HAZARD AND VULNERABILITY ASSESSMENT TOOL

NATURALLY OCCURRING EVENTS

SEVERITY = (MAGNITUDE - MITIGATION)

PROBABILITY HUMAN PROPERTY BUSINESS PREPARED- INTERNAL EXTERNAL
EVENT IMPACT IMPACT IMPACT NESS RESPONSE RESPONSE
Time, Community/
Likelihood this will Possibility of Physical losses Interuption of
Preplanning effectivness, Mutual Aid staff
occur death or injury and damages services
resouces and supplies

0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A

1 = Low 1 = Low 1 = Low 1 = Low 1 = High 1 = High 1 = High
SCORE 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 3 2 = Moderate 2 = Moderate
3 = High 3 = High 3 = High 3 = High = Low or none 3 = Low or none 3 = Low or none

Gempa bumi 1 1 1 3 2 2 2
Gelombang pasang 0 0 0 0 0 0 0
Suhu Ekstrem 0 0 0 0 0 0 0
Kekeringan 0 0 0 0 0 0 0
Banjir, Eksternal 1 1 1 3 1 1 1
Kebaran 3 1 1 3 0 0 0
Tanah longsor 0 0 0 0 0 0 0
Genangan Bendungan 0 0 0 0 0 0 0
Gunung berapi 0 0 0 0 0 0 0
Epidemic 1 3 0 2 2 2 2

AVERAGE SCORE 0.38 0.38 0.19 0.69 0.31 0.31 0.31

*Threat increases with percentage.

6 RISK = PROBABILITY * SEVERITY
35 0.02 0.13 0.12

Natural Hazards : 677177748.xlsx

 RISK

Relative threat*

0 - 100%

20%
0%
0%
0%
15%
28%
0%
0%
0%
20%

2%

Natural Hazards : 677177748.xlsx

 HAZARD AND VULNERABILITY ASSESSMENT TOOL
TECHNOLOGIC EVENTS
SEVERITY = (MAGNITUDE - MITIGATION)
PROBABILITY HUMAN PROPERTY BUSINESS PREPARED- INTERNAL EXTERNAL RISK
IMPACT IMPACT IMPACT NESS RESPONSE RESPONSE
EVENT
Time, Community/
Possibility of Physical losses Interuption of
Likelihood this will occur Preplanning effectivness, Mutual Aid staff Relative threat*
death or injury and damages services
resouces and supplies
0 = N/A
0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A
0 = N/A 1 = Low 1 = Low
1 = Low 1 = Low 1 = High 1 = High 1 = High
SCORE 2 = Moderate 2=
2 = Moderate 2 = Moderate 2 = Moderate 3 2 = Moderate 2 = Moderate 0 - 100%
3 = High Moderate
3 = High 3 = High = Low or none 3 = Low or none 3 = Low or none
3 = High
Kegagalan Listrik 1 1 1 3 2 2 2 20%

Kegagalan Generator 1 1 1 3 2 2 2 20%

Kegagalan Transportasi 0 0 0 0 0 0 0 0%

Kekurangan Bahan Bakar 0 0 0 0 0 0 0 0%

Kegagalan Gas Alam 0 0 0 0 0 0 0 0%

Kegagalan Air 1 1 1 3 2 2 2 20%

Kegagalan Saluran
0 0 0 0 0 0 0 0%
Pembuangan
Kegagalan Uap 0 0 0 0 0 0 0 0%

Kegagalan Alarm Kebakaran 1 3 3 3 2 2 2 28%

Kegagalan Komunikasi 1 2 1 3 2 2 2 22%

Kegagalan Gas Medis 1 3 0 3 2 2 2 22%

Kegagalan Vakum Medis 1 3 0 3 2 2 2 22%

Kegagalan HVAC 1 1 1 2 2 2 2 19%

Kegagalan Sistem Informasi
(Jaringan, Virus, 1 1 1 3 2 2 0 17%
Sistem Aolikasi

Kebakaran, Internal 2 3 3 3 2 2 2 56%

Banjir, Internal 0 0 0 0 0 0 0 0%
Paparan B3, Internal 3 1 2 3 2 2 2 67%
Kekurangan Pasokan 0 0 0 0 0 0 0 0%
Kerusakan Struktural 1 3 3 3 2 2 3 30%

AVERAGE SCORE 0.79 1.21 0.89 1.84 1.26 1.26 1.21 11%

Technological Hazards : 677177748.xlsx

*Threat increases with percentage.
15 RISK = PROBABILITY * SEVERITY
146 0.11 0.26 0.43

Technological Hazards : 677177748.xlsx

 HAZARD AND VULNERABILITY ASSESSMENT TOOL
HUMAN RELATED EVENTS

SEVERITY = (MAGNITUDE - MITIGATION)

PROBABILITY
HUMAN PROPERTY BUSINESS PREPARED- INTERNAL EXTERNAL
IMPACT IMPACT IMPACT NESS RESPONSE RESPONSE
EVENT
Time, Community/
Likelihood this will Possibility of Physical losses Interuption of
Preplanning effectivness, Mutual Aid staff
occur death or injury and damages services
resouces and supplies
0 = N/A 0 = N/A
0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A
1 = Low 1 = Low
1 = Low 1 = Low 1 = High 1 = High 1 = High
SCORE 2 = Moderate
2= 2=
2 = Moderate 2 = Moderate 3 2 = Moderate 2 = Moderate
Moderate Moderate
3 = High 3 = High = Low or none 3 = Low or none 3 = Low or none
3 = High 3 = High

Insiden Korban Massal (trauma) 2 3 0 1 2 2 2

Insiden Korban Massal (medis / infeksius) 2 3 0 1 2 2 2

Terorisme, Biologis 0 0 0 0 0 0 0

Situasi VIP 0 0 0 0 0 0 0

Penculikan Bayi 3 3 0 3 1 1 1

Situasi Penyanderaan 1 1 0 3 2 2 2

Gangguan Sipil (huru-hara,anarki,tawuran 2 1 1 3 2 2 2

Aksi Demo 2 2 1 3 3 1 2

Penerimaan Forensik (pasien terkait

0 0 0 0 0 0 0
masalah hukum)

Ancaman Bom 2 3 3 3 1 1 1

AVERAGE 1.40 1.60 0.50 1.70 1.30 1.10 1.20

*Threat increases with percentage.

14 RISK = PROBABILITY * SEVERITY
74 0.21 0.47 0.46

Human Hazards : 677177748.xlsx

 RISK

Relative threat*

0 - 100%

37%

37%

0%

0%

50%

19%

41%

44%

0%

44%

21%

Human Hazards : 677177748.xlsx

 HAZARD AND VULNERABILITY ASSESSMENT TOOL
EVENTS INVOLVING HAZARDOUS MATERIALS
SEVERITY = (MAGNITUDE - MITIGATION)
PROBABILITY HUMAN PROPERTY BUSINESS PREPARED- INTERNAL EXTERNAL RISK
EVENT IMPACT IMPACT IMPACT NESS RESPONSE RESPONSE
Time, Community/
Likelihood this will Possibility of Physical losses Interuption of
Preplanning effectivness, Mutual Aid staff and Relative threat*
occur death or injury and damages services
resouces supplies
0 = N/A
0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A
1 = Low
1 = Low 1 = Low 1 = Low 1 = High 1 = High 1 = High
SCORE 2 = Moderate
2=
2 = Moderate 2 = Moderate 2 = Moderate 3 2 = Moderate 2 = Moderate 0 - 100%
Moderate
3 = High 3 = High 3 = High = Low or none 3 = Low or none 3 = Low or none
3 = High

Insiden B3/Korban
Hazard Material (Dari 0 0 0 0 0 0 0 0%
kejadian
yang pernah terjadi di
RS Anda dengan> = 5
korban)

Insiden Hazmat Korban 1 3 0 0 2 2 2 17%

Sedikit (Dari kejadian
yang pernah terjadi di
RS Anda dengan> = 5
korban)
Paparan kimiawi, 1 3 0 0 2 2 2 17%
eksternal
Tumpahan Internal
Berukuran Kecil- 1 1 0 0 2 2 2 13%
Menengah
Tumpahan Internal 0 0 0 0 0 0 0 0%
Besar
Terorisme, Kimia 0 0 0 0 0 0 0 0%
Paparan Radiologis, 1 3 0 1 2 2 2 19%
Internal

Paparan Radiologis, 0 0 0 0 0 0 0 0%
Eksternal

0 0 0 0 0 0 0 0%
Terorisme, Radiologis
AVERAGE 0.44 1.11 0.00 0.11 0.89 0.89 0.89 3%

*Threat increases with percentage.

RISK = PROBABILITY * SEVERITY
4
Hazardous Materials : 677177748.xlsx
35 0.03 0.15 0.22

Hazardous Materials : 677177748.xlsx

 SUMMARY OF HAZARDS ANALYSIS

Total for Facility

Technological

Hazmat
Natural

Human
Probability 0.13 0.26 0.47 0.15 0.24

Severity 0.12 0.43 0.46 0.22 0.30

Hazard Specific Relative Risk:
0.02 0.11 0.21 0.03 0.07

Hazard Specific Relative Risk

1.00
Relative Threat to Facility

0.90
0.80
0.70
0.60
0.50
0.40
0.30
0.20
0.10
0.00
Natural Technological Human Hazmat

Probability and Severity of Hazards

1.00
0.90
Relative Impact on Facility

0.80
0.70
0.60
0.50
0.40
0.30
0.20
0.10
0.00
Probability Severity

677177748.xlsx Summary
 INSTRUCTIONS
Evaluate potential for event and response among the following categories using
the hazard specific scale.
Issues to consider for probability include, but are not limited to:
1 Known risk
2 Historical data
3 Manufacturer/vendor statistics
Issues to consider for response include, but are not limited to:
1 Time to marshal an on-scene response
2 Scope of response capability
3 Historical evaluation of response success
Issues to consider for human impact include, but are not limited to:
1 Potential for staff death or injury
2 Potential for patient death or injury
Issues to consider for property impact include, but are not limited to:
1 Cost to replace
2 Cost to set up temporary replacement
3 Cost to repair
Issues to consider for business impact include, but are not limited to:
1 Business interruption
2 Employees unable to report to work
3 Customers unable to reach facility
4 Company in violation of contractual agreements
5 Imposition of fines and penalties or legal costs
6 Interruption of critical supplies
7 Interruption of product distribution
Issues to consider for preparedness include, but are not limited to:
1 Status of current plans
2 Training status
3 Insurance
4 Availability of back-up systems
5 Community resources
Issues to consider for internal resources include, but are not limited to:
1 Types of supplies on hand
2 Volume of supplies on hand
3 Staff availability
4 Coordination with MOB's
Issues to consider for external resources include, but are not limited to:
1 Types of agreements with community agencies
2 Coordination with local and state agencies
3 Coordination with proximal health care facilities
4 Coordination with treatment specific facilities
Complete all worksheets including Natural, Technological, Human and Hazmat. The summary
section will automatically provide your specific and overall relative threat.
HAZARD AND VULNERABILITY ANALYSIS
RSUD CILINCING
2018
 BAB IV
CONCLUSION

Identifikasi dikeluarkan sebagai referensi untuk semua departemen di RSUD Cilincing dalam bermeditasi keselamata
Ketika program implementasi didirikan kendala dan kesulitan yang tidak bisa ia dilaksanakan sesuai kondisi yang seb
Kejadian yang paling besar kemungkinan terjadi bencana di RSUD Cilinicing adalah gempa bumi, banjir, penculikan

Jakarta, 2 Januari 2018

Dibuat oleh

Dr. Rafael

Ketua
temen di RSUD Cilincing dalam bermeditasi keselamatan pasien dan keamanan, pengunjung dan bekerja selama 2018.
n yang tidak bisa ia dilaksanakan sesuai kondisi yang sebenarnya jadi kita dari tim K3RS permintaan positif saran sebagai evalua
RSUD Cilinicing adalah gempa bumi, banjir, penculikan bayi, dan kebakaran

Diketahui

Director
Dr. Netty Siahaan, M.K.M
NIP 196104241987112001
bekerja selama 2018.
an positif saran sebagai evaluasi yang penting dari program dilaksanakan dan membuat referensi untuk melakukan program perb
k melakukan program perbaikan untuk tahun depan.