Medical Center Hazard and Vulnerability Analysis

INSTRUCTIONS:

Evaluate potential for event and response among the following categories using
the hazard specific scale.

Issues to consider for probability include, but are not limited to:
1 Known risk
2 Historical data
3 Manufacturer/vendor statistics
Issues to consider for response include, but are not limited to:
1 Time to marshal an on-scene response
2 Scope of response capability
3 Historical evaluation of response success
Issues to consider for human impact include, but are not limited to:
1 Potential for staff death or injury
2 Potential for patient death or injury
Issues to consider for property impact include, but are not limited to:
1 Cost to replace
2 Cost to set up temporary replacement
3 Cost to repair
Issues to consider for business impact include, but are not limited to:
1 Business interruption
2 Employees unable to report to work
3 Customers unable to reach facility
4 Company in violation of contractual agreements
5 Imposition of fines and penalties or legal costs
6 Interruption of critical supplies
7 Interruption of product distribution
Issues to consider for preparedness include, but are not limited to:
1 Status of current plans
2 Training status
3 Insurance
4 Availability of back-up systems
5 Community resources
Issues to consider for internal resources include, but are not limited to:
1 Types of supplies on hand
2 Volume of supplies on hand
3 Staff availability
4 Coordination with MOB's

Issues to consider for external resources include, but are not limited to:
1 Types of agreements with community agencies
2 Coordination with local and state agencies
3 Coordination with proximal health care facilities
4 Coordination with treatment specific facilities

Complete all worksheets including Natural, Technological, Human and Hazmat. The summary
section will automatically provide your specific and overall relative threat.

367588869.xls
 HAZARD AND VULNERABILITY ASSESSMENT TOOL
KEJADIAN ALAM 2016

SEVERITY = (MAGNITUDE - MITIGATION)

PROBABILITY HUMAN PROPERTY BUSINESS PREPARED- INTERNAL EXTERNAL RISK
KEJADIAN IMPACT IMPACT IMPACT NESS RESPONSE RESPONSE
Time, Community/
Likelihood this Possibility of Physical losses Interuption of
Preplanning effectivness, Mutual Aid staff Relative threat*
will occur death or injury and damages services
resouces and supplies

0 = N/A 0 = N/A
0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A
1 = Low 1 = High
SCORE 1 = Low 1 = Low 1 = Low 1 = High 1 = High
2 = Moderate 2 = Moderate 2 = Moderate
2 = Moderate
2 = Moderate 2 = Moderate
2 = Moderate 0 - 100%
3 = High 3 = Low or
3 = High 3 = High 3 = High 3 = Low or none 3 = Low or none
none

BADAI 0 0 0 0 0 0 0 0%
TORNADO 0 0 0 0 0 0 0 0%
Hujan Badai 0 0 0 0 0 0 0 0%
Hujan Es 0 0 0 0 0 0 0 0%
Putting Beliung 1 1 1 1 1 1 1 11%
Gempa Bumi 1 2 2 3 1 1 1 19%
Cuaca Ekstrem 1 0 0 0 3 3 3 17%
Banjir 1 1 2 2 3 3 3 26%
Kabut Asap 1 2 1 2 1 1 1 15%
Longsor 0 0 0 0 0 0 0 0%
Volcano 1 2 2 2 1 1 1 17%

AVERAGE SCORE 0.38 0.50 0.50 0.63 0.63 0.63 0.63 2%

*Threat increases with percentage.
6 RISK = PROBABILITY * SEVERITY
56 0.02 0.13 0.19

Natural Hazards : 367588869.xls

 HAZARD AND VULNERABILITY ASSESSMENT TOOL
TECHNOLOGIC EVENTS 2016
SEVERITY = (MAGNITUDE - MITIGATION)
PROBABILITY HUMAN PROPERTY BUSINESS PREPARED- INTERNAL EXTERNAL RISK
EVENT IMPACT IMPACT IMPACT NESS RESPONSE RESPONSE
Time, Community/
Likelihood this Possibility of Physical losses Interuption of
Preplanning effectivness, Mutual Aid staff Relative threat*
will occur death or injury and damages services
resouces and supplies
0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A
0 = N/A 0 = N/A
1 = Low 1 = Low 1 = Low 1 = Low 1 = High
1 = High 1 = High
SCORE 2 = Moderate 2= 2= 2 = Moderate
2 = Moderate 2 = Moderate
2 = Moderate 0 - 100%
3 = High Moderate Moderate 3 = High 3 = Low or
3 = Low or none 3 = Low or none
3 = High 3 = High none
Kelistrikan Rumah Sakit 2 1 1 2 1 1 1 26%
Genset 2 1 1 2 1 1 1 26%

Kegagalan Transportasi 1 2 0 2 1 1 1 13%

Kesulitan BBM 1 1 1 2 1 1 1 13%
Kesulitan BBG 1 1 0 2 1 1 1 11%
Kesulitan Air 1 2 0 2 1 1 1 13%
Kegagalan Saluran
0 0 0 0 0 0 0 0%
Pembuangan
Kegagalan Komunikasi 1 1 1 2 1 1 1 13%
Fire Alarm Failure 1 2 3 3 1 1 1 20%
Medical Gas Failure 1 2 0 2 1 1 1 13%
Medical Vacuum Failure 0 0 0 0 0 0 0 0%

Kegagalan Sistem Informasi 2 0 0 2 1 1 1 19%

Fire Internal 1 2 2 2 1 1 1 17%

Flood Internal 0 0 0 0 0 0 0 0%

AVERAGE SCORE 0.74 0.79 0.47 1.21 0.58 0.58 0.58 6%

*Threat increases with percentage.

14 RISK = PROBABILITY * SEVERITY
80 0.06 0.25 0.23

Technological Hazards : 367588869.xls

 HAZARD AND VULNERABILITY ASSESSMENT TOOL
HUMAN RELATED EVENTS 2016

SEVERITY = (MAGNITUDE - MITIGATION)

PROBABILITY HUMAN PROPERTY BUSINESS PREPARED- INTERNAL EXTERNAL RISK
EVENT IMPACT IMPACT IMPACT NESS RESPONSE RESPONSE

Time, Community/
Likelihood this Possibility of Physical losses Interuption of
Preplanning effectivness, Mutual Aid staff Relative threat*
will occur death or injury and damages services
resouces and supplies
0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A
0 = N/A 0 = N/A
1 = Low 1 = Low 1 = Low 1 = Low 1 = High
1 = High 1 = High
SCORE 2 = Moderate 2= 2= 2 = Moderate
2 = Moderate 2 = Moderate
2 = Moderate 0 - 100%
3 = High Moderate Moderate 3 = High 3 = Low or
3 = Low or none 3 = Low or none
3 = High 3 = High none
Mass Casualty
0 0 0 0 0 0 0 0%
Incident (trauma)
Mass Casualty
Incident 1 2 0 3 1 1 1 15%
(medical/infectious)

Terrorism, Biological 0 0 0 0 0 0 0 0%

VIP Situation 0 0 0 0 0 0 0 0%

Infant Abduction 1 2 0 3 1 1 1 15%

Hostage Situation 0 0 0 0 0 0 0 0%

Civil Disturbance 0 0 0 0 0 0 0 0%

Labor Action 0 0 0 0 0 0 0 0%

Forensic Admission 0 0 0 0 0 0 0 0%

Bomb Threat 0 0 0 0 0 0 0 0%

AVERAGE 0.20 0.40 0.00 0.60 0.20 0.20 0.20 1%

*Threat increases with percentage.

2 RISK = PROBABILITY * SEVERITY
16 0.01 0.07 0.09

Human Hazards : 367588869.xls

 HAZARD AND VULNERABILITY ASSESSMENT TOOL
EVENTS INVOLVING HAZARDOUS MATERIALS 2016
SEVERITY = (MAGNITUDE - MITIGATION)
PROBABILITY HUMAN PROPERTY BUSINESS PREPARED- INTERNAL EXTERNAL RISK
EVENT IMPACT IMPACT IMPACT NESS RESPONSE RESPONSE
Time, Community/
Likelihood this Possibility of Physical losses Interuption of
Preplanning effectivness, Mutual Aid staff and Relative threat*
will occur death or injury and damages services
resouces supplies
0 = N/A 0 = N/A 0 = N/A
0 = N/A 0 = N/A 0 = N/A 0 = N/A
1 = Low 1 = Low 1 = Low
1 = Low 1 = High 1 = High 1 = High
SCORE 2 = Moderate 2=
2 = Moderate
2 = Moderate
2 = Moderate 2 = Moderate 2 = Moderate 0 - 100%
3 = High Moderate 3 = High
3 = High 3 = Low or none 3 = Low or none 3 = Low or none
3 = High

Mass Casualty
Hazmat Incident (From 0 0 0 0 0 0 0 0%
historic events at your
MC with >= 5 victims)

Small Casualty
Hazmat Incident (From 0 0 0 0 0 0 0 0%
historic events at your
MC with < 5 victims)
Chemical Exposure,
0 0 0 0 0 0 0 0%
External
Small-Medium Sized
1 2 0 3 1 1 1 15%
Internal Spill
Large Internal Spill 0 0 0 0 0 0 0 0%

0 0 0 0 0 0 0 0%
Terrorism, Chemical
Radiologic Exposure,
0 0 0 0 0 0 0 0%
Internal
Radiologic Exposure,
0 0 0 0 0 0 0 0%
External

0 0 0 0 0 0 0 0%
Terrorism, Radiologic
AVERAGE 0.11 0.22 0.00 0.33 0.11 0.11 0.11 0%

*Threat increases with percentage.

1 RISK = PROBABILITY * SEVERITY

8 0.00 0.04 0.05

Hazardous Materials : 367588869.xls

 SUMMARY OF MEDICAL CENTER HAZARDS ANALYSIS

Total for Facility

Technological

Hazmat
Natural

Human
Probability 0.13 0.25 0.07 0.04 0.14

Severity 0.19 0.23 0.09 0.05 0.16

Hazard Specific Relative Risk:
0.02 0.06 0.01 0.00 0.02
R e la tiv e T h re a t to F a c ility

Hazard Specific Relative Risk to Medical Center

1.00
0.90
0.80
0.70
0.60
0.50
0.40
0.30
0.20
0.10
0.00
Natural Technological Human Hazmat
Relative Im pact on Facility

Probability and Severity of Hazards to Medical Center

1.00
0.90
0.80
0.70
0.60
0.50
0.40
0.30
0.20
0.10
0.00
Probability Severity

367588869.xls Summary