The West Coast DHB (WCDHB) Emergency Management Plans are based on the Coordinated Incident Management System (CIMS) currently being adopted by all the emergency services. This system provides a functional framework for planning for emergencies. All our current plans are using this model.

A WCDHB Emergency Management Planning Group has been established. The terms of reference include the following functions:

• To form divisional partnerships and build good working relationships;
• To facilitate an integrated, company-wide approach to emergency management;
• To develop organisational-wide strategies/framework which will underpin our response and recovery plans;
• To focus on specific emergency management issues as they arise, including reviewing and reporting on the management of actual events;
• To develop, and monitor achievement of a WCDHB strategic plan for emergency management planning;
• To create a forum which can collectively comment on the future direction of emergency management planning for the WCDHB.

In order to manage an emergency and mitigate its immediate and potential effects, WCDHB facilities and services need thoroughly prepared emergency response plans.

Emergency management plans must:

• Build on routine arrangements/systems
• Be flexible
• Be integrated (ie between services and facilities)
• Be reviewed annually or following service changes
• Be practised regularly

• Understand their roles and the roles of others
• Understand their plan's systems and procedures
• Know how accommodation should be used
• Know where equipment is kept and how to use it
• Make necessary preparations
• Perform to an agreed standard
• Learn from experience

• Ensuring that staff have the right skills and knowledge to undertake the roles expected of them during an incident
• Familiarising all staff, particularly new staff, with special equipment or systems
• Testing emergency plans by appropriate exercises
• Assessing plans and training needs as part of an ongoing cycle of quality improvement

Training needs and priorities may be identified by asking the following questions:

• Who needs to be trained and what do they need to be trained to do?
• Have organisational changes created a training need?
• How have people performed in exercises, incidents or other crises?

Methods and levels of training vary according to roles, individual choice, legal/statutory requirements and personal circumstances. Methods may include:

• Learning on the job
• Instructional videos
• Group training
• Exercises
• Self-learning packages

• Inform, motivate and increase the confidence of staff
• Bring together those likely to be involved in managing a major incident and allows them to examine their performance under controlled conditions
• Provide an assessment of the impact of an event on the organisation
• Identify the strengths and weaknesses of organisational systems
• Demonstrate commitment to quality to local stakeholders and external inquirers

Exercises are used to test all or part of a plan, and, apart from live exercises, should not be a major commitment of staff time or other resources. Types of exercise include:

• Full-scale, multi-agency
• Familiarisation visits and inspection of equipment
• Communications tests
• Call-out procedures (particularly for key staff) - 6 monthly
• Communications systems, including contact arrangements for supporting departments/agencies
• Live exercise (simulating actual response)
• Table-top. (Low-cost; test working relationships, the integration and control links between departments/agencies)
• Participation in other agencies exercises

• acute clinical episodes, such as a cardiac arrest;
• fire;
• environmental hazards, such as a hazardous substance spill;
• breaches of security;
• bomb threats;
• utility failure;
• industrial action;
• an unexpected influx of acutely ill patients (such as a multi-casualty incident or public health emergency).

Depending on the event, this type of incident can have a major impact on one part of the organisation, or it can affect the whole organisation.

• How the plan is activated
• Critical dependencies
• Critical equipment
• Key functions
• An alternative location
• Duty cards for key people
• Resources and supplies required for relocation
• Appendices which should include contact staff list and key service contacts

1. To provide a clinical response;
2. To liaise with the ambulance service, other hospitals and agencies in order
   to manage the impact of the incident;
3. To maintain communications with relatives and friends of existing patients
   and those from the incident, the local community, the media, and VIPs;
4. To ensure the hospital continues all its essential functions throughout the
   incident.

The usual points of communication of a major external event are:

• via St John Ambulance to the Emergency Department
• directly to the Duty Manager

The first line of action for all staff of the WCDHB is via the Emergency Procedures 'flip-chart' found in every ward and department. This document provides staff with clear procedures to follow in an emergency situation, and is designed to ensure that staff always get the assistance they require in as short a time possible. Staff procedures for the following events are outlined in the WCDHB flip-chart:

• mass casualty
• internal emergency (accident endangering property or life; utility failure; etc)
• cardiac arrest
• earthquake
• fire
• hazardous substance spill
• security threat
• bomb/arson threat
• radiation emergency

The flip chart also identifies to staff how they will be informed of an 'all clear' at the end of an emergency.

Management of the ongoing situation may include, but is not limited to, any or all of the following:

• Activating the Emergency Operations Centre
• Calling in specific staff
• Activating the Rapid Discharge procedure
• Evacuation a department/ward/unit to an alternative location
• Arranging for services to be provided by an external agency, eg an external Laboratory
• Arranging for media liaison
• Calling in contractors to rectify the situation