HAZARD AND VULNERABILITY ASSESSMENT TOOL

NATURALLY OCCURRING EVENTS

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 Relative threat*
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

SCORE 1 = Low 1 = Low 1 = Low 1 = Low 1 = High 1 = High 1 = High
2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate 3 2 = Moderate 2 = Moderate 0 - 100%
3 = High 3 = High 3 = High 3 = High = Low or none 3 = Low or none 3 = Low or none

Angin puting beliung 2 2 2 2 1 1 1 33%

Gempa Bumi 0 0 0 0 0 0 0 0%
Banjir 1 1 1 2 1 1 1 13%
Tanah Longsor 1 1 1 2 1 1 1 13%
Kebakaran 2 2 2 2 2 2 2 44%
Gunung meletus 0 0 0 0 0 0 0 0%
Sunami 0 0 0 0 0 0 0 0%
Kekeringan 0 0 0 0 0 0 0 0%
Bendungan Jebol 0 0 0 0 0 0 0 0%
Hujan Badai 0 0 0 0 0 0 0 0%

AVERAGE SCORE 0.38 0.38 0.38 0.50 0.31 0.31 0.31 2%

*Threat increases with percentage.

6 RISK = PROBABILITY * SEVERITY
35 0.02 0.13 0.12

Natural Hazards : 775747031.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
Gangguan listrik 1 1 1 3 2 2 2 20%
Kegagalan genset 1 1 1 3 2 2 2 20%
Kegagalan transportasi 0 0 0 0 0 0 0 0%
Gangguan BBM 0 0 0 0 0 0 0 0%
Gangguan gas LPG 0 0 0 0 0 0 0 0%
Gangguan air 0 0 0 0 0 0 0 0%
Gangguan linen 0 0 0 0 0 0 0 0%
Gangguan alarm
0 0 0 0 0 0 0 0%
kebakaran

Gangguan komunikasi 1 3 3 3 2 2 2 28%

Gangguan gas medis 0 0 0 0 0 0 0 0%

Gangguan vacum
0 0 0 0 0 0 0 0%
central
Gangguan Air
0 0 0 0 0 0 0 0%
Conditioner ( AC )
Gangguan sistem
1 1 2 2 2 2 2 20%
informasi
Kebakaran 1 1 1 3 2 2 0 17%

Paparan B3 (internal) 0 0 0 0 0 0 0 0%

Gangguan supply 0 0 0 0 0 0 0 0%
Kerusakan struktur
0 0 0 0 0 0 0 0%
bangunan

AVERAGE SCORE 0.26 0.37 0.42 0.74 0.53 0.53 0.42 1%

*Threat increases with percentage.

5 RISK = PROBABILITY * SEVERITY
57 0.01 0.09 0.17

Technological Hazards : 775747031.xlsx

 HAZARD AND VULNERABILITY ASSESSMENT TOOL
HUMAN RELATED EVENTS

SEVERITY = (MAGNITUDE - MITIGATION)

PROBABILITY RISK
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 Relative threat*
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 0 - 100%
Moderate Moderate
3 = High 3 = High = Low or none 3 = Low or none 3 = Low or none
3 = High 3 = High
Musibah massal
0 0 0 0 0 0 0 0%
(trauma)
Musibah massal
0 0 0 0 0 0 0 0%
(infeksi/medis)

Ancaman gas biologis 0 0 0 0 0 0 0 0%

Situasi VIP 0 0 0 0 0 0 0 0%

Penculikan bayi 0 0 0 0 0 0 0 0%

Penyanderaan 0 0 0 0 0 0 0 0%

Huru-hara sipil 0 0 0 0 0 0 0 0%

Aksi Serikat Karyawan 0 0 0 0 0 0 0 0%

Dvi forensik 0 0 0 0 0 0 0 0%

Ancaman bom 0 0 0 0 0 0 0 0%

AVERAGE 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0%

*Threat increases with percentage.

0 RISK = PROBABILITY * SEVERITY
0 0.00 0.00 0.00

Human Hazards : 775747031.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

Mass casualty hazmat

incident ( korban ≥ 5 0 0 0 0 0 0 0 0%
orang )
Small casualty hazmat
incident ( korban < 5 0 0 0 0 0 0 0 0%
orang )
Paparan kimia 0 0 0 0 0 0 0 0%
( eksternal ) 0 0 0 0 0 0 0 0%
Tumpahan B3 kecil 0 0 0 0 0 0 0 0%

0 0 0 0 0 0 0 0%
Tumpahan B3 besar
Ancaman terorisme 0 0 0 0 0 0 0 0%
kimia
Paparan radiasi 0 0 0 0 0 0 0 0%
( internal ) 0 0 0 0 0 0 0 0%
Paparan radiasi 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0%

RISK = PROBABILITY * SEVERITY

0
0 0.00 0.00 0.00

Hazardous Materials : 775747031.xlsx

 SUMMARY OF HAZARDS ANALYSIS

Total for Facility

Technological

Hazmat
Natural

Human
Probability 0.13 0.09 0.00 0.00 0.07
Severity 0.12 0.17 0.00 0.00 0.09
Hazard Specific Relative Risk:
0.02 0.01 0.00 0.00 0.01

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

775747031.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.
aan positif saran sebagai evaluasi yang penting dari program dilaksanakan dan membuat referensi untuk melakukan program perb
k melakukan program perbaikan untuk tahun depan.