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HazardVulnerabilityAnalysisTool1.xls

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Instructions


	Medical Center Hazard and Vulnerability Analysis
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.

&R&"Arial,Italic"&8&F

Natural Hazards

HAZARD AND VULNERABILITY ASSESSMENT TOOL
NATURALLY OCCURRING EVENTS
		SEVERITY = (MAGNITUDE - MITIGATION)
EVENT	PROBABILITY	HUMAN IMPACT	PROPERTY IMPACT	BUSINESS IMPACT	PREPARED-NESS	INTERNAL RESPONSE	EXTERNAL RESPONSE	RISK
	Likelihood this will occur	Possibility of death or injury	Physical losses and damages	Interuption of services	Preplanning	Time, effectivness, resouces	Community/ Mutual Aid staff and supplies	Relative threat*
SCORE	0 = N/A 1 = Low 2 = Moderate 3 = High	0 = N/A 1 = Low 2 = Moderate 3 = High	0 = N/A 1 = Low 2 = Moderate 3 = High	0 = N/A 1 = Low 2 = Moderate 3 = High	0 = N/A 1 = High 2 = Moderate 3 = Low or none	0 = N/A 1 = High 2 = Moderate 3 = Low or none	0 = N/A 1 = High 2 = Moderate 3 = Low or none	0 - 100%
Hurricane								0%
Tornado								0%
Severe Thunderstorm								0%
Snow Fall								0%
Blizzard								0%
Ice Storm								0%
Earthquake								0%
Tidal Wave								0%
Temperature Extremes								0%
Drought								0%
Flood, External								0%
Wild Fire								0%
Landslide								0%
Dam Inundation
Volcano								0%
Epidemic								0%
AVERAGE SCORE	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0%
*Threat increases with percentage.
0		RISK = PROBABILITY * SEVERITY
0		0.00	0.00	0.00

&R&"Arial,Italic"&8&A : &F&"Arial,Regular"&10

Technological Hazards

HAZARD AND VULNERABILITY ASSESSMENT TOOL
TECHNOLOGIC EVENTS
		SEVERITY = (MAGNITUDE - MITIGATION)
EVENT	PROBABILITY	HUMAN IMPACT	PROPERTY IMPACT	BUSINESS IMPACT	PREPARED-NESS	INTERNAL RESPONSE	EXTERNAL RESPONSE	RISK
	Likelihood this will occur	Possibility of death or injury	Physical losses and damages	Interuption of services	Preplanning	Time, effectivness, resouces	Community/ Mutual Aid staff and supplies	Relative threat*
SCORE	0 = N/A 1 = Low 2 = Moderate 3 = High	0 = N/A 1 = Low 2 = Moderate 3 = High	0 = N/A 1 = Low 2 = Moderate 3 = High	0 = N/A 1 = Low 2 = Moderate 3 = High	0 = N/A 1 = High 2 = Moderate 3 = Low or none	0 = N/A 1 = High 2 = Moderate 3 = Low or none	0 = N/A 1 = High 2 = Moderate 3 = Low or none	0 - 100%
Electrical Failure								0%
Generator Failure								0%
Transportation Failure								0%
Fuel Shortage								0%
Natural Gas Failure								0%
Water Failure								0%
Sewer Failure								0%
Steam Failure								0%
Fire Alarm Failure								0%
Communications Failure								0%
Medical Gas Failure								0%
Medical Vacuum Failure								0%
HVAC Failure								0%
Information Systems Failure								0%
Fire, Internal								0%
Flood, Internal								0%
Hazmat Exposure, Internal								0%
Supply Shortage								0%
Structural Damage								0%
AVERAGE SCORE	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0%
*Threat increases with percentage.
0		RISK = PROBABILITY * SEVERITY
0		0.00	0.00	0.00

&R&"Arial,Italic"&8&A : &F

Human Hazards

HAZARD AND VULNERABILITY ASSESSMENT TOOL
HUMAN RELATED EVENTS
		SEVERITY = (MAGNITUDE - MITIGATION)
EVENT	PROBABILITY	HUMAN IMPACT	PROPERTY IMPACT	BUSINESS IMPACT	PREPARED-NESS	INTERNAL RESPONSE	EXTERNAL RESPONSE	RISK
	Likelihood this will occur	Possibility of death or injury	Physical losses and damages	Interuption of services	Preplanning	Time, effectivness, resouces	Community/ Mutual Aid staff and supplies	Relative threat*
SCORE	0 = N/A 1 = Low 2 = Moderate 3 = High	0 = N/A 1 = Low 2 = Moderate 3 = High	0 = N/A 1 = Low 2 = Moderate 3 = High	0 = N/A 1 = Low 2 = Moderate 3 = High	0 = N/A 1 = High 2 = Moderate 3 = Low or none	0 = N/A 1 = High 2 = Moderate 3 = Low or none	0 = N/A 1 = High 2 = Moderate 3 = Low or none	0 - 100%
Mass Casualty Incident (trauma)								0%
Mass Casualty Incident (medical/infectious)								0%
Terrorism, Biological								0%
VIP Situation								0%
Infant Abduction								0%
Hostage Situation								0%
Civil Disturbance								0%
Labor Action								0%
Forensic Admission								0%
Bomb Threat								0%
AVERAGE	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0%
*Threat increases with percentage.
0		RISK = PROBABILITY * SEVERITY
0		0.00	0.00	0.00

&R&"Arial,Italic"&8&A : &F

Hazardous Materials

HAZARD AND VULNERABILITY ASSESSMENT TOOL
EVENTS INVOLVING HAZARDOUS MATERIALS
		SEVERITY = (MAGNITUDE - MITIGATION)
EVENT	PROBABILITY	HUMAN IMPACT	PROPERTY IMPACT	BUSINESS IMPACT	PREPARED-NESS	INTERNAL RESPONSE	EXTERNAL RESPONSE	RISK
	Likelihood this will occur	Possibility of death or injury	Physical losses and damages	Interuption of services	Preplanning	Time, effectivness, resouces	Community/ Mutual Aid staff and supplies	Relative threat*
SCORE	0 = N/A 1 = Low 2 = Moderate 3 = High	0 = N/A 1 = Low 2 = Moderate 3 = High	0 = N/A 1 = Low 2 = Moderate 3 = High	0 = N/A 1 = Low 2 = Moderate 3 = High	0 = N/A 1 = High 2 = Moderate 3 = Low or none	0 = N/A 1 = High 2 = Moderate 3 = Low or none	0 = N/A 1 = High 2 = Moderate 3 = Low or none	0 - 100%
Mass Casualty Hazmat Incident (From historic events at your MC with >= 5 victims)								0%
Small Casualty Hazmat Incident (From historic events at your MC with < 5 victims)								0%
Chemical Exposure, External								0%
Small-Medium Sized Internal Spill								0%
Large Internal Spill								0%
Terrorism, Chemical								0%
Radiologic Exposure, Internal								0%
Radiologic Exposure, External								0%
Terrorism, Radiologic								0%
AVERAGE	0.00	0.00	0.00	0.00	0.00	0.00	0.00	0%
*Threat increases with percentage.
0		RISK = PROBABILITY * SEVERITY
0		0.00	0.00	0.00

&R&"Arial,Italic"&8&A : &F&"Arial,Regular"&10

Summary

SUMMARY OF MEDICAL CENTER HAZARDS ANALYSIS
	Natural	Technological	Human	Hazmat	Total for Facility
Probability	0.00	0.00	0.00	0.00	0.00
Severity	0.00	0.00	0.00	0.00	0.00
Hazard Specific Relative Risk:	0.00	0.00	0.00	0.00	0.00

&R&"Arial,Italic"&8&F &A

Summary

Relative Threat to Facility

Hazard Specific Relative Risk to Medical Center

Relative Impact on Facility

Probability and Severity of Hazards to Medical Center