Hazard and

Vulnerability
Assessment

OSHA Training Institute Region IX

University of California, San Diego (UCSD) - Extension

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Objectives
Discuss methods of conducting a hazard
vulnerability analysis (HVA)
Identify how the HVA is applicable to
preparedness and evacuation
Practice effective training techniques in
conducting a HVA

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The HVA and the Relationship
to Evacuation
The HVA is a tool used to evaluate the potential
risks for a facility
It is not an evaluation of the potential for
evacuation
However, risks identified in the process may
focus the organization toward the need to
mitigate and prepare for circumstances that
could include evacuation

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The Purpose of the HVA
The purpose is a prioritization process that will
result in a risk assessment for all hazards
The tool includes consideration of multiple
factors
The focus is on organization planning and
resources and /or the determine that no action
may be required. This is an organization
decision

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Is this required?
The Joint Commission, previously called the
Joint Commission of Accreditation of Healthcare
Organizations (JCAHO), requests an HVA for
organizations to determine the focus of their
emergency planning
There is no specific tool nor method defined

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HVA Categories for Evaluation
There are categories considered in a formal
process of assessing an HVA
Most HVA tools include an assessment of the
following factors:
Probability that an event will occur
The risk of disruption to the organization associated
with the event scored as high, moderate or low or a
similar description.
The level of preparedness

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Probability of Occurrence
The probability may be based on statistics and
objective information but also may be intuitive
and highly subjective.

The following factors are often considered:

Known risk
Historical data
Manufacturer or vendor statistics

American Society of Healthcare Engineering 2001

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Historical Data
Natural events
Hazardous material
releases
Technological
accidents
Infrastructure
problems

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Risk Assessment
The risk of an event is assessed based on:
Threat to life and/or health
Disruption of services
Damage for failure possibilities
Loss of community trust
Financial impact and legal issues

American Society of Healthcare Engineering 2001

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Preparedness
Preparedness of the organizations ability
to manage risks, can include items such
as:
Status of current plans
Training
Insurance
Back up systems
Community resources

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Models
There are a number of models for an HVA.
Two well known models are from
American Society of Healthcare Engineering (ASHE)
Kaiser Foundation
Both models can be adjusted to fit the
organization
Security organizations and other vendors also
market HVA tools

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Medical Center HVA Model
Kaiser model also includes:
Probability
Response factors
Human, property and business impacts, each
considered as a separate issue

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A Comparison of Threat Events
Considered in HVA Models

ASHE Model 2001 Kaiser Foundation

Model 2001
Human Events Human Events
Natural Events Natural Events

Technological Events Technological Events

Hazmat Events

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Natural Events

Risks common to the area or geography of the

region, for example: storms, earthquakes,
floods, and tornadoes, and other natural causes
of damage
The impact may be able to be mitigated or may
result in a partial or complete evacuation
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Mitigation Plans for Regions
Other models use sophisticated software to
determine the hazards by cities, counties or
regional areas
Are used for the development of mitigation
plans for multi-jurisdictions

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Drill HVA
Grayville Hospital
Location: Grayville, CA; Eastern Sierras
Population: 150,000
Description: small town with general
services, small businesses, surrounded by
rural areas and ranches

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Grayville Hospital
70 Beds
Two story building; 50 years old
ED: 5 beds; in West Wing of hospital
West Wing is single story, recently renovated
and structurally reinforced 5 yrs ago
ED connected to hospital by an enclosed
corridor
Patient units on second floor of hospital
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Grayville Hospital
On the first floor:
Six bed ICU/CCU
Two room Labor and Delivery
Ten bed family unit
Small nursery
OR:
4 suites, 2 procedure rooms
5 gurney recovery room
Radiology and Laboratory
Five Administrative offices
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Why is this
Important to Worker Well-being?
Preparedness efforts, plans and resources are
directly related to the organizations HVA
Engineering controls may occur as a result of
HVA thus reducing risk for the work force
Safety factors are considered
Process promotes understanding of current
resources that may not have been known
beyond the expert

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Evacuation Implications
When a risk is identified in the HVA that would
potentially result in an evacuation, the
organization should focus on issues that could
impact the need to evacuate or to mitigate the
risk. Examples:
Routes
Locations
Personal Protective Equipment (PPE)
Communication to employees with special needs
Special situations - management of family on site

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What Does It All Mean?
HVA tools, used to prioritize specific and overall
relative risks, are based on mathematical
formulas that are either embedded in the
document or managed manually
The factors considered in the assessment
includes the assumption that the risk occurs at
the worst possible time and with a full patient
census

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Summary:
What is the greatest risk?
The HVA process helps
an organization prioritize
in the order of criticality
The efforts to decrease
the consequences of a
possible event can be
focused upon. This
includes evacuation.

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Examples of HVA Tools
American Society for Healthcare Engineering of the American
Hospital Association
www.ashe.org

Kaiser Permanentes interactive HVA tool available at:

www.emsa.ca.gov/dms2/kp_hva.xls

Emergency Management Program Guidebook

Published by VHA Center for Engineering & Occupational Safety and
Health, St. Louis, MO
vaww.ceosh.med.va.gov

For review of an HVA sample go to:

http://www1.va.gov/emshg/apps/emp/emp.htm
Click HVA under index link

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References
American Society of Healthcare Engineering 2001
WWW.ashe.org
FEMA. Emergency Management Institute Hazard
vulnerability analysis and risk assessment. Unit 2
http://www.training.fema.gov/emiweb/EMICourses/E464
CM/02%20Unit%202.pdf
Joint Commission Resources Hazard vulnerability
analysis (HVA), May/Jun 2002, 2-3

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More References
Kaiser Permanente. Medical center hazard and
vulnerability analysis. 2001 Kaiser Foundation
Health Plan, Inc.
Schwartz RB. Hospital preparedness for mass
casualties in disasters. Institute of Disaster
Medicine Medical College of Georgia slide set
www.achd.net/swprjttf/pubs/pdf/hospitalprep.pdf

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