Developed by the CHA Hospital Preparedness
Program, this checklist is intended to be used as one of
several tools to assist in preparation for Seasonal Influenza and
The checklist recommendations are general in nature with a
purpose of prompting review and action. Public health is the lead
agency during these events, and every effort should be made to
remain up-to-date with rapidly changing local, state, and federal
guidance and regulations.
Wildfires, landslides and influenza surge are only some of the
incidents to hit California hospitals this past year. The
initial response to an emergency begins with recognition that an
incident may (or has) occurred.
In cases where the incident is likely to impact or disrupt
routine operations, and may require coordination of efforts and
response involvement among hospitals, Health Care Coalition
partners, EMS, public health, and environmental health.
Key management issues involving situational status, incident
characteristics and resource capabilities must be quickly
determined and communicated amongst response partners in order to
establish a common operating picture.
A helpful tool providing cybersecurity information and resources
for health care organizations, tools to assist with gap analysis
and state support systems, a mitigation checklist, and
suggestions for where to report cyberattacks, as well as share
The toolkit was developed to provide guidance to hospitals
in planning for and documenting emergency food supplies as
mandated by regulatory requirements. These resources
were developed for use by hospital Food Services directors
and/or hospital dietitians. Hospital Emergency planners should
also review and become familiar with these documents for joint
Users should first print the following attachments prior
to viewing the video presentation:
The purpose of the Hospital Surge Plan Checklist and Resources is
to assist hospitals in developing and/or updating their plans for
response to a significant surge event, as well as to provide
tools, examples and guides to assist with plan development and
In the wake of the Newtown, Connecticut shooting, the CHA
Hospital Preparedness Program (CHA-HPP) released its most
recently developed tool “Hospital Code Silver Activation – Active
Shooter Planning Checklist”. The checklist is provided to support
hospital efforts in reviewing and developing active shooter
This resource was initially developed to support the CHA-HPP
course “Planning and Training for Active Shooter Events”.
The tool was developed with key advisements from agencies such as
FEMA, Department of Homeland Security and the International
Association for Healthcare Security and Safety.
This tool was was developed by the CHA Hospital
Preparedness Program to assist hospitals in development,
implementation and evaluation of their exercises.
Individual exercises are part of an Exercise and Evaluation Cycle
under the hospital’s Emergency Management Program. These
exercises may be isolated within the hospital, or part of a
larger community, or even statewide, exercise such as the
California Statewide Medical Health Exercise. It is the
intent of the checklist to provide an overview, guidance and
resources for hospitals which allows a more coordinated effort
and can be tailored to the facility.
This tool is designed to assist hospitals in the development of
an Incident Action Plan (IAP) for each Operational Period. The
IAP is a process which uses a combination of Hospital Incident
Command System (HICSi) Forms; it is minimally comprised of HICS
201 Incident Briefing, HICS 202 Incident Objectives, HICS 203
Organization Assignment List, HICS 204 Branch Assignment List,
and HICS 215A Incident Action Safety Analysis.
The attached Guidelines for Developing Best Practices to Assist
California Hospitals in Preparing for and Responding to a Water
Disruption may be used for any hospital water disruption planning
These guidelines were drafted under the CHA Hospital Preparedness
Program with participation from a work group which was comprised
of hospital representatives and state regulatory agencies.
The guidelines address:
Overview of a hospital water disruption
The hospital water supply planning team
Conducting a water use audit
Role of California Regulatory Agencies in a water disruption
Water disruption standards and regulations
Coordinating with the community response to a water
The guidelines contain links to federal and state references and
include six attachments which provide additional information and
check lists to assist hospitals with water disruption planning
Attached is a new tool for hospitals entitled Hospital
Repopulation after Evacuation Guidelines and Checklist
(Repopulation Guidelines). The purpose of the document is to
identify hospital operational and safety best practices, as well
as regulatory agency requirements, which must be considered when
repopulating after full or partial evacuation of general acute
care hospital inpatient building(s) (GACHB). The association
sought consultation from a number of State agencies prior to
publishing this document.
There is no one standard format for an Emergency Management
Program (EMP). The Emergency Operations Plan (EOP) is one
component of the EMP. This tool provides guidance for hospitals
regarding the components included in an EMP.
Attached is a diagram intended for use in context to the TJC
2009 EM Standards. (Note that the term “Emergency Management
Plan” is no longer in TJC EM Standards or a part of NIMS
terminology.) This tool was developed by CHA’s Hospital
This checklist provides guidance in the development or update of
a hospital evacuation plan containing detailed information,
instructions, and procedures that can be engaged in any emergency
situation necessitating either full or partial hospital
evacuation, as well as sheltering in place.
The expectation will be that staff may need to accompany patients
and work in staging areas, in local government Alternative Care
Sites (ACS) and/or at receiving facilities, subject to receiving
proper emergency credentials. Drills, training and reviews must
be conducted to ensure that staff have a working knowledge of the
plan and to ensure that the plan is workable.
The hospital evacuation plan should be consistent with federal
NIMS and The Joint Commission requirements.
Attached is the Shelter-In-Place (SIP) Planning Checklist
developed by CHA. The tool includes a decision-making algorithm
for SIP and evacuation activation.
The Checklist and decision tree may be used to assist hospitals
with developing, reviewing or updating their plans. Updated
hospital evacuation plans and shelter in place protocols that
document a hospital’s critical decision making processes are a
Hospital Preparedness Program (HPP) Year 7 requirement.
The document was developed as a tool to help hospitals ensure
that elements listed have been addressed in their plans,
policies and procedures.
The “Reference” column is to allow each hospital to note where in
their documentation each item is addressed. The decision tree is
to allow you to consider the critical decision making factors.
This is a Tool for the hospital, and is not for submission to the
It is important to note that there are a number of situations or
events that may require or lead a hospital to decide to shelter
in place and, therefore, to plan in advance for those situations.
Please also note that your plan should include what happens to
those “locked out” when you are “locked down” (identify a
sheltering site(s) outside of locked-down facilities). Also note
that SIP differs depending on the type of event.
This updated document reflects upcoming changes which will take
place on July 1, 2012. This tool ws developed to assist
hospitals with National Incident Management System (NIMS)
implementation. The compliance objectives are mandated, however
the examples to achieve compliance are only suggestions.
Hospitals may have other means for demonstrating compliance.
Coordination of the facility mass fatality plan with
county/region mass fatality planning must occur to provide better
community response. Education, training and exercises must be
conducted to ensure that staff have a working knowledge of the
plan and to ensure that the plan is workable. The hospital mass
fatality plan should be consistent with state and local
regulations, National Incident Management System and The Joint
The CHA Hospital Preparedness Program has developed this
checklist for hospital CEOs. It can serve as a reference to
ensure appropriate planning is occurring within your
organization. The expanded checklist below is for hospital