Being prepared for a natural disaster, infectious disease outbreak or other emergency where many injured or ill people need medical care while maintaining ongoing operations is a significant challenge for local health systems. Challenges to developing and sustaining community coalitions may reflect the structure of preparedness activities, which are typically administered by designated staff in hospitals or large medical practices. Providers and policy makers alike increasingly have recognized the value of collaboration through community-based preparedness initiatives to minimize the amount of redundant capacity each provider must maintain.
A number of different federal, state and local organizations work with health care providers individually and collectively to promote collaboration in preparedness activities. In contrast, much less attention and funding have focused on involving other health care providers, such as independent physician practices, ambulatory care centers, specialty care centers and long-term care facilities, in community-based preparedness activities. However, such stakeholders as schools and employers can and do influence medical treatment during disasters.
Most primary care respondents agreed that physicians are focused mainly on their patients’ day-to-day needs and do not see preparedness as part of their mission.
A few respondents reported that competition did affect preparedness collaborations, particularly when hospital leaders are guarded about sharing capabilities and needs with peers at other institutions. During the H1N1 pandemic, for example, some coalitions developed plans to distribute supplies in advance. Nearly all hospitals working with both hospital-employed physicians and independent community-based physicians reported that hospital-employed physicians are easier to engage, suggesting that markets with larger physician groups and more hospital employment of physicians would be better positioned to build integrated surge-capacity plans.
Because of the generally collegial approach to preparedness activities, respondents reported that tighter hospital affiliations in consolidated markets had little impact. While all providers felt the strain of competing demands in allocating resources for emergency preparedness, rural providers were particularly strapped. Across sites, respondents consistently reported that hospitals and hospital-owned physician practices typically are much more involved in emergency-preparedness coalitions than other stakeholders, reflecting both the federal financial support hospitals receive for preparedness activities and their size, structure and resources. There are two general approaches policy makers could consider to broaden participation in emergency-preparedness coalitions: providing incentives for more stakeholders to join existing preparedness coalitions or building preparedness into activities providers already are pursuing. Consider building preparedness into activities providers already are pursuing.An alternative approach to traditional preparedness coalitions would be to leverage activities providers already are pursuing unrelated to preparedness activities. One option would be to incorporate preparedness activities into existing incentive programs aimed at underrepresented stakeholders, including independent physicians and nursing homes. Other opportunities might include incorporating community-level preparedness activities into care-coordination activities that can count toward patient-centered medical home certification or encouraging electronic health record vendors to include features that facilitate electronic submission of important data to local, state and federal authorities during a disaster. If collaborative preparedness activities leveraged existing affiliations and activities among stakeholders, the resulting coalitions might look very different from community to community. For example, nursing homes owned by or closely affiliated with hospitals may use the hospitals’ preparedness staff, making it easy to develop collaborative approaches to preparedness.
The development and employment of a SEMP is an important complement to such existing plans, because it promotes an integrated and coordinated approach to emergency management planning within federal institutions and across the federal government. The Emergency Management Planning Guide uses a step-by-step approach and provides instructions that are supplemented by the Blueprint and the Strategic Emergency Management Plan (SEMP) template provided in Annexes A and B, respectively. The Emergency Management Planning Unit, Public Safety Canada, is responsible for producing, revising and updating this Guide.
Given this variety of EM planning documents, the distinctions between them are summarized in the following table. The National Strategy and Action Plan for Critical Infrastructure establishes a public-private sector approach to managing risks, responding effectively to disruptions, and recovering swiftly when incidents occur.
This step involves starting the formal planning process in recognition of the responsibility to prepare a SEMP.
Consider including a member of your institution's corporate planning area on the EM planning team in order to help align the EM planning cycle with the institution's overall business planning cycle.
Federal government institutions should consider identifying the range of experience and skill sets required in the EM planning team. Additional supporting planning tools and templates as well as an EM glossary are provided in Annexes C and D, respectively. The Planning Context is represented in a target diagram that consists of three circles representing the factors federal institutions should consider in order to understand the context in which it operates and how it could potentially be affected.
As an example of Business Continuity Plan Sample this plan of action signifies the actual organization dedication in order to reaction, resumption, recuperation, as well as repair preparing. Learn how to develop disaster recovery strategies as well as how to write a disaster recovery plan with these step-by-step instructions.
Once this work is out of the way, you’re ready to move on to developing disaster recovery strategies, followed by the actual plans. In addition to using the strategies previously developed, IT disaster recovery plans should form part of an incident response process that addresses the initial stages of the incident and the steps to be taken. Important: Best-in-class DR plans should begin with a few pages that summarise key action steps (such as where to assemble employees if forced to evacuate the building) and lists of key contacts and their contact information for ease of authorising and launching the plan. The Guide includes a Blueprint (see Annex A), a Strategic Emergency Management Plan (SEMP) template (see Annex B), and supporting step-by-step instructions, tools and tips to develop and maintain a comprehensive SEMP—an overarching plan that establishes a federal government institution's objectives, approach and structure, which generally sets out how the institution will assist with coordinated federal emergency management, including response.
As such, federal institutions are to base EM plans on mandate-specific all-hazards risk assessments, as well as put in place institutional structures to provide governance for EM activities and align them with government-wide EM governance structures. It should integrate and coordinate elements identified in operational plans and business continuity plans (BCPs). The SEMP should be central to the federal government institution's EM activities and provide clear linkages for integrating and coordinating all other intra-departmental and inter-departmental emergency management plans.
This process can be seen as a timeline, such as in Figure 2, in which incident response actions precede disaster recovery actions. The next section should define roles and responsibilities of DR recovery team members, their contact details, spending limits (for example, if equipment has to be purchased) and the limits of their authority in a disaster situation. Located at the end of the plan, these can include systems inventories, application inventories, network asset inventories, contracts and service-level agreements, supplier contact data, and any additional documentation that will facilitate recovery.
These are essential in that they ensure employees are fully aware of DR plans and their responsibilities in a disaster, and DR team members have been trained in their roles and responsibilities as defined in the plans. It does not lay out the requirements for preparing related EM protocols, processes, and standard operating procedures (SOP) internal to the institution; however, these should be developed in support of the SEMP and related plans. And since DR planning generates a significant amount of documentation, records management (and change management) activities should also be initiated. EM planning, in particular, aims to strengthen resiliency by promoting an integrated and comprehensive approach that includes the four pillars of EM: prevention and mitigation, preparedness, response and recovery.
In addition, there are other existing EM planning documents and initiatives that apply to a range of federal government institutions, such as the Federal Emergency Response Plan (FERP) and deliverables under the National Strategy for Critical Infrastructure. The aim is to develop a SEMP that integrates and coordinates elements identified in hazard-specific plans and BCPs.
Emergency preparedness requires coordination of diverse entities at the local, regional and national levels.
There are two general approaches policy makers could consider to broaden participation in emergency-preparedness coalitions: providing incentives for more stakeholders to join existing coalitions or building preparedness into activities providers already are pursuing.
11, 2001, terrorist attacks, many health care providers have adopted emergency-preparedness plans, including participation in such activities as community-wide drills and tabletop exercises, to strengthen their ability to respond to a disaster.
First, preparedness activities, such as planning, training and participating in drills, do not generate revenue for health care providers but have costs in staff time and materials.


Few communities involve independent practitioners other than maintaining a list of those willing to volunteer in the event of a disaster, for which no special training or expertise in disaster response is required. Nonmedical stakeholders, such as police, fire, coroners, school systems and employers, have varying degrees of involvement in medical emergency planning collaboration. In some hospital systems, the system’s preparedness plan directly encompassed physician practices owned by the hospital system. However, most attention has focused on population-level management of obesity or chronic illness rather than disaster preparedness and response. Other stakeholders, particularly smaller and independent primary care practices, could potentially contribute to preparedness efforts, but there are significant barriers to involving them in traditional coalitions in a sustainable way.
Policy makers could encourage groups whose participation is currently limited in most communities, such as independent physician practices, to join traditional preparedness coalitions that meet regularly to develop joint plans or coordinate responses. For example, programs that offer extra payment to primary care practices to coordinate care of patients with specific chronic conditions might also encourage and reward coordination related to emergency preparedness or the creation of business continuity plans.
Employment of physicians is only one of the ways markets vary—hospitals may be independent or tightly affiliated with one another, nursing homes may be closely linked to local hospitals or to national chains, and health information may be shared widely or not at all. Federal government institutions in the early stages of developing a SEMP may find it useful to read the material in Sections One and Two, while other institutions with more established plans may wish to proceed directly to Section Three. The purpose of this Guide is to assist federal officials, managers and coordinators responsible for emergency management (EM) planning. Operational plans may be based on all four pillars of EM planning, or focus on the specific activities of a single pillar. Emergency management (EM) refers to the management of emergencies concerning all hazards, including all activities and risk management measures related to prevention and mitigation, preparedness, response and recovery. Consider having members of the EM planning team designated by your institution's senior management.
The composition of the EM planning team will vary depending on institutional requirements; however, it is important that clear terms of reference (TOR) for the team be established and that individual assignments be clearly defined.
An inventory of critical assets and services will assist the planning team in identifying the associated threats, hazards, vulnerabilities and risks unique to their institution. Risk assessment is central to any risk management process as well as the EM planning cycle. The actual [Name of Nonprofit] Business Continuity Plan is supposed to supply the construction with regard to making programs to guarantee the security associated with workers, volunteers as well as customers (customers) and also the resumption associated with time-sensitive procedures as well as providers in case of an urgent situation (fireplace, energy or even marketing communications blackout, tornado, storm, ton, earthquake, municipal disruption, and so on, catastrophe, or even additional business being interrupted.
Formulating a detailed recovery plan is the main aim of the entire IT disaster recovery planning project.
Once you have identified your critical systems, RTOs, RPOs, etc, create a table, as shown below, to help you formulate the disaster recovery strategies you will use to protect them. Once your disaster recovery strategies have been developed, you’re ready to translate them into disaster recovery plans.
It reflects leading practices (such as those provided by the International Organization for Standardization (ISO) and Canadian Standards Association) and procedures within the Government of Canada, and should be read in conjunction with the Federal Emergency Response Plan, the Emergency Management Framework for Canada and the Federal Policy for Emergency Management.
It is intended that governments and industry partners will work together to assess risks to the sector, develop plans to address these risks, and conduct exercises to validate the plans. The size and composition of the team may vary between federal government institutions; however, the planning team should ideally have the skill and experience necessary to develop the SEMP. A sample cross-reference table of existing plans by identified institutional risks is provided in Annex C, Appendix 4. Based on the findings from incident response activities, the next step is to determine if disaster recovery plans should be launched, and which ones in particular should be invoked.
As outlined in the Preface, many federal government institutions already have specific plans or processes to deal with aspects of emergency management; many also have a long track record of preparing and refining BCPs, which endeavour to ensure the continued availability of critical services. This section defines the criteria for launching the plan, what data is needed and who makes the determination. Given the diversity of stakeholders, fragmentation of local health care systems and limited resources, developing and sustaining broad community coalitions focused on emergency preparedness is difficult. Maintaining preparedness is a daunting task, given that emergencies can spring up at a national, regional or local level and take forms as varied as a global pandemic, a regional hurricane or a local outbreak of food-borne illness. While there is limited funding for preparedness activities, hospitals are not subsidized to keep beds empty and supplies stockpiled for a disaster, and it is impractical for trained staff to sit idle until a disaster strikes. The H1N1 influenza pandemic was the most recent national event that required large-scale preparedness and response. Given the low probability of certain events, stockpiling supplies and committing staff to emergency preparedness often are not high institutional priorities.4 In addition, community coalitions require competitors to work collaboratively. Regional or specialty-based medical societies may maintain similar lists and can provide basic training in disaster planning through continuing medical education. A hospital respondent in another community coalition cited reluctance to work with nursing homes because of the perception that they are primarily looking for a place to offload patients in an emergency. However, respondents across all sites generally agreed that providers put normal competitive dynamics aside for preparedness efforts and meet and share information on capacity and supply chains when needed. At the same time, public health preparedness experts have sought to develop methods to evaluate community coalitions. Likewise, hospital efforts to work with physician practices and long-term care facilities to prevent avoidable readmissions might incorporate preparedness activities. Each of these factors may affect how planning responsibilities, staff and information are most efficiently shared in preparation for and during a disaster. It is important to note that collaborations based on existing affiliations and less-formal relationships would still require some oversight to avoid situations where disparities in market position may leave some providers at a disadvantage in securing needed information and supplies during a disaster.
Supporting templates and tools can contribute to effective emergency management planning and are provided with this Guide. The EM plans of federal government institutions should address the risks to critical infrastructure within or related to the institution's areas of responsibility, as well as the measures for protecting this infrastructure. The Emergency Management Continuum is depicted in a wheel diagram where all four risk-based functions of emergency management are interconnected and interdependent in a system from prevention and mitigation to preparedness, response, and recovery. One of the most crucial steps in the EM planning process is to identify appropriate members for the EM planning team.
After the EM planning team has clear authority and direction, the next step is to review any relevant existing legislation and policies. Even though this plan of action offers assistance as well as paperwork where in order to bottom crisis reaction, resumption, as well as recuperation preparing initiatives, it’s not meant as an alternative with regard to knowledgeable decision-making. The following section details the elements in a DR plan in the sequence defined by ISO 27031 and ISO 24762.
This work at the sector level will inform, and will be informed by, work at the organizational level such as EM plans and their component parts.
The EM planning governance structure may include representatives of an institution's senior management team, from all functional areas (such as programs) and all corporate areas (including communications, legal services and security). A section on plan document dates and revisions is essential, and should include dates of revisions, what was revised and who approved the revisions. Planning can be triggered by the EM planning cycle or it can be initiated in preparation for, or in response to, an event that is induced either by nature or by human actions.
Technology DR plans can be enhanced with relevant recovery information and procedures obtained from system vendors.


As a prolonged, low-mortality event, H1N1 tested community preparedness, clarified the challenges different stakeholders face, and pointed to ways to broaden and strengthen local collaboration.
And, unlike other events that health care organizations must prepare for, such as Joint Commission inspections, there are no predictable, short-term consequences for failing to engage in collaborative, community-level disaster planning. The focus on hospitals reflects their historic importance in providing staff, space for planning and response, and treatment of emergency victims, including such specialized services as decontamination or burn care. Some health systems did expect employed physicians in community practices to work collaboratively in disaster planning. This study’s findings suggest that preparedness work could be integrated with broader care delivery, with possible implications for how to evaluate coalitions. The SEMP is the overarching plan that provides a comprehensive and coordinated approach to EM activities. In the center of the wheel are the main elements that influence the development of a Strategic Emergency Management Plan (SEMP). As noted in Section Two, the EM planning process should be carried out as part of an institution's overall strategic and business planning processes—this will support their alignment. Consider gathering a list of institutional risks and cross-referencing the existing plans (as identified in Step 2-1c) that address each risk. Rather, the Business Continuity Plan is actually a good on-going, financed business exercise budgeted to supply assets necessary to: Carry out actions necessary to create and gaze after programs Teach as well as retrain workers Create as well as modify guidelines as well as requirements since the division modifications Physical exercise methods, methods, group as well as assets needs Statement on-going business continuity likely to older administration Investigation procedures as well as systems to enhance resumption as well as recuperation effectiveness Creating a Business Continuity Plan which includes actions necessary to preserve the practical continuity capacity helps to ensure that a regular preparing strategy is actually put on all the [Name of Nonprofit] procedures.
This is why Public Safety Canada has developed this Emergency Management Planning Guide, which is intended to assist all federal government institutions in developing their all-hazards Strategic Emergency Management Plans (SEMPs). Emergency Management resource requirements should be identified as early as possible to integrate into plans.
For example, an institution can be constrained by the availability of training for EM planning team members and by the number of EM positions they have staffed. Once the plan has been launched, DR teams take the materials assigned to them and proceed with response and recovery activities as specified in the plans.
If your organisation already has records management and change management programmes, use them in your DR planning.
Physicians and other clinicians employed by hospitals or working in community-based practices owned by hospitals usually fall under the umbrella of hospital preparedness activities. Even in a disaster where victims seek care at hospitals, community-based clinicians can play a role. In some cases, this reflected a commitment at the highest levels of organizations, but, in other cases, it reflected rapport among preparedness staff.
High levels of physician participation in those markets were attributed to hospital systems setting the expectation that physicians would participate and paying them for their efforts, and, in some cases, even allotting them administrative time to participate in preparedness or other system-level work. No rural respondents described working with their state office of rural health on emergency preparedness.
Lack of time, training and sometimes simply awareness that they have a role in disaster response also are important factors. Two additional sites were added: New York City because of significant investment in preparedness and Chicago to increase Midwestern representation. The SEMP should ideally be reviewed on a cyclical basis as part of a federal government institution's planning cycle, as presented in Figure 2 below. Developing the SEMP can be supported by a formal work or project plan to ensure that established timelines for plan development are met.
Many federal government institutions already have specific planning documents or processes to deal with aspects of emergency management that relate to their particular mandates; many also have a long track record of preparing and refining BCPs. Inputs should ideally be assembled, reviewed and well understood prior to engaging in each distinct planning activity as they form an important foundation for the work to be completed. After completing the above steps, the planning team should consider developing a detailed work plan that includes a schedule with realistic timelines, milestones that reflect the institutional planning cycle, and a responsibility assignment matrix with assigned tasks and deadlines.
This plan of action should be held present to guarantee the precision associated with its material.
This section should specify who has approved the plan, who is authorised to activate it and a list of linkages to other relevant plans and documents. Included within this part of the plan should be assembly areas for staff (primary and alternates), procedures for notifying and activating DR team members, and procedures for standing down the plan if management determines the DR plan response is not needed. For example, in a disaster, hospitals generally try to discharge as many inpatients as possible, and community-based providers could help by seeing or contacting discharged patients to ensure they are receiving needed follow-up care.
Sixty-seven telephone interviews were conducted between June 2011 and May 2012 with representatives of state and local emergency management agencies and health departments, emergency-preparedness coalitions, hospital emergency preparedness coordinators, primary care practices and other organizations working on emergency preparedness and response. This figure represents the optimal planning cycle federal institutions should consider for undertaking their emergency management planning activities.
As a next step, federal government institutions should consider developing a comprehensive understanding of the planning context.
It is important that the planning team confirm the strategic priorities of the institution and of senior management so that they can be reflected in the SEMP.
As a matter of process, the Emergency Management Planning Guide will be reviewed annually or as the situation dictates, and amendments will be made at that time. It entails a process of gathering and analyzing information and typically considers both internal and external factors (see Figure 3: The Planning Context for additional information on the factors to consider). It is in these plans that you will set out the detailed steps needed to recover your IT systems to a state in which they can support the business after a disaster. If DR plans are to be invoked, incident response activities can be scaled back or terminated, depending on the incident, allowing for launch of the DR plans. Check with your vendors while developing your DR plans to see what they have in terms of emergency recovery documentation. Other respondents reported frequent communication among competing hospitals on shared pandemic plans and hospital policies for emergencies. The planning team should aim to clearly identify the planning constraints and institutional limitations that will influence the SEMP building blocks and the subsequent development of the SEMP. The key to any emergency planning is awareness of the potential situations that could impose risks on the organization and on Canadians and to assess those risks in terms of their impact and potential mitigation measures. Here we’ll explain how to write a disaster recovery plan as well as how to develop disaster recovery strategies.
The more detailed the plan is, the more likely the affected IT asset will be recovered and returned to normal operation. Business Continuity Plan Sample: This particular record offers the Business Continuity Plan. If gaps are identified, these should ideally be gathered and presented as part of Step 3 when developing the EM Planning Framework and confirming the institution's strategic EM priorities. For further information, you may wish to consult the Canadian Disaster Database, which contains detailed disaster information on over 900 natural, technological and conflict events (excluding war) that have directly affected Canadians over the past century.



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