Risk & Safety Management in Hospital Constructions and Crisis Management in case of an Earthquake
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Transcript of Risk & Safety Management in Hospital Constructions and Crisis Management in case of an Earthquake
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Project group N:
Kostantinos Kostalas
Georgios Pardalis
Maria Xygkogianni
Risk & Safety Management in Hospital
Constructions and
Crisis Management in case ofan Earthquake
Risk Management & Safety IPE061
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Scope of the project / introduction
Hospital design considerations
Case study
Tools (FMEA Analysis / Swiss Cheese Mod el)
Recommendations
Crisis Management
Conclusions
Agenda
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Natural disasters
Earthquakes
Risk management
methods are limited
to only two strategies,
which are:
Pre-event mitigation Recovery services
Introduction
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Assessing risk
At the stage of design every building has to follow a certain set of rules
regarding its use and the existing building codes. The sad experience of
past earthquakes has led to more strict l imitations and rules regarding the
construction of a hospital facil ity.
There is no way to create a facil ity that is going to be 100% safe against
any possible damage, caused by an incident such as an earthquake. We
need though to create a facil ity with the least possible risk chance.
Evacuation considerationsThe limited mobility of so me patients and others who are under critical l ife
support.
For a successful evacuation scenario; efficient plan and training of the staff.
Hospital design considerations
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Ippokrateio Hospital , Thessaloniki Greece
The whole evacuation plan of the hospital is being updated every 5 years
It is considered one of the most well structured plans in Gree ce
Simulation of the evacuation plan for the most crit ical parts of the hospital;the intensive care units
Capacity; 6 units , 109 beds
Plan:
Emergent : Bui lding col lapse, Medical
gas fai lure, plumbing
Timeframe: immediate evacuation
(
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The evacuation flowchart in case of an earthquake or/ and related hazards
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Factors
Severity
Probability of Occurrence
Detection Rating
Formula:
R isk Priority Number = Severity * Occurrence * Detect Abilit y
- Next phase: identification of an action plan- Identification of those failure modes that have a RPN score from
100 point and above
Failure in evaluation process
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RPN
Insufficient staff for unit evacuation 300Insufficient space to maintain patients at final evacuation location 300Shortage of medication at final evacuation location 300Insufficient electrical/ medical gas infrastructure for patient support at final location 300Patient movement issues Vertical evacuation 300Insufficient equipment for vertical evacuation 300Safe areas for evacuation not identified 300Planned evacuation route is blocked 250Traffic jams when moving patients with inability to move 250Automation in the hospital (automatic doors, access card readers etc.) may not work 250The severity of the event is assessed wrong (leads to faulty event response urgency) 80Misidentification of the number of patients impacted 80Insufficient lighting for patient evacuation 50No alternative routes for vertical evacuation 45
The total of all RPN score s is: 3105
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Fishbone diagram of evacuation failure
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Structural Vulnerability: The design of the structural system of
the hospital should address to the p otential maximum hazard
forces.
Nonstructural Vulnerability: Past experience showed that during
hazardous events severe damages in the non -structuralcomponents of building caused serious accidents and equipment
damage during the evacuation process.
Organizational Vulnerabilities: All the hospitals are obliged to
emergency operations plans, but a vast majority of them have
not predicted organizational plans in case of emergencies.
Potential Vulnerabilities
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The multi-hazard approach helps in the identification of possible
conflicting effects of certain mitigation measu res and makes
hospitals as a whole complex system, less vulne rable
The multi-h azard design matrix shows the interaction between a
particular hazard and a build ing design component or system
Multi-Hazard approach
Indicates a desirable condition or beneficial interaction
between the designated component/system and a
given hazardIndicates an undesirable condition or the increasedvulnerability of a designated component/system to a
given hazardIndicates little or no significant interaction between the
designated component/system and a given hazard
# Site & Building Seismic Flood Fire E planation of interaction
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# Site & BuildingCharacteristics Seismic Flood Fire Explanation of interaction
1 Site-specific andbuilding specific all-hazard
analysis.Beneficial for all hazards
2 Two or more means of accessto the site Beneficial for all hazards
3 Two or more evacuationroutes from the site Beneficial for all hazards
4 Enclosed courtyard planforms May cause stress concentrations and torsional forces inearthquakes.
5 Heavy structure with concretefloors, reinforced concrete
moment frame, or frame with
reinforced concrete ormasonry shear walls
Although weight increases seismic forces it is not a design
problem. Requires special non-ductile detailing for large
building frames. Generally beneficial for all other hazards
6 Unreinforced masonry load-bearing walls Very poor performance in earthquakes and high winds.Undesirable for all hazards because of possibility of
collapse.7 Large seismic separation
joints in structure Improves seismic response, but creates possible path fortoxic gases during fire8 Brick veneer on exterior walls In earthquakes, winds, and floods material may detach and
cause costly damage and injury. Careful detailing and
quality control necessary for good performance.9 Vibration-isolated equipment
designed for seismic forces:
snubbers prevent equipment
from falling off isolators
Very beneficial for earthquake, not significant for flood or
fire.
10 Anchorage/bracing of systemcomponents Essential for earthquake, beneficial for fire
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Crisis Management
Crisis Management Cycle
Preparation: Dealing with issues, like
planning, education and training
Management: Dealing with issues, like
allocation of resources, command and
communication systems
Evaluation: Lessons learned in post crisis
phase and use this knowledge for
improving policies.
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Different types of crisis exercise
Preparing for crisis
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Model for an integrated command system
Managing crisis
Post-crisis evaluation
The examples of past crises and the way in which hospitals have
dealt with them have affected in a great way the way that hospitals
handle with crises situations nowadays.
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Readiness to manage
injuries and casualties
Pre-designed areas for
casualties management
Use of triage Psychological
supportive care
Preparedness based on
surge science
Staff, stuff, structu re
Hospital preparedness and response in
earthquake crises
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Conclusions
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Thank you!
Questions?
andremember