Fri, Feb 5, 2016

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Four Pillars of Emergency Management

The four pillars of Emergency Management are phases of planning and action undertaken by the Department of Emergency Management to ensure Upstate University Hospital maintains a comprehensive approach to Emergency Management, while maximizing the safety of staff and patients. The four phases are:


Mitigation is the most cost-efficient method for reducing the impact of hazards. A precursor activity to mitigation is the identification of risks. Physical risk assessment refers to the process of identifying and evaluating hazards. The higher the risk, the more urgent the need is to target hazard specific vulnerabilities through mitigation efforts. One example of mitigation at University Hospital is the 96 Hour Business Continuity Plan, which includes mitigation strategies and plans that have been developed to ensure continuity of operations in areas such as utilities, communications, food, water, medication, staffing, and medical supplies when the community is unable to support the hospital due to an external disaster scenario.


Preparedness is a continuous cycle of planning, organizing, training, equipping, exercising, evaluation, and improvement activities that allows Upstate University Hospital to ensure effective coordination and the enhancement of capabilities to prevent, protect against, respond to, recover from, and mitigate against disaster events that have been identified within the hospital's Hazard Vulnerability Analysis (HVA).

In the preparedness phase, the Emergency Management Department develops plans of action to manage and counter risks and takes action to build the necessary capabilities needed to implement such plans.


The Response phase includes the mobilization of the identified emergency staff, including first responders, to an internal or external event which could have an impact on patient care operations. Response procedures are pre-determined by the hospital, and are detailed in disaster plans during the Preparedness phase. Response to an internal or external event in the hospital is directed through the Incident Command System (ICS). Response plans remain flexible in nature due to the varying members of staff available in the hospital at any given time.

Response procedures and plans are constantly evaluated and changed based on improvements identified during After Action Reviews (AARs) which are held after disaster events. Response is also evaluated regularly by the hospital through drills, exercises, tracers, and live events.


The aim of the Recovery phase is to restore the affected area to its previous state. It differs from the Response phase in its focus: recovery efforts are concerned with issues and decisions that must be made after immediate needs are addressed. Recovery efforts are primarily concerned with actions that involve rebuilding destroyed property, re-employment, the repair of other essential infrastructure, as well as the re-opening of essential services in the hospital.

Recovery operations are an extremely important phase in the Emergency Management continuum and yet one that is often overlooked. The Incident Command System team is responsible for the implementation of the Recovery phase.

Hazard Vulnerability Analysis

The basis of the "All Hazards" approach starts with University Hospital's Hazard Vulnerability Analysis (HVA). The HVA identifies disasters and other events from a technological, natural, man-made and hazardous materials perspective which are most prevalent for the region. These events are ranked in order of severity and greatest impact to University Hospital and patient care operations. A risk factor is obtained for each identified hazard by ranking probability, human impact, property impact, business impact, and overall preparedness from an internal and external response entity.

The Hazard Vulnerability Analysis is reviewed annually, or as required by hospital leadership and the Emergency Management Committee. The HVA, including the top five ranked disasters, is shared with community government and emergency response agencies including the Office of Emergency Management, Public Health, Emergency Medical Services (EMS), Police, Fire, and the Medical Examiner's (ME) office. The top five events identified by University Hospital in 2009 were influx of patients (surge), pandemic/epidemic, snowfall, water failure, and internal flood.