Medical Center Hazard and Vulnerability Analysis

Dokumen ini adala h contoh tool Hazard Vulnerability Analysis. Bukan utk Untuk kesiapan pertimbangkan:
sebagai pengganti program emergency preparedness yg komprehensif. Individu atau 1 Status PLAN yg dimiliki saat ini
FASKES yang menggunakan tool ini bertanggungjawab melakukan asesmen hazard yg 2 Frekuensi pelatihan
mengancam dan mematuhi regulasi dan peraturan perundangan yg ada 3 Status pelatihan
4 Asuransi
INSTRUKSI: 5 Ketersediaan sumberdaya alternatif untuk pelayanan/supply kritikal

Evaluasi potensi kejadian dan respon untuk beberapa kategori dgn

menggunakan nilai yg sdh ditetapkan. Asumsikan setiap insiden terjadi Untuk respon internal pertimbangkan:
pada saat waktu terburuk (cth. saat pasien banyak). 1 Jenis supply yg disiapkan/akankan supply bermafaat?
2 Jumlah supply yg disiapkan/akankah supply bermanfaat?
Perhatikan kriteria nilai pada setiap lembar kerja agar tercatat akurat 3 Ketersediaan staf
4 Koordinasi dgn Komite K3
Untuk probabilitas pertimbangkan: 5 Ketersediaan sistem cadangan/back-up
1 Risiko yg diketahui 6 Kemampuan sumberdaya internal untuk menghadapi bencana/survivability
2 Data historikal
3 Data vendor Untuk respon eksternal pertimbangkan:
1 Jenis kesepakatan dengan lembaga masyarakat/pelatihan?
Untuk respons pertimbangkan: 2 Koordinasi dengan lembaga lokal dan nasional
1 Waktu untuk merespon ke TKP 3 Koordinasi dengan faskes terdekat
2 Kemampuan untuk merespon 4 Koordinasi dengan fasilitas penanganan khusus
3 Evaluasi historikal keberhasilan merespon 5 Sumberdaya masyarakat

Untuk dampak manusia pertimbangkan Lengkapi semua lembar kerja termasuk Alam, Teknologi, Human, Hazmat.
1 Potensi staf cedera atau meninggal Pada lembar ringkasan secara otomatis akan muncul ancaman risiko yg dihadapi faskes.
2 Potensi pasien cedera atau meninggal

Untuk dampak properti pertimbangkan:

1 Biaya utk mengganti
2 Biaya untuk membuat tempat sementara
3 Biaya utk memperbaiki
4 Biaya utk memulihkan
Untuk dampak bisnis pertimbangkan:
1 Bisnis terganggu
2 Staf tdk bisa bekerja
3 Pasien tidak bisa mencapai lokasi
4 Faskes terancam kesepakatan kontrak
5 Kena denda dan pinalti atau biaya legal
6 Terganggunya supply kritikal
7 Terganggunya distribusi produk
8 Reputasi dan citra publik
9 Beban finansial

section will automatically provide your specific and overall relative threat.

1.4.4.a .1 HVA TEMPLATE MODIF KAIZER PERMANENTE Tanjungsari

 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 Interuption
Preplanning effectivness Mutual Aid staff Relative threat*
will occur death or injury losses and of
, resouces and supplies
damages services

0 = N/A 1 0 = N/A 1 0 = N/A 1 0 = N/A 0 = N/A 0 = N/A 0 = N/A

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

BADAI 1 2 2 3 1 1 1 19%

ANGIN TOPAN 1 2 2 3 1 1 1 19%

GUNTUR YG
1 3 1 1 1 1 1 15%
PARAH
GUNUNG MELETUS 0 2 3 3 1 1 1 0%
BANJIR
1 1 2 2 1 1 1 15%
EKSTERNAL
TANAH LONGSOR 2 2 3 3 1 1 1 41%

GEMPA BUMI 1 1 2 3 1 1 1 17%

AWAN PANAS 0 2 1 2 1 1 1 0%
KEMARAU
1 1 1 1 1 1 1 11%
PANJANG
KEBAKARAN
0 1 1 1 1 1 1 0%
HUTAN
KEBAKARAN
1 1 3 2 1 1 1 17%
EKSTERNAL
TSUNAMI 0 3 3 3 1 1 1 0%

DAM RUSAK 0 2 2 2 1 1 1 0%
GELOMBANG
0 1 1 2 1 1 1 0%
PASANG
CUACA EKSTREM 1 1 1 1 1 1 1 11%

WABAH 1 3 0 3 1 1 1 17%

AVERAGE SCORE 0,69 1,75 1,75 2,19 1,00 1,00 1,00 11%

Natural Hazards : 1.4.4.a .1 HVA TEMPLATE MODIF KAIZER PERMANENTE Tanjungsari

*Threat increases with percentage.
RISK = PROBABILITY * SEVERITY
0,11 0,23 0,48
Catatan:

Tulis semua
bencana alam yg
bisa terjadi di
lingkungan
Kolom A FASKES kita.

Kolom B probalitasnya

Kolom C dampak thdp

Kolom D dampak thdp

Kolom E dampak

Kolom F kesiapan

Kolom G respon internal

Kolom H respon

Setelah nilai

Natural Hazards : 1.4.4.a .1 HVA TEMPLATE MODIF KAIZER PERMANENTE Tanjungsari

 HAZARD AND VULNERABILITY ASSESSMENT
TOOL TECHNOLOGIC 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 Interuption of
Preplanning effectivness Mutual Aid Relative threat*
will occur death or losses and services
, resouces staff and
injury damages
supplies
0 = N/A 1 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A
= Low 2 1 = Low 1 = Low 1 = Low 1 = High 1 = High 1 = High
SCORE = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate
0 - 100%
3 = High 3 = High 3 = High 3 = High 3 = Low or 3 = Low or 3 = Low or
none none none

GAGAL LISTRIK 1 1 2 2 1 1 1 15%

GAGAL GENERATOR 2 1 2 2 1 1 1 30%

GAGAL TANSPORATSI 1 2 1 2 1 1 1 15%

KEHABISAN BBM 1 1 1 2 1 1 1 13%

GAGAL GAS NON

1 2 2 1 1 1 1 15%
MEDIS

GAGAL AIR 1 1 1 2 1 1 1 13%

GAGAL PEMBUANGAN
1 2 2 2 1 1 1 17%
LIMBAH PADAT

GAGAL PEMBUANGAN
1 2 2 2 1 1 1 17%
LIMBAH CAIR

GAGAL ALARN
1 3 3 3 1 1 1 22%
KEBAKARAN

GAGAL KOMUNIKASI 1 2 1 2 1 1 1 15%

Technological Hazards : 1.4.4.a .1 HVA TEMPLATE MODIF KAIZER PERMANENTE Tanjungsari

GAGALGAS MEDIS 1 2 1 2 1 1 1 15%

GAGAL VAKUM 1 2 1 2 1 1 1 15%

GAGAL HVAC 1 1 1 2 1 1 1 13%

GAGAL SISTEM
1 1 1 2 1 1 1 13%
INFORMASI

KEBAKARAN INTERNAL 1 3 3 3 1 1 1 22%

BANJIR INTERNAL 1 2 2 3 1 1 1 19%

PAPARAN HAZMAT
1 2 1 1 1 1 1 13%
INTERNAL

KEKURANGAN
1 1 1 1 1 1 1 11%
PASOKAN

KERUSAKAN
1 1 1 2 1 1 1 13%
STRUKTUR

AVERAGE SCORE 1,05 1,68 1,53 2,00 1,00 1,00 1,00 16%
*Threat increases with percentage.
RISK = PROBABILITY * SEVERITY
0,16 0,35 0,46

Catatan:

Kolom A hazard

Kolom B probalitasnya

Kolom C dampak thdp

Kolom D dampak thdp

Kolom E dampak

Kolom F kesiapan

Technological Hazards : 1.4.4.a .1 HVA TEMPLATE MODIF KAIZER PERMANENTE Tanjungsari

 HAZARD AND VULNERABILITY ASSESSMENT TOOL
HUMAN RELATED EVENTS

SEVERITY = (MAGNITUDE - MITIGATION)

PROBABILITY HUMAN PROPERT BUSINESS PREPARED- INTERNAL EXTERNAL RISK
EVENT IMPACT Y IMPACT NESS RESPONSE RESPONSE
IMPACT
Time, Community/
Likelihood this Possibility of Physical Interuption of
Preplanning effectivness Mutual Aid Relative threat*
will occur death or losses and services
, resouces staff and
injury damages
supplies
0 = N/A 1 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A
= Low 2 1 = Low 1 = Low 1 = Low 1 = High 1 = High 1 = High
SCORE = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 0 - 100%
3 = High 3 = High 3 = High 3 = High 3 = Low or 3 = Low or 3 = Low or
none none none
INSIDEN KORBAN 1 2 3 3 1 1 1 20%
INSIDEN KORBAN 1 2 3 3 1 1 1 20%

TERORISME 1 3 3 3 1 1 1 22%

SITUASI VIP 1 2 1 1 1 1 1 13%

PENCULIKAN BAYI 1 3 1 2 1 1 1 17%

PENYANDERAAN 1 3 1 1 1 1 1 15%

GANGGUAN SIPIL 1 2 2 1 1 1 1 15%

AKSI DEMONSTRASI 1 1 2 3 1 1 1 17%

TAWURAN MASSAL 1 3 3 3 1 1 1 22%

ANCAMAN BOM 1 3 3 3 1 1 1 22%

AVERAGE 1,00 2,40 2,20 2,30 1,00 1,00 1,00 18%

*Threat increases with percentage.

RISK = PROBABILITY * SEVERITY
0,18 0,33 0,55

Catatan:

Kolom A hazard human

Kolom B probalitasnya

Kolom C dampak thdp

Kolom D dampak thdp

Kolom E dampak

Kolom F kesiapan

Human Hazards : 1.4.4.a .1 HVA TEMPLATE MODIF KAIZER PERMANENTE Tanjungsari

 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 and damages services
resouces and
injury
supplies
0 = N/A 1 0 = N/A 0 = N/A 1 0 = N/A 0 = N/A 0 = N/A 0 = N/A
= Low 2 1 = Low = Low 2 = 1 = Low 1 = High 1 = High 1 = High
SCORE = Moderate 3 2 = Moderate Moderate 3 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate
0 - 100%
= High 3 = High = High 3 = High 3 = Low or 3 = Low or 3 = Low or
none none none
KORBAN MASSAL (>5) 0 3 0 0 1 2 2 0%
KORBAN MASSAL 1 1 0 0 1 2 2 11%
EKSTERNAL 0 1 1 1 1 2 2 0%
UKURAN KECIL- 1 1 1 1 1 2 2 15%
BESAR 0 2 1 3 1 2 2 0%
TERORISME KIMIA 0 3 0 3 0 0 0 0%
DARI FASKES KE 1 2 0 3 1 2 2 19%
PAPARAN HAZMAT 1 1 0 1 1 1 1 9%
INTERNAL EKSTERNAL

PENCEMARAN LIMBAH
INFEKSIUS FASKES KE 1 2 0 2 1 2 2 17%
LINGKUNGAN
AVERAGE 0,56 1,78 0,33 1,56 0,89 1,67 1,67 8%

*Threat increases with percentage.

RISK = PROBABILITY * SEVERITY
0,08 0,19 0,44

Catatan:

Tulis semua
risiko hazard
material yg bisa
terjadi di
lingkungan
Kolom A FASKES kita

Hazardous Materials : 1.4.4.a .1 HVA TEMPLATE MODIF KAIZER PERMANENTE Tanjungsari

 Tentukan
probalitasnya utk
masing2 risiko
hazmat (0
3) --> makin
sering
probabilitas
makin tinggi
Kolom B nilainya

Tentukan dampak
thdp manusia utk
masing2 risiko
hazmat (0-3) --
> makin buruk
dampaknya
makin tinggi
nilainya
Kolom C

Tentukan dampak
thdp properti
FASKES utk
masing2 risiko
hazmat (0-3) --
> makin buruk
dampaknya
makin tinggi
nilainya
Kolom D

Kolom E dampak

Kolom F kesiapan

Hazardous Materials : 1.4.4.a .1 HVA TEMPLATE MODIF KAIZER PERMANENTE Tanjungsari

 SUMMARY OF MEDICAL CENTER HAZARDS ANALYSIS

Total for Facility

Technological

Hazmat
Natural

Human
Probability 0,23 0,35 0,33 0,19 0,28
Severity 0,48 0,46 0,55 0,44 0,48

Hazard Specific Relative Risk: 0,11 0,16 0,18 0,08 0,14

Hazard Specific Relative Risk to Medical Center

1,00
0,90
Relative Threat to Facility

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 to Medical Center

1,00
0,90
0,80
Relative Impact on Facility

0,70
0,60
0,50
0,40
0,30
0,20
0,10
0,00

Probability Severity

1.4.4.a .1 HVA TEMPLATE MODIF KAIZER PERMANENTE Tanjungsari Summary