Risk & Safety Management in Hospital Constructions and Crisis Management in case of an Earthquake

8/12/2019 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

Risk & Safety Management in Hospital Constructions and Crisis Management in case of an Earthquake

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