Q3 Contingency planning allows an organization to be prepared for the unexpected.

Education and training are important parts of contingency planning because it allows all parties to understand the procedures and terminology used and to enable an integrated response if something unexpected were to happen. Education and training also provides a fundamental level of emergency management awareness to the workforces that are employed by different healthcare delivery organizations so that they can respond efficiently and effectively to all hazards that may occur. A needs assessment is conducted to identify the healthcare delivery workers level of education in emergency preparedness and disaster response, as well as their training preference. After educating and training all workers the organization can determine what changes need to be made to prepare its work-force for any incidences that may occur.

Q4 Redundancy is the duplication of critical components of a system with the intention of increasing reliability of that system, such as a backup or fail-safe. YNHHS established a primary and backup off -site center known as EOC; a room where administrators and HEICS leaders meet to discuss the crisis and support the emergency response activities. It is equipped with computers, copiers, backup power sources and other items that may be needed in the event of a disaster. Creating this backup site improves the reliability of communication systems because if one goes down you can use the backup at the EOC. EOC was established to allow communications systems to function when needed and to enable statewide communication between hospitals. MedNet was established to link hospitals through a radio communication system. MedSat serves as a backup communication system to the telephone system and MedNet. Both provide further assurance of communication reliability.

Q2 A needs assessment is a process for determining and addressing needs, or gaps between current conditions and desired conditions. YNH conducted needs assessments for each healthcare organization in education and training, clinical strategies and logistical solutions which identified gaps in emergency preparedness. The results were used to improve the current performance or correct the deficiencies. These gaps were then addressed by new programs and services developed by the center as well as by the adaptation of existing programs and services offered by the individual healthcare organizations. The center used surveys to identify the healthcare delivery workers level of education in emergency preparedness and disaster response, as well as training preferences. This also helped the center create new policies and enhance existing ones.

Q1 Integrated planning approaches are necessary for building healthcare capacity and providing a coordinated response to emergencies and disasters because they ensure participation of all affected departments and it identifies possible crisis situations, their impacts, and plan a suitable course of action. This can improve the organizations ability to respond. The stronger the capacity of the healthcare organization the less vulnerable they will be. Integrated planning will also allow the organization to efficiently manage all types of emergencies and bring about an orderly transition from relief to recover. Effective capacity planning can significantly enhance the capability and effectiveness of treatment for emergency patients with injuries resulting from a disaster. Disasters like 9/11 led Yale-New Haven to establish the Center for Emergency Preparedness and Disaster Response with its mission being the development and delivery of

services that improve healthcare planning, preparedness, and response for emergency events and disasters. YNHs five objectives included: identifying emergency preparedness with the YNHHS member hospitals, preparing YNHHS to respond effectively to emergency preparedness and disaster response issues; providing leadership to healthcare delivery organizations; serving as a model for emergency preparedness and disaster response initiatives at national and international levels, and to advise statewide and national legislative and nongovernment organizations on the development of standards and policies for emergency preparedness and disaster response. Regional Emergency Planning Process Within the state of Connecticut, the center has helped develop a regional emergency planning process among the states medical organizations. They are organized into 5 emergency planning regions to help build healthcare capacity and to provide a coordinated response to acts of terrorism and other medical related emergencies. Critical Roles and Responsibilities The center identified each healthcare delivery organizations role and the emergency preparedness critical capacities (e.g., programs and services) needed to fulfill that role. Based on the identified critical capacities, the center conducted need assessments for each healthcare organization in the areas of education and training, clinical strategies, and logistical solutions. Clinical Strategies YNH contributed to the development of numerous clinical strategies for disaster response. These plans and protocols focus on chemical, biological, and radiological emergencies. The Connecticut Hospital Chemical Response Plan was created to address these situations. Training and educating DPH contracted with the center to provide education and training in emergency preparedness and disaster response to the 178,500 healthcare delivery workers throughout Connecticut. The goal was to provide a fundamental level of emergency management awareness to a large, diverse, and geographically dispersed workforce employed by many types of healthcare delivery organizations. As part of this initiative, a needs assessment is conducted to see what training is required. The courses use common terminology to promote communication between healthcare workers and to enable an integrated response during an emergency.