Medical Center Hazard and Vulnerability Analysis Medical Center Hazard and Vulnerability Analysis

This document is a sample Hazard Vulnerability Analysis tool. It is not a Issues to consider for preparedness include, but are not limited to:
substitute for a comprehensive emergency preparedness program. Individuals or 1 Status of current plans
organizations using this tool are solely responsible for any hazard assessment and 2 Frequency of drills
compliance with applicable laws and regulations. 3 Training status
4 Insurance
INSTRUCTIONS: 5 Availability of alternate sources for critical supplies/services
Evaluate potential for event and response among the following categories using
the hazard specific scale. Assume each event incident occurs at the worst Issues to consider for internal resources include, but are not limited to:
possible time (e.g. during peak patient loads). 1 Types of supplies on hand/will they meet need?
2 Volume of supplies on hand/will they meet need?
Please note specific score criteria on each work sheet to ensure accurate recording. 3 Staff availability
4 Coordination with MOB's
Issues to consider for probability include, but are not limited to: 5 Availability of back-up systems
1 Known risk 6 Internal resources ability to withstand disasters/survivability
2 Historical data
3 Manufacturer/vendor statistics Issues to consider for external resources include, but are not limited to:
1 Types of agreements with community agencies/drills?
Issues to consider for response include, but are not limited to: 2 Coordination with local and state agencies
1 Time to marshal an on-scene response 3 Coordination with proximal health care facilities
2 Scope of response capability 4 Coordination with treatment specific facilities
3 Historical evaluation of response success 5 Community resources
Issues to consider for human impact include, but are not limited to: Complete all worksheets including Natural, Technological, Human and Hazmat.
1 Potential for staff death or injury The summary section will automatically provide your specific and overall relative threat.
2 Potential for patient death or injury
Issues to consider for property impact include, but are not limited to:
1 Cost to replace
2 Cost to set up temporary replacement
3 Cost to repair
4 Time to recover

Issues to consider for business impact include, but are not limited to:
1 Business interruption
2 Employees unable to report to work
3 Customers unable to reach facility
4 Company in violation of contractual agreements
5 Imposition of fines and penalties or legal costs
6 Interruption of critical supplies
7 Interruption of product distribution
8 Reputation and public image
9 Financial impact/burden

© 2001 Kaiser Foundation Health Plan, Inc. 421023136.xls

 HAZARD AND VULNERABILITY ASSESSMENT TOOL
NATURALLY OCCURRING EVENTS

Dampak = (Besarnya - Mitigasi)

FREKUENSI DAMPAK KE DAMPAK KE DAMPAK KE KESIAPSIAGA RESPON RESPON
KEJADIAN KEJADIAN MANUSIA FASILITAS PELAYANAN AN INTERNAL EKSTERNAL
Kemungkinan Waktu,
Kemungkinan Kerugian fisik Pelayanan
kematian atau Perencanaan efektivitas dan Komunitas/staf
akan terjadi atau kerusakan terganggu
cidera sumber daya

0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A

1 = Rendah 1 = Rendah 1 = Rendah 1 = Rendah 1 = Rendah 1 = Rendah 1 = Rendah
Nilai 2 = Sedang 2 = Sedang 2 = Sedang 2 = Sedang 2= 2= 2 = Sedang
3 = Tinggi 3 = Tinggi 3 = Tinggi 3 = Tinggi Sedang 3 Sedang 3 = Tinggi
= Tinggi 3 = Tinggi

Banjir 2 1 1 1 2 2 1
Kemacetan Lalu Lintas 2 0 0 0 0 0 0
Kecelakaan Lalu Lintas 3 2 0 1 3 3 2
Gempa Bumi 2 1 2 2 3 2 1

AVERAGE SCORE 0.56 0.25 0.19 0.25 0.50 0.44 0.25

*Threat increases with percentage.
9 RISK = PROBABILITY * SEVERITY
30 0.02 0.19 0.10

© 2001 Kaiser Foundation Health Plan, Inc. Natural Hazards : 421023136.xls

VULNERABILITY ASSESSMENT TOOL
RALLY OCCURRING EVENTS

RESIKO

Relative threat*

0 - 100%

30%
0%
61%
41%

2%

© 2001 Kaiser Foundation Health Plan, Inc. Natural Hazards : 421023136.xls

 HAZARD AND VULNERABILITY ASSESSMENT TOOL
TECHNOLOGICAL RELATED EVENTS

Dampak = (Besarnya - Mitigasi)

FREKUENSI DAMPAK KE DAMPAK KE DAMPAK KE KESIAPSIAGA RESPON RESPON RESIKO
KEJADIAN KEJADIAN MANUSIA FASILITAS PELAYANAN AN INTERNAL EKSTERNAL
Kemungkinan
Kemungkinan Kerugian fisik Pelayanan Waktu, efektivitas
kematian atau Perencanaan Komunitas/staf Relative threat*
akan terjadi atau kerusakan terganggu dan sumber daya
cidera
0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A
1 = Rendah 1 = Rendah 1 = Rendah 1 = Rendah 1 = Rendah 1 = Rendah 1 = Rendah
Nilai 2= 2= 2= 2 = Sedang 2 = Sedang 2 = Sedang 2 = Sedang 0 - 100%
Sedang 3 Sedang Sedang 3 3 = Tinggi 3 = Tinggi 3 = Tinggi 3 = Tinggi
= Tinggi 3 = Tinggi = Tinggi

Kegagalan Listrik 1 0 1 1 1 1 0 7%
Kegagalan Genset 0 0 1 1 1 1 0 0%
Kegagalan air 0 0 0 1 1 1 0 0%
Kegagalan Sistem alarm Kebakaran 1 0 1 1 1 1 0 7%
Kegagalan Komunikasi 0 0 0 1 1 1 0 0%
Kegagalan gas medis 1 1 1 1 1 1 0 9%
Kegagalan HVAC 0 0 1 1 1 1 0 0%
Kebakaran (Internal) 1 1 1 1 2 1 0 11%

AVERAGE SCORE 0.21 0.11 0.32 0.42 0.47 0.42 0.00 1%

*Threat increases with percentage.
4 RISK = PROBABILITY * SEVERITY
33 0.01 0.07 0.10

© 2001 Kaiser Foundation Health Plan, Inc. Technological Hazards : 421023136.xls

 HAZARD AND VULNERABILITY ASSESSMENT TOOL
HUMAN RELATED EVENTS

Dampak = (Besarnya - Mitigasi)

FREKUENSI DAMPAK KE DAMPAK KE DAMPAK KE KESIAPSIAGA RESPON RESPON RESIKO
KEJADIAN MANUSIA FASILITAS PELAYANAN AN INTERNAL EKSTERNAL
KEJADIAN
Kemungkinan
Kemungkinan Kerugian fisik Pelayanan Waktu, efektivitas
kematian atau Perencanaan Komunitas/staf Relative threat*
akan terjadi atau kerusakan terganggu dan sumber daya
cidera
0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A
1 = Rendah 1 = Rendah 1 = Rendah 1 = Rendah 1 = Rendah 1 = Rendah 1 = Rendah
Nilai 2= 2= 2= 2 = Sedang 2 = Sedang 2 = Sedang 2 = Sedang 0 - 100%
Sedang 3 Sedang Sedang 3 = Tinggi 3 = Tinggi 3 = Tinggi 3 = Tinggi
= Tinggi 3 = Tinggi 3 = Tinggi
Food Poisoning 1 2 1 2 3 3 2 24%
0%
AVERAGE 0.10 0.20 0.10 0.20 0.30 0.30 0.20 0%
*Threat increases with percentage.
1 RISK = PROBABILITY * SEVERITY
13 0.00 0.03 0.07

© 2001 Kaiser Foundation Health Plan, Inc. Human Hazards : 421023136.xls

 HAZARD AND VULNERABILITY ASSESSMENT TOOL
EVENTS INVOLVING HAZARDOUS MATERIALS
Dampak = (Besarnya - Mitigasi)
FREKUENSI DAMPAK KE DAMPAK KE DAMPAK KE KESIAPSIAGA RESPON RESPON RESIKO
KEJADIAN KEJADIAN MANUSIA FASILITAS PELAYANAN AN INTERNAL EKSTERNAL
Kemungkinan
Kemungkinan Kerugian fisik Pelayanan Waktu, efektivitas
kematian atau Perencanaan Komunitas/staf Relative threat*
akan terjadi atau kerusakan terganggu dan sumber daya
cidera
0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A
0 = N/A 1
1 = Rendah 1 = Rendah 1 = Rendah 1 = Rendah 1 = Rendah 1 = Rendah
= Rendah
Nilai 2= 2= 2= 2 = Sedang 2 = Sedang 2 = Sedang
2 = Sedang 0 - 100%
Sedang Sedang Sedang 3 3 = Tinggi 3 = Tinggi 3 = Tinggi
3 = Tinggi
3 = Tinggi 3 = Tinggi = Tinggi
Terpapar bahan kimia 1 1 1 1 2 1 0 11%

1 1 1 1 2 1 0 11%
Terpapar Radioaktif (Internal)
AVERAGE 0.22 0.22 0.22 0.22 0.44 0.22 0.00 1%

*Threat increases with percentage.

2 RISK = PROBABILITY * SEVERITY

12 0.01 0.07 0.07

© 2001 Kaiser Foundation Health Plan, Inc. Hazardous Materials : 421023136.xls

 SUMMARY OF MEDICAL CENTER HAZARDS ANALYSIS

Total for Facility

Technological

Hazmat
Natural

Human
Probability 0.19 0.07 0.03 0.07 0.10
Severity 0.10 0.10 0.07 0.07 0.09
Hazard Specific Relative Risk:
0.02 0.01 0.00 0.01 0.01
R elative Threat to Facility

Hazard Specific Relative Risk to Medical Center

1.00
0.90
0.80
0.70
0.60
0.50
0.40
0.30
0.20
0.10
0.00
R e la tiv e Im pa c t on Fa c ility

Natural Technological Human Hazmat

Probability and Severity of Hazards to Medical Center

1.00
0.90
0.80
0.70
0.60
0.50
0.40
0.30
0.20
0.10
0.00
Probability Severity

This document is a sample Hazard Vulnerability Analysis tool. It is not asubstitute for a comprehensive emergency preparedness program.
Individuals or organizations using this tool are solely responsible for any hazard assessment and compliance with applicable laws and regulations.

© 2001 Kaiser Foundation Health Plan, Inc. 421023136.xls Summary