre

Transcription

1 Guide for Establishing, Operating and Evaluating an Emergency Operations Centre WHO Western Pacific Regional Office

2 The Guide is a simplified, howto manual and memory aid Subject more complex than presented Many options not explored Based on proven practices and an emerging standard Users need to adapt the approach to their circumstances

3 Module Module 1 1 Introduction to a few concepts and key issues in emergency management Learning Objectives: -participants will be familiar with a few key concepts and definitions -participants can identify probable sources of failure in emergency response management

4 Useful words Some of the words in the Guide have specific meanings in the context of emergency management. Some of these are defined in the text and most are also found in the glossary. Here are a few to consider immediately:

5 All-hazards: an approach to emergency management based on the recognition that there are common elements in the management of responses to virtually all emergencies, and that by standardizing a management system to address the common elements, greater capacity is generated to address the unique characteristics of different events.

6 Command post: a form of site-level emergency operations centre, assembled as needed by the first agencies to respond to an event.

7 Consequence management: distinguishes between dealing with the emergency event (putting out the fire) versus dealing with the effects or aftermath of the event. (Treating the burn and smoke inhalation victims). Some examples of consequence management in the health sector include mass casualty management; psychosocial services; communicable disease control and environmental health measures.

8 Emergency: an exceptional event of any magnitude that produces damage and injury and exceeds or potentially exceeds the capacity of normal resources to cope. Emergencies have effects that may be considered on a continuum from localized incidents with limited consequences, to wide area disasters with catastrophic consequences, and are often referred to as incidents or events, with the terms used interchangeably.

9 Emergency Coordination Centre: a term used to describe a type of Emergency Operations Centre that has no direct, tactical/operational function, but serves as a point of control and coordination of the strategic allocation of resources and management of policy issues. Commonly found at the national level.

10 Emergency management: Sometimes referred to as disaster management. Emergency management is a discipline dealing with the assessment, reduction and avoidance of excessive risk; the organized response to natural, human-generated or technological disasters or risk events and post-event support for the planning and rebuilding of damaged institutions.

11 EOC, Emergency Operations Centre: a place, activated for the duration of an emergency, within which personnel responsible for planning, organizing, acquiring and allocating resources and providing direction and control can focus these activities on responses to the emergency

12 Event: an emergency incident or occurrence. Event is often used to describe an emergency with a number of incidents, but most often, event and incident are used interchangeably. Under the International Health Regulations, an event is a public health emergency of international concern.

13 Jurisdiction: an organization (an agency or level of government) with the authority and responsibility to provide particular functions and services within a defined area.

14 Modular: an organizational characteristic where components are standardized to support flexibility in building or adjusting the organization to address changing requirements.

15 Plans: Plans are specific to their intended users: a contingency plan is specific to both the unique event (contingency) and the agency mandated to deal with it; an agency emergency plan is specific to the agency and deals generally with the kind of emergencies that agency is mandated to address; an EOC plan is specific to the EOC and relates to the management and coordination processes of the EOC; and a support plan is specific to a supporting agency or jurisdiction (such as a national government) and lays out when and how they will support another jurisdiction s emergency response.

16 Scalable: capable of being enlarged or reduced in size to adjust capacity and capability by adding or deactivating modules, in order to adapt to changes in demand without the need for reconfiguration of a basic structure.

17 Sector: a division, or a collective aspect of a geographical area, an economy or a society.

18 Site-level: the actual location of the hands-on, tactical level response to an emergency. When site-level emergency responses capacities are overwhelmed, the role of a site-support EOC is to provide logistical (resources) and strategic (direction and coordination) assistance.

19 Strategic: The defining characteristic of strategic is that it deals with the concepts of relatively long term and big picture in relation to the pattern or plan that integrates an organization's major goals, policies, and action sequences into a cohesive whole.

20 Tactical: those activities, resources and manoeuvres that are directly applied to achieve goals.

21 Technical communications: relates to the protocols, procedures and methods used to pass critical information among key participants during the management of an emergency.

22 Unified management: a team approach to the management of complex, multiagency or multi-jurisdictional emergencies that allows all agencies with geographical or functional responsibilities in the response to establish a common set of objectives and strategies.

23 To varying extent, depending on culture, citizens expect governments, agencies and businesses to safeguard their security

24 Historical issues in the management of emergency responses Lack of leadership, related to qualifications or judgment Lack of coordination, due to failures in cooperation Lack of integration, due to competition Lack or loss of resources, due to failures in planning Lack of planning, due to absence of commitment Lack of media support, due to all of the above plus failures in risk and crisis communications.

25 Populations and institutions are increasingly interdependent and vulnerable to emergency events and broad-impact, multi-sectoral events are increasingly common Health sector to lead in disease prevention and management Health sector to assist with casualty management Health sector to assist or cooperate in broader consequence management activities Assist means health resources directly employed Cooperate means that health resources indirectly support

26 Health Sector consequence management services in emergencies Casualty management (first aid, triage, transport, prehospital care, in-patient care, out-patient care) Communicable disease control (surveillance, tracking, treatment, prophylaxis, isolation and quarantine) Management of the dead

27 Consequence management 2 Environmental health measures (water, sanitation, environmental pollution) Psychosocial services Health information Management of health risks (risk assessment, mitigation, communication, preparedness and response leadership)

28 The role EOC personnel is to address six values-based, universal emergency management objectives Protect response personnel and resources Minimize loss of life, disability and suffering Protect public health Protect civil infrastructure Protect environmental and economic assets, including property Reduce economic losses

29 The purpose of an Emergency Operations Centre (EOC) is to provide a place to manage the health sector s contribution to an emergency It may large or small Dedicated or shared Permanent or temporary

30 Successful emergency management systems Focus decisions and resources on priority objectives Support sustained, high levels of collaboration and communication Provide systemic accountability mechanisms Are designed to address a number of principles

31 Core Principles for emergency management systems Based on an all-hazards approach Modular, scalable or adaptable organization Support for joint engagement of multiple jurisdictions/organizations in management decisions Clear lines of accountability Clearly defined roles and responsibilities, consistent with normal roles and supported by training

32 Core principles 2 Clearly articulated procedures for activation, escalation, and demobilization of emergency capacities. Common functional groupings and consistent terminology Integrated with stakeholder agencies Mechanisms for the involvement of all stakeholders and users of the EOC in its design, operational planning and evaluation. Provision of capacity to manage public communications opportunities as part of the response to emergencies.

33 The Guide advocates a standardized, pan-jurisdictional approach to management of all emergencies Pan-jurisdictional means: Within all agencies with responsibilities in a certain area AND Across all agencies within a political jurisdiction (eg: a municipality; a country) Even an approximation of such an approach yields benefits

34 Benefits of a universal standard Consistent management and planning strategies Maximizes potential for cooperation by clarifying roles and responsibilities Facilitates coordination of public, private and NGO sectors Creates common organizations and control systems

35 Universal standards benefit 2 Creates common nomenclature (naming conventions and working language) Supports uniform training and qualifications Supports development of common technologies Supports development of common documentation

36 A universal standard would apply across sectors Health Sector Governance Sector Private Sector Ministry of Health Health Authority (Hospital/EMS) Coordination Site management (EMS/hospital) National Coordination Centre Site support level EOC Municipal or Provincial Site - level agency incident management (Command post) National Coordination Central Regional Coordination Local Site Coordination

37 Response and management roles change at each level: Site -tactical resources directly applied to address emergency problems -responders may come from one agency, or many -the on-site response is directed by one agency by jurisdiction or agreement -operates from an ad-hoc site command post -utilizes standard functions

38 Response and management roles continued: Site support provides logistical support and policy direction to sitelevel operates from a pre-established EOC activated for larger and multi-site/agency/jurisdiction events uses standard functions

39 Response and Management roles continued: Provincial and National coordination level facilitates and coordinates the flow of critical information and policy direction in large scale, high impact emergencies directs and coordinates the acquisition and deployment of trans-jurisdictional resources operates through an Emergency Coordination Centre, uses standard functions

40 End of module 1 Questions and Discussion Review learning objectives Learning Objectives: -participants will be familiar with a few key concepts and definitions -participants can identify probable sources of failure in emergency response

41 Module 2: The Functional Elements of an EOC Learning Objective: -Participants can describe the functional components and organization of an emergency operations centre.

42 Most emergency responses require six intuitive behaviors Evaluate situation and options Decide what to do Acquire response resources Initiate a response Keep track of the resources Report on situation and actions

43 This is the functional model for all-hazards emergency response. The behaviors are intuitive, but operation of an emergency management system based on them is not so intuitive Requires structure, trained process and practiced discipline

44 Elements are both functional and structural Policy Management Operations Planning Logistics Administration

45 Elements apply to all response and response management activities conducted by one person or hundreds all types of management facilities small local command post to a national coordinating centre with several dozen staff.

46 The guide is concerned primarily with a site-support EOC responsible for: Provision of policy guidance and support Establishment of priorities Coordination of agencies and operations

47 Guide is concerned with 2 Collection, evaluation and display of information about the event for decision makers Resource acquisition and management Communications within the response structures Public information, risk and crisis communication

48 Policy Function Executive officers, government officials with strategic leadership duties Provides high level resource allocation and policy direction to the Management function

49 Management Function Emergency policy Operational decisions and coordination Responder safety Risk management Public communications Agency relationships

50 Operational Function Tactical response activities (site level) Coordination of response activities Implementing and improvising response plans

51 Planning Function Collect, evaluate and communicate event information Develop objectives, strategies and action plans Identify resource requirements for future operations

52 Logistical Function Acquire and track operational resources Support services for the EOC facility and staff Information technology and communications support

53 Administrative Function Tracking of material and human resources Record systems Payments

54 Organizational Structure Policy Management Develops goals and objectives Management Support staff Safety/ risk mgmt Liaison officer Communications Operations Planning Logistics Administration Accomplishes Goals and objectives Supports Management and Operations

55 End of module 2 Questions and discussion Review learning objective Learning Objective: Participants can describe the functional components and organization of an emergency operations centre.

56 Module 3: Operational Aspects of an EOC Learning Objective: -participants can describe how the functional elements of emergency management work together to produce a coherent, appropriately scaled response.

57 Competent staff An EOC needs skilled people who will work together Functional familiarity through regular job Oriented and trained to the EOC role Good team players

58 Draw personnel from appropriate agency operations Policy group: Elected officials; chief medical officers; chairs of boards or board committees; legal advisors; chief executive, operating, administrative or financial officers; senior department heads Management: Chief executive, operating or administrative officers; emergency program coordinators or planners; communications officers; safety officers; risk managers

59 Draw personnel from 2 Operations: Division and department heads with programmatic responsibility relevant to the emergency, who can work directly with the incident manager Planning: program and emergency planners; analysts; subject matter experts

60 Draw personnel from 3 Logistics: staff from purchasing departments; information technology and systems support; human resources officers Administration: financial officers, accounts and contracts processing personnel; financial analysts; administrative assistants; clerks

61 Plan for redundancy and generous clerical support more people than just one shift for long duration events an EOC generates and manages a lot of records.

62 EOC Plan the primary reference for EOC staff Provides guidance for the management, operation and staffing of the EOC standardize basic and routine activities minimize the need for improvisation in the EOC management process

63 Contents of an EOC Plan purpose of the plan concept of operations, management structure, roles of personnel and how the components work together Activation procedures and levels, and who has authority Escalation and de-escalation plan Call-out list and notification procedures

64 Contents of EOC Plan 2 Checklists of the roles and responsibilities of EOC functions Checklists of standard operating procedures floor plan, with inventory and locations of equipment and supplies Electronic information management processes (including a layout plan of phone, fax, data lines, cables, switches and outlets) Communication resources and procedures, especially mobile phones and radios Public information and warning processes

65 Contents of EOC Plan 3 Procedures for engaging levels of government and/or a superior jurisdiction Standard forms and instructions for documenting EOC activities Maps of the area of the event Guidelines for worker care and safety agency and position responsible for maintaining and updating the plan Training and exercise schedule to ensure staff and procedures are up-to-date.

66 Escalation of capacity expand capacity or specialize capability each of the functions can be selectively activated or not, as needed, each of the functions can be scaled up or down to suit changing requirements.

67 Escalation Principles The Incident Manager/EOC Director is responsible for all functions and if one is not activated by staffing it, then the manager/director is doing it. Only as much or as many of the functions as the situation requires, need to be activated and resourced For site-level response, the functions are expanded from the ground up by the on-scene Incident Manager

68 Escalation Principles 2 For a site-support EOC or more distant Coordinating Centre, functions expand from the top down span of control (ratio of supervisors to workers) ideally one to five, and each supervisor is one of no more than five reporting to the next level, up to the EOC Director. This provides for a clear chain of control and accountability, unity of management, with each person directly reporting to only one person.

69 Joint or Unified Management provides for agencies with coincident geographic or functional jurisdiction for an emergency to jointly manage the response by establishing a common set of objectives and strategies. does not mean giving up agency authority, responsibility, or accountability. It means that all involved agencies contribute to the management process

70 Joint Management Processes: Jointly determine overall objectives. Plan jointly for operational activities while conducting integrated operations. Maximize use of all assigned resources. Coordinate the emergency response functions are under a single action plan

71 Joint Management processes 2 Designate one jointly resourced Operations Section as responsible for implementing the action plan Activate one EOC or Incident Management Post (as opposed to multiple) Designating one of the joint managers to act as spokesperson

72 Internal Communication: the key to teamwork Facilitated by a 1:5 span of control Vertical briefing process every supervisor must keep their staff briefed Horizontal briefing through mandatory supervisory attendance at planning meetings Shared situation reports Shared new intelligence Shared media briefings

73 Management by objectives: the key to results The mission of an EOC is pursue objectives that result in a transition from reactive response to pro-active situation management by the application of four steps:

74 MBO 2 Within the context of agency policy and direction (mandate) establish observable or measurable, achievable objectives From an evaluation of the options, select an appropriate strategy Direct the use of tactical resources the Apply tactics that are appropriate to strategy Assign the right resources Monitor and evaluate outcomes to either re-initiate this cycle or achieve the goal

75 Use an Action Plan to achieve objectives: May be oral or written. provides the EOC supervisory personnel with directions for both current and future actions form the basis for defining operational periods; based on the needs of the event, and the time required to achieve objectives When the emergency event is large and involves the full or partial activation of an off-site EOC to support the response helps ensure continuity of action and management

76 Elements of an oral or written Module 1 Action Plan A statement of objectives, appropriate to the entire event Identification of the functional EOC elements that will be activated for the current and estimated future operational periods Resource assignments with the intended strategies and tactics, for each organizational element Supporting materials; maps of the event area; communications plan, patient transportation plan, traffic management plan, etc.

77 Post event debriefing After every live or practice event The hot wash. A short oral debriefing process immediately on conclusion of the event when impressions and information are still fresh A second more structured process where events are reviewed and formal recommendations noted for future action. debriefing sessions are the primary evaluation process for an EOC

78 Debriefing 2 What met or exceeded standards or expectations What partially met standards or expectations, and how can future responses be improved What did not meet standards or expectations, needs to be re-thought and what options are there for fixing the problems Lessons learned report

79 End of module 3 Questions and discussion Review of learning objective -participants can describe how the functional elements of emergency management work together to produce a coherent, appropriately scaled response.

80 Module 4: Developing an EOC Learning objectives -participants can identify the sources of authority for developing an EOC and who would be most appropriate for a steering committee and EOC project or working group. -participants can describe the space requirements and configuration for an EOC in their jurisdiction or agency, which will meet their anticipated requirements.

81 The Steering Committee site-level command posts are spontaneously created by on-scene responders a site-support EOC requires committed, top-down leadership, policy and funding support identify an executive sponsor who will convene a steering committee

82 Steering committee 2 steering committee should consist of the most senior decision makers from the participating agencies. for a single agency EOC, the steering committee will likely be the agency s Emergency Management Committee (or similar). The steering committee appoints an EOC Working (or Task or Project) Group that directly manages or does the project work to create the EOC.

83 The working group overall responsibility for addressing the facility, equipment, procedures, training and exercise requirements for the primary and secondary emergency operations centres

84 There are three important considerations when selecting members of the team: team members must have the commitment, authority and access to resources to complete the project The members must understand their organizations, the community and the processes of emergency response and planning. be in agreement on their purpose and committed to working cooperatively

85 Module Suggested 1 members for an EOC Working Group: Emergency Management Coordinator/Planner Medical officers Health Authority (Hospital and Clinic) Administrative and Program Managers EMS Managers and Dispatch personnel Risk Management personnel Media Communications Officer Operational supervisors and managers

86 Working Group members 2 Planners Purchasing managers/supervisors Accounts processing and procurement managers/supervisors Information Technology business analysis and technical support Managers Facilities management and engineering Managers An effective working group should probably be limited to 12 members, preferably fewer.

87 Physical attributes of an EOC Two primary considerations: -Location, including access, security, proximity to partners -Facility, including size, amenities and configuration

88 Location Is there an emergency management agency that could sponsor it? Proximity to partners, stakeholders, donors and humanitarian agencies Is some integration with the broader emergency management infrastructure of the jurisdiction possible. Can the facility survive the hazards in the area? Is it accessible in an emergency?

89 Facility a dedicated, purpose-built Health EOC is relatively rare except at the level of national governments a dual or multi-purpose EOC, where the space is routinely used for some other purpose is more common

90 If contemplating dual use space, consider: convert and activate the space as an EOC in less than one hour, appropriate security measures can be put in place in the same time facility should meet the basic requirements of disaster survivability and access sufficient space for personnel and equipment required to run it. a mix of open and closed work space.

91 Size and configuration There are no standards except for staff safety evaluate the scale of likely events size depends on people depends on event size make form follow function

92 Must provide space for: core functions (management, operations, planning, logistics and administration) Policy group intermittently when required A communications and message centre Break-out/meeting rooms Rest and eating areas Storage Media relations/public information. (may be offsite)

93 Useful considerations: the EOC Director should be positioned so that they can easily oversee operations. Functions that are interdependent should be co-located. Locate functions adjacent to any displays that pertain to their activity A separate, quiet meeting room for priority setting discussions, management briefings, etc.

94 Useful considerations 2 If a high volume of incoming communication is anticipated, a separate message centre in the communications room is desirable All entrances and exits must be secure at all times. Food and rest areas should be away from the main area, and food handling practices and storage facilities should meet the highest public health standards

95 Building and resources: If staff sleep on site, segregated sleeping facilities will be required, along with enhanced facilities including water and sewage systems Heating, ventilation and air conditioning and emergency power systems scaled for the extra burden of some crowding heatproducing office equipment. Furnishings may be fixed or movable, with movable, ergonomically suitable furniture offering greater flexibility The facility should support generous use of communications technologies, There should be a facility floor plan that identifies the workstations and maps the wiring and equipment at each station.

96 Office equipment and supplies office equipment and supplies should, to the extent possible, be identical to that which the assigned personnel normally use in their daily work. Where computers are used, there should be a backup pen and paper system systems for documentation and reference, in the event of a system failure.

97 Office equipment and Supplies 2 Information displays, if electronic or projected, should be backed up by manual systems (flipcharts, whiteboards). Information is the lifeblood of an EOC. Use all the possible display space. At least one television and radio tuned to the local media

98 Redundancy have back-up plans for technological failures within the EOC have an alternate site for the EOC itself, in the event that circumstances make the designated facility uninhabitable. the alternate site may not fully satisfy all the requirements rely on moving some of the equipment, along with personnel from the primary site.

99 End of Module 4 Questions and Discussion Review of learning objectives: -participants can identify the sources of authority for developing an EOC and who would be most appropriate for a steering committee and EOC project or working group. -participants can describe the space requirements and configuration for an EOC in their jurisdiction or agency, which will meet their anticipated requirements.

100 Module 5: Evaluating an EOC Learning objective -participants can describe a suitable process for the evaluation of key aspects of EOC functional capabilities.

101 An appreciation of the utility of an EOC can only be gained by actually using it: during real emergency events, which are usually infrequent, or during training exercises, which ought to be relatively frequent. start exercises during the planning and development phases by conducting orientation exercises. As participants informally work through the exercises and become familiar with the physical EOC, its supporting hardware, protocols and procedures, they will be engaged in both a training and an evaluation process.

102 Types of evaluation exercises Orientation exercise -informal discussions -focus on plans, roles and procedures -deal with questions of coordination and assignment of responsibilities. Drills -to develop, evaluate and maintain skills in specific procedures, such as alerting and notification, passage of critical information, activation of emergency resources that constitute one or more components of the EOC operational plan. -part of every drill is a critique of the procedure being practiced and whether the facility properly supports it.

103 Types of exercise 2 table-top exercise. -Informal gathering of assigned personnel, including the policy group, - examine, discuss and hypothetically respond to simulated emergency situations and attempt to hypothetically respond and resolve problems using the EOC operational plan. -success of the exercise lies in the identification and evaluation of problem areas.

104 Types of exercise 3 functional exercise -challenges participants by requiring them to respond in the roles designated for them -time constraints similar to, or more challenging than a real event -conducted in the EOC facility, so the available tools and technologies can be used and evaluated. -designed to evaluate policies, roles and responsibilities, capabilities and procedures, of single or multiple emergency management functions or agencies -requires considerable resources.

105 Types of Exercise 4 full-scale exercise -focuses on evaluating operational capabilities of emergency response and management systems -features actual deployment of the resources required to demonstrate coordination and response capabilities. -the added planning, staffing, operational and insurance costs are considerable -full-scale exercises are seldom used to evaluate an EOC by itself, but rather as a component of a total response system.

106 End of Module 5 Questions and discussion Review of learning objective -participants can describe a suitable process for the evaluation of key aspects of EOC functional capabilities.