DISASTER PREPAREDNESS:

LEADERSHIP AND
COORDINATION IN
DISASTER IN HEALTH CARE
SYSTEM: DRRM IN
THE PHILIPPINE
PERSPECTIVE
DISASTER RISK REDUCTION and
MANAGEMENT (DRRM)
• It is a systematic process of using administrative
decisions, organization and operational skills and
capacities to implement strategies, policies and improved
coping capacities of the society and community in order to
lessen the adverse impacts of hazards and the possibility
of a disaster.
 2 ASSUMPTIONS

• 1. disaster risk is endemic

• 2. it is within the power of the state to reduce disaster risk

• (Source: IRR of RA 10121)

DRRMC ORGANIZATIONAL NETWORK
• National Disaster Risk Reduction & Management Council
• 12 Regional Disaster Risk Reduction & Management
Councils
• 80 Provincial Disaster Risk Reduction and Management
Councils
• 122 City Disaster Risk Reduction and Management
Councils
• 1,512 Municipal Disaster Risk Reduction and
Management Councils
• 42,026 Barangay Disaster Risk Reduction and
Management Committees
THE NATIONAL DISASTER RISK REDUCTION
MANAGEMENT COUNCIL (NDRRMC)

• The National Disaster Risk Reduction and Management

Council (NDRRMC), formerly known as the National
Disaster Coordinating Council (NDCC), is a working group
of various government, non-government, civil sector and
private sector organizations of the Government of the
Republic of the Philippines established by Republic Act
10121 of 2010.
THE NATIONAL DISASTER RESPONSE PLAN

• The NDRP is the Government of the Philippines’ “multi-

hazard” response plan. Emergency management as
defined in the NDRRM Act of 2010 (RA10121), is the
organization and management of resources to address all
aspects or phases of the emergency, mitigation of,
preparedness for, response to and recovery from a
disaster or emergency
The NDRP is also built on the following understanding:

• All government agencies and instrumentalities have their own

respective Disaster Preparedness Plans for Terrorism related
incidents;
• All Local Government Units (LGUs) have prepared their
Contingency Plans for Terrorism related incidents and
implemented their Local Disaster Risk Reduction and
Management Plans (LDRRMPs) within the DRRM Framework
of Prevention/Mitigation, Preparedness, programs and
activities that are directly connected to response like
prepositioning of key assets and resources; and
• The Cluster Approach System and Incident Command System
in response operations have been cascaded to all levels of
government both national and local.
National Disaster Risk Reduction and Management
Plan 2011-2028
COORDINATION AND EMERGENCY AND
DISASTER
Challenges in Managing Emergencies related to Coordination and
Communication

• • No identifiable leader or incident manager

• • No basic organizational structure for chain of command and span of
control
• • No common terminology
• • No unified communications system
• • No system for allocating resources
• • Lack of integration, due to competition
• • Lack or loss of resources, due to failures in planning and lack of
resource allocation
• • Lack of planning, due to absence of commitment
• • Failures in risk and crisis communications
INCIDENT MANAGEMENT SYSTEM
• Is a standardized, all hazards incident management
concept.
• It can be composed of several levels
•  ICP (INCIDENT COMMAND POST)
•  EOC (EMERGENCY OPERATIONS CENTER)
•  ECC (EMERGENCY COORDINATION CENTER)

• Allows its users to adopt an integrated organization

structure to match the complexities and demands of single
or multiple incidents without hindered by jurisdictional
boundaries
Emergency Response Management Systems: Core
Principles
• • Based on an all-hazards approach
• • Modular, scalable or adaptable organization
• • Support for joint engagement of multiple institutions / organizations in
management decisions
• • Clear lines of accountability and authority
• • Clearly defined roles and responsibilities, consistent with normal roles and
supported by training
• • Clearly articulated procedures for activation, escalation, and demobilization of
emergency capacities.
• • Common functional groupings and consistent terminology
• • Integrated with stakeholder agencies
• • Mechanisms for the involvement of all stakeholders and users of the EOC in
its design, operational planning and
• evaluation.
• • Provision of capacity to manage public communications opportunities as part
of the response to emergencies
Core Components of the System
• • integrated communications
• • modular organization
• • unified command structure
• • manageable span of control
• • consolidated incident action plans
• • comprehensive resource management
• • pre-designated incident facilities
The essence of the system 5 functions (in many
countries)
• 1. Incident management (manager who coordinates)
• 2. Operations
• 3. Planning
• 4. Logistics
• 5. Administration and finance
• Management: provides overall direction of the response through
the establishment of objectives for the system. This functional
area usually includes other activities that are critical to providing
adequate management:
• – Public Information manages information released to media and
public;
• – Safety assesses hazardous and unsafe conditions and develops
measures to ensure responder safety; and
• – Liaison provides coordination with agencies outside the
response system. For the purposes of this discussion, the terms
• Operations: achieves management’s objectives through directed
strategies and developed tactics.
• Logistics: supports management and operations with personnel,
supplies, communications equipment, and facilities.
• Plans/Information: supports management and
operations with information processing and the
documentation of prospective plans of actions (also
known as action plans, or APs). Critical components
include:
• Administration/Finance: supports management and
operations through tracking of such issues as
reimbursement and regulatory compliance.
Incident Management System
• The IMS (or Incident Command System) refers to the
combination of facilities, equipment, personnel,
procedures, and communications operating within a
common organizational structure and designed to aid in
the management of resources during incident response.
The MCM Management System emphasizes
management rather than command because no inherent
“line authority” exists in a multidisciplinary response by
which assets can be commanded.
Levels of command
• Level 1: using emergency response plans of the hospitals;
developing operational plans to respond to a crisis
• Level 2: information sharing; systems: mutual aid
• Level 3: there are several command and coordination
mechanisms: at the site (Incident Command Post); the
Emergency Operations Centre (EOC) at the local
authority level (multi-sectoral). Depending upon the
organization of the country (its size; level of development,
resources available) the EOC can be at District level or
even at Provincial level
• Level 4: in some countries level 3 is assumed by level 4 in
this diagram. The notion of Emergency Coordination
Centre is important when the size of the incident justify
the activation of national (or provincial in some countries)
plans. In some particular circumstances the national level
has not only a coordination function but also a
“managerial function of the response” (it can be in the
case of a pandemic; for managing the international
donations, etc.)
Incident Command Post (ICP)
• • Site
• • tactical resources directly applied to address emergency
problems
• • responders may come from one agency, or many
• • the on-site response is directed by one agency by
jurisdiction or agreement
• • operates from an ad-hoc site command post
• • utilizes standard functions
• • Advise incoming units of what’s going on. What does it
contain?
• • Be part of solution, not the problem. May have to wait for
special resources to arrive. Does a problem still exist?
• • Do not rush to a scene. Gather info before entering a
scene. Is the area safe to be in? If not, make it safe with
• your capabilities or wait for trained resource to arrive
• • Expect chaos & confusion
• • Careless heroics can injure or kill you
• • First priority is personal safety, then team safety, then by
standers safety and last is patient safety
EOP requires much preparatory work, especially a plan
describing the core elements: The plan usually is composed of:
• • purpose of the plan
• • concept of operations, management structure, roles of
personnel and how the components work together
• • Activation procedures and levels, and who has authority
• • Escalation and de-escalation plan
• • Call-out list and notification procedures
• • Checklists of the roles and responsibilities of EOC functions
• • Checklists of standard operating procedures
• • floor plan, with inventory and locations of equipment and
supplies
• • Electronic information management processes (including a
layout plan of phone, fax, data lines, cables, switches
• and outlets)
• • Communication resources and procedures, especially mobile
phones and radios
• • Public information and warning processes
• • Procedures for engaging levels of government and/or a
superior authority/ jurisdiction
• • Standard forms and instructions for documenting EOC
activities
• • Maps of the area of the event
• • Guidelines for worker care and safety
• • agency and position responsible for maintaining and updating
the plan
• • Training and exercise schedule to ensure staff and
procedures are up-to-date.
Role of Health Emergency Manager in IMS
• • Protect response personnel and resources
• • Minimize loss of life, disability and suffering
• • Protect public health
• • Protect civil infrastructure
• • Protect environmental and economic assets, including
property
• • Reduce economic losses
Risk Communication
• - purposeful exchange of information about the existence,
nature and form severity or acceptability of health risks
between policymakers, health care providers and the
public/media aimed at changing behavior and inducing
action to minimize/reduce risks.

• - The process of bringing together various stakeholders to

come to a common understanding about the risks, their
acceptability, and actions needed to reduce the risks
Risk Communication Activities
Nurses’ Responsibility in Risk Communication

• • Identifying/ verifying sources of information

• • Protecting patients’ rights to privacy and confidentiality
• • Advocating for the public’s right to know
• • Following institution’s chain of command or flow of
communication
• • Supporting institution’s official statements about public
health risk and safety
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