– Look at two of my classmate’s posts. I need you to respond to each one separately. Don’t write about how good their posts or how bad. All you need to do is to choose one point of the post and explore it a little bit with one source support for each response. In attached you will find all the classmates posts.- APA Style.
db_student_post_649_9.docx

strengthening_hazard_vulnerability_analysis.pdf

health_care_system_hazard_vulnerability.pdf

Unformatted Attachment Preview

Discussion Board question:
– Based on your readings and experience, comment on the effectiveness of
HVAs. Are they too subjective? How would you approach developing an
HVA?
– Develop an HVA for a hospital in your community. Provide details on the
hospital (bed numbers, location, ect.). List the top 5 hazards. Defend your
answers.
Readings
Campbell, P., Trockman, S. J., & Walker, A. R. (2011). Strengthening Hazard
Vulnerability Analysis: Results Of Recent Research In Maine. Public Health
Reports, 126(2), 290–293.

Strengthening Hazard Vulnerability Analysis.pdf
Fares, S., Femino, M., Sayah, A., Weiner, D. L., Yim, E. S., Douthwright, S., & …
Ciottone, G. (2014). Health care system hazard vulnerability analysis: an
assessment of all public hospitals in Abu Dhabi. Disasters, 38(2), 420-433.
doi:10.1111/disa.12047

Health care system hazard vulnerability.pdf
Student 1 post:
Hazard Vulnerability Analysis
In my own opinion, I believe that HVAs are not subjective and the main reason
for this is because hospitals usually develop them based on the various man-made
and natural disasters that are likely to affect a hospital and thus this is a clear indication
that they are not implemented based on personal opinions but on the risks factors
likely to affect an organization. An effective hazard vulnerability analysis can only be
implemented through experience at the workplace and thorough research is
made (Campbell et al., 2011). I believe that HVAs are effective in the sense that they help
a hospital to acknowledge the various risk factors that are likely to affect their day to
day operations and with this information the management of the hospital can be able
to come up with effective measures and tools that will help to counter attack the risks
whenever they take place. The best way to use in order to develop an effective HVA
is through assessing all the risks that are likely to affect the hospital which includes all
the manmade and the natural risks and thus with this I believe a hospital can come up
with the necessary strategies and tools that can help minimize the chances of losses
when a disaster strikes.
Hazard Analysis for Twin-star Community Hospital
Twin-star is a small community hospital that is located in San Diego California.
The main purpose of the hospital is to provide quick health services to people in great
need of it or in emergency situations instead of traveling long distances in order to get
health services (Campbell et al., 2011). The hospital has 10 doctors, 63 nurses, and 250
beds. The main hazards that are likely to affect this particular hospital include the
following:
Employee Errors
We all know that man is to error and nobody is perfect which means that
sometimes nurses may end up misplacing information concerning patients or even
sometimes they may end up using the wrong tools to treat a patient which may
definitely lead to problems.
Hurricane
San Diego is a place that is vulnerable to Hurricanes which is a natural disaster
that may occur at any moment without notifying anybody and thus it is important to
always be ready by having the necessary strategies and tools to minimize losses when
a Hurricane happens to take place (Campbell et al., 2011).
Earthquake
Earthquake is another natural disaster that may affect the day to day activities
of the hospital and the reason for this is because it can take place at any time without
notifying anybody which means that if the hospital had not prepared themselves then
it could definitely encounter huge losses and deaths that are not easy to recover from.
Theft
Since the hospital is equipped with expensive equipment, anybody may want
to steal them which will definitely lead to losses and thus it is important to have a
physical security system that will help to minimize the chances of theft in the
hospital (Fares et al., 2014).
Hacking
Since most of the day to day activities of the hospital are carried out through
the internet, hacker may attempt to hack the system of the company and thus, for
this reason, the hospital needs to a network security system that will help them
minimize the chances of hacking activities from affecting the hospital (Hagenlocher et al.,
2018)
.
Total
25
External
Internal
Impact
on
Human
Probability of
Type
resources
resources
the hospital
Impact
occurring
Disasters
available
available
5
5
5
5
5
Employee
Errors
18
3
3
5
5
2
Hurricane
18
3
3
5
5
2
Earthquake
18
3
3
5
5
2
Theft
25
5
5
5
5
5
Hacking
Key:


– Highest probability
– Lowest probability
of
References
Campbell, P., Trockman, S. J., & Walker, A. R. (2011). Strengthening Hazard Vulnerability Analysis: Results
Of Recent Research In Maine. Public Health Reports, 126(2), 290–293.
Fares, S., Femino, M., Sayah, A., Weiner, D. L., Yim, E. S., Douthwright, S., & … Ciottone, G. (2014). Health care
system hazard vulnerability analysis: an assessment of all public hospitals in Abu
Dhabi. Disasters, 38(2), 420-433. doi:10.1111/disa.12047
Hagenlocher, M., Renaud, F. G., Haas, S., & Sebesvari, Z. (2018). Vulnerability and risk of deltaic socialecological systems exposed to multiple hazards. Science of the Total Environment, 631, 71-80.
Student 2 post:
From my knowledge about hazard vulnerability analysis, so far HVA is the best tool of hazard
analysis. It not only profiles the types of the risks an organization faces but also ranks them in
terms of severity and impact to the organization. This kind of analysis gives the organization
information on how to plan; they are able to determine what kind of resources they need and
when. HVAs therefore make it easier, more efficient for an organization to manage its disasters.
HVA effectiveness will depend on how it is applied, the organizational commitment to it and
desire to continuously improve it to make it better. However, it is important to note that hazard
vulnerability analysis is not absolutely effective as a disaster vulnerability analysis and
management tool (Campbell et al., 2011). First, HVAs are too subjective. Most health care
organizations design HVAs too specific to their hospital disasters as if such hospitals
operate in isolation. Secondly, most organizations still have not committed substantial
amount of their budgets to hazard vulnerability analysis in addition to the fact that
decision-making is more of information. Hazard vulnerability analysis is yet to be taken
as a mainstream disaster management tool in most organizations. In light of these
challenges that make HVAs in effective, I would have the HVA developed to standard
levels for a range of hospital institutions especially those within the same region and face
similar risks. For example, organizations should have a standard time for HVA
preparation. The idea of organizations doing HVA when they feel like presents a
disjointed emergency management for hospital organizations. I would also have the top
management properly involved because they will influence the HVA success in terms of
time, human resource and other materials allocation (Campbell et al., 2011).
Roxborough Memorial Hospital Hazard vulnerability analysis
Event
Severity
Location
Impact on Impact Impact
Level

people
on
preparedn
Philadelp
(staff and proper
activity
ess
hia
patients)
flow
Facility-
350
Roxboro
members
beds)
Injury,
Dama
on
of Internal
External
response
response
Delayed Emergenc
Dedicate
NGO
ge,
operatio
y
d
support
ty
staff (342
ugh
Probabil
Memoria
ity
l
occurren incapacitat
compl
ns,
managem
departm
and
Hospital
ce
ete
some
ent plan,
ent,
support
loss
operatio
resource
from
ns may
s
communit
be
available y
of death,
ion
stopped
organizati
for
ons
days
other
and
hospitals
Score
0-N/A
0-N/A
0-N/A
0-N/A
0-N/A
0-N/A
0-N/A
1-Low
1-Low
1-Low
1-Low
1-high
1-high
1-high
2-
2-medium
2-
2-
2-
2-
2-
medium
3-high
mediu
medium
medium
medium
medium
3-low
3-low
3-low
3-high
m
3-high
3-high
Floods
3
3
3
3
2
2
1
Fire
3
3
3
3
1
2
1
Gun
2
2
1
2
3
3
2
1
3
0
3
1
1
2
2
3
1
3
2
3
2
attack
Essential
supply
outage
Cyber
attack
From the HVA above, it is evident that the hospital is at a higher risk of fire and floods. The
hospital is also adequately prepared towards such eventualities both internally and externally.
However, it is also important to note that the hospital is highly exposed to gun attacks but
poorly prepared to handle such a risk. It is in this regard that the hospital should improve its
preparedness towards this threat. The hospital is moderately prepared towards essential supply
outage and cyber-attack.
References
Campbell, P., Trockman, S. J., & Walker, A. R. (2011). On linkages: Strengthening hazard
vulnerability analysis: Results of recent research in Maine. Public Health Reports, 126(2),
290-293.
Fares, S., Femino, M., Sayah, A., Weiner, D. L., Yim, E. S., Douthwright, S., … & Burstein, J.
L. (2014). Health care system hazard vulnerability analysis: an assessment of all public
hospitals in Abu Dhabi. Disasters, 38(2), 420-433.
From the
Schools of Public Health
On Linkages
STRENGTHENING HAZARD
VULNERABILITY ANALYSIS: RESULTS
OF RECENT RESEARCH IN MAINE
Paul Campbell, MPA, ScD
Steven J. Trockman, MPH
Amanda R. Walker, MPPM
Since the events of September 11, 2001 (9/11), healthcare institutions have been encouraged to enhance
their readiness for disasters. The Joint Commission
(previously the Joint Commission on Accreditation of
Healthcare Organizations) has, since 2001, required
member hospitals to complete an annual hazard vulnerability analysis (HVA), which is expected to provide
a foundation for emergency planning efforts. A literature search revealed that little has been written and
published on HVA since that requirement came into
effect, and no known investigation of current HVA
procedures has been completed.
To begin to address this gap, researchers from the
Harvard School of Public Health and the Southern
Maine Regional Resource Center for Public Health
Emergency Preparedness (SMRRC) interviewed staff
members at eight hospitals in Maine to document current HVA processes and develop recommendations for
improvement. SMRRC is one of three regional nonprofit hospital-based centers in Maine guiding health
systems and public health preparedness activities.
BACKGROUND AND OBJECTIVES
Hospitals and other health-care organizations have
always had to prepare for and respond to a wide array
of routine emergency and catastrophic disaster events.
Since the terrorist attacks of 9/11 and subsequent attention and funding from the U.S. Department of Health
and Human Services and Department of Homeland
Security, hospitals have been urged to substantially
expand their response plans and overall readiness for
disasters. Hospitals are now expected to develop, implement, train, and exercise comprehensive all-hazards
emergency management and operations plans. These
planning efforts need to be inclusive of all four phases
of emergency management: mitigation, preparedness,
response, and recovery.
Emergency management programs and their associated emergency operations plans are only as good as
the assumptions upon which they are based, which is
especially true at the local level where planning must
take into account specific risks unique to the immediate
environment. Local priorities need to be considered,
in addition to those required by federal and state
authorities, and detailed in the goals, objectives, and
deliverables tied to all funding streams. However, local
priorities based on opinion alone, and not on objective data, can provide a weak foundation for planning.
Expert clinical or administrative staff opinions can
result in waste, duplication, missed opportunities, siloing, and confusion over what the true priorities are in
terms of threat, vulnerability, and risk.
In the 2001 edition of its Comprehensive Accreditation
Manual for Hospitals, the Joint Commission significantly
revised the existing standard for emergency management.1 For the first time, the Joint Commission was
guiding hospital emergency preparedness efforts “into
the same arena as emergency management in the community as a whole.”2 Hospitals were now expected to
function as an “integrated entity within the scope of
the broader community.”
The 2001 standard urged that hospital response
plans now must be “based on a hazard vulnerability
analysis (HVA) performed by the hospital.” Although
HVA was a relatively new term for hospital staff, the
concept itself was not.2 The Joint Commission defined
HVA as “the identification of hazards and the direct
and indirect effects these hazards may have on the hospital.” The actual or anticipated hazards are analyzed
in the context of the population at risk to determine
the vulnerability to each specific hazard.
Hospital emergency managers have long performed
HVAs in their heads, as “much of the process is highly
Articles for From the Schools of Public Health highlight practice- and academic-based activities at the schools. To submit an
article, faculty should send a short abstract (50–100 words) via e-mail to Allison Foster, ASPH Deputy Executive Director, at
afoster@asph.org.
290 E
Public Health Reports / March–April 2011 / Volume 126
From the Schools of Public Health
intuitive.” For example, hospitals in the Midwest do
not need to plan for hurricanes, while those along
the Atlantic Coast must. Even the way risk has been
defined both qualitatively and quantitatively for hospitals is wide-ranging in its scope and use. As a result,
“risk may be one of the most elusive concepts in health
emergency management.”3
While mandating that hospitals perform HVA, the
2001 Joint Commission standard did not formalize
the process for doing so. Additionally, the Joint Commission did not offer a specific tool to normalize the
process in hospitals. While the American Society for
Healthcare Engineering (ASHE) of the American
Hospital Association offered the first standard methodology in 2001 for performing a hospital HVA,2 a
wide array of other tools and methods also became
available for hospitals to utilize for risk and vulnerability assessment.3
Later in 2001, Kaiser Permanente developed a
modified Hazard Vulnerability and Assessment Tool for
Medical Center Hazard and Vulnerability Analysis.4 This
tool expanded both the guidance and scope of hazard
“events” that hospitals should consider. Specifically, it
expanded the risk measures to include human impact,
property impact, and business impact. Each measure
was rated separately for each event and weighted in
the final vulnerability score. Likewise, the mitigation
measure was expanded from the ASHE tool, which
simply rated preparedness as “poor,” “fair,” or “good.”
The new tool broke mitigation down into preparedness
(preplanning), internal response (time, effectiveness,
and resources), and external response (community/
mutual aid staff and supplies). This final measure
reflected the intended outcome of the new Joint Commission standard by assessing hospitals as community
organizations rather than stand-alone institutions.
The following year, HCPro, Inc., a private healthcare regulation and compliance product and service
provider, published its own HVA Toolkit for hospitals.5
Similar to the Kaiser tool, this toolkit is meant to facilitate the evaluation of every potential event in each of
the three categories: probability, risk, and preparedness. Like the others, the kit allows the user to add
events as necessary. To determine probability, users are
encouraged to consider known risk, historical data, and
manufacturer/vendor statistics. The Joint Commission
does not provide this level of detail or guidance; rather,
it is individual private publishers that offer HVA tools
with this level of specificity. While helpful, these modifications make it difficult to draw comparisons among
hospitals, or across jurisdictions or states.
While the Joint Commission continues to refine
and expand emergency management standards, it
E
291
has yet to provide a standardized method or tool for
conducting HVAs. What none of these tools or the
Joint Commission standard offers, however, is a standardized method for collecting or using HVA data at
the hospital or community level. Hospitals are left on
their own to determine how they will collect information on probability and severity, how they will process
that information within the institution, and what to
do with the results.
The primary objective of this study was to investigate
how institutions at the local level, in particular hospitals
in Maine, currently implement HVA, in an effort to
encourage future research on this topic to ultimately
improve HVA efficacy.
METHODS
During 2005 and 2007, the SMRRC invited eight hospitals in the Southern Maine region to participate in
a regional HVA process. The Southern Maine region
includes acute care and mental health hospitals within
York, Cumberland, Sagadahoc, and Lincoln counties,
most of which are Joint Commission accredited. An
electronic copy of the Medical Center HVA template
and instructions were provided to each hospital’s
emergency preparedness contact. These individuals
participate regularly in SMRRC activities and preparedness efforts. They represent a variety of departments
from their institutions, including hospital administration, planning, safety, infection control, and facilities
management.
Administration of the HVA tool was customized to
best meet the needs and available resources of each
facility. If a facility had recently completed an HVA, its
staff members were encouraged to use those data to aid
in the completion of the SMRRC version. Other facilities distributed the HVA forms to individual members
of their internal Environment of Care or Emergency
Preparedness Committees and then convened as a
group to reach consensus for the organization. The
HVA tool used in this study was based on the model
developed by Kaiser Permanente and modified for use
by the SMRRC.
During April 2008, we conducted a series of faceto-face, semi-structured, in-depth interviews with staff
from each of the participating hospitals who were
identified to have a key role in the HVA process at
their facility. Two interviewers attended each discussion
and subsequently compared notes to assure objectivity. The questions were largely drawn from a paper
entitled, “Risk and Risk Assessment in Health Emergency Management.”3 Beyond the issues suggested by
this paper, the interviewers discussed the HVA results
Public Health Reports / March–April 2011 / Volume 126
292 E From the Schools of Public Health
produced in each hospital and changes in results from
year to year.
6.
RESULTS
The lack of standardization in the HVA process from
hospital to hospital became apparent as the survey
progressed. Specifically, the researchers found the
following:
1. The scope of risk varied a great deal across the
institutions. Some hospital staff considered the
scope to be limited to the institution’s campus,
while others had an expanded view and considered risks to the hospital’s entire service area.
2. The planning time frame was rarely clarified
and often varied from institution to institution.
In some hospitals, staff believed that they were
planning for one year, while in other hospitals
they believed that they were planning for a
longer time frame (e.g., three to five years).
3. The individuals facilitating the process had
a large impact on the results. For example,
regarding scope of risk, staff members with
hospital engineering backgrounds focused on
the institution, while others with public health
exposure and training tended to focus on the
community. An individual’s personal experience
with disasters had a substantial impact on the
results. Changes in HVA results from period
to period tended to be those hospitals with
su …
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