全国疾控卫生应急培训之7-Emergency Planning卫生应急预案

1、HEALTH EMERGENCY RESPONSE PLANNING卫生应急预案Dr Mukundan PillayTeam Leader Building Healthy Communities and PopulationsWORLD HEALTH ORGANIZATIONCHINA Describe the steps of emergency response planning process in terms of inputs, outputs and outcomes 以输入、输出和结果的形式描述编制应急预案的过程 Create flowcharts for emergency

2、response planning 建立编制应急预案流程图 To identify the various plans that must be developed and the harmonization between them 明确需要制定的各种预案和它们之间的协调What is an emergency response plan? 应急预案是什么？Why to develop emergency response and recovery plans?为什么要制定应急和恢复预案？How are emergency response planning processes differ

3、ent from routine planning processes for the health sector?卫生部门应急预案编制过程与常规预案编制过程有什么不同？An integrated set of long-term, multi-sectoral development activities一套长期的、多部门参与的完整制定活动一套长期的、多部门参与的完整制定活动Goal: to achieve an increasing level of “readiness” within communities to cope with any situation which demand

4、s an emergency response, using their own resources. This requires the development and maintenance of :目标：实现社区内需要应急响应以处理各种情况目标：实现社区内需要应急响应以处理各种情况“准备准备”水平水平的提高，并且用它自己的资源。这需要发展和维持：的提高，并且用它自己的资源。这需要发展和维持：Political authority, policy for EMPlans and Procedures for EM and Recovery training and educationIns

5、titutional and human resources for EMPublic awareness & educationSystem for the collection, analysis and distribution of information related to emergencies Emergency Preparedness Program - Reminder应急准备项目应急准备项目-提醒提醒EM的政治支持和政策的政治支持和政策EM的应急预案和程序和恢复的训练和教育的应急预案和程序和恢复的训练和教育EM的应急机构和人力资源的应急机构和人力资源公共意识和教

6、育公共意识和教育应急相关信息的搜集、分析和发布系统应急相关信息的搜集、分析和发布系统PublicSafetyRisk ManagementEmergency ManagementHazard ReductionVulnerability ReductionEmergency PreparednessDamage Assessment & Needs AnalysisEpidemiology and ReportingMass Casualty ManagementHospital PlanningCurative CareShelter and SecurityWater and Sa

7、nitationControl of Communicable DiseaseFood and NutritionReproductive HealthPsychosocial NeedsMedical Supplies and LogisicsMedia and Public InformationRecovery and Rehabilitationsafer communities+Response plans公共安全风险管理风险管理减少灾害降低易损性应急准备应急管理 损伤评估&需求分析流行病学调查和报告大规模人员伤亡管理医院预案医疗护理住房和安全饮水和卫生传染病控制食物与营养生

8、殖健康心理社会需求医疗设备供应和后勤保障媒体和公共信息恢复和康复安全社区+应急预案q ERP focuses on: ERP重点关注重点关注:Coordination and management systems of resources from several sectors协调和不同部门的资源管理系统emergency management and incident management systems应急管理和事故管理系统Management of information 信息管理q arrangements for intra-sectoral and inter-sectoral

9、coordination of activities and mobilization of resources (surge capacity)q 部门内和部门间活动协调和资源动员的安排（应变能力）q What are the characteristics of routine planning in your field of activity?q 你所参与的领域常规预案的特点是什么？THE RATIONALE FORDEVELOPINGRESPONSE PLANS制定应急预案的依据qWhat may be the different activities, situations and

10、 risks.that the Health Sector must think of when developing response plan and contingency plans ?q卫生部门在制定应急预案和应变计划时必须考虑可能不同的活动、情况和风险是什么？qWith what the response plan of the Health Sector must deal with ?q卫生部门必须用什么样的应急预案进行处理？qCasualty management (first aid, triage, transport, pre-hospital care, in-pat

11、ient care, out-patient care)qCommunicable disease control (surveillance, tracking, treatment, prophylaxis, isolation and quarantine)qContinuity of delivery of critical services for all emergency patientsqManagement of the dead and missingqManagement of information (public information; support activi

12、ties; health info system)qMental healthqEnvironmental healthqReproductive healthqPublic health programs (continuity of essential programs)q人员伤亡管理（急救、伤员鉴别分类、转运、院前急救、住院治疗、门诊治疗）q 传染病控制（监测、跟踪、治疗、预防、隔离和检疫）q 对所有应急病人关键性服务的延续性q 死亡和失踪人员的管理q 信息的管理（公共信息、支持活动、健康信息系统）q 心理健康q 环境卫生 q 生殖健康q 公共卫生计划（ 重要计划的延续性）Plannin

13、g based on risk analysis is planning for any emergency, by predicting: what might happen when it might happen where it might occur how big it might be what effect it might have how long it might last (emergency period + recovery period) What are the strategies to respond and recover 基于风险分析的预案是适用于任何紧

14、急情况，通过预测： 可能发生什么 可能什么时候发生- 可能在哪里发生- 它的影响可能有多大- 它可能有什么影响？- 它可能会持续多久（应急期+恢复期）- 应对和恢复的策略是什么Disaster Management is:80% generic15% specific5% uniqueto all disastersto the hazardto the event1. OrganizationEOCearthquaketimecoordinationlarge numbers of trapped and injuredplacecommunicationslarge numbers of

15、homeless and displacedweathertransportlarge numbers of dead and missinglogistics and suppliesgeographyinformation and mediadead, injured and missing staffclimatereporting and surveillancedamaged critical infrastructure / resources (hospitals, vehicles)loss of water, gas, electricity, phone, transpor

16、t, fuel networkssecurity2. Responseloss of road, sea, air, rail infrastructure / accesssearch and rescuepoliticsevacuationlong period of SAR, victim extractioneconomymass casualty managementhigh demand for FA, stretchers, triage, medical transportgovernancemanagement of dead and missinghigh demand f

17、or beds, surgery, blood products, referralsecuritywound infections, amputations, tetanus, dust inhalationemergency management capacitytemporary shelter, clothing and utensilshigh demand for orthotics, prosthetics, disability, dentallogistics capacityemergency water, sanitation and energydemand for s

18、pecialized spinal and head injury caredisposal of inappropriate donationsemergency food supplieshigh demand for temporary shelter, food, utensils, stoves,emergency public and environmental health water, energy, clothing, tents, blanketsleadershipemergency engineering and public workshigh demand for

19、psychosocial support of victims and staffsolidaritymanagement of donated supplies / foreign teamsmorale3. Recoveryfew outbreaks of communicable diseasescorruptionvariable demand for medicines and equipmentcrimecurative and public health care (acute / chronic injury care - high, infectious disease -

20、low,lootingeducation potentially unstable chronic disease - medium)agriculturecompensation claimstrade and commercecontamination of water, air and soilinsurance claimstoxic chemical, sewerage and gas leaks / spills4. Rehabilitation and Reconstructionurban fires, explosionsownership disputespeoplecon

21、taminated, infested and unsafe foodsproperty disputespropertyincreased vector breedingserviceslivelihoodsloss of livelihoods, markets, distribution networksenvironmentTHIS IS WHAT WE PLAN FOR .Emergency Response Plan and Recovery Plan应急预案和恢复计划q an agreed set of arrangements for responding to, and re

22、covering from emergenciesq 针对从紧急情况响应和恢复的一个一致的安排体系，q plans involve the description ofq 预案包括对以下内容的描述 Responsibilities 职责 management structures 管理结构 resource and information management 资源和信息管理 Logistics management 后勤保障管理 Training and exercises 培训和演练q plans focus on protecting life, property and the env

23、ironmentq 预案侧重于生命、财产和环境的保护q Outcomes 结局A response plan will define and discuss : a line of authority and clear responsibilities of all the stakeholders involved the management systems: ICP; EOC; EEC the communications system alert and warning mechanisms public information arrangements resource manag

24、ement (human, financial and material) Monitoring, reporting and accounting arrangements应急预案会规定和阐述： 一系列的权威和所有利益相关者明确的职责 管理制度： ICP; EOC; EEC 通讯系统 警报和预警机制 公共信息的安排 资源管理（人力、财力和物力） 监测、报告和财务安排q Clear responsibilities (who, what, when, how, with whom, where)q 明确的职责（谁，什么，何时，如何，和谁在一起，在哪里）q All key stakeholder

25、s need to be involved in the planning process, including:q 所有关键的利益相关者必须参与预案的过程，包括： agencies with disaster responsibilities 灾难职责部门 community members / groups 社区成员/团体 Institutions and legal authorities 相关机构和执法部门q Relevant to emergency events: 与紧急事件相关的: large scale; complex; relatively rare; hard to pr

26、edict 大规模的；复杂的；较为罕见的；很难预测的q Consequences of poor decisions can be acuteq 拙劣的决定的后果可能是严重的q Scrutiny of mistakes is often in detail and in publicq 对所犯错误的调查通常是详尽和公开的Community Risk Management Plan社区风险管理预案Provincial EmergencyDisaster Plans省级灾难预案National Emergency Disaster Plan国家灾难应急预案HazardSpecificPlans特定

27、危害预案Agencies SpecificPlans (hospitals)机构具体预案（医院）SectoralPlans部门预案Intersectoral in nature实际上是跨部门的Context of emergency plans for a community一个社区的应急预案内容The following sectors are involved in the emergency planning process:以下部分包含于应急预案的制定过程中：以下部分包含于应急预案的制定过程中：How these sectors can contribute to the develo

28、pment of the health sector response plan?这些方面如何能够有助于卫生部门应急预案的制定呢？ Communications 通讯 Police 警察 relief and rescue 救济和救援 Health 健康 social welfare 社会福利社会福利 Transport 交通 public works 公共建设工程 also agriculture, media, education, fire, ambulance, engineering, meteorology 同时包括农业、传媒、教育、消防、救护车、工程、气象Policy, guid

29、elines, standardsNationallevelCommunitiesShould be allowedDevelop and implementPreparedness activitiesVulnerability reduction plansEmergency response plansNational & provincial levels = support communities in their workMobilise extra-resourcesInternational org & assistanceProvinciallevelEmer

30、gency Preparedness ProgramMitigation plansRehabilitation and recovery plansPolicy - Guidelines Standards Community Plans and Role of the MOH政策政策 、 指南指南 、标准、标准国家级水平国家级水平社区应该包括社区应该包括制定和实施制定和实施准备活动准备活动减少易损性的预案减少易损性的预案应急预案应急预案国家国家&省级水平省级水平=对社区工作的支持对社区工作的支持额外资源的调动额外资源的调动国际组织国际组织&援助援助省级水平省级水平应急准备项

31、目应急准备项目减灾预案减灾预案康复和恢复预案康复和恢复预案政策政策 - 指南指南 - 标准标准 - 社区预案和卫生部的作用社区预案和卫生部的作用The role of national authorities is to support local planning processes by establishing the planning framework:国家当局的作用是通过建立预案的框架以支持地方预案进程q setting national policies for risk reduction, emergency preparedness, emergency response

32、and disaster recoveryq 制定降低风险、应急准备、应急响应和灾难恢复的国家政策 q issuing technical guidelines and administrative procedures for the process of planning and for the implementation of the policy (contents of the plans, etc.)q 为预案过程和政策实施的提供技术指导原则和行政程序（计划的内容等） q developing national plans (multi-sectoral; sectoral; c

33、ontingency) for those situations that are not under the direct responsibility of local authoritiesq 对地方当局不负直接责任的情况制定的国家预案（多部门；部门；意外事故）q developing procedures for how national resources can be deployed in an emergencyq 制定国家资源如何能够在紧急情况下使用的程序q allocating funds to support the development of new local ca

34、pacity and for local risk reductionq 拨款以支持新地方能力的发展和减少当地风险q planning for those hazards that are not the primary responsibility of local government e.g. Securityq 对于当地政府的不负首要责任的危害制定预案，如：安全q international cooperation and assistance q 国际合作与援助WHAT ARE THE PRESENT CONSTRAINTS IN YOUR COUNTRY ?q 你们国家目前的限制是

35、什么？q Reduce the vulnerabilities of its own infrastructures and systems: hospital mitigation; EMS System; etc.q 降低自身基础设施和系统脆弱性：医院减灾; EMS系统等等q Raise awareness first of the health staff then of the general public (in collaboration with other sectors) q 首先提高卫生工作人员的认识，然后(与其他部门合作）提高一般公众的认识q Reduce health

36、consequences of crisis and major emergencies (core function of the health sector). A “health emergency management program/unit” should be institutionalised within the MOH; development of emergency response plansq 减少危机和重大突发事件的健康后果（卫生部门的核心职能）。一个“健康应急管理项目/单元” 应当是在卫生部内制度化，制定应急预案q Assume its normative ro

37、le and lead function (guidance) in health (emergency preparedness and risk management)q 承担其在卫生方面的规范的作用和主要功能（指导）（应急准备和风险管理）q Integration strategy q 整合策略整合策略q Vulnerability reduction and hazard mitigationq 降低易损性和减轻危害降低易损性和减轻危害q Community risk management frameworkq 社区风险管理框架社区风险管理框架q Inter-sectoral coop

38、eration 部门内部协调部门内部协调q Planning based on existing resources (all types)q 基于现有资源的预案编制（所有类型）基于现有资源的预案编制（所有类型）q Decentralization of the response capacityq应急能力的分散化应急能力的分散化q Community participation (and end-users)q社区参与（和最终用户）社区参与（和最终用户）q Institutionalization of an emergency/disaster Unit within the MOHq 在

39、卫生部内紧急适合和灾害项目的制度化在卫生部内紧急适合和灾害项目的制度化THE EMERGENCY PLANNING PROCESS应急预案编制过程q Determine the authority responsible for the processq 确定由官方负责预案编制过程q Establish a planning committee and objectives; management structure of the processq 建立预案编制委员会和目标；编制过程的管理结构q Conduct a risk assessment - hazards and community

40、 vulnerabilities (core elements) q 实施风险评估-危险和社区易受损性（核心要素）q Assign responsibilitiesq 分配职责q Identify and analyse capacities and resourcesq 识别和明确能力和资源q Develop the emergency management systems and arrangementsq 制定应急管理系统和安排q Document the planq Test the plan; Review and update the plan on a regular basis

41、q 检验预案；在一个规则的基础上评审和更新预案q A set of emergency response plans who does what when using existing capacity:q 一组应急预案-在目前的能力水平下，谁该做什么事情 search and rescue plan 搜救预案 evacuation / temporary shelter plan 疏散/临时安置预案 mass casualty plan / hospital plans 大规模伤亡预案/医院预案 sectoral relief plans (food, water, health, life

42、lines etc.) 部门救援预案（食物，水、健康、命脉等） security plans 安全预案 Mitigation; EWS (MCM: all hazards) 减轻损失； EWS (MCM: 所有危害) q A disaster recovery and reconstruction plan (education, agriculture, public works etc.)q 灾害恢复和重建预案（教育、农业、公共建设工程等）The planning process is a sequence of steps whereby a planning entity (e.g.

43、government, community) agrees on ways to enhance and protect its own safety. It is an interactive and iterative process that should lead to:预案编制的过程是一系列的步骤，在这个步骤中预案编制实体（如政府、社区）达成能够提高和保护他们自身安全的方法。这是一个交互的、反复的过程以达到：q better understanding of the roles and responsibilities of all members of the community

44、in prevention, mitigation, and responseq 更好地理解社区所有成员在预防，减灾和响应过程中的作用和责任q greater awareness of risk reduction in the communityq 更加注重社区风险的降低q higher levels of readiness to respond and to recoverq 更高水平的反应和恢复准备q an emergency response plan and a recovery plan (and contingency plans when relevant)q 应急预案和恢复

45、计预案（意外事件预案）q increased public safety (including for the health sector such as safer hospitals, etc.)q 提高公众的安全（包括卫生部门，如更安全的医院等）How do we know a plan is a functional plan?我们如何确定一个预案是否是有用的预案？q it meets the national planning criteria and policy ?q 它符合国家预案编制标准和政策？q it conforms to the national planning fo

46、rmat ?q 它符合国家预案编制的格式？q it has been developed through a true emergency planning process (from vulnerability analysis up to participation of end-users) ?q 它已经通过一个真正的应急预案的制定过程？（从脆弱性分析到最终用户的参与）？q it is tested, validated and regularly exercised ?q 它是经过检验，验证和定期演练的？q all key staff are familiar with the det

47、ails of the plan and know their responsibilities ?q 所有主要工作人员熟悉该预案的细节，知道他们的职责是什么？q WHAT DO YOU WANT TO ADD?q 你还想补充什么？ It is essential to:这些是非常重要的q simulate an emergency to test the planq 模拟应急情况来测试该预案q familiarise all staff with the planq 让所有工作人员都熟悉该计划q brief all new staff about the planq 让新员工简要掌握预案q

48、familiarise local government, emergency services and the community with the planq 让当地政府，应急服务机构和社区熟悉预案q train those staff with special roles and responsibilities in the planq 培训在计划中起特殊的作用和承担责任的工作人员q review and update the plan after an emergency, after each simulation and whenever new resources are ac

49、quiredq 在应急情况后、每次模拟后和每次获得新信息时，审查和更新预案q conduct regular exercisesq 定期进行演练q the plan (paper document) is given more importance than the planning process itselfq 与预案编制过程比较，预案（书面的文件）往往更被重视q not key community members (or staff of the institutional plan) are aware of the existence of a planq 非社区主要成员（或机构预案

50、的工作人员）意识到计划的存在q revision is overlookedq 忽视修订q emergency planning is not integrated into normal activities (integration strategy) whenever possibleq 应急预案没有尽可能的完整纳入正常活动（一体化战略）q different plans are developed for different hazards by different agencies the all hazards approach should be preferred (no sy

51、nergy; no compatibility)q 不同的机构根据不同的危害制定了不同的计划-应该首选全危害的做法（无协同作用，没有兼容性）q no or weak training programsq 没有或轻视项目的培训q what do you want to add?q 你还想补充什么？ Plans are out of date as soon as they are published 预案刚被印刷出来的时候就过时了PLANS NEED REGULAR REVIEW预案需要定期评审 Procedures, policies and guidelines are needed to

52、guide the planning process at local level 需要程序，政策和准则来指导地方一级的预案编制过程q implemented selectively by those agencies which have been delegated that responsibility by the Government or by the communityq由代表政府或社区的机构来选择性的执行q it is vital that.agenciesq这是至关重要的.机构. . . professionally managed 专业化管理 adequately reso

53、urced 资源充足 highly trained 训练有素 demonstrated competence 论证能力 emergency management family 家庭应急管理Define the ERM policy of the Agency界定机构的界定机构的ERM政策政策Enter the planing process (ERM)进入预案编制过程进入预案编制过程（ERM）Allocation of required resources of all kind分配各种有需要的资分配各种有需要的资源源Implementation: activities role functi

54、ons执行情况：活动执行情况：活动-角色角色-功功能能Monitoring reevaluation process监测监测-再评价过程再评价过程ERM process for an Agency机构的机构的ERM过程过程As part of an overall emergency response plan for the Asian Games, you are requested to prepare the Health Sector Response Plan.作为亚运会总体应急预案的一部分，你被要求准备卫生部门的应预案. .Instructions as follows:说明如下

55、：to identify a city in one country of your choice1. 根据你的选择找出一个国家的一个城市2. to discuss potential problems, which can impact on health in this city2 . 讨论可以对这个城市居民的健康产生影响发的潜在问题3. to identify the stakeholders who will be involved to contribute to the management of these health problems3 . 确定对这些健康问题的管理作出贡献的

56、利益相关者4. to identify the key headings of the components of your Emergency Response Plan (for Health Sector in this city)4 . 确定你的应急预案组成部分的主要标题（城市中的卫生部门） Why Emergency Response Plans must be regularly revised ? 为什么要定期修订应急预案？q update the current political, social and economic situationq 更新当前的政治，社会和经济形势更

57、新当前的政治，社会和经济形势q update hazard reduction, emergency preparedness and vulnerability reduction activities in all sectors and by all organisationsq 通过各种组织更新所有部门的降低风险，应急准备和降低易损性的活通过各种组织更新所有部门的降低风险，应急准备和降低易损性的活动动q update changes in resources, systems and proceduresq 更新资源，系统和程序的变化更新资源，系统和程序的变化q update earl

58、y warning information systemq 更新早期预警信息系统更新早期预警信息系统q mandate and authority to deliver relief (scope of responsibility)q 提供救济的任务和权力（职责范围）提供救济的任务和权力（职责范围）q management and command structure (coordination among stakeholders)q 管理和指挥组织（利益相关者之间的协调）管理和指挥组织（利益相关者之间的协调）q competencies of staff (knowledge and sk

59、ills and ability)q 工作人员的能力（知识、技能和能力）工作人员的能力（知识、技能和能力）q the availability and accessibility of informationq 信息的可用性和可及性信息的可用性和可及性q the existence and relevance of plansq 预案预案的存在和相关性预案预案的存在和相关性q the existence and relevance of proceduresq 程序的存在和相关性程序的存在和相关性q the networking of the plans of the Health Secto

60、r with the plans of the other sectorsq 加强卫生部门与其他部门预案的网络化加强卫生部门与其他部门预案的网络化The emergency response plans are useful only:只有在以下情况下应急预案是有用的：只有在以下情况下应急预案是有用的：q when they are activated q 当它们被激活时当它们被激活时q they are relevant and functionalq 它们是相关的和有用的它们是相关的和有用的q They are efficiently usedq 他们被有效的利用他们被有效的利用So the early activation of the res