HAZARD AND VULNERABILITY ASSESSMENT TOOL

NATURALLY OCCURRING EVENTS

DAMPAK = (LUAS KEJADIAN - MITIGASI)

PROBABILITAS DAMPAK DAMPAK DAMPAK RESPON RESPON
KESIAPAN
KEJADIAN MANUSIA PROPRTI BISNIS INTERNAL EXTERNAL
Kemungkinan Masyarakat /
Probalitas akan Kehilangan dan Gangguan Waktu, Efektifitas,
Meninggal atau Pra Perencanaan Bantuan Umum &
terjadi Kerusakan Fisik Pelayanan Sumber Daya
Cedera Suplai
0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A
1 = Rendah 1 = Rendah 1 = Rendah 1 = Rendah 1 = Tinggi 1 = Tinggi 1 = Tinggi
NILAI 2 = Moderat 2 = Moderat 2 = Moderat 2 = Moderat 2 = Moderat 2 = Moderat 2 = Moderat
3 = Tinggi 3 = Tinggi 3 = Tinggi 3 = Tinggi 3 = Rendah / Tidak 3 = Rendah / Tidak 3 = Rendah / Tidak
ada ada ada

BADAI 1 1 2 3 3 1 1
ANGIN TOPAN 1 1 2 3 3 1 1
GUNTUR YANG PARAH 1 1 1 1 2 2 2
GUNUNG MELETUS 1 1 1 1 2 2 2
BANJIR EXTERNAL 3 0 2 2 2 1 2
TANAH LONGSOR 0 0 0 0 0 0 0
GEMPA BUMI 1 2 2 3 2 1 1
AWAN PANAS 0 0 0 0 0 0 0
KEMARAU PANJANG 1 0 1 1 2 1 2
KEBAKARAN HUTAN 0 0 0 0 0 0 0
KEBAKARAN EXTERNAL 1 1 2 3 2 1 2
TSUNAMI 0 0 0 0 0 0 0
DAM RUSAK 0 0 0 0 0 0 0
GELOMBANG PASANG 0 0 0 0 0 0 0
CUACA EXTREM 0 0 0 0 0 0 0
WABAH 3 3 0 3 2 2 1

AVERAGE SCORE 0.81 0.63 0.81 1.25 1.25 0.75 0.88

*Threat increases with percentage.

13 RISK = PROBABILITY * SEVERITY
89 0.08 0.27 0.31

Natural Hazards : 713327357.xlsx

 RISIKO

Ancaman Relatif*

0 - 100%

20%
20%
17%
17%
50%
0%
20%
0%
13%
0%
20%
0%
0%
0%
0%
61%
0%

8%

Natural Hazards : 713327357.xlsx

 HAZARD AND VULNERABILITY ASSESSMENT TOOL
TECHNOLOGICAL EVENTS

DAMPAK = (LUAS KEJADIAN - MITIGASI)

PROBABILITAS DAMPAK DAMPAK DAMPAK
KESIAPAN
KEJADIAN MANUSIA PROPRTI BISNIS
Kemungkinan
Probalitas akan Kehilangan dan Gangguan
Meninggal atau Pra Perencanaan
terjadi Kerusakan Fisik Pelayanan
Cedera
0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A
1 = Rendah 1 = Rendah 1 = Rendah 1 = Rendah 1 = Tinggi
NILAI 2 = Moderat 2 = Moderat 2 = Moderat 2 = Moderat 2 = Moderat
3 = Tinggi 3 = Tinggi 3 = Tinggi 3 = Tinggi 3 = Rendah / Tidak
ada

GAGAL LISTRIK 2 0 0 3 3
GAGAL GENERATOR 0 0 0 0 0
GAGAL TRANSPORTASI 0 0 0 0 0
KEHABISAN BBM 0 0 0 0 0

GAGAL GAS NON MEDIS 0 0 0 0 0

GAGAL AIR 2 0 0 1 3
GAGAL PEMBUANGAN
LIMBAH PADAT
GAGAL PEMBUANGAN
LIMBAH CAIR
GAGAL ALARM
0
KEBAKARAN
GAGAL KOMUNIKASI 2
GAGAL GAS MEDIS 1
GAGAL VAKUM 0
GAGAL HVAC
GAGAL SISTEM
2
INFROMASI
KEBAKARAN INTERNAL 2
BANJIR INTERNAL
PAPARAN HAZMAT
INTERNAL

KEKURANGAN PASOKAN

KERUSAKAN STRUKTUR 2

AVERAGE SCORE 0.81 0.00 0.00 0.25 0.38

*Threat increases with percentage.

13 RISK = PROBABILITY * SEVERITY
20 0.02 0.27 0.07
SESSMENT TOOL
NTS

DIAN - MITIGASI)
RESPON RESPON RISIKO
INTERNAL EXTERNAL
Masyarakat /
Waktu, Efektifitas,
Bantuan Umum & Ancaman Relatif*
Sumber Daya
Suplai
0 = N/A 0 = N/A
1 = Tinggi 1 = Tinggi
2 = Moderat 2 = Moderat 0 - 100%
3 = Rendah / Tidak 3 = Rendah / Tidak
ada ada

3 3 44%
0 0 0%
0 0 0%
0 0 0%

0 0 0%

2 2 30%

0%

0%

0%

0%
0%
0%
0%

0%

0%

0.31 0.31 2%
 HAZARD AND VULNERABILITY ASSESSMENT TOOL
HUMAN RELATED EVENTS

SEVERITY = (MAGNITUDE - MITIGATION)

PROBABILITY RISK
HUMAN PROPERTY BUSINESS PREPARED- INTERNAL EXTERNAL
IMPACT IMPACT IMPACT NESS RESPONSE RESPONSE
EVENT
Time, Community/
Likelihood this will Possibility of Physical losses Interuption of
Preplanning effectivness, Mutual Aid staff Relative threat*
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 3 2 = Moderate 2 = Moderate 0 - 100%
Moderate Moderate
3 = High 3 = High = Low or none 3 = Low or none 3 = Low or none
3 = High 3 = High
Mass Casualty Incident
2 3 0 1 2 2 2 37%
(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 : 713327357.xlsx

 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 will Possibility of Physical losses Interuption of
Preplanning effectivness, Mutual Aid staff and Relative threat*
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 3 2 = Moderate 2 = Moderate 0 - 100%
Moderate
3 = High 3 = High 3 = High = Low or none 3 = Low or none 3 = Low or none
3 = High

Mass Casualty Hazmat

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

Small Casualty Hazmat

1 3 0 0 2 2 2 17%
Incident (From 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%

0 0 0 0 0 0 0 0%
Terrorism, Chemical
Radiologic Exposure, 1 3 0 1 2 2 2 19%
Internal
Radiologic Exposure, 0 0 0 0 0 0 0 0%
External

0 0 0 0 0 0 0 0%
Terrorism, Radiologic
AVERAGE 0.44 1.11 0.00 0.11 0.89 0.89 0.89 3%

*Threat increases with percentage.

RISK = PROBABILITY * SEVERITY
4
35 0.03 0.15 0.22

Hazardous Materials : 713327357.xlsx

 SUMMARY OF HAZARDS ANALYSIS

Total for Facility

Technological

Hazmat
Natural

Human
Probability 0.27 #REF! 0.40 0.15 #REF!
Severity 0.31 #REF! 0.46 0.22 #REF!
Hazard Specific Relative Risk:
0.08 #REF! 0.19 0.03 #REF!

Hazard Specific Relative Risk

1.00
Relative Threat to Facility

0.90
0.80
0.70
0.60
0.50
0.40
0.30
0.20
0.10
0.00
Natural Technological Human Hazmat

Probability and Severity of Hazards

1.00
0.90
Relative Impact on Facility

0.80
0.70
0.60
0.50
0.40
0.30
0.20
0.10
0.00
Probability Severity

713327357.xlsx 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
temen di RSUD Cilincing dalam bermeditasi keselamatan pasien dan keamanan, pengunjung dan bekerja selama 2018.
n yang tidak bisa ia dilaksanakan sesuai kondisi yang sebenarnya jadi kita dari tim K3RS permintaan positif saran sebagai evalua
RSUD Cilinicing adalah gempa bumi, banjir, penculikan bayi, dan kebakaran

Diketahui

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