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HAZARD AND VULNERABILITY ASSESSMENT TOOL

NATURALLY OCCURRING EVENTS

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 = 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

Earthquake 3 3 3 3 2 2 2 50%
Tidal Wave 0 0 0 0 0 0 0 0%
Temperature
0 0 0 0 0 0 0 0%
Extremes
Drought 0 0 0 0 0 0 0 0%
Flood, External 2 3 0 3 2 2 2 44%
Wild Fire 0 0 0 0 0 0 0 0%
Landslide 0 0 0 0 0 0 0 0%
Dam Inundation 0 0 0 0 0 0 0 0%
Volcano 0 0 0 0 0 0 0 0%
Epidemic 1 3 0 2 2 2 2 20%

AVERAGE SCORE 0.38 0.56 0.19 0.50 0.38 0.38 0.38 2%


*Threat increases with percentage.
6 RISK = PROBABILITY * SEVERITY
38 0.02 0.13 0.13

Natural Hazards : 402265855.xls


HAZARD AND VULNERABILITY ASSESSMENT TOOL
TECHNOLOGIC EVENTS
SEVERITY = (MAGNITUDE - MITIGATION)
PROBABILITY HUMAN PROPERTY BUSINESS PREPARED- INTERNAL EXTERNAL RISK
IMPACT IMPACT IMPACT NESS RESPONSE RESPONSE
EVENT
Time, Community/
Possibility of Physical losses Interuption of
Likelihood this will occur Preplanning effectivness, Mutual Aid staff Relative threat*
death or injury and damages services
resouces and supplies
0 = N/A 0 = N/A 0 = N/A 0 = N/A
0 = N/A 1= 0 = N/A 0 = N/A
1 = Low 1 = Low 1 = Low 1 = High
Low 2= 1 = High 1 = High
SCORE Moderate 3=
2= 2= 2 = Moderate
2 = Moderate 2 = Moderate
2 = Moderate 0 - 100%
Moderate Moderate 3 = High 3 = Low or
High 3 = Low or none 3 = Low or none
3 = High 3 = High none
Electrical Failure 1 1 1 3 2 2 2 20%
Generator Failure 1 1 1 3 2 2 2 20%
Transportation Failure 0 0 0 0 0 0 0 0%
Fuel Shortage 0 0 0 0 0 0 0 0%
Natural Gas Failure 0 0 0 0 0 0 0 0%
Water Failure 1 1 1 3 2 2 2 20%
Sewer Failure 0 0 0 0 0 0 0 0%
Steam Failure 0 0 0 0 0 0 0 0%
Fire Alarm Failure 1 3 3 3 2 2 2 28%
Communications
1 2 1 3 2 2 2 22%
Failure
Medical Gas Failure 1 3 0 3 2 2 2 22%
Medical Vacuum
1 3 0 3 2 2 2 22%
Failure
HVAC Failure 1 1 1 2 2 2 2 19%
Information Systems
1 1 1 3 2 2 0 17%
Failure
Fire, Internal 2 3 3 3 2 2 2 56%
Flood, Internal 0 0 0 0 0 0 0 0%
Hazmat Exposure,
2 3 3 1 2 2 2 48%
Internal
Supply Shortage 0 0 0 0 0 0 0 0%
Structural Damage 1 3 3 3 2 2 3 30%

AVERAGE SCORE 0.74 1.32 0.95 1.74 1.26 1.26 1.21 11%

*Threat increases with percentage.


14 RISK = PROBABILITY * SEVERITY
147 0.11 0.25 0.43

Technological Hazards : 402265855.xls


HAZARD AND VULNERABILITY ASSESSMENT TOOL
HUMAN RELATED EVENTS

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
2 3 0 1 2 2 2 37%
Incident (trauma)
Mass Casualty
Incident 2 3 0 1 2 2 2 37%
(medical/infectious)

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

VIP Situation 0 0 0 0 0 0 0 0%

Infant Abduction 3 3 0 3 1 1 1 50%

Hostage Situation 1 1 0 3 2 2 2 19%

Civil Disturbance 0 3 3 3 1 1 1 0%

Labor Action 2 2 1 3 3 1 2 44%

Forensic Admission 0 0 0 0 0 0 0 0%

Bomb Threat 2 3 3 3 1 1 1 44%

AVERAGE 1.20 1.80 0.70 1.70 1.20 1.00 1.10 19%

*Threat increases with percentage.


12 RISK = PROBABILITY * SEVERITY
75 0.19 0.40 0.46

Human Hazards : 402265855.xls


HAZARD AND VULNERABILITY ASSESSMENT TOOL
EVENTS INVOLVING HAZARDOUS MATERIALS
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 = 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 1 3 0 0 2 2 2 17%
historic events at your
MC with < 5 victims)
Chemical Exposure,
1 3 0 0 2 2 2 17%
External
Small-Medium Sized
1 1 0 0 2 2 2 13%
Internal Spill
Large Internal Spill 0 0 0 0 0 0 0 0%
Terrorism, Chemical 0 0 0 0 0 0 0 0%
Radiologic Exposure,
1 3 0 1 2 2 2 19%
Internal
Radiologic Exposure,
0 0 0 0 0 0 0 0%
External
Terrorism, Radiologic 0 0 0 0 0 0 0 0%
AVERAGE 0.44 1.11 0.00 0.11 0.89 0.89 0.89 3%

*Threat increases with percentage.

4 RISK = PROBABILITY * SEVERITY


35 0.03 0.15 0.22

Hazardous Materials : 402265855.xls


SUMMARY OF HAZARDS ANALYSIS

Total for Facility


Technological

Hazmat
Natural

Human
Probability 0.13 0.25 0.40 0.15 0.22

Severity 0.13 0.43 0.46 0.22 0.30

Hazard Specific Relative Risk:


0.02 0.11 0.19 0.03 0.07
R elative T h reat to F acility

Hazard Specific Relative Risk

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

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

402265855.xls Summary
0.20
0.10
0.00
Probability Severity

402265855.xls Summary
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.
HAZARD AND VULNERABILITY ANALYSIS
RSUD CILINCING
2018
BAB IV
CONCLUSION

Identifikasi dikeluarkan sebagai referensi untuk semua departemen di RSUD Cilincing dalam bermeditasi keselamata
Ketika program implementasi didirikan kendala dan kesulitan yang tidak bisa ia dilaksanakan sesuai kondisi yang seb
Kejadian yang paling besar kemungkinan terjadi bencana di RSUD Cilinicing adalah gempa bumi, banjir, penculikan

Jakarta, 2 Januari 2018


Dibuat oleh

Dr. Rafael

Ketua
emen di RSUD Cilincing dalam bermeditasi keselamatan pasien dan keamanan, pengunjung dan bekerja selama 2018.
yang tidak bisa ia dilaksanakan sesuai kondisi yang sebenarnya jadi kita dari tim K3RS permintaan positif saran sebagai evaluas
SUD Cilinicing adalah gempa bumi, banjir, penculikan bayi, dan kebakaran

Diketahui

Director
Dr. Netty Siahaan, M.K.M
NIP 196104241987112001
kerja selama 2018.
positif saran sebagai evaluasi yang penting dari program dilaksanakan dan membuat referensi untuk melakukan program perbaik
akukan program perbaikan untuk tahun depan.