Emergency Operations Plan Research Articles

Coping with Sinkholes: A Systematic Literature Review

Sinkholes have frequently occurred around soluble rock formations, but they have been indirectly related to imprudent human practices, based on long-standing recognition. The aim of this study was to explore how to improve sinkhole hazard management to decrease the extent of related risks. The main methodology was a systematic literature review that identified and synthesized the relevant information. The proposed analytical framework served as the basis for review criteria, and the scope of literature was mainly restricted to relevant text data. Analytical categories and analytical units were both used in the text synthesis process. Sinkholes were traditionally treated as natural events; however, major stakeholders started to pay attention to them as human-induced events under climate change. These players extensively included international organizations, sinkhole-prone countries (e.g., Venezuela, China, Saudi Arabia, etc.), and sinkhole-resistant countries (e.g., United Arab Emirates, Kenya, Australia, etc.) in this study. A key theme in the literature was that these stakeholders would no longer deal with sinkholes as natural events but as human-induced events, based on potential advantages (i.e., managing manmade sinkholes and implementing emergency operation plans). Similarly, as addressing emergency prevention, public awareness, technological application, social challenges, education, and training, the key tenet of study would be further achieved in terms of managerial implications. The results of this study suggested that human activities would act as negative factors in sinkhole occurrence more directly than were indicated previously. Hence, the understanding of sinkhole hazard management would be quite deepened via social environment, while policy makers were to proactively manage the issue with the sincere cooperation of local residents.

Evaluating communication capability across diverse groups for disaster medicine: A time-tracking method for functional exercises

Recent experiences in disaster medicine in Japan have shown the importance of preventing post-disaster health deterioration among citizens during the evacuation and recovery phases. The effective involvement of various medical, social welfare, and nursing organizations is necessary to mitigate these health problems. This study explored the effectiveness of a time-tracking evaluation method for functional exercises in analyzing the communication and joint task-processing capabilities of various medical and social welfare organizations in response to a citywide heavy-rain disaster. Each exercise inject was analyzed in advance to create a task-processing chain according to the emergency medical response plan. The actions of the exercise players were then compared with the expected tasks in the processing chain. The exercise created overload for some player groups. The completion rates and average execution times of the tasks were compared across task types and player groups, indicating the potential weaknesses of the current emergency operation plan. Responses of local medical associations to similar exercise injects were compared to analyze the range of diversity in responses and the merits of past exercise participation. Although the results of this time-tracking evaluation need to be carefully interpreted by combining the results regarding the quality of players' exercise actions, this method provides a new perspective for evaluating emergency operation plans through functional exercises.

A flow-directed minimal path sets method for success path planning and performance analysis

Emergency operation plans are indispensable elements for effective process safety management especially when unanticipated events occur under extreme situations. In the paper, a synthesis framework is proposed for the integration success path planning and performance analysis. Within the synthesis framework, success path planning is implemented through flow-directed signal tracing, renaming and reconstruction from a complete collection of Minimal Path Sets (MPSs) that are obtained using graph traversal search on GO-FLOW model diagram. The performance of success paths is then evaluated and prioritized according to the task complexity and probability calculation of MPSs for optimum action plans identification. Finally, an Auxiliary Feed Water System of Pressurized Water Reactor (PWR-AFWS) is taken as an example system to demonstrate the flow-directed MPSs search method for success path planning and performance analysis. It is concluded that the synthesis framework is capable of providing procedural guidance for emergency response and safety management with optimal success path planning under extreme situations.

An Examination of Texas K-12 Teachers’ Opinions on Teacher and Staff Gun Carrying

ABSTRACT While previous studies have assessed public opinions for arming teachers in K-12 schools in the United States, comparatively less research has focused on understanding teachers’ opinions for such policies and assessed whether and to what extent school- and individual-level factors are associated with differences in support. The current study aims to address these voids in the current body of literature by analyzing self-report data from a large sample of Texas K-12 educators (N = 9,196) to assess relations between theoretical correlates of teacher and staff gun carrying, demographic as well as school characteristics, and support for carrying. A series of logistic regression models reveal that favorable views of an emergency operation plan in a school setting and general negative view of guns in school are associated with lower odds of support. The strength of these associations varies across teacher and school characteristics. The implications of the reported results for K-12 school policy is discussed.

Examining Knowledge of US DOE Best Practices for Disaster Planning Among Five Private Christian K–12 School Administrators After a Hurricane: A Multi-Case Study

Destruction wrought by hurricanes can physically impact schools, houses, and businesses, all of which can delay or prevent recovery within communities. This study investigated the awareness among five private K–12 Christian administrators of the United States Department of Education (USDOE) guidelines for developing emergency operation plans (EOPs) for effective response and recovery. The five administrators were selected from a pool of 12 whose schools sustained on-site damage during the 2017 hurricane season. Their interview responses supported evidence of general knowledge of USDOE guidelines. Notably, veteran administrators reported that their previous hurricane response experience was more useful than their knowledge of government EOP guidelines.

Lessons Learned from an OB / Newborn / Neonatal Intensive Care Full-Scale Exercise

Introduction:Children are frequently victims of disasters. However, gaps remain in disaster planning for pediatric patients. The New York City Pediatric Disaster Coalition (NYCPDC) is funded by the NYC Department of Health and Mental Hygiene (DOHMH) to prepare NYC for mass casualty incidents that involve large numbers of children.On April 26, 2018, the NYC PDC conducted a first in NY, full-scale exercise with the NYC Fire Department (FDNY) testing evacuation, patient tracking, communications, and emergency response of the Obstetrics, Newborn and Neonatal units at a NYC based hospital. The goal of the exercise was to evaluate current Ob/Newborn/Neonatal plans and assess the hospital’s ability to evacuate patients.Method:The exercise planning process included a review of existing OB / Newborn / Neonatal plans, four group planning meetings, as well as, targeted specific area meetings and plan revisions. The exercise incorporated scenario-driven, operations-based activities, which challenged participants to employ the facility's existing evacuation plans during an emergency.Results:The Exercise assessed the following: Communication, Emergency Operation Plans, Evacuation, Patient Tracking, Supplies and Staffing. Internal and external evaluators rated exercise performance on a scale from 1-4. Evaluators completed an exercise evaluation guide based on the Master Scenario Event List.An After Action Report was written based on the information from the exercise evaluation guides, participant feedback forms, hot-wash session, and after action review meeting. Strengths included the meaningful improvement of plans before the exercise (including the fire department) and the overall meeting of exercise objectives.Conclusion:Lessons learned included: addressing gaps in effective internal and external communications, adequate supplies of space, staff, equipment needed for vertical evacuations; providing staging and alternate care sites with sufficient patient care and electrical-power resources. The lessons learned are being utilized to improve existing hospital plans to prepare for future full-scale exercise and or real-time events.

Lessons Learned from 28 Hospitals and City Agencies: Pediatric Disaster Exercise

Introduction:Children are frequently victims of disasters. However, gaps remain in pediatric disaster preparedness. The New York City Pediatric Disaster Coalition (NYCPDC) is funded by the NYC Department of Health and Mental Hygiene (DOHMH) to prepare NYC for mass casualty events that involve large numbers of children. The NYC PDC conducted a functional exercise testing surge, communications, and secondary transport. Participants included 28 NYC hospitals, the NYC Fire Department-Emergency Medical Services (FDNY-EMS), NYC Emergency Management (NYCEM), NYC DOHMH and the NYC Medical Reserve Corps (MRC).Method:The hospitals and agencies participated in group and individual planning meetings. Scenario-driven, operations-based activities challenged participants to employ their facility's existing pediatric surge and secondary transport plans during an event. The exercise assessed: Communications, Emergency Operation Plans, Surge, Patient Tracking, Patient Transfer, Supplies, and Staffing. Internal and external evaluators assessed the exercise performance.Results:An After-Action Report was written based on information from evaluation data, site-specific and group hot-washes, and an after-action conference. Strengths included meaningful improvement of plans before/after the exercise and doubling pediatric critical care capacity through the implementation of the exercise objectives. Challenges included: gaps in communication/patient tracking, lack of sufficient sub-specialty support, the need for "babysitters” and inadequate supplies of blood products and ventilators.Conclusion:Conducting a multi-hospital and agency pediatric specific exercise demonstrated current planning and produced lessons learned to address planning and training gaps that can improve citywide planning and capabilities during future full-scale exercise and real-time events.

Investigating the Challenges of Ammonia Emission in Firuzabad Sodium Carbonate Factory Incident: A Case Study

Background: An ammonia gas explosion poses immediate health hazards such as respiratory tract burns, skin and eye irritation, and potential death within seconds. It also causes long-term negative impacts on biodiversity, affecting aquatic life and vegetation. An explosion in the Firuzabad sodium carbonate factory in Iran led to massive ammonia gas leakage and the poisoning of several employees. This study evaluates the risks of ammonia gas release caused by the explosion and the rescue team’s response in the same factory. Materials and Methods: This study was conducted in 2020 in Firuzabad City, Iran. The investigation was based on case reports and data analysis obtained via field observations, document reviews, interviews, and experiments. Technical and specialized information on explosion were analyzed by ALOHA software. Results: Based on data analysis, red, orange, and yellow zones around the explosion area were identified. The red zone had an ammonia emission range of 1.2 km with an explosive power of 10 kW, causing potential death in 60 seconds. Orange zone had a range of about 1.7 km, an explosive power of 5 kW, and the potential for second-degree burns and respiratory damage within 60 seconds of release. The yellow zone covered an area of about 3.3 km. Interviews and field observations provided information on the risk-based response process, response equipment, medical treatment, hazardous materials, handling and response equipment, personal protective equipment, mutual aid, and resource typing. Conclusion: The results of this study show that the immediate evacuation of the area, employment of the rapid warning system, the triage of the injured, the presence of an emergency operation plan to control hazardous and toxic materials disasters, the performance of the rapid response team and multi-specialty teams were among the existing challenges of the operation team. Background of this study confirms the potential hazards associated with ammonia gas emissions from explosions in sodium carbonate plants.

The crisis you can’t plan for: K-12 leader responses and organisational preparedness during COVID-19

ABSTRACT Unlike many types of educational crises, the COVID-19 pandemic was a crisis leaders could not have prepared for. But research is only starting to examine how leaders’ responses and organisational context have played a role. This mixed-methods study accordingly examines how leaders have mitigated challenges presented by the COVID-19 pandemic, and what local factors are most salient. Investigating two districts over two years in the United States, we conducted extensive interviews with leaders (n = 41) and teachers (n = 18), gathered responses to the Comprehensive Assessment of Leaders for Learning (CALL) survey (N = 111), and district emergency operation plans. We find those education organisations possessing a culture focused on instructional inquiry, more developed distributed leadership networks, and greater material resources were better positioned to respond to the unexpected crisis. In contrast, those lacking such capacities experienced increased stress. Together, these findings further demonstrate the importance organisational preparedness and resources play when limited expertise and technical solutions exist.

A National Survey of Hospital Cyber Attack Emergency Operation Preparedness.

Cyberattacks on healthcare systems are increasing in frequency and severity. Hospitals need to integrate cybersecurity preparedness into their emergency operations planning and response to mitigate adverse outcomes during increasingly likely cyber events. No data currently exist regarding the level of preparedness of United States hospital systems for cybersecurity attacks. We surveyed hospital emergency managers to assess cybersecurity preparedness for these events. Fifty-seven emergency managers representing hospitals across the United States participated in an online Qualtrics survey regarding current preparedness and response procedures for cybersecurity hazards. Survey responses between April 2019 and May 2021 demonstrated that a majority of hospital systems surveyed included cybersecurity disasters in their HVA (82.4%; 47/57), and most ranked it as 1 of their top 5 priorities (57.4%; 27/47). However, over half denied specifically mentioning cybersecurity in their Emergency Operations Plans (EOPs; 52.6%; 30/57). Fourteen of the 57 hospital systems (24.5%) endorsed previously activating an emergency response for a cybersecurity incident unrelated to information technology (IT) failure. The survey results suggest that American hospitals are currently underprepared for cybersecurity disasters. We emphasize the importance of prioritizing cybersecurity in Hazard Vulnerability Analyses (HVAs) and implementing specific EOP annexes for cybersecurity emergencies.

Can Live-Actor Patients in a Mass Casualty Incident Exercise Benefit as Exercise Players?

In a mass casualty incident (MCI) exercise, live-actor patients (LAPs) simulated different scenarios in the exercise. This study compared the benefit to LAPs with that to exercise players (EPs) and nonparticipants (NPs). An MCI exercise was conducted in 2018. Emergency department (ED) nurses were assigned as EPs, LAPs, or NPs and asked to attend a pre-exercise lecture. A pre-exercise survey evaluated all ED nurses' background, confidence level, and knowledge of MCI management. Knowledge assessment included disaster medicine knowledge (DMK) and on emergency operation plan familiarity (EOPF). The same survey was conducted again after the exercise. A paired t-test was used to analyze the difference before and after the exercise in the 3 groups. Twenty-nine ED nurses completed both surveys. Confidence improved significantly for both the EP and LAP groups. The DMK of the LAP group improved significantly. EOPF also improved significantly for all 3 groups. A comparison of the improvement levels showed no significant difference between the EP and LAP groups for confidence, DMK, and EOPF. ED nurses can benefit from participating as LAPs in full-scale MCI exercises. Having ED nurses act as LAPs makes it possible to train more staff in 1 exercise.

Hurricanes: A Disastrous Storm or Famous Louisiana Cocktail? A Headache Either Way

Features| April 2022 Hurricanes: A Disastrous Storm or Famous Louisiana Cocktail? A Headache Either Way Kyle P. Nester, MD, FASA; Kyle P. Nester, MD, FASA Search for other works by this author on: This Site PubMed Google Scholar Katherine S. Cox, MD, FASA Katherine S. Cox, MD, FASA Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor April 2022, Vol. 86, 29. https://doi.org/10.1097/01.ASM.0000826984.50290.2f Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share MailTo Twitter LinkedIn Cite Icon Cite Get Permissions Search Site Citation Kyle P. Nester, Katherine S. Cox; Hurricanes: A Disastrous Storm or Famous Louisiana Cocktail? A Headache Either Way. ASA Monitor 2022; 86:29 doi: https://doi.org/10.1097/01.ASM.0000826984.50290.2f Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsASA Monitor Search Advanced Search Topics: headache, hurricanes, louisiana Living in Louisiana is great: the food, the people, the vibrant culture. But there are six months out of the year that give many of us pause. Hurricane season can lead to unpredictable events that present unique challenges for physicians. Thankfully, anesthesiologists are notorious planners. In times of impending disaster, hospitals must have emergency operation plans and activate an incident command center. Planning is essential, but each storm brings unique challenges. It was a rough year for all in 2020; no one will argue with that statement. For southwest Louisiana, and in particular the city of Lake Charles, Mother Nature brought “a little something extra,” or “lagniappe” (LAN-yap), as we say in Louisiana. However, the lagniappe was neither little nor welcomed. Two major storms, Hurricane Laura on August 27, 2020, and Hurricane Delta on October 9, 2020, delivered a devastating blow to the area. Category 4 Hurricane Laura became the... You do not currently have access to this content.

Awareness of Emergency Nursing Staff about Emergency Operations Plan in a Tertiary Care Hospital in Riyadh, Saudi Arabia

Awareness of Emergency Nursing Staff about Emergency Operations Plan in a Tertiary Care Hospital in Riyadh, Saudi Arabia

Adaptation of ED design layout during the COVID-19 pandemic: a national cross-sectional survey

BackgroundThe aim was to describe the organisational changes in French EDs in response to the COVID-19 pandemic with regard to architectural constraints and compare with the recommendations of the various...

The Impact of the Storm Prediction Center's Convective Outlooks and Watches on Emergency Management Operational Planning

For many emergency managers (EMs) and National Weather Service (NWS) forecasters, Convective Outlooks issued by the Storm Prediction Center (SPC) influence the preparation for near-term severe weather events. However, research into how and when EMs utilize that information, and how it influences their emergency operations plan, is limited. Therefore, to better understand how SPC Convective Outlooks are used for severe weather planning, a survey was conducted of NWS core partners in the emergency management sector. The results show EMs prefer to wait until an Enhanced Risk for severe thunderstorms is issued to prepare for severe weather. In addition, the Day 2 Convective Outlook serves as the threshold for higher, value-based decision making. The survey was also used to analyze how the issuance of different risk levels in SPC Convective Outlooks impact emergency management preparedness compared to preparations conducted when a Convective Watch is issued.

Space-Time Cluster's Detection and Geographical Weighted Regression Analysis of COVID-19 Mortality on Texas Counties.

As COVID-19 run rampant in high-density housing sites, it is important to use real-time data in tracking the virus mobility. Emerging cluster detection analysis is a precise way of blunting the spread of COVID-19 as quickly as possible and save lives. To track compliable mobility of COVID-19 on a spatial-temporal scale, this research appropriately analyzed the disparities between spatial-temporal clusters, expectation maximization clustering (EM), and hierarchical clustering (HC) analysis on Texas county-level. Then, based on the outcome of clustering analysis, the sensitive counties are Cottle, Stonewall, Bexar, Tarrant, Dallas, Harris, Jim hogg, and Real, corresponding to Southeast Texas analysis in Geographically Weighted Regression (GWR) modeling. The sensitive period took place in the last two quarters in 2020 and the first quarter in 2021. We explored PostSQL application to portray tracking Covid-19 trajectory. We captured 14 social, economic, and environmental impact’s indices to perform principal component analysis (PCA) to reduce dimensionality and minimize multicollinearity. By using the PCA, we extracted five factors related to mortality of COVID-19, involved population and hospitalization, adult population, natural supply, economic condition, air quality or medical care. We established the GWR model to seek the sensitive factors. The result shows that adult population, economic condition, air quality, and medical care are the sensitive factors. Those factors also triggered high increase of COVID-19 mortality. This research provides geographical understanding and solution of controlling COVID-19, reference of implementing geographically targeted ways to track virus mobility, and satisfy for the need of emergency operations plan (EOP).

Improving rural disaster response preparedness.

Disasters happen in all communities and negatively impact the health and safety of populations if not well managed. Rural health organizations face greater challenges when implementing emergency preparedness policies and need unique resources to help ensure the health of their communities. The purpose of this article is to describe the development and evaluation of an agricultural simulation scenario designed for rural health organizations. The agricultural disaster scenario was developed after determining the desired content domains. Forty students from nursing, medicine, public health, and social work participated in a functional simulation using the scenario. Outcomes were measured using a pre-post measurement with one cohort design. Data were analyzed using paired-samples t-tests. Students reported a 30% increase in self-confidence, 38% increase in disaster competence, and 19% increase in interprofessional collaboration competence after the simulation. Statistically significant increases in student scores were noted on all surveys across professions. The agricultural disaster simulation is a valid scenario to use for disaster preparation using emergency operations plans.

Language access in emergency and disaster preparedness: An assessment of local government “whole community” efforts in the United States

In 2011, the United States Federal Emergency Management Agency enunciated a “whole community” strategic approach to emergency and disaster preparedness. Central to this approach is inclusion of the interests and concerns of all residents of a jurisdiction, including those with heightened vulnerabilities. However, relatively few studies have investigated how subnational governments have translated those federally-identified principles of access and inclusion into practice. Here, we ask: what is the current state of local government performance on language access, what might explain it, and what are its implications? While limited English proficiency (LEP) is both a key vulnerability indicator and important to emergency preparedness and operations, it is seldom studied systematically. We investigate how language accessibility is addressed in two distinct elements of community preparedness: emergency operations plans (EOPs) and household emergency preparedness guides (HPGs). Using a sample of 110 U S. counties, we find somewhat positive performance: nearly half the counties score high on language access in their EOPs, and two-thirds acknowledge the issue. Local HPGs are moderately language accessible. But our analysis also indicates that underlying demand (proportion LEP residents, community hazards profiles) does not correspond to specific efforts. Rather, other aspects of local administrative capacity might drive performance variation. Taken together, this suggests a policy challenge: emergency preparedness on language access remains relatively variable across U.S. communities and might depend primarily on local capacity and commitment. The findings imply uniform adoption of whole community principles in emergency preparedness actions across the U.S. is unlikely to occur reflexively.

Experience and practice of the Emergency Operations Center, Chinese Center for Disease Control and Prevention: a case study of response to the H7N9 outbreak

BackgroundEmergency Operations Center (EOC) is a place to provide response to public health emergencies. Chinese Center for Disease Control and Prevention (China CDC)’s EOC was officially established in 2016, which has been the core department for the public health emergencies and risk response. In recent years, we have been continuously improving the function of EOC through many incidents. In the study, we hope to share the construction status, operation management experience of China CDC’s EOC and the response process in the human avian influenza A (H7N9) outbreak.Main textThe China CDC’s EOC mainly focus on building the five core elements including sites/places and facilities, information and data, plans and procedures, training and exercises, and logistics. Based on summarizing previous emergency response, the China CDC’s EOC established its own incident management and the standardized response procedures. The event-specific data, context-specific data and event management data could be obtained through various source. The logistics department of the EOC also provides comprehensive support. The well-trained staff is another necessary conditions for its operation. Through sharing the response process of H7N9 outbreak, it further explains the EOC’s functions in the five phases of outbreak response, such as the formulation of the incident response framework, monitoring, personnel dispatch and resource mobilization.ConclusionsThe EOC contributes to faster and more efficient responses during emergencies which enable a greater reduction in morbidity and mortality. Compared with the traditional incident response process, under the command and coordination of China CDC’s EOC, each group involved in the response has a clearer goal, responsibilities and tasks at each stage. Meanwhile, each group also gave full play to its own expertise and advantages. As a whole, incident response tended to be more specialized and precise, which generally improves the efficiency of incident response. However, different countries and regions have different response processes to the events. We still suggested that appropriate emergency operation plan should be made according to the complexity of incident response in the region when constructing response mechanism, through our experience. And the China CDC’s EOC is still at growing and groping phase.Graphic abstract

The CMS Emergency Preparedness Rule: Challenges for Rural Medical Centers

This study examines how rural medical centers in Northwest Missouri achieve emergency planning compliance with the current Centers for Medicare and Medicaid Services (CMS) emergency preparedness rule. This 2017 study focused on rural hospitals, critical access hospitals, and long‐term care facilities. An exploratory qualitative research study with an interpretive phenomenological approach was applied. Data were gathered from 11 face‐to‐face interviews with medical centers’ emergency and disaster planners in Northwest Missouri. Several categories and subcategories were identified in the data and developed into themes. Thematic analysis indicated significant barriers, including a CMS unfunded mandate, preparedness conducted by a single individual with other duties, lack of a whole community approach, and a lack of financial planning by medical center administration, hinder compliance with the CMS rule, necessary to mitigate nationwide emergencies. All participants agreed to the development of the emergency operations plan, which is essential for compliance. The findings from this study support the need for additional planning staff, time, and training to understand the elements of preparedness. Compliance with the CMS emergency preparedness rule cannot be achieved unless identified barriers are addressed.