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Pharmacy Name:XXXXX

Single Point of Contact:XXXXX

PHARMACY

BUSINESS CONTINUITY

EMERGENCY PLAN

Contact: Barry Simpson

Regional Planning Coordinator South Island

During an Emergency:

Expect normal routine to be disrupted for the duration of the emergency

If at work, stay at work until ALL CLEAR given or otherwise instructed

Restrict telephone use to essential communication only

The most senior staff member present at work shall assume control of the emergency if the designated person is not available, or until a more senior staff member formally takes over

Business Continuity and Emergency Plan

Organisation Name:

Address:

Telephone:

Fax:

Email Address:

Date Plan Created:

Plan Approved by:

Plan Review:

Date:

/

Approved by:

Date:

/

Approved by:

Date:

/

Approved by:

TABLE OF CONTENTS

INTRODUCTION

Section AREDUCTION

A1Service/BusinessRisks

A1.1Environmental risk and hazards

A1.2Facility risks and hazards

A1.3Business risks and hazards

A2Service/Business Continuity

Section BREADINESS

B1Service Description

B2Equipment Essential to Service Delivery

B3Contact Lists:

B3.1Staff

B3.2Emergency/Health Related Contacts

B4Staff training, education and exercises

Section CRESPONSE

C1General Emergency Response Checklist
C2Situation Report

Section DRECOVERY

D1Recovery Action Planning

Section ELINKS TO REFERENCES AND RESOURCES

Section FAppendices

Appendix 1Emergency Memorandum of UnderstandingTemplate

Appendix 2Influenza Pandemic Plan

Appendix 3South Island Regional Risks

Appendix 4Action Card Template

Appendix 5Staff Communication TreeTemplate

Appendix 6Local Emergency Groups (LEG)

Appendix 7Annual Training RecordTemplate

Appendix 8 Pharmacy Situation Report Red, Amber Green Status Definitions

INTRODUCTION

In order to manage an emergency and mitigate its immediate and potential effects, health care facilities and services need to have pre-prepared and tested emergency response plans.

There are also a number of legal requirements incumbent on health care services with regard to emergency planning, including (but not limited to) the following:

  • NZ Public Health and Disability Act 2000,
  • National Health Emergency Plan 2015,
  • The Health and Safety in Employment Act 1992, and
  • The National Civil Defence Emergency Management Act 2002 and Plan Order 2005.

This plan is intended as a guide to the systems and processes that will be used to prepare and respond to an emergency situation. It is intended that this plan be flexible enough to cater for a variety of situations and be based on known hazards and risks and readily available resources.

This plan should be activated by the Emergency Manager, or persons acting in this capacity,when normal business practice is likely to be seriously affected. The facility should advise Canterbury Primary Response Group (CPRG), Canterbury District Health Board (DHB) and other interested parties that the Business Continuity Plan has been activated.

This plan needs to be coordinated with other local health services, the emergency services and relevant national plans. To assist with planning and exercising plans, please contact emergency planning advisors from SIAPO, CPRG or Canterbury DHB.

Facilities should have arrangements in place to manage an increased demand for services, i.e.,a short term response to a single event affecting several people, or a longer term increase in demand due to an outbreak of an infectious disease.These arrangements should include the ability to assess and prioritise several acute people presenting at the same time, provide essential medicine and other treatment, and referral to other providers as needed.

Ensure all interested parties are aware of and have a copy of your plan. Requesting copies of interested parties’ Business Continuity Plans would provide additional information to assist with integrating plans.Planning for health emergencies adopts an ‘all-hazards’ approach using the four ’Rs’ of emergency management planning:

The Four ‘Rs’ of Emergency Management Planning
Reduction / Recognition of hazards and risks and mitigation to avoid or minimise the impact prior to the event.
Readiness / Planning, establishing response systems, training, maintaining readiness to respond.
Response / Mobilising and activating the Emergency Plan.
Recovery / Actions to recover from the incident, including moving back to business/service as usual and reviewing and updating the emergency plan, based on what has been learnt from the incident

Section AREDUCTION

In the emergency management planning context, reduction activities are those that will reduce the impact of health emergencies or other events.

A1Service/Business Risks

A1.1Environmental Risks and Hazards

INDICATELow Med orHigh inLikelihoodcolumn

Hazard/Risk / Likeli-hood / Consequence/Impact / Mitigation
Located in flood prone area / Low
Med
High / May need to evacuate the building
Isolation until flooding subsides /
  • MOU with …………………………(see Appendix 1)
  • Local Civil Defence aware of risk and Business ContinuityPlan
  • Staff trained/updated regularly (seeB6.1)
  • Emergency supplies kept on site and rotated prior to expiry dates.

Building structure affected byextreme weather event. / Total or partial evacuation of building /
  • MOU as above if total evacuation needed
  • Decide if non affected areas of the building will allow business as usual
  • Plan for operating with reduced staff numbers

Building security compromised /
  • Additional security measures could be required as protection from looters/burglars. Consider hiring guard from reputable security company.

Earthquake / Total or partial evacuation of building /
  • Adequate insurance cover

Possible Mass Causality Incident /
  • Well-practiced Business Continuity Plan for practice.
  • Liaise with CPRG, DHB and Civil Defence; participate in training exercises

Disruption to payroll, creditor payments and invoicing /
  • Plan for multi-tasking of staff so more than one staff member is familiar with essential processors
  • Offsite backup essential
  • Ensure remote access to server

Staff unable to get to work place /
  • Staff may be able to assist in workplaces close to their residence. The practice may be able to obtain staff who live nearby but work in other practices. A list of volunteers should include these people.

Ability to provide services impacted /
  • Suspend non urgent services and devote greater resources to essential services

Patients unable to
collect medication e.g. methadone /
  • Establish alternative dispensing options

Tsunami / Premises in danger of being flooded /
  • Move quickly either 1km inland or 35 meters above sea level

Building isolation
Patients may be isolated /
  • Possible disruption to services
  • Advise CPRG / Civil Defence/ DHB of patients likely to require assistance

Staff may not be able to get to work /
  • Cancel non-essential services

Essential supplies may be affected /
  • Liaise with other pharmacies, DHB and wholesalers

Avalanche orrock falls / Damage to buildings and may cause relocation /
  • Adequate insurance to cover building repairs, relocation and interruption to business
  • Ensure robust relocation plan is kept up to date

A1.2 Facility Risks and Hazards

INDICATELow Med orHigh inLikelihoodcolumn

Hazard/Risk / Likeli-hood / Consequence/Impact / Mitigation
Electricity outage / Impact on lighting /
  • Hire company for generatoris:…………………….
  • Torches and batteries on hand
  • Gas lantern and matches on battery lighting (50 hours , according to manufacturer)
  • A UPS (uninterrupted power supply) device is fitted to server to allow controlled shut down and not lose information

No EFTPOS /
  • Battery operated wireless terminal
  • Manual EFTPOS forms available

Loss of PABX telephone system /
  • Hard wired, analogue telephone available

Loss of fax/
Unable to receive scripts /
  • Additional staff to handle increased patient presentations. Focus on core activities. Do not undertake non-essential services

Vaccine fridge compromise cold chain accreditation /
  • Have a prearranged alternative storage location
  • Chilly bins and ice available for storage and transportation
  • Ensure adequate insurance cover

No computer or
printer access /
  • Have a fully backed up and charged laptop available with software loaded to access/enter client information

Alarm System Battery Back-up likely to fail after 24-48 hours /
  • Arrange for on-site security orremove valuable stock to another secure premises after estimate of length of power outage has been obtained

Loss of unsaved data /
  • Ensure computer automatically backs up at regular intervals

Robot dispenser system not operational; impact on aged residential care facilities /
  • Formal reciprocal agreement with another robot owner to supply in unplanned event

Fire / May need to relocate /
  • MOU with other pharmacies foralternative location
  • Ensure adequate insurance cover cost to replace building or relocation

Equipment destroyed /
  • Insurance covers adequate to replacement equipment
  • Ensure sufficient number of fire extinguishers on site and staff trained in operation

No water / Lack of water for cleaning, drinking, hand washing, toilets
Reconstituting water for antibiotics /
  • Keep emergency supply of water on site
  • Use alternative hand washing options, from First Aid section such as alcohol-based products
  • MOU with alternative location that conforms to licencing requirements
  • Consider Portaloo for staff as short term solution

A1.3Business Risks and Hazards

INDICATELow Med orHigh inLikelihoodcolumn

Hazard/Risk / Likeli-hood / Consequence/Impact / Mitigation
Inability to staff to required levels (e.g. due to pandemic/influenza) / Unable to provide serviceto required standards or contracted levels /
  • Identify options ahead of time
  • Identify potential volunteers and service groups which might assist
  • Involve Canterbury Community Pharmacy Group (CCPG) in planning

Unable to handle surge capacity / Staff fatigue resulting in mistakes occurring
Patients become agitated at delays /
  • Ensure staff breaks are taken
  • Call back part time staff
  • Extend opening hours if able to staff effectively
  • Request assistance from CPRG

Permanent loss of a business partner / Reduced income for practice. /
  • Business partnershave insurance cover to cover such eventuality

Unable to obtain Personal Protective Equipment(PPE) / Staff exposed to infection /
  • Increase stock holding of PPE gear, ESPECIALLY MASKS AND GLOVES
  • Arrange with suppliers to be advised of any projected supply shortages
  • Have more than one supplier
  • Arrange with DHB for supplies in an emergency

Armed holdup/burglary / Staff exposed to potentially dangerous situation /
  • Staff training in hold up procedure,SOP in Shop Manual. Refresher courses required
  • Comprehensive intruder alarm system incorporating monitored duress alarm

Staff trauma /
  • Provide counselling services available through Pharmacy Defence

Interruption to business as usual /
  • Adequate insurance cover

Delays in stock replacement /
  • Ensure security precautions meet or exceed required standards. Including appropriate signage
  • Borrow from other Pharmacies until replacement stock arrives

A2 Service/Business Continuity

[Pharmacy Name]will take all possible steps to maintain service delivery or restore essential services as rapidly as possible following an event. This includes arrangements for (as appropriate):

  • Moving to temporary facilities
  • includes pre-organised agreements (e.g.,MOUs – see Appendix 1)
  • Acquisition of emergency supplies
  • includes arrangements with usual suppliers
  • Protection of clinical records, personal information, data
  • includes offsite backup of critical data at regular intervals
  • Continuation of payroll services
  • Sprinkler systems, intruderand smoke alarms
  • Protection of medical and business equipment
  • includes identifying/using Uninterrupted Power Supply (UPS), surge protectors, etc.
  • ensure all serial numbers, dates of purchase, costs and maintenance agreements are listed for insurance purposes.

Plus:

  • Determining the length of time the service can operate on emergency power; if available
  • Ensuring staff are aware of emergency procedures and are regularly updated – see B4.1 – staff training, education and exercises. This may include:
  • emergency management planning as part of new staff orientation/induction
  • use of PPE (location,when and how to use it, how to test it, etc.)
  • emergency management exercises – table top, simulated and actual event
  • fire drills.
  • Maintaining an up-to-date contact list for employees, local emergency services, Civil Defence and other support services available to assist in an emergency – see B3.2
  • Testing systems (e.g. generator/battery testing, UPS checks, smoke alarms, etc.) regularly.

Section BREADINESS

Readiness activities are those taken to ensure a state of readiness for health emergencies.

B1Service Description

Providing contractedpharmacyservices and pharmaceutical advice to the community of:
Number of Staff
Pharmacists / Technicians / Admin/Management/Retail
Building Information(e.g. purpose built pharmacy constructed in 2012)
Location of Hazard Register
Relocation Site Preferences
Two alternative sites if the service has to relocate, including one location outside your immediate area:
1.
2.
Memorandum of Understanding (MOU) in place for the above two alternative sites? no yes
If yes:(See Appendix 1 – MOU template)
Name of Service: Name, address and key contact details / MOU covers: Details of services to be provided

BCP Sept 2017

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B2Essential Equipment

MEDICAL SUPPLIES / SET UP / 6/12 KIT CHECK
Thermometer
Hand sanitizer
Masks
Gloves
Disposable aprons
Emergency drugs (analgesia, anti-inflamms, Ventolin)
Dressing packs, wound care products, bandages, slings
Other
BACK-UP EQUIPMENT
Torches
Analogue phone
Battery-operated radio
Spare batteries
Car phone charger
Spare keys for pharmacy
USB pen drive
Computer cords (with USB connections)
Extension cords
Multibox
GENERAL SUPPLIES
Bottled water
Disposable drinking cups
Water purification tablets
Snack food, e.g. muesli bars, barley sugars
Blankets
Plastic rubbish bags
Toilet paper
Screwdrivers, pliers, hammer, nails, scissors (heavy duty), duct tape
Camera (for insurance)
Other
PAPERWORK / SET UP / 6/12 KT CHECK
ControlledDrugs register
Current Controlled Drug prescriptions
Labels (1 or 2 rolls)
A5 sheets of blank prescription labels and instructions to set up in Toniq/LOTS (for a standard A4/A5 printer until a thermal printer can be accessed)
EFTPOS offline paper vouchers and a ‘zip-zap’ machine with merchant number for credit cards
Bank deposit book
Copy of latest Toniq/LOTS program disc/USB for loading into a laptop
Instructions for accessing back-ups and restoring onto computer
Passwords for CDC and/or Propharma websites
Contact numbers for staff
Contact numbers for patients who have compliance packs or regular deliveries
File to keep paper notes
Pens, stamps, stamp pad, and other stationery essentials
Clipboards
Other
BACK-UP EQUIPMENT TO CONSIDER
Generator (need to pre-arrange power cabling)
Water pump and tank
Chemical toilet
Multi-plug box and extension cords

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B3Contact Lists

B3.1Staff

NAME / POSITION / PHONE / MOBILE / EMAIL / RESPONSE
(coming in; not home; message left) / EXPECTED TRAVEL TIME TO FACILITY
(for emergency call back purposes)

B3.2Emergency/Health Related Contacts

Contact / Email Address / Phone / Fax / Contact Person
Police Communications / 0800 POL INFO LINE
Ambulance Communications / 0800 ST JOHN (78 56 46)
Fire Communications
Civil Defence / / 03 941 8999 or 0800 800 169
ChCh City Council / 03 941 8999
Community and Public Health / 03 364 1777 / 03 379 6125
Canterbury Primary Response Group (CPRG) Emergency Operations Centre / / 03 353 9966
Local Emergency Group (LEG) Leader
Computer Hardware IT Support
ToniqHelp Desk
RxONEHelp Desk / 03 3410195
09 300 7007
CDC
Propharma Christchurch / 03-379 5480
03 962 0801 / 03 359-3971
03 389 5459
Moorhouse Medical Centre / 03 365 7900
Pegasus Health 24Hour Surgery / 03 365 7777
Riccarton Clinic / 03 343 3661
Ashburton Hospital / 03 307 8450
Christchurch Hospital / 03 364 0640
Princess Margaret Hospital / 03 337 7899
Rangiora Health Hub / 03 313 7299 / 03 313 7683
Hillmorton Hospital / 03 339 1081
Kaikoura Health / 03 319 3500 / 03 319 3513
Urgent Pharmacy / 03 366 4439
Community Alcohol & Drug Service
CCPG - Key Contact / / 03 353 9926 / 03 3655977
NZ Pharmacy Guild / / 04 802 8200 / 04 384 8085
Local Pharmacy Guild
Pharmaceutical Society of NZ / / 04 802 0030 / 04 382 9297
Pharmacy Defence / / 0800 PDA HELP (732 4357) / 04 802 8208
Residential Home/ Providers you supply (1)
Residential Home or other (2)
Residential Home or other (3)
Residential Home or other (4)
Nearest Community Pharmacy (1)
Nearest Community Pharmacy (2)
Nearest General Practice (1)
Nearest General Practice (2)
Nearest Dentist
District Nursing Provider
Community Laboratory
Courier Service
Other tenants who use premises
Utilities and Services
Accountant
Builder
Building Engineer
Cleaner
Diesel Supplier
Drain layer
Electrician
Generator Hire
Insurance Company
Landlord
Lawyer
Plumber
Portaloo Hire
Power Company
Security
Telecommunications
Waste Management
Water Supplier

B4Staff Training, Education and Exercises

This section should:

  • Outline how staff are oriented to emergency management procedures at the start of employment
  • Outline the programme for regular (annual) updates and refreshers
  • Identify the programme for exercising all, or aspects of, the plan on an annual basis
  • Identify any other relevant emergency management planning activities, e.g., DHB emergency planning workshops.

B4.1Staff Training Template

Training / Activity / When / Provider / Invites
Staff induction
Refer also to Pharmacy SOPs /
  • Orientate / educate staffin emergency preparedness, procedures and plan
  • Orientate / educate staff to Personal Protective Equipment (PPE) and the resources held on site.
  • Orientate staff to the location of water and gas mains, fuse boxes, etc.
/ On commencing employment / All staff
Staff training
Refer also to Pharmacy SOPs /
  • First aid
  • Identification of hazards
  • Evacuation exercise
  • Natural hazards
  • Regular refresher training/updates
  • Attend workshops on emergency planning
/ Procedures Manual,
regular referral to this / All staff
Staff participation in emergency exercises (table top, simulated, actual) /
  • Example of emergency exercise undertaken
  • Document outcomes and improvements required and plan to achieve these
  • Review of lessons learned and any procedural changes advised to staff
  • Update staff training records
/ As part of staff training program / All Staff
Review / update the pharmacy Business Continuity and Emergency Management Plans /
  • Review Date:…………………………………………………………
  • Person responsible: ……………………………………………..

Other relevant emergency planning activities undertaken /
  • Attendance at Civil Defence/Canterbury Primary Response Group (CPRG) planning workshops

Other training: /
  • Attendance at stakeholder meeting(s)

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Section C RESPONSE

C1 General Emergency Response Checklist

Take all necessary action to maintain safety and protect clients, staff and visitors