Senior health and safety managers should engage early with emergency management planners.

Figure 1 below depicts the six-step process for developing emergency management plans. This step formalizes a whole-of-community approach to developing or updating plans in response to a crisis. Forming this team involves clarifying the organizational leadership’s intent for such plans. Leaders may scope emergency management plans to support the organization’s mission, goals, values, and strategic-level risks—for example, by ensuring that the plans are sustainable over time. Many organizations may not have the assets or qualified personnel in-house to sustain operations past a 24- to 72-hour period. The plan must reflect this temporal limit and ultimately specify a transition or shutdown phase as well as required recovery tasks to regain “normal operations.”

Obtaining leadership “buy-in” early in the planning process is critical to the plan’s acceptance. Engaging with senior leadership shows the team’s interest in their leaders and allows leaders to recognize the importance of preparing their organizations for a crisis. Together, both senior leaders and the Collaborative Planning Team can forge a comprehensive plan agreeable to stakeholders and manageable within the organization’s leadership hierarchy.

To ensure health and safety principles are integrated into the planning process, senior health and safety managers should engage early with emergency management planners. Too often, the health, safety, and environmental management community is integrated with emergency management plans after those plans are developed. In these cases, complying with worker health and environmental regulations and safeguarding the population are more challenging. Early engagement is necessary through active participation within a Collaborative Planning Team.

This step involves research to identify hazards and threats. The planning team determines the physical effects and operational impacts to the organization, the susceptible work force, and the public.

Research is required in several areas. First, the team must clarify the intent of the plan (based on input from stakeholders and leadership). Threats and hazards, as well as their physical effects, are specified for various scenarios. For example, if a hurricane scenario is used, the physical effects include the hurricane category and sustained wind conditions. From these physical effects, operational impacts are determined, such as damage to facilities, power outages, disruption of the water system, and housing issues for the affected work force. The team should categorize these physical and operational impacts according to the organization’s capability to respond.

This analysis should identify facts. In the absence of facts, the analysis should identify valid assumptions that are necessary for the plan to be effective. For example, during an influenza pandemic, it is a fact that the disease will cause severe illness and, in some cases, death among the work force. An assumption may be that significant numbers of workers may not show up to work due to illness, death, or fear of becoming infected. Another assumption with this scenario is the likely shortage of PPE, specifically N95 respirators or non-latex gloves. Both assumptions are valid based on past pandemics. They are also necessary because the assumptions point to potential shortfalls in personnel and resources.

Next, the team develops “planning factors.” This activity consolidates the physical and operational impacts, facts, and assumptions. Quantitative planning factors may include specific numbers or percentages such as 20 percent work force absenteeism, 500,000 tons of debris (resulting from a tornado or hurricane), or economic loss in dollar value. Qualitative planning factors may also be used if quantitative measures aren’t available.

Planning factors are the basis for making decisions. For example, if 20 percent absenteeism is expected during an influenza pandemic, the organization may opt to cease noncritical functions, hire contractor support, or deploy PPE and implement safe work practices (such as 6-foot social distancing) applicable to remaining personnel to sustain all organizational functions. Another example is PPE shortage where the planning factor specifies a 6-month delay in receiving N95 respirators due to high demand. This planning factor may prompt leaders to begin stockpiling PPE or to consider rearranging work schedules to increase social distancing. Thorough research and analysis in Step 2 helps the Collaborative Planning Team achieve a good understanding of threats, hazards, required capabilities, and resource shortfalls. In addition, the research and analysis points the team to what the organization must do to survive a major event.

Step 3 entails a description of the end state, which clarifies what the organization will look like after a major crisis and successful implementation of response and recovery actions. In an influenza pandemic outbreak, for example, an end state may be that the organization has maintained its critical functions with modest impacts to its work force.

Next, the team should develop a mission statement for the plan. The statement defines the plan’s purpose and primary operational objectives. A simple description of the “who, what, where, when, and why” of the plan will ensure that the team maintains focus on meeting this mission.

After the mission statement, the team should set goals and objectives. Goals are general statements that indicate the intended solution to problems identified by the planning team. An example of a goal for the influenza pandemic scenario is “to ensure the work force is adequately trained on pandemic influenza awareness before the next outbreak occurs.” From these goals, the team develops objectives—specific, identifiable actions carried out during an operation. One objective in a pandemic is “to direct the Office of Health and Safety to immediately conduct 2-hour pandemic influenza awareness training for all employees over a 5-day work week upon notification of the outbreak by CDC and the state/local health department.” With mission statement, goals, and objectives clarified, the Collaborative Planning Team can begin to develop the plan. This step entails the development and analysis of various courses of action necessary to execute the goals and objectives. Using a scenario as the basis for initiating the planning process, the team develops a timeline. From “zero hour”—the beginning of a crisis—the team should specify the decision points to initiate response actions. Stakeholder input from the community is essential in this step. Without it, decisions and response actions critical to the planning process are likely to be missed.

When identifying the response tasks, the team should ensure that specific information about those tasks is clearly stated. For example, what is the action and who is responsible for it? When should the action take place? How long should the action take and how much time is available? What has to happen before the action? What happens after? What resources does the person or entity need to perform the action?

Health and safety professionals should review these same response tasks from a different perspective. Based on the scenario, what are the hazards associated with these actions? Are there enough people to carry out the actions, and are they trained in managing the risks of those hazards? What PPE will these individuals require to safely conduct these actions? Does the organization have that PPE on hand, or can access be granted in a convenient and timely manner? Are there engineering controls and safe work practices to perform those actions safely? Do current organizational procedures include the safety and health practices to perform these actions?

Once the response tasks and appropriate courses of action are identified, the team can identify required resources. At first, the team should not question the availability of the resource; it should focus only on need. Afterwards, the team can match these requirements with realistic resource availability. A resource gap exists when needed resources exceed available resources (either before the crisis or during the crisis). Identifying resource gaps can help the team determine if the courses of action or specific response tasks are feasible. For example, the planning team might determine from its influenza pandemic analysis that N95 respirators are needed for all employees to sustain critical functions for 90 working days. After identifying the required resources—the number of N95 respirators per day and per person—the team may determine that procuring or storing this quantity is not feasible. The team may specify alternative paths such as supplying N95 respirators to only 50 percent of the work force while the remaining 50 percent work from home or an alternate site. The Collaborative Planning Team can now draft the basic plan. FEMA’s publication “Developing and Maintaining Emergency Operations Plans: Comprehensive Preparedness Guide 101” provides examples of plan formats that organizations may use. In short, the plan should have the following characteristics:

• Simple wording written in the appropriate language(s).
  
• Checklists and visual aids (for example, maps and flowcharts) to help communicate complex processes and requirements.
  
• Active voice and short sentences that avoid qualifiers and vague wording.
  
• Sufficient detail (varies by organization and scope of operations).
  
• Consideration of solutions and options during a crisis while avoiding discussions of policy and regulations.
  
• Limited discussion of procedures. For example, the plan shouldn’t describe how to don respirators or how to perform decontamination.
  
• Ease of accessibility.
  
• Identification of the scope and concept of planned response tasks and valid, reasonable assumptions.
  
• Feasibility based on broad concurrence among the Collaborative Planning Team, management, and the larger organizational community.
  

This step encompasses training the organization; performing exercises; and reviewing, revising, and maintaining the plan.

Training the organization is critical. It’s extremely important to raise awareness of the plan, of each organizational component, and of each individual’s responsibilities during a crisis.

Performing exercises involves a combination of training events, discussion-based or tabletop exercises, and a full-scale operational exercise. After initial awareness training, the organization should create a timeline for building up the organizational members’ competencies related to crisis response. The discussion-based or tabletop exercise represents the opportunity for the various components to discuss how the organization evolves during a large response. The full-scale exercise is the actual “doing” where employees and key external stakeholders (for example, community first responders) can execute the tasks described in the plan.

Based on the lessons learned from the various training and exercises, the planning team can work with leadership to review the plan and identify any shortfalls. If the training and exercise iterations validate the plan, the planning team and leadership can ensure maintenance of the plan through recurring awareness training. Emergency management planning is an extensive and deliberative process. Time and wide stakeholder input is vital to ensuring clarity around critical decisions, tasks, and resources. Health and safety professionals can provide valuable technical expertise in identifying the specific hazards and appropriate controls necessary to protect the work force during a crisis, and should be actively engaged in all six steps of the plan’s development. .