Chapter 4 An Emergency Operations Plan for King Abdulaziz Naval Base Essay

Attached. Please let me know if you have any questions or need revisions.EMERGENCY OPERATIONS PLAN1An Emergency Operations Plan for King Abdulaziz Naval Base Armed Forces HospitalFATFebruary 20, 2020EMERGENCY OPERATIONS PLAN2AbstractEmergency Operations Plans are an important component of public health emergencypreparedness. They are vital to mitigating the consequences of a disaster. The EmergencyOperations Plan (EOP) in King Abdulaziz Naval Base Armed Forces Hospital, Al-Jubail needs tobe revised and updated to better respond to and recover from emergencies. This paper a proposedEOP model which contains five mission areas: protection, prevention, response, mitigation, andrecovery. These mission areas are defined and followed by an outline of planning principles thatfeature a consideration of all potential hazards and threats, leadership, provision for functionalneeds and access to resources, and the use of a collaborative procedure in EOP planning. Theprinciples are followed by instruction in the six steps of the planning process: forming acollaborative planning team; identifying hazards and threats and risk assessment; determiningobjectives and goals; developing an action plan; preparing, reviewing, and approving the plan; andplanning maintenance and implementation.EMERGENCY OPERATIONS PLAN11.13An Emergency Operations Plan for King Abdulaziz Naval Base Armed Forces HospitalBackground of StudyKing Abdulaziz Naval Base Armed Forces Hospital (KANBAFH) in Al-Jubail takes aproactive role to mitigate, respond to, and recover from any possible technological and naturalhazards or terrorist events. The hospital is occasionally monitored by a risk manager to determinethe occurrence or the potential occurrence of an event that could result in an emergency or adisaster. KANBAFH, a Ministry of Defense facility accredited by the Joint Commission, onJanuary 2019, and with different regulations and standards government hospital, hopes to preventemergencies as soon as they occur and to facilitate an efficient and orderly response to andrecovery from all emergencies and disasters. This hospital directly managed by the MedicalServices Division of the Ministry of Defense and Aviation, handles emergencies with the help ofan Emergency Operations Plan (EOP), which is a tool that provides the processes and the structurethat the organization uses to respond to and initially recover from an event. This EOP is theresponse and recovery component of the hospital’s Emergency Management Plan. While thehospital already has an EOP, the need to revise and update it to better respond to and recover fromemergencies was identified, especially since the EOP was last updated in 2015.While KANBAFH is only located in Al Jubail, there are other armed forces hospital inSaudi Arabia. Nonetheless, the facility’s EOP is meant to be an all-hazards plan and is designedto respond to all the emergencies that could affect hospital operations as identified in the HazardsVulnerability Analysis. It is established to ensure that there are available personnel, equipment,supplies, facilities, and other resources required to continue with patient care during emergencies.Furthermore, the plan addresses victims’ medical needs during emergencies. KANBAFH’s currentEmergency Operations Plan includes of the six critical elements of:EMERGENCY OPERATIONS PLAN•Staff responsibilities•Utilities•Resources and assets•Communications•Security and safety•Clinical Supports services4It has been five years since the hospital’s EOP was last updated. Within this period, therehave been several occurrences all over the world, including landslides, wildfires, and eveninfluenza surge. Specific to Saudi Arabia, fires and floods, are some of the incidents that haveoccurred within the past five years. In the past, Saudi Arabia has seen disasters such as heavy rains,fire during hajj, Jizan floods, Jeddah floods and Rift Valley Fever outbreak. Among other disastersto look out for are technological hazards such as the breakdown of hospital equipment, disasterssuch as terrorist attacks and major MVCs, natural disasters like floods, rains, and epidemics. Allthese incidents have shown the need to constantly review and update the Emergency OperationsPlan, thus the following proposal.1.2Purpose StatementThe mission of the KANBAFH is to improve people’s health in the society by providingquality health, cost-effective, and hospital services consistent with this mission. The hospital’sadministration, medical staff, and the governing body have established and provided for ongoingsupport for an Emergency Management Program as conceived by the hospital’s formal EmergencyManagement Committee. However, there is a need to review this Emergency Operations Plan andprovide recommendations on how to improve it to meet the hospital’s mission and vision better.The current EOP has not been updated for five years. It is important to assess, review, and updateEMERGENCY OPERATIONS PLAN5it since there have been various disasters, such as the ongoing novel coronavirus and the 2017Middle East respiratory syndrome coronavirus outbreak, that have shown the need to update theEmergency Operations Plan constantly to support pandemic illness planning. Hospitals arecurrently required to identify outbreaks and implement effective isolation and suspected casesquickly. This requirement calls upon the need to regularly update the Emergency Operations Planto accommodate for such emergency disasters.The researcher set out to propose an updated Emergency Operations Plan, for KANBAFHto respond effectively to disasters that threaten and endanger the staff, patients, and visitors. Thegoal was to identify key personnel whose early involvement will fasten the coordination of hospitalassistance to impacted zones. The coordinated efforts of this team would supply and re-supplyassets and resources that are necessary for meeting the urgent needs that arise from disasters. Theywill work to coordinate all the crisis management functions that are crucial to the hospital’srestoration and recovery.This project aims to describe the response as well as the recovery process of the hospitalfacility from all hazards such as uncontrolled fires, earthquakes, floods as well as bombing andexplosions. It entails the response to both internal emergencies, that is, situations that affect thehospital staff and patients and external disasters that disrupt the hospital environments increasingthe demand for healthcare services. It gives an outline of the need for the project, the personnel incharge of the whole emergency process, the resources and activities to be carried out as well as adescription of the interaction between these activities to achieve maximum response to theemergency. Furthermore, the methodologies utilized in the project completion are documented.These methodologies include the conduction of interviews to look for views on the EmergencyOperations Plan (EOP) used within the Hospital under study as well as the variousEMERGENCY OPERATIONS PLAN6recommendations on how it can be further improved for maximum disaster management. Whenconducting this review, KANBAFH’s emergency management checklist was used as a benchmarkto ensure that all the planning elements are addressed.1.3Need for the ProjectAn Emergency Operations Plan (EOP) is an essential requirement in the overall process ofdisaster management, as outlined by the Federal Emergency Management Agency (FEMA). Thiscomprehensive approach to disaster management aids in the achievement of the maximum patientand healthcare personnel safety as well as a timely return of the healthcare facility into its predisaster level. Its main role is to give an outline of the responses as well as the recovery process ofthe various healthcare facilities to all hazardous events. These disasters could affect hospitalsdirectly by damaging their buildings and disruption on the essential utilities such as power, orcould result in mass effects within its surroundings hence increasing the demand for healthcareservices.Saudi Arabia is prone to various disasters, which include both natural and man-madeevents. These include floods, earthquakes, tsunamis, hurricanes, uncontrolled fires, bombings aswell as dust and sandstorms (Pararas-Carayannis, 2013). Al Jubail for instance, is located in theeastern province of the country which is mainly affected by shifting dunes as well as dust stormswhich have a direct effect on the people living within those environments especially thosesuffering from lung diseases as it serves as an exacerbating factor.. Dust storms also reducevisibility which results in increased cases of both traffic accidents and plane crashes. This will, inturn, increase the demand for healthcare services in the healthcare facilities in that region.Bioterrorism attacks such as explosions and bombing are also prevalent in some parts of thecountry with some being targeted on the healthcare facilities hence affecting the healthcareEMERGENCY OPERATIONS PLAN7personnel, patients as well as an overall disruption in the healthcare provision process.Furthermore, there have been some fire incidents in Al Jubail such as the fire in the petrochemicalfactory.The prevalence of the above disasters in the country necessitates a well-formulated EOPwithin KANBAFH. The standards of The Joint Commission facilitate this formulation. Accordingto Canton (2019), through unmatched expertise, knowledge, and leading practices, the JointCommission helps organizations across the continuum of care to lead the way to zero harm. Thesix elements within The Joint Commission’s Emergency Management Standards should thus, beincorporated during the document formulation as noted by Canton (2019). These key elementsinclude- “communication, resources and assets, security and safety, hospital staff responsibilities,utilities as well as various clinical support activities” to facilitate the coordination of the overallresponse to the emergency (Canton, 2019). They are necessary as they enhance accountability ofthe EOP. Moreover, the various mission areas of the Emergency Management Cycle, includingmitigation, preparedness, response, and recovery, should be considered during the EOPformulation. The reason for this is that these mission areas are vital to making plans, identifying,and providing resources to protect people from hazards. A systematic approach would be to treateach of the four actions as one phase of a comprehensive process, with each mission area buildingon the accomplishments of the preceding one so as to achieve the overall goal of minimizing theimpact caused by emergencies. The formation of the EOP should also be based on the nationalstandards as well as a systematic analysis of the various disasters that show prevalence within theregion. The national standards, systematic analysis, collaboration, and the four mission areas ofthe emergency cycle are key for the effectiveness of an EOP (MacVarish, 2016). They arenecessary for the achievement of the main goals and objectives of the hospital EOP, which are toEMERGENCY OPERATIONS PLAN8ensure effective preparation and management of disasters and to restore hospital operationalcapacities to normalcy. According to MacVarish (2016). The functions of the EOP include:1. To assign various roles and responsibilities to the staff when there is an emergency;2. To describe how various operations will be coordinated to return the facility to operatenormally;3. To describe how the victims’ safety and security will be accommodated.4. To identify the resources, the disaster management personnel, and the essentialequipment and alternate sources for supplies to be utilized in the response and recoveryprocess.The fulfillment of the above-outlined roles, goals, and objectives of the hospital EmergencyOperations Plan substantiates the need for an effective scheme that ensures proper managementand response to various health emergencies. The ultimate result of the EOP is attention to nationalstandards, four mission areas of the emergency management cycle, systematic analysis of hazards,and collaboration. Together, these considerations will result in the formulation of an efficaciousapproach to any future emergencies thus, facilitating early prevention of their effects on disastervictims, the healthcare staff, and the overall health organization.Emergency preparedness is mandatory for numerous situations in day to day operations ofKANBAFH. Without it, it would be impossible for the hospital to lessen the threat posed byemergencies. As such, it should use the resources at its disposal to prepare for and handle possiblethreats to the hospital, its personnel, and other people within it. According to the Institute ofMedicine, Board on Health Care Services, and Committee on the Future of Emergency Care in theUnited States Health System (2007), an analysis of various emergencies such as tsunamis andearthquakes shows that although proper planning may be done, it is still possible not to respond toEMERGENCY OPERATIONS PLAN9and recover from emergencies. World Health Organization Director Dr. Michael Ryan providedmuch-needed insight into how planning in the Emergency Operations Centers affects the properhandling of a disaster (Ryan, 2013). He posited that planning is critical to the success of the overallsituational awareness and field operations. It provides a foundation from which an organizationoperates during disasters. The most important thing is that the success of the disaster managementoperations is dependent on how well prepared the organizations involved are and the level ofcooperation they have (Ryan, 2013).These centers usually bring various professionals with expertise in different sectors andfrom different organizations that have diverse ways of handling situations. These professionals arethen divided into small groups. They have to find a way to understand the current situation andwork out a way of allocating the scarce resources that they have. During an emergency, a hospitalis most likely already operating at full capacity, and is forced to take in more patients (Ryan, 2013).The number of beds, pharmaceutical resources, and rooms available may be limited. It is also notuncommon for the hospital to be lacking a particular specialist who can treat various injuries(Ryan, 2013).Notably, the commonly used method of communication is verbal communication, whichpresents another set of challenges. The presence of conflicting information could lead to confusionwhich makes the situation worse (Ryan, 2013). Richard Oloruntoba, in his analysis of thechallenges to plans of the 2009 Victoria bushfires, described how those handling the disaster weredistracted from the main problem and instead focused on a smaller problem that they were able todefine and handle more easily. The paper also points out how training focuses on teaching peoplehow to handle and respond to a presumed threat. The primary focus here is the response to thedisaster, rather than making the process an investment into the future, for instance by usingEMERGENCY OPERATIONS PLAN10previous disasters as a foreshadow and thereby being able to prepare for a wider range ofchallenges (Oloruntoba, 2013). After conducting a study on Finland’s disaster management,Kimmo Laakso and Jari Palomaki pointed out how poor communication can make the situation gofrom bad to worse when handling a disaster. The main problems identified by these authors werepoor awareness of the situation and poor flow of information among those involved in disastermanagement. The drills in which those involved were trained also failed to function as they shouldhave. Experts involved in the study argued that the was often poor planning of emergency drillsbesides poor commitment of training attendees. Lack of communication at the time disaster struckand after also had consequences (Palomaki, 2013).This project seeks to ensure that in the operations of hospitals, the most importantphilosophy of disaster management is observed: ensuring that every emergency is handedefficiently especially when considering geographical and organizational demographics. This willrequire improved communication systems, better planning and response of emergencies andinvolvement and cooperation of all the stakeholders, especially those at the local level (Institute ofMedicine; Board on Health Care Services; Committee on the Future of Emergency Care in theUnited States Health System, 2007). This project looks at what it means for a hospital toaccommodate the changing situations, occurrences and threats by updating its EOP. The projectwill clarify what makes hospital Emergency Operations Plans fail, and go a step further to findnew ways to handle emergencies. Coordination and planning between hospitals and otherimportant stakeholders, such as air medics to facilitate the patient transfer, were highlighted. Waysin which those in the same region can work together to find ways of dealing with sudden increasesin capacity includes training, to familiarize personnel with their responsibilities and to acquire theskills needed to perform assigned tasks. Training, tailored towards personnel roles whenEMERGENCY OPERATIONS PLAN11effectively responding to emergencies, should give thought to the future and how mistakes madein previous emergencies can be avoided as well as the provision of important and scarce resourcessuch as personal protective equipment and pharmaceuticals. A look at the training of hospitalpersonnel to deal with disasters, shown that a lot of progress has been made over the years, but weneed to look into new methods that can ensure the training is standardized and the environment inwhich it is undertaken is open to further education and expansion (Institute of Medicine; Board onHealth Care Services; Committee on the Future of Emergency Care in the United States HealthSystem, 2007).Looking into Emergency Operations Plans especially in hospitals, is very importantbecause if a tragedy occurs, be it natural or human-made. This plan could be what determines theextent to which individual lives in the community will be affected. Although some research hasbeen done in this area, very little focuses on the medical field. As highlighted above, there arenumerous challenges faced when individuals who don’t normally work together have to do so andoften; such situations are unplanned. Given the seriousness of the task they are assigned, it isimportant that the planning and the systems they use work extremely well and that is what thisresearch paper is hoping to facilitate.EMERGENCY OPERATIONS PLAN22.112Literature ReviewIntroductionEmergency management has been attributed to being among the most critical departmentsin any organization that deals with and avoids risks, especially those that have catastrophicrepercussions for regions, communities, and entire countries (National Research Council; MappingScience Committee, 2007). Emergency management denotes the dynamic process of preparingfor, mitigating, reacting to, and recovering from an emergency. The concept deals with thecoordination and administration of the resources and activities for dealing with all humanitarianaspects of emergencies. The primary aim of emergency management is to minimize the harmfulimpact of all hazards, including disasters. The section provides a comprehensive overview of theemergency operations plan, its mission areas, elements, and the process of creating an emergencyresponse plan.2.2Components of the Emergency Operations PlanAn Emergency Operations Plan is an evolving process considering that it is regularlyupdated to accommodate the continuously changing situations, occurrences and threats. Inparticular, recovery efforts are important, and thus getting employees back into the building safely,communicating restrictions, and inviting qualified vendors to repair any physical damages musthappen quickly. Adini and Goldberg (2006) state that there are various components of theemergency response plan comprising planning, training, drills, and coordination. Other elementsinclude communication, education, and technology (Adini & Goldberg, 2006). Planning entailsworking through many possible scenarios as all unexpected events should be considered duringthe development of the EOP. Training involves conducting both situational and classroom trainingto help the emergency response team to become confident, informed, and prepared. Moreover,EMERGENCY OPERATIONS PLAN13integrators responsible for installing emergency systems should actively engage in educatingsecurity and management on the need for efficient and accurate use of the installed systems.Moreover, coordination is a critical component that minimizes conflicts between individual plansand systems, especially in buildings where there are multi-tenant organizations. The approach iscrucial in minimizing confusion during an emergency (Adini & Goldberg, 2006).2.3The Mission Area of Emergency Operations PlanningIn their research, Huss et al.(2012) state that organization and emergency managementprovide a comprehensive analysis of ways in which information and trust attribute to the level oforganizational preparedness for disasters. In their study, the investigators interviewed andexamined data on 227 organizations in Memphis, Tennessee. They analyzed data to assess theextent to which these organizations used hazard-related insights to make relevant decisions. Theoverwhelming majority of the organizations agreed that the information from these hazard-relatedinsights were both relevant and adequate (Huss, Sadiq, & Weible, 2012). Moreover, organizationsunder investigation were also asked to identify their sources of information which they trusted toassist them in the preparation of disaster. The results revealed that more than half of organizationsin the region depended on the data for disaster management and that it was sufficient and effective.The researchers further identified the various mission areas of emergency response planning whichcomprised mitigation, preparedness, response, and recovery. Mitigation was considered the mostinexpensive technique for minimizing the impacts of disasters. It involves the identification ofrisks and the evaluation of hazards, and undertaking actions to prevent them. Therefore, the higherthe risk, the more crucial the need to recognize disaster-specific threats through eliminationattempts. Preparedness is the second phase and encompass intermittent cycle of planning,organizing, equipping, exercising, evaluation, training and improvement activities that allow anEMERGENCY OPERATIONS PLAN14organization or Hospital to ensure effective management and the improvement of efforts to deter,and safeguard, react to, and hence recover from disaster events (Huss, Sadiq, & Weible, 2012).2.4The Process of Hazard Emergency PreparednessNcube and Chimenya (2016), on the other hand, studied hazard emergency preparednessat Onandjokwe Lutheran Healthcare in Namibia, Africa. The investigators used both qualitativeand quantitative research techniques and about 120 people participated in the study with a responserate of 75%. The study focused on analyzing the features of the hospital’s disaster system againstthe standard procedure in the healthcare organization. In particular, , the results indicated that therewas a moderate insight into the principled conduct and abilities to react to crises such as diseaseoutbreaks in the hospital. Furthermore, it was ascertained that positive attempts in threatpreparedness were being integrated. Nevertheless, the process needed readjustment, particularlyin the lanes of training, infrastructure alignment, and revisions to ensure the process is effectiveand relevant. The researchers provided a detailed process involved in the Hospital’s disasteremergency preparedness encompassing developing policy, examining vulnerability, planning foremergencies, training, and educating in addition to monitoring and evaluation (Ncube &Chimenya, 2016).Specifically, policy development is the first step and focuses on establishing long-termgoals by assigning tasks, recommending work practices, and determining criteria for decisionmaking. Vulnerability examination follows the policy development step and involves theidentification and prioritization of possible hazards impacting communities and offers a foundationfor the recovery approaches. Organizations or hospitals can then make informed decisions onwhich risks to prioritize based on the limited available resources. The next step is planning fordisasters. Upon the development of policies and assessment of vulnerabilities, having a responseEMERGENCY OPERATIONS PLAN15plan is critical in ensuring an effective and efficient response during an emergency. Thepreparedness plan consists of the identification of potential emergency shelters, evacuationframeworks and routes, training of personal for responding to the hazard as well as command andcommunication procedures. In their research, Ncube and Chimenya, (2016) clarified that anEmergency Operations Plan should comprise an agreed-upon set of activities that can be used toprepare for, react to, and recover from emergencies. Training and education are also a crucial stepin the emergency management process. The phase encompasses equipping the emergency team,empowering communities, and allowing them to engage in developing the emergency managementstrategies and creating awareness on various types of hazards and where to seek help.2.5Challenges Associated with Emergency Operations PlansKaragiannis and Synolakis (2017) substantiated the claims that disasters result inoverwhelming and unprecedented demands to affected societies and thus pose inherent challengesthat seem to complicate efforts reinforcing the response. The investigators delved into theobservation of 50 disaster activities whereby they recognized 20 crucial points in EmergencyOperation Planning which require improvements. As evidenced in numerous works of literature,it is in such an environment of complexities, uncertainty, and time-constraints that EOP managersare expected to create incident plans that address the various demands that are challenging foremergency managers thereby poorly implementing the plans (Karagiannis & Synolakis, 2017).The researchers sampled the most complex components of Emergency Operations Planning, whichconstitute collecting of information from the field, response-generated demands, runningapproximates of the incident, and mobilization time and resource capabilities. Other issuescomprise decision-making under tension and uncertainty and course of action development andexamination. The study further identified several good practices of incident planning whichEMERGENCY OPERATIONS PLAN16included the fact that the process was iterative, and the planners revisited various steps in a backand forth approach. Other good practices comprised intuitive and rational decision-making processbeing used during the occurrence of the incidence and the production of better plans whenflexibility is integrated into the course of action to solve the expected developments of the issuesor in the decision-making scenarios (Karagiannis & Synolakis, 2017).2.6Recommendation: Best Practices of EOPsAs evidenced in the literature, planning for hazards, events, and threats have a substantialimpact on access to, and provision of healthcare services to the society. Hospitals have beensubjected to various requirements to ensure that they are adequately planning for emergencies.Therefore, the emergency management program (EMP) should outline the process ofimplementing emergency management guidelines of mitigation, preparedness, response, andrecovery. Moreover, the program should state the relevant authorities and initiative managementand administration. Hospital system planners should ensure the EMP is modified to integrate thecurrent and changing framework of requirements, threats, regulations, and hazards. In particular,adhering to standards will assist the hospital and other organizations to adequately and effectivelyreact to and recover from hazards in addition to cohesively working with emergency managementstakeholders. Therefore, the plan created should be inclusive and must be in line with the localEOPs for information sharing and resource requests (World Health Organization (WHO), 2017).To develop an all-hazard management plan, the planning phase should include all keypersonnel considering that effective planning ensures that the entire community is involved andrepresented in the planning procedure. Involving the community through representatives andcommunity leaders empowers the society by reinforcing the expectations that the community hasa shared responsibility and strengthens the public morale to plan for themselves and theirEMERGENCY OPERATIONS PLAN17organizations. It is also critical for the planning team to consider the flexibility element associatedwith the plan which should be able to address both conventional and catastrophic events. This canbe done through scalable planning solutions that are likely to be executed and understood correctlyby the planning personnel. Consequently, planners should test if the crucial components areadequately flexible by exercising them against possible events of varying magnitude and type(World Health Organization (WHO), 2017).EMERGENCY OPERATIONS PLAN1833.1MethodLiterature review processThe literature review was conducted in five phases to meet the research objectives. Thesefive phases were: components of an EOP, the mission area of emergency operations planning, theprocess of hazard emergency preparedness, challenges associated with emergency operations plan,and best practices for EOPs. The sources included books, official reports, article journals, andauthorities’ official websites. Books, official reports, and journal articles were obtained from onlinedatabases, namely ProQuest, CQ Researcher, EBSCOhost, and Google Scholar. Other readings,including public information and statistics, were retrieved from the official websites of localauthorities.3.2ParticipantsThe target population in this study were within the hospital setting of KANBAFH. Thissetting was ideal since the goal of the study was to revise and update the EOP of the hospital tobetter respond to and recover from emergencies. Purposeful recruiting was the technique used torecruit disaster coordinators with realistic insight, knowledge, and familiarity of disastermanagement in hospitals. The resulting 37 participants, comprised of the hospital managementincluding the Hospital Director, the Disaster Coordinator, the medical and the nursing director.The contact information of the participants were obtained from the Disaster control center. Achain-referral technique was then used to recruit additional practitioners initially not identifiedusing the purposeful recruiting method. These participants were however, not compensated sincethe budget was not available for true compensation. However, token of appreciations in the formof gift cards and gift certificates were given to the participants.EMERGENCY OPERATIONS PLAN3.319MaterialsOne of the materials that was used in the study was questionnaire that were constructed bythe researcher. The questionnaires consisted of two parts. The first part of this phase focused onthe demographic characteristics of the participants. These characteristics included age, gender,their exact role, and the duration they had worked in the hospital. The second part of thequestionnaire was made up of questions about the risk issues within the facility, such as theavailability of disaster managers, the types of resources devoted for disaster management, thehospital’s overall level of disaster preparedness, and the challenges faced in the implementation ofthe disaster management plans. The second section culminated in a question that asked therespondents to provide a recommendation for improving the current EOP of the hospital. Auditreports and surveys were also used to help in the construction of interview questions for theparticipants. The researcher also looked for the facility surveys of the hospital and used them toassess the hospital’s measure to benchmark data.3.4ProcedureAs shown in Figure 3.1, this study’s research process was divided into four distinctiveprocedures: instructions to participants, ethical considerations, data collection and data analysis.This methodology is illustrated diagrammatically in Figure 3.1. This approach was adopted tosimplify the entire research process.EMERGENCY OPERATIONS PLAN20Instructions toParticipantsWhat is thestudy about?EthicalConsiderationsInformedConsentData CollectionQuestionnairesand audit reportsData AnalysisContent analysisand narrativeanalysisFigure 3. 3. 1 Research Procedure3.4.1 Instructions to ParticipantsThe participants were told that the study was about reviewing and updating the EOP ofKANBAFH. They were informed that updating the current EOP was necessary so as to betterrespond to and recover from emergencies, especially since the EOP was last updated in 2015.3.4.2 Ethical ConsiderationsEach of the research participants was required to sign an informed consent that confirmedhis/her awareness of the whole research process and the main aim of the study. The decision of theparticipant on whether to participate in the study was voluntary. Any participant who wished towithdraw from the study was free to do so without any form of hindrance. Furthermore, all theparticipants were granted equal participation opportunities regardless of their status within thehospital. Confidentiality was also key. As such, the researcher was the only individual whoaccessed the various responses from the participants. All participants who wished to remainanonymous were also granted their wish. Furthermore, the researcher obtained an InstitutionalReview Board (IRB) approval to conduct the research.EMERGENCY OPERATIONS PLAN213.4.3 Data CollectionExploratory interviews through semi structured, open-ended interview questions wereconducted. Since the Covid-19 pandemic limited the use of face-to-face interviews, questionnaireswere emailed to the respondents and the researcher followed up with telephone interviews in thefall of 2020. This method was advantageous since it saved a lot of time and travel expenses and itwas convenient for both the researcher and interviewee. Semi-structured interviews were usedbecause of their highly flexible nature which allowed for further probing of the participants, henceenabling the acquisition of adequate information. Open-ended questions made up a greaterpercentage of the interview questions as they provided the respondents with a chance to provideunrestrained responses – hence the acquisition of more detailed data. The participants were alsoprovided with an opportunity to give their overall views and recommendations at the end of theinterview. The collected information was then assessed for completeness as well as consistencybefore data analysis.The selection of this method of data collection was mainly based on its wide range ofadvantages. These advantages include its extensive nature which allows for a thorough collectionof the essential information such as views and recommendations from the various participants(Oltmann, 2016). Moreover, the interviewee’s verbal and non-verbal cues could be gauged in thetelephone follow-up process. For this study, the procedure for grading non-verbal cues was basedprimarily on the attentiveness of the interviewees. Attentiveness was gauged by how much therespondents interrupted the interviewee in telephone interviews. Getting few, if any interruptionswas a great sign that the interviewees are attentive. On the other hand, in analyzing the interviewevaluations, attentive respondents answered the questions and were willing to share theirEMERGENCY OPERATIONS PLAN22responses. Inattentive interviewees gave vague answers (Bolderston, 2012). A combination ofthese two observation techniques was thus, used to grade verbal cu…

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