1.1. This Committee shall be called the "Disaster Management Committee" (hereinafter referred to as "the Committee") of Netaji Subhas Medical College and Hospital, Amhara, Bihta, Bihar.
1.2. The Committee is established in accordance with the National Disaster Management Act 2005, National Disaster Management Authority (NDMA) Guidelines on Hospital Safety 2016, National Accreditation Board for Hospitals & Healthcare Providers (NABH) standards, and guidelines issued by the Ministry of Health and Family Welfare, Government of India on Hospital Disaster Preparedness and Mass Casualty Management.
1.3. The Committee shall function as the apex body responsible for disaster preparedness, mitigation, response, recovery, and ensuring structural and functional safety of the medical college and hospital during both internal and external disasters.
Article 2: Objectives and Functions
2.1. Objectives:
To establish and maintain a comprehensive Hospital Disaster Management Plan (HDMP) addressing pre-disaster preparedness, disaster response, and post-disaster recovery phases.
To ensure the hospital remains structurally safe and functionally operational during and immediately after disasters to provide critical healthcare services to the affected community.
To minimize risks to human life, patients, staff, visitors, and hospital infrastructure through multi-hazard and inter-disciplinary disaster management approach.
To develop and implement Hospital Incident Response System (HIRS) for effective coordination, resource management, and emergency operations during disasters.
To ensure the hospital can manage sudden surge in patient load through optimal utilization of available resources and networking with other healthcare facilities.
To create disaster-resilient infrastructure and ensure business continuity of essential hospital services during emergencies.
To train and prepare all hospital staff, faculty, students, and ancillary workers for effective disaster response through regular drills, simulations, and capacity building programs.
To conduct hazard vulnerability analysis, risk assessment, and implement mitigation measures to reduce disaster impact on hospital operations.
To coordinate with district, state, and national disaster management authorities, emergency services, and other stakeholders for integrated disaster response.
2.2. Functions and Powers:
The Committee shall have the following functions and powers:
To develop, review, update, and operationalize the Hospital Disaster Management Plan (HDMP) with Standard Operating Procedures (SOPs) for all phases of disaster management.
To establish and implement the Hospital Incident Response System (HIRS) with clear command structure, roles, responsibilities, and job action sheets for all personnel.
To conduct comprehensive Hazard Vulnerability Analysis (HVA) to identify potential internal and external disaster scenarios including:
Natural disasters: earthquakes, floods, cyclones, lightning, landslides
Man-made disasters: fire, building collapse, chemical spills, gas leaks, explosions, transportation accidents
Biological emergencies: epidemics, pandemics, bioterrorism
CBRN emergencies: Chemical, Biological, Radiological, and Nuclear incidents
Mass Casualty Incidents (MCI): road accidents, rail accidents, stampedes, terrorist attacks
Internal emergencies: utility failures (electricity, water, medical gases), equipment failure, bomb threats
To ensure structural safety of hospital buildings through compliance with National Building Code 2016, seismic safety norms, wind load calculations, and disaster-resistant construction standards.
To ensure non-structural safety by securing medical equipment, furniture, storage shelves, suspended ceilings, lighting fixtures, pipelines, and other elements that may fall or shift during disasters.
To ensure continuity of critical lifeline services during disasters:
Electricity supply (main power, DG sets, UPS, solar backup)
Water supply (municipal supply, bore wells, storage tanks, tankers)
Medical gases (oxygen, nitrous oxide, medical air, vacuum)
Communication systems (telephone, internet, wireless, mobile networks)
Medical equipment (ventilators, monitors, dialysis machines, laboratory equipment)
Sanitation and waste management systems
To establish Hospital Command Centre as the nerve centre for disaster operations with:
Designated location with backup power and communication systems
24x7 operational capability
Emergency contact database of all staff, departments, and external agencies
Real-time information management and decision-making support systems
Coordination with District Incident Response System and DDMA/SDMA
To constitute and train specialized teams for disaster response:
Hospital Incident Response Team (HIRT) with designated commander and deputies
Triage Team for patient categorization and priority assignment
Medical Response Teams for clinical care in emergency situations
Evacuation Teams for safe movement of patients from affected areas
Search and Rescue Team for internal emergencies
Security and Crowd Control Team
Communication and Documentation Team
Logistics and Supply Management Team
Psychological First Aid and Counseling Team
To ensure surge capacity preparedness for mass casualty incidents:
Expansion protocols to increase bed capacity by 20-30% within 4 hours
Identification of areas for temporary patient accommodation (corridors, waiting areas, auditoriums)
Rapid discharge protocols for stable patients
Protocols for diversion of non-emergency admissions and elective surgeries
Augmentation of human resources through recall of off-duty staff
To establish hospital networking with:
Government hospitals (district hospital, CHCs, PHCs, sub-divisional hospitals)
Private hospitals and nursing homes
Medical colleges and specialty hospitals
Blood banks and diagnostic laboratories
Ambulance services (108, private ambulances, NGO ambulances)
Sharing of resource inventory, bed availability, specialist services, and patient transfer protocols
To establish and operationalize Triage System for effective patient management:
Color-coded triage tags (Red - Immediate, Yellow - Delayed, Green - Minor, Black - Deceased/Expectant)
Designated Triage Officer and trained triage team
Triage area at hospital entry with adequate space, lighting, and supplies
Dynamic triage protocols with re-assessment as patient condition changes
Documentation of triage category, time, and treatment provided
To maintain comprehensive resource inventory including:
Human resources: doctors (specialty-wise), nurses, paramedics, technicians, support staff with 24x7 contact numbers
Infrastructure: bed capacity (ward-wise, ICU, HDU, isolation), OT capacity, ventilators, dialysis machines
Emergency supplies: disaster store with medicines, IV fluids, surgical supplies, dressing materials, splints, stretchers
Equipment: portable X-ray, ultrasound, ventilators, monitors, suction apparatus, oxygen cylinders
Transportation: ambulances (BLS, ALS, mobile ICU) with driver contact numbers
Communication equipment: wireless sets, satellite phones, megaphones, public address system
Emergency lighting: battery-operated lights, torches, generator sets
To develop and maintain Standard Operating Procedures (SOPs) for:
Disaster alert and activation of HDMP
Code announcement protocols (Code Red - Fire, Code Blue - Medical Emergency, Code Orange - External Disaster, Code Yellow - Internal Disaster, Code Black - Bomb Threat, Code Purple - Hostage Situation)
Hospital Command Centre activation and operations
Triage protocols for different types of casualties
Patient reception, registration, and tracking system
Emergency treatment protocols for trauma, burns, blast injuries, chemical exposure, radiation exposure
Patient evacuation (vertical and horizontal) including ICU patients, OT patients, bedridden patients
Decontamination procedures for chemical and biological incidents
Mass fatality management and mortuary protocols
Communication protocols (internal and external)
Media management and public information dissemination
Documentation and medico-legal requirements
Post-disaster debriefing and psychological support
To ensure electrical safety and power backup:
Regular maintenance and testing of DG sets (weekly no-load test, monthly load test)
Automatic changeover systems between main power and DG sets
UPS systems for critical areas (ICU, OT, NICU, CCU, emergency, blood bank)
Solar power backup systems where feasible
Adequate diesel storage for 72 hours continuous operation
Emergency lighting systems with battery backup in all patient care areas, corridors, stairways
To ensure water supply security:
Multiple water sources (municipal supply, bore wells, tanker supply arrangements)
Adequate storage capacity (underground tanks, overhead tanks)
Emergency water supply agreements with tanker suppliers
Water quality monitoring and chlorination arrangements
Rainwater harvesting systems where feasible
To ensure medical gas supply continuity:
Regular inspection of oxygen generation plant, manifold system, and pipeline distribution
Backup oxygen cylinders in critical areas
Emergency supply agreements with medical gas vendors
Safety protocols for storage and handling of medical gases
Monitoring of gas pressure, leakage detection, and alarm systems
To establish communication systems for disaster situations:
Multiple redundant communication channels (landline, mobile, wireless, satellite phone, internet)
Public address system for internal announcements
Emergency contact database of all staff (updated quarterly)
Communication protocols with external agencies (ambulance services, police, fire brigade, district administration, DDMA/SDMA)
Social media and mass media communication protocols for public information
To ensure security arrangements during disasters:
Augmentation of security staff during emergencies
Traffic management within hospital premises
Crowd control at emergency department and triage area
Access control to restricted areas (OT, ICU, mortuary)
Protection of hospital property and equipment
Coordination with police for law and order
Security of stored supplies and disaster stores
To establish patient tracking and documentation system:
Disaster casualty register with unique disaster number for each patient
Patient tracking board showing triage category, location, and treatment status
Simplified documentation in disaster situation (minimum essential information)
Medico-legal documentation for casualties
Photograph-based identification where patient identity unknown
Information desk for relatives to inquire about patients
Regular updates to District Administration and media about casualty statistics
To develop protocols for vulnerable populations:
Priority evacuation of vulnerable groups (ICU patients, children, pregnant women, elderly, differently-abled persons)
Special evacuation equipment (evacuation chairs, stretchers, wheelchairs)
Trained personnel for handling ventilator-dependent patients during evacuation
Protocols for evacuation of psychiatric patients, infectious disease patients
Post-evacuation assembly points and accountability procedures
To establish psychological support services:
Psychological First Aid for disaster victims
Counseling services for bereaved families
Critical Incident Stress Debriefing (CISD) for hospital staff involved in disaster response
Referral protocols for long-term psychiatric care
Psychologist/psychiatrist on call for disaster situations
To organize regular training programs for all categories of staff:
Mandatory disaster management orientation for all new employees within one month of joining
Annual refresher training for all staff on HDMP and HIRS
Specialized training for HIRS position holders and backup personnel
Training on triage protocols, basic life support, trauma care, burn management
Training on decontamination procedures for CBRN incidents
Training on psychological first aid and stress management
Training records maintained with date, participants, topics covered, and assessment results
To conduct periodic disaster drills and simulation exercises:
Quarterly tabletop exercises with full HIRS team to test command structure and decision-making
Biannual functional drills (Mass Casualty Incident drill, Fire evacuation drill)
Annual full-scale drill with external agencies (police, fire brigade, ambulance services, district administration)
Drills conducted at different times (day shift, night shift) and different scenarios
Evaluation of drills using standardized assessment tools with third-party evaluators
Documentation of drill reports including observations, gaps identified, time taken for various actions, and corrective measures
Hot-wash debriefing immediately after each drill for learning and improvement
Revision of HDMP within 7 working days based on drill findings
To conduct annual hospital capacity and capability analysis:
Assessment of physical infrastructure and structural safety
Inventory of human resources with skills mapping
Assessment of equipment and supplies
Evaluation of critical lifeline services
Gap analysis and prioritization of interventions
Budgetary proposals for capacity enhancement
To maintain liaison and coordination with external agencies:
District Disaster Management Authority (DDMA)
State Disaster Management Authority (SDMA)
District Medical Officer (Health)
Police (local station, district SP, traffic police)
Fire Brigade (district fire station)
Ambulance services (108, private providers)
Other hospitals in the district for networking and mutual support
NGOs, voluntary organizations, Red Cross Society
Civil defense, home guards, NCC, NSS units
Media organizations for public communication
Municipal authorities for water supply, sanitation, road clearance
To establish mass fatality management protocols:
Temporary mortuary arrangements for large number of casualties
Refrigerated storage facilities (existing mortuary, refrigerated containers, ice arrangements)
Body identification procedures (tagging, photography, documentation)
Post-mortem examination protocols in disaster situation
Coordination with police for medico-legal requirements
Dignified handling of deceased with respect for religious and cultural sentiments
Relatives waiting area separate from mortuary
Grief counseling support for bereaved families
To implement infection control measures during disasters:
Coordination with Hospital Infection Control Committee
Adequate supplies of personal protective equipment (PPE)
Hand hygiene facilities at all patient care areas
Isolation facilities for infectious casualties
Bio-medical waste segregation and disposal during mass casualty situation
Disinfection and decontamination of affected areas post-disaster
Post-disaster epidemiological surveillance for communicable diseases
To ensure adequate supplies and logistics management:
Disaster stores with buffer stocks of emergency medicines, IV fluids, surgical supplies, dressing materials
Vendor agreements for emergency procurement and 24x7 supply
Pharmacy protocols for rapid dispensing during mass casualties
Blood bank preparedness with emergency blood donor mobilization protocols
Laboratory readiness for high-volume sample processing
Dietary services for feeding large number of patients and staff during extended operations
Housekeeping and sanitation services scaled up for disaster situations
To establish financial management protocols for disasters:
Contingency fund allocation for disaster response
Simplified financial authorization procedures during emergencies
Emergency procurement procedures with delegation of financial powers
Post-disaster financial accounting and audit
Insurance coverage for hospital infrastructure and equipment
Coordination with state and central government for financial assistance
To develop community preparedness initiatives:
Community awareness programs on disaster preparedness
Training of community volunteers as first responders
Coordination with local self-government institutions (Panchayats, Municipalities)
School disaster preparedness programs
Public education on when to rush to hospital and when to seek primary care
Display of emergency contact numbers at public locations
To implement post-disaster recovery measures:
Damage assessment (structural, equipment, supplies)
Restoration of normal hospital services in phased manner
Replenishment of disaster stores and supplies
Debriefing of staff involved in disaster response
Documentation of lessons learned and best practices
Psychological support for staff experiencing stress and burnout
Recognition and appreciation of staff performance during disaster
Follow-up care for disaster victims requiring continued medical attention
To ensure compliance with regulatory requirements:
National Disaster Management Act 2005 and State Disaster Management Act
NDMA Guidelines on Hospital Safety and Management of Biological Disasters
NABH standards on disaster preparedness (FMS.6, FMS.7, FMS.8)
National Building Code 2016 for structural safety
Fire Safety Act and Fire NOC requirements
Bio-Medical Waste Management Rules
Clinical Establishments Act requirements
NMC (National Medical Commission) inspection requirements for disaster preparedness
To submit periodic reports to senior management and regulatory authorities:
Quarterly reports on disaster preparedness activities, drills conducted, training programs
Annual report on hazard vulnerability analysis, capacity assessment, and mitigation measures implemented
Post-disaster reports on response actions, casualties managed, challenges faced, and recommendations
Reports to District Administration during disaster response on real-time basis
Documentation maintained for NMC inspections, NABH accreditation surveys, and other regulatory audits
To recommend budgetary provisions for:
Procurement of disaster response equipment and supplies
Structural strengthening and retrofitting of buildings
Installation and maintenance of lifeline services
Training programs and simulation exercises
Hospital networking and communication systems
Insurance coverage for disaster risk transfer
3.1. Constitution of the Committee:
The Disaster Management Committee shall be a multidisciplinary body consisting of the following members:
| S.No. | Designation/Position | Status in Committee |
|---|---|---|
| 1. | Principal cum Dean, Netaji Subhas Medical College | Chairperson |
| 2. | Medical Superintendent, NSMCH Hospital | Vice-Chairperson |
| 3. | Deputy Medical Superintendent, NSMCH Hospital | Member Secretary |
| 4. | Disaster Management Officer (to be designated) | Convener |
| 5. | Professor & Head, Department of Emergency Medicine | Member (Clinical Coordinator) |
| 6. | Professor & Head, Department of General Surgery | Member |
| 7. | Professor & Head, Department of Orthopedics | Member |
| 8. | Professor & Head, Department of Anesthesiology | Member |
| 9. | Professor & Head, Department of Medicine | Member |
| 10. | Professor & Head, Department of Pediatrics | Member |
| 11. | Professor & Head, Department of Obstetrics & Gynecology | Member |
| 12. | Professor & Head, Department of Forensic Medicine | Member |
| 13. | Professor & Head, Department of Community Medicine | Member |
| 14. | Professor & Head, Department of Psychiatry | Member |
| 15. | Chief Nursing Superintendent | Member |
| 16. | Nursing Superintendent (Emergency Department) | Member |
| 17. | Nursing Superintendent (ICU) | Member |
| 18. | Nursing Superintendent (OT) | Member |
| 19. | Hospital Administrator/Administrative Officer | Member |
| 20. | Chief, Maintenance and Engineering Department | Member |
| 21. | Assistant Engineer (Electrical) | Member |
| 22. | Assistant Engineer (Civil) | Member |
| 23. | Chief of Biomedical Engineering Department | Member |
| 24. | Security Officer/Chief of Security | Member |
| 25. | Fire Safety Officer | Member |
| 26. | Infection Control Officer | Member |
| 27. | Blood Bank Officer/In-charge | Member |
| 28. | Chief Pharmacist | Member |
| 29. | Chief of Laboratory Services | Member |
| 30. | Chief of Radiology Services | Member |
| 31. | Medical Records Officer | Member |
| 32. | Public Relations Officer | Member |
| 33. | Manager, Quality Assurance and Accreditation | Member |
| 34. | IT Manager | Member |
| 35. | Ambulance In-charge | Member |
| 36. | Housekeeping Supervisor | Member |
| 37. | Dietary Services In-charge | Member |
| 38. | Representative from District Disaster Management Authority | Member (Special Invitee) |
| 39. | Representative from Local Police Station | Member (Special Invitee) |
| 40. | Representative from Fire Brigade | Member (Special Invitee) |
| 41. | Representative from 108 Ambulance Service | Member (Special Invitee) |
Table 1: Composition of Disaster Management Committee
3.2. Ex-Officio Members:
The Principal cum Dean and Medical Superintendent shall be ex-officio Chairperson and Vice-Chairperson respectively by virtue of their positions.
3.3. Disaster Management Officer:
The Principal shall designate a Disaster Management Officer who shall serve as Convener of the Committee.
The Disaster Management Officer should preferably be a senior faculty member with administrative experience and training in disaster management.
The Disaster Management Officer shall report directly to the Principal on all disaster management matters.
The Disaster Management Officer shall be responsible for:
Overall coordination of disaster preparedness, response, and recovery activities
Development and periodic updating of Hospital Disaster Management Plan
Conducting hazard vulnerability analysis and risk assessment
Organizing training programs and disaster drills
Maintaining resource inventory and disaster stores
Activating Hospital Incident Response System during disasters
Serving as Incident Commander during disaster situations
Liaison with district and state disaster management authorities
Documentation and reporting of disaster management activities
3.4. Multidisciplinary Representation:
The Committee ensures comprehensive representation from:
Clinical services (all major specialties)
Nursing services (emergency, critical care, wards, OT)
Hospital administration
Facility management and engineering
Support services (pharmacy, laboratory, blood bank, radiology, dietary)
Safety and security services
Quality assurance and infection control
External agencies (DDMA, police, fire brigade, ambulance services)
3.5. Special Invitees:
The Chairperson may invite:
Representatives from District Administration (Collector, Additional Collector)
Representatives from State Disaster Management Authority
Civil Surgeon or District Medical Officer
Representatives from other hospitals for networking
Disaster management experts and consultants
NGO and voluntary organization representatives
Media representatives for specific agenda items
Special invitees shall participate in discussions but shall not have voting rights.
4.1. The term of office for all nominated members shall be three years from the date of their appointment/nomination, except for ex-officio members who shall continue as members by virtue of holding their respective positions.
4.2. Members may be re-nominated for subsequent terms.
4.3. A member ceasing to hold the position by virtue of which they were appointed shall automatically cease to be a member of the Committee.
4.4. The Principal may nominate substitute members in case of death, retirement, resignation, transfer, or prolonged absence of any member.
4.5. The Disaster Management Officer (Convener) shall identify and train 2nd and 3rd line backup personnel for all HIRS position holders to ensure continuity of disaster response capability.
5.1. Chairperson:
The Principal cum Dean shall be the Chairperson of the Committee.
The Chairperson shall have overall supervision and control of the Committee's functioning and disaster management program implementation.
The Chairperson shall:
Approve the Hospital Disaster Management Plan and major revisions
Approve budgetary provisions for disaster preparedness and response
Review quarterly progress reports on disaster management activities
Declare activation of Hospital Disaster Management Plan during major disasters
Represent the institution in meetings with district and state authorities on disaster management
Approve investigation reports of disaster incidents and corrective actions
In the absence of the Chairperson, the Vice-Chairperson shall preside over meetings and discharge the functions of the Chairperson.
5.2. Vice-Chairperson:
The Medical Superintendent shall be the Vice-Chairperson of the Committee.
The Vice-Chairperson shall:
Assist the Chairperson in discharge of duties
Preside over meetings in the absence of the Chairperson
Oversee day-to-day implementation of disaster preparedness measures in the hospital
Monitor resource allocation and procurement for disaster management
Coordinate with clinical departments for surge capacity planning
Serve as alternate Incident Commander during disaster situations
5.3. Member Secretary:
The Deputy Medical Superintendent shall serve as Member Secretary of the Committee.
The Member Secretary shall:
Assist the Chairperson and Vice-Chairperson in administrative matters
Coordinate preparation of agenda and circulation of meeting notices
Ensure proper documentation and maintenance of minutes of meetings
Monitor implementation of decisions taken in Committee meetings
Coordinate preparation of periodic reports
Serve as liaison between the Committee and various departments
5.4. Convener (Disaster Management Officer):
The Disaster Management Officer designated by the Principal shall serve as Convener.
The Convener shall report directly to the Principal on all disaster management matters.
The Convener shall be responsible for:
Coordinating all activities of the Disaster Management Committee
Convening meetings in consultation with the Chairperson
Developing and maintaining the Hospital Disaster Management Plan
Conducting hazard vulnerability analysis and updating risk assessment annually
Establishing and maintaining Hospital Incident Response System (HIRS)
Preparing job action sheets for all HIRS positions and regular staff
Organizing regular training programs for all categories of staff
Conducting disaster drills (tabletop exercises, functional drills, full-scale drills)
Maintaining comprehensive resource inventory (human resources, equipment, supplies, infrastructure)
Ensuring adequacy of disaster stores with buffer stocks
Coordinating with external agencies (DDMA, police, fire brigade, ambulance services)
Establishing hospital networking with other healthcare facilities
Serving as Incident Commander and activating Hospital Command Centre during disasters
Coordinating all disaster response operations
Receiving and investigating disaster incident reports and near-miss events
Conducting post-disaster debriefing and documentation
Preparing quarterly and annual reports on disaster management activities
Maintaining comprehensive records and documentation
Ensuring compliance with NDMA guidelines, NABH standards, and regulatory requirements
Handling correspondence on behalf of the Committee
6.1. HIRS Structure:
The Committee shall establish a Hospital Incident Response System (HIRS) as the organizational structure for managing disaster situations.
HIRS shall have the following key features:
Clear command structure with single Incident Commander
Modular organization that can expand or contract based on incident size
Manageable span of control (3-7 persons per supervisor)
Consolidated action plans with defined objectives and strategies
Comprehensive resource management
Functional positions covering Operations, Planning, Logistics, and Finance/Administration
HIRS organizational chart and detailed job action sheets shall be included in the Hospital Disaster Management Plan.
6.2. Key HIRS Positions:
Incident Commander: Disaster Management Officer (Convener) or designated senior administrator
Operations Section Chief: Head of Emergency Medicine or senior clinician
Planning Section Chief: Hospital Administrator or designated faculty
Logistics Section Chief: Chief of Maintenance & Engineering
Finance/Administration Section Chief: Finance Officer or Administrative Officer
Triage Officer: Senior Emergency Medicine faculty or designated surgeon
Medical Controller: Senior clinician for coordinating clinical operations
Nursing Controller: Chief Nursing Superintendent
Security Controller: Security Officer
Communication Officer: Public Relations Officer or IT Manager
Liaison Officer: Designated faculty for coordination with external agencies
6.3. HIRS Activation:
HIRS shall be activated by the Incident Commander (Disaster Management Officer) upon:
Receipt of information about major external disaster with potential mass casualties
Occurrence of internal disaster threatening hospital operations
Declaration by Principal/Medical Superintendent
Request from District Administration or DDMA
Upon activation, all HIRS position holders shall report to Hospital Command Centre immediately.
Code announcement protocols shall be used for internal communication (e.g., "Code Orange - External Disaster" or "Code Yellow - Internal Disaster").
All staff shall report to their designated duty stations as per job action sheets.
6.4. Hospital Command Centre:
A designated room shall serve as Hospital Command Centre with:
Multiple communication systems (landline, mobile, wireless, internet)
Emergency contact database and resource inventory
Hospital layout maps showing critical areas and evacuation routes
Whiteboard for tracking casualties and resource deployment
Backup power supply
24x7 accessibility
During disasters, the Command Centre shall coordinate all operations including:
Receipt and dissemination of information
Resource mobilization and deployment
Communication with external agencies
Decision-making and strategic planning
Documentation and record-keeping
6.5. Specialized Response Teams:
The Committee shall constitute and train the following specialized teams:
Triage Team: Emergency physicians, surgeons, anesthesiologists, senior nurses (minimum 4-6 persons) trained in triage protocols
Medical Response Teams: Multi-specialty teams for emergency treatment in various areas
Evacuation Teams: Floor-wise teams led by nursing staff with support from security and housekeeping for safe patient evacuation
Search and Rescue Team: Security and maintenance staff trained in basic search and rescue for internal emergencies
Decontamination Team: Trained in handling chemical and biological contamination incidents
Psychological Support Team: Psychiatrists, psychologists, social workers for psychological first aid and counseling
Communication Team: For documentation, media management, and information dissemination
Logistics Team: For supply management, transportation coordination, and facility management
All team members shall be trained in their specific roles with regular drills and exercises.
7.1. Frequency of Meetings:
The Committee shall meet at least once every three months (minimum four meetings per year). Additional emergency meetings may be convened as required, particularly after disaster incidents or major drills.
7.2. Notice of Meetings:
The Convener shall convene meetings with at least 7 days' prior notice to all members.
The notice shall include the date, time, venue, and detailed agenda for the meeting.
Relevant documents and reports shall be circulated at least 3 days before the meeting.
In case of urgent matters (post-disaster review, immediate safety concerns), meetings may be convened with 24 hours’ notice with approval of the Chairperson.
7.3. Quorum:
The quorum for meetings shall be one-third of the total members or 10 members, whichever is higher.
The Chairperson or Vice-Chairperson must be present for the meeting to proceed.
If quorum is not present within 30 minutes of the scheduled time, the meeting shall stand adjourned to a date within 7 days, when no quorum shall be necessary.
7.4. Agenda of Meetings:
Regular meetings shall include the following agenda items:
Confirmation of minutes of previous meeting
Action taken report on previous decisions
Review of disaster preparedness status
Status of Hospital Disaster Management Plan and SOPs
Report on training programs and drills conducted
Analysis of drill observations and corrective actions
Resource inventory status and procurement needs
Hazard vulnerability analysis updates
Reports on disaster incidents or near-miss events (if any)
Investigation reports and corrective actions
Coordination with external agencies
Hospital networking status
Compliance with regulatory requirements (NABH, NMC, Fire NOC)
Budgetary matters and financial provisions
Any other matter with permission of Chair
7.5. Conduct of Meetings:
Meetings shall be conducted in accordance with established rules of procedure.
All members shall have the right to participate in discussions and express opinions.
Special invitees may participate in discussions but shall not have voting rights.
Presentations may be made on specific topics by members or invited experts.
Disaster drill reports and incident investigation reports shall be reviewed in detail.
7.6. Decisions and Resolutions:
Decisions shall ordinarily be taken by consensus after thorough discussion.
Where consensus cannot be reached, matters shall be decided by simple majority vote of members present and voting.
In case of a tie, the Chairperson shall have a casting vote.
All important decisions shall be recorded as resolutions with:
Clear action points
Responsible persons for implementation
Timelines for completion
Resource requirements
7.7. Minutes:
The Member Secretary shall prepare minutes of each meeting within 10 days of the meeting.
Minutes shall include:
Date, time, venue, and list of members’ present
Summary of discussions on each agenda item
Decisions taken and resolutions passed
Action points with responsible persons and timelines
Any dissent notes recorded by members
Draft minutes shall be submitted to the Chairperson for approval and then circulated to all members.
Confirmed minutes shall be placed on the hospital website (excluding confidential matters).
Copies of minutes shall be submitted to the Managing Committee and made available to senior management.
Confirmed minutes shall be maintained in a permanent record book.
8.1. Development and Approval:
The Committee shall develop and maintain a comprehensive Hospital Disaster Management Plan approved by the Chairperson and Managing Body.
8.2. Contents of HDMP:
The Hospital Disaster Management Plan shall include:
Introduction and Policy Statement
Vision and objectives of disaster management
Commitment of hospital leadership
Scope and applicability
Hazard Vulnerability Analysis (HVA)
Identification of potential hazards (natural, man-made, biological, CBRN)
Risk assessment and vulnerability mapping
Prioritization of risks
Hospital Capacity and Capability Analysis
Infrastructure assessment (buildings, utilities, equipment)
Human resource inventory with skills mapping
Surge capacity estimation
Identification of gaps and mitigation measures
Hospital Incident Response System (HIRS)
Organizational chart with command structure
Roles and responsibilities of each position
Job action sheets for all positions
HIRS activation protocols
Hospital Command Centre operations
Standard Operating Procedures (SOPs)
Disaster alert and activation protocols
Code announcement systems
Triage protocols
Patient reception and registration
Emergency treatment protocols
Evacuation procedures (vertical and horizontal)
Decontamination procedures
Communication protocols
Security and crowd control
Mass fatality management
Media management
Documentation requirements
Demobilization and stand-down procedures
Resource Management
Human resource inventory and recall procedures
Equipment and supply inventory
Disaster stores and buffer stocks
Emergency procurement protocols
Transportation and ambulance coordination
Essential Services Continuity
Electricity backup systems
Water supply security
Medical gas continuity
Communication systems
Waste management
Hospital Networking
List of networked hospitals with contact details
Inter-hospital transfer protocols
Resource sharing agreements
Communication protocols
External Coordination
Contact details of all external agencies
Liaison protocols
Mutual aid agreements
Training and Drills
Training program schedule
Drill protocols and evaluation tools
Documentation requirements
Floor Plans and Maps
Hospital layout with all departments
Evacuation routes and assembly points
Location of emergency equipment
Utility shut-off locations
Annexures
Emergency contact lists
Forms and templates
Triage tags
Patient tracking forms
Incident reporting forms
Resource inventory checklists
8.3. Review and Updates:
The HDMP shall be reviewed annually and updated as necessary.
Updates shall be made within 7 working days after each major drill or actual disaster incident based on lessons learned.
All departments shall be provided with updated copies of relevant SOPs.
Changes shall be clearly marked with revision date and version number.
Copies of the HDMP shall be available with:
All Committee members
All department heads
Hospital Command Centre
Security office
Emergency department
All nursing stations
Administrative office
Key SOPs shall be displayed prominently at relevant locations.
9.1. Training Programs:
The Committee shall organize regular training programs for all categories of hospital staff:
Orientation Training: All new employees shall undergo mandatory disaster management orientation within one month of joining covering:
Introduction to hospital disaster management
Hazards and risks specific to the hospital
Individual roles and responsibilities
HDMP and HIRS overview
Code announcement systems
Evacuation routes and assembly points
Location of emergency equipment
Annual Refresher Training: All staff shall undergo annual refresher training covering:
Updates to HDMP and SOPs
Review of individual roles and job action sheets
Triage protocols
Basic life support (BLS)
Psychological first aid
Communication during emergencies
Specialized Training: Targeted training for specific groups:
HIRS position holders: Incident command system, decision-making, leadership
Triage team: Advanced triage protocols, START triage, JumpSTART pediatric triage
Medical staff: Mass casualty management, trauma care, burn management, blast injuries
Nursing staff: Emergency nursing, patient mobilization, evacuation techniques
Security staff: Crowd control, traffic management, search and rescue basics
Engineering staff: Utility systems management, emergency repairs
Decontamination team: CBRN incident response, PPE use, decontamination procedures
Psychological support team: Critical incident stress debriefing, grief counseling
Training Documentation: All training programs shall be documented with:
Date, venue, and duration
Topic and objectives
Trainer details and qualifications
Participant list with signatures
Training materials used
Assessment results (if applicable)
Feedback and evaluation
9.2. Disaster Drills and Simulation Exercises:
The Committee shall conduct the following drills as per NABH standards:
Tabletop Exercises:
Frequency: Quarterly (minimum 4 per year)
Participants: Full HIRS team and key personnel
Duration: 2-3 hours
Format: Discussion-based simulation using hypothetical scenarios
Objectives: Test command structure, decision-making, communication, coordination
Documentation: Scenario details, participants, decisions made, gaps identified, recommendations
Functional Drills:
Frequency: Twice per year (biannual)
Types:
Mass Casualty Incident (MCI) drill
Fire evacuation drill
Utility failure drill
Chemical spill/CBRN drill
Participants: All relevant departments and staff
Duration: 2-4 hours
Format: Simulated patients, actual movement of personnel and resources
Objectives: Test operational procedures, resource deployment, patient flow, communication
Full-Scale Drills:
Frequency: Annually
Participants: Hospital staff plus external agencies (police, fire brigade, ambulance, DDMA)
Duration: 4-6 hours
Format: Realistic simulation with simulated patients, equipment deployment, multi-agency coordination
Objectives: Test entire disaster response system from pre-hospital to definitive care
Drill Variations:
Drills shall be conducted at different times (day shift, night shift, weekends)
Different locations (emergency department, wards, OT complex, OPD)
Different scenarios (trauma, burns, chemical exposure, infectious disease outbreak)
Announced and unannounced drills
Drill Evaluation:
All drills shall be evaluated using standardized assessment tools
Third-party evaluators (external disaster management experts) should be engaged for major drills
Evaluation parameters:
Time taken for various actions (alert, mobilization, triage, treatment, evacuation)
Effectiveness of command and control
Communication efficiency
Resource mobilization and utilization
Staff response and performance
Adherence to protocols
Gaps and deficiencies identified
Hot-Wash Debriefing:
Immediate debriefing session within 2 hours of drill completion
All participants share observations, challenges faced, and suggestions
Facilitator documents key learning points
Initial corrective actions identified
Drill Documentation:
Comprehensive drill report prepared within 7 days including:
Date, time, location, and type of drill
Scenario description
Participant list (staff and external agencies)
Timeline of events
Evaluation results with metrics
Photographs and video recordings
Observations and gaps identified
Recommendations for improvement
Corrective and preventive actions with timelines
Drill reports reviewed in Committee meetings
Submitted to senior management and made available for inspections
HDMP updated based on drill findings within 7 working days
10.1. Disaster Alert and Activation:
Disaster alert may be received from:
District Administration/DDMA
Police or emergency services (100, 108)
Media reports
Hospital emergency department (casualties arriving)
Hospital security or staff at incident site
Public or bystanders
Upon receiving disaster alert, the following immediate actions shall be taken:
Verify authenticity and gather initial information (type, location, estimated casualties)
Inform Principal/Medical Superintendent immediately
Activate Hospital Disaster Management Plan
Announce appropriate code (e.g., "Code Orange - External Disaster")
Alert all HIRS position holders to report to Command Centre
Alert all departments to implement their disaster SOPs
10.2. Hospital Command Centre Activation:
Incident Commander (Disaster Management Officer) reports to Command Centre
All HIRS section chiefs report within 15-20 minutes
Establish communication links with all departments
Establish communication with District Administration, police, fire brigade, ambulance services
Situation assessment and initial action plan development
Resource mobilization initiated
Regular situation updates every 30 minutes
10.3. Emergency Department and Triage Area Preparation:
Clear emergency department of non-urgent patients
Rapid discharge of stable patients from wards to create bed capacity
Diversion of routine OPD patients
Postponement of elective surgeries
Set up triage area at hospital entrance
Mobilize triage team with adequate supplies
Establish patient flow from triage to treatment areas
Activate additional treatment areas (OPD rooms, procedure rooms, day care)
10.4. Triage Protocols:
JumpSTART triage system for pediatric casualties
Color-coded triage tags:
RED (Immediate): Life-threatening injuries requiring immediate intervention (e.g., airway obstruction, severe bleeding, shock)
Triage tags shall include:
Unique disaster casualty number
Time of triage
Triage category with color
Brief description of injuries
Vital signs
Treatment given
Name if known (or marked as "Unknown Male/Female")
Re-triage performed periodically as patient condition changes
10.5. Patient Flow and Treatment:
RED casualties: Immediate transfer to resuscitation area, OT, or ICU
GREEN casualties: Transfer to minor treatment area (dressing room, OPD areas)
BLACK casualties: Transfer to temporary mortuary area
Each treatment area shall have designated medical team with adequate supplies
Patient tracking board updated continuously
Documentation of treatment provided
Disposition recorded (admitted, transferred, discharged, deceased)
10.6. Resource Mobilization:
Recall of off-duty staff using pre-established call tree
Mobilization of medical students, nursing students, interns, residents
Activation of disaster stores for supplies
Emergency procurement from vendors as per agreements
Blood bank activation with emergency donor mobilization
Laboratory and radiology services scaled up
Pharmacy operating on emergency dispensing mode
Additional ambulances mobilized
Housekeeping and sanitation services augmented
Dietary services for extended operations
10.7. Communication and Documentation:
Regular situation reports (sitreps) sent to Command Centre
Updates provided to District Administration every hour
Casualty statistics updated (received, treated, admitted, discharged, referred, deceased)
Information desk established for relatives
Media briefings by authorized spokesperson (PRO or Medical Superintendent)
Patient tracking maintained with location and status
Medico-legal documentation for all casualties
Photographic documentation where identity unknown
10.8. Security and Crowd Control:
Augmentation of security staff
Traffic management within hospital premises
Separate entry and exit routes for ambulances
Crowd control at emergency department entrance
Access control to treatment areas (only authorized personnel)
Protection of disaster stores and supplies
Coordination with police for law and order
Media management and restricted area enforcement
10.9. Patient Transfer and Networking:
When hospital capacity overwhelmed, activate networking with other hospitals
Transfer protocols for:
Patients requiring specialty care not available
Stable patients to create capacity for critical patients
Patients for definitive care after initial stabilization
Transfer documentation with patient condition, treatment given, and receiving hospital details
Ambulance coordination for transfers
Receiving hospital notified in advance
Patient tracking updated with transfer details
10.10. Stand-Down and Demobilization:
When casualty influx stabilizes and hospital returns to manageable operations
Incident Commander declares stand-down in consultation with Chairperson
Phased demobilization of resources
Staff released in stages maintaining adequate coverage
Disaster stores replenished
Equipment cleaned, maintained, and restocked
Hospital services gradually return to normal operations
Documentation completed
Debriefing scheduled
11.1. Internal Disaster Scenarios:
The Committee shall develop specific protocols for internal disasters including:
Fire in hospital premises
Building collapse or structural failure
Utility failures (electricity, water, medical gas)
Chemical spills or gas leaks
Bomb threats or suspicious objects
Hostage situations or violence
Cyber-attacks affecting hospital information systems
Equipment failures in critical areas
11.2. Internal Disaster Response:
Immediate alert to security and fire safety team
Activation of internal disaster protocol (e.g., "Code Yellow - Internal Disaster")
Evacuation of affected areas if required
Control of incident (fire suppression, utility isolation, containment)
Patient safety as top priority
Coordination with external agencies (fire brigade, police, bomb squad)
Communication with patients and families
Alternate arrangements for continued care
Post-incident assessment and restoration
11.3. Evacuation Protocols:
Floor-wise evacuation teams activated
Priority evacuation sequence:
Affected area patients
ICU and HDU patients
OT patients (if feasible)
Pediatric and neonatal patients
Maternity patients
Infectious disease isolation patients
General ward patients
Ambulatory patients
Evacuation routes and exits clearly marked and unobstructed
Assembly points designated outside building
Patient accountability and tracking during evacuation
Special equipment for evacuation:
Evacuation chairs for stairways
Stretchers and wheelchairs
Portable oxygen cylinders
Portable suction devices
Emergency lights
Temporary patient care areas established at safe locations
Patient transfer to other hospitals if prolonged evacuation
12.1. Immediate Post-Disaster Actions:
Assessment of casualties managed and final disposition
Assessment of hospital staff injuries or stress
Damage assessment (structural, equipment, supplies)
Restoration of essential services
Replenishment of disaster stores and supplies
Return of borrowed resources and equipment
Documentation completion
12.2. Debriefing and After-Action Review:
Hot-wash debriefing within 24-48 hours with all participants
Structured after-action review meeting within 7 days
Discussion of:
What worked well
What did not work well
Challenges faced
Gaps identified
Resource adequacy
Communication effectiveness
Coordination issues
Staff performance
Patient outcomes
Documentation of lessons learned
Recommendations for improvement
12.3. Psychological Support:
Critical Incident Stress Debriefing (CISD) for staff involved in response
Counseling services for staff experiencing burnout or stress
Peer support programs
Referral for professional psychiatric care if needed
Recognition and appreciation of staff efforts
12.4. Corrective Actions:
Prioritized list of corrective actions based on debriefing
Assignment of responsibilities and timelines
Budgetary provisions for corrective measures
Revision of HDMP and SOPs within 7 working days
Implementation monitoring
Follow-up review
12.5. Reporting:
Comprehensive post-disaster report prepared including:
Incident description and timeline
Casualties received, treated, and final disposition
Resources deployed
Actions taken
Challenges and issues
Staff and infrastructure impact
Financial expenditure
Lessons learned
Recommendations
Report submitted to Principal, Managing Body, and District Administration
Report presented in next Committee meeting
Records maintained for regulatory inspections and accreditation
13.1. The Disaster Management Committee shall coordinate closely with:
Fire Safety Committee: For fire prevention, fire drills, and fire emergency response
Hospital Safety Committee: For overall facility safety and risk management
Hospital Infection Control Committee: For infection control during mass casualties and epidemics
Bio-Medical Waste Management Committee: For safe disposal of large volume of waste during disasters
Transfusion Committee: For blood bank preparedness and emergency donor mobilization
Pharmacy and Therapeutics Committee: For drug supply management and emergency procurement
Medical Equipment Committee: For equipment maintenance and emergency repairs
Electrical Safety Sub-Committee: For power backup and electrical safety
Anti-Ragging Committee: For security and prevention of violence
Internal Complaints Committee: For addressing staff concerns during high-stress situations
13.2. Joint meetings may be held to ensure integrated approach to hospital safety and emergency preparedness.
13.3. SOPs shall be coordinated to avoid contradictions and ensure seamless operations during emergencies.
14.1. Quarterly Reports:
The Committee shall submit quarterly reports to the Principal and Managing Committee covering:
Status of Hospital Disaster Management Plan
Training programs conducted and participants
Disaster drills conducted and evaluation results
Resource inventory and disaster stores status
Hazard vulnerability analysis updates
Networking status with other hospitals
Disaster incidents or near-miss events (if any)
Corrective actions implemented
Budgetary utilization and requirements
Compliance with NABH standards and regulatory requirements
14.2. Annual Report:
The Committee shall prepare a comprehensive annual report detailing:
Overall disaster preparedness status
Hazard vulnerability analysis and risk profile
Hospital capacity and capability assessment
Training programs and coverage
Drill statistics and effectiveness
Disaster incidents and response actions
Lessons learned and improvements implemented
Hospital networking and external coordination
Infrastructure improvements and equipment procurement
Compliance status with NDMA guidelines, NABH standards
Challenges faced and recommendations
Future plans and budgetary proposals
14.3. Accountability:
The Committee shall be accountable to the Managing Body for all disaster management matters and compliance with regulations.
The Disaster Management Officer (Convener) shall report directly to the Principal on matters requiring immediate attention or emergency situations.
The Committee shall ensure compliance with:
National Disaster Management Act 2005
NDMA Guidelines on Hospital Safety 2016
NABH standards on disaster preparedness
National Building Code 2016
Fire Safety Act and regulations
NMC inspection requirements
15.1. Records to be Maintained:
The Convener shall maintain the following records:
Hospital Disaster Management Plan with all revisions
HIRS organizational chart and job action sheets
Hazard Vulnerability Analysis reports
Hospital capacity and capability assessment reports
List of Committee members with contact details
Resource inventory (human, equipment, supplies, infrastructure)
Disaster stores inventory with stock levels
Hospital networking agreements and contact lists
Emergency contact database
Training program records with attendance and assessment results
Disaster drill reports with evaluation results
Drill photographs and videos
Debriefing notes and lessons learned
Disaster incident reports (if any)
Post-disaster reports and investigation findings
Corrective action implementation records
Copies of all agendas and minutes of Committee meetings
Correspondence with DDMA, SDMA, and other agencies
Quarterly and annual reports
Compliance certificates and audit reports
Maps, floor plans, and evacuation diagrams
SOPs and protocols with revision history
Equipment maintenance records
Financial records related to disaster management
15.2. Retention Period:
All records shall be maintained for a minimum period of 5 years or as required by applicable regulations, NMC requirements, and NABH accreditation standards.
15.3. Confidentiality:
Records related to disaster incidents causing casualties or significant damage shall be maintained confidentially.
Disclosure only to authorized persons, regulatory authorities, or legal requirements.
Patient information shall be protected as per patient confidentiality norms.
16.1. This Constitution may be amended by a resolution passed by two-thirds majority of the total members of the Committee.
16.2. Proposed amendments shall be circulated to all members at least 14 days prior to the meeting where they are to be considered.
16.3. All amendments shall be subject to approval by the Managing Committee of Sitwanto Devi Mahila Kalyan Sansthan and must be in conformity with National Disaster Management Act, NDMA Guidelines, NABH standards, National Building Code, and applicable laws.
17.1. In case of any doubt or dispute regarding the interpretation of any provision of this Constitution, the decision of the Chairperson shall be final, subject to the approval of the Managing Body.
17.2. Matters not covered by this Constitution shall be governed by applicable provisions of the National Disaster Management Act 2005, NDMA Guidelines on Hospital Safety 2016, NABH standards, National Building Code 2016, and other relevant laws and regulations.
18.1. This Constitution shall come into force with effect from the date of its adoption by the Managing Committee of Sitwanto Devi Mahila Kalyan Sansthan.
Annexure A: Disaster Casualty Registration Form
Disaster Management Committee - Casualty Registration Form
