Emergency Preparedness is the readiness for unexpected lethal or harmful events involving more casualties than health care infrastructures are normally designed to handle. Traditionally, this has focused on mass casualty trauma and natural disasters.

Since the terror attacks of September 11, 2001, emergency planners, and specifically those in the health care sector, have become more aware of the need to be prepared to deal with mass casualty events involving chemical, biological, radiological and nuclear (CBRN) substances in addition to trauma. The SARS experience in Ontario highlights the urgent need for health care emergency preparedness in all areas of Canada; natural disasters and infectious disease outbreaks may occur anywhere and any time.

Emergency planning for a disaster involves large numbers of agencies at all levels of government as well as non-governmental organizations. Federal, provincial and municipal governmental agencies are in the process of developing emergency response plans, often in isolation from one another. Health care facilities and personnel sometimes participate in municipal, provincial and even federal plans, but are often neglected by traditional emergency planners. This lack of coordinated planning will likely lead to a disorganized and ineffective disaster response with the attendant financial costs, social disruption and health morbidity and mortality.

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Health Sector Requirements in Emergency Preparedness

Physicians, nurses, other health care professionals, hospital administrators, health planners and funding agencies have specific and unique requirements in emergency planning development. Nonetheless, these planning initiatives must be integrated with emergency management as a whole at all levels of planning.

Components of health care emergency preparedness may include:

• Standards for mitigation, preparedness, protection, response and recovery
  
• Tools for risk assessment
  
• Templates for risk management
  
• Reliable and valid methodologies for assessment of compliance with the standards, and risk management strategies
  
• Educational programs for providers
  
• A consistent incident management tool for health care
  
• Integrated response plans with other health care providers
  
• Integrated response plans with emergency response providers
  
• Access to funding/resources to support the health component of integrated response
  
• An objective third party certifying agency to assess readiness of health care organizations

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The Centre of Excellence in Emergency Preparedness

The Centre of Excellence in Emergency Preparedness (CEEP) was developed to address the requirements noted above. It is comprised of experts from across Canada in emergency medicine, public health, infectious diseases, toxicology, emergency medical services, health emergency planning, government and research. Our mission is:

"to facilitate and maintain optimal Canadian health emergency preparedness by providing expert consensus based on evidence and best practice."

CEEP will fulfil its vision by:

• Defining and promoting standards in emergency preparedness with respect to the health and well being of Canadians
  
• Acting as a resource to health care professionals and institutions, emergency providers, decision makers and funding sources on health emergency preparedness
  
• Promoting and conducting research in emergency preparedness and disseminating findings through peer-reviewed venues
  
• Working with local, national and international stakeholders in the establishment, development and improvement of comprehensive, evidence-based health emergency preparedness plans

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What makes CEEP unique?

CEEP has a few characteristics that makes it a unique organization in the context of Canadian disaster response. These are as follows:

1. Health Care: CEEP's primary focus is health care. While emergency preparedness by definition is multi-faceted and interdependent among various agencies, we will address issues from a health-centred perspective.
   
2. Emergency Planning: While the management of trauma and illness related to disasters may be viewed as an extension of health care in general, our focus will be on health care mitigation/prevention, preparedness, response and recovery consistent with federal, provincial and municipal legislation and direction. Furthermore, we will break down the traditional silos between health and other agencies by developing educational programs and promoting common terminology and incident management templates.
   
3. Best Evidence/Best Practice: Perhaps the true uniqueness of CEEP is demonstrated by our commitment to science and research. As academic-based clinicians and experts in emergency planning, our standards, opinions, educational programs, and all documents bearing CEEP identification will be based on best evidence or expert consensus with respect to best practice.
   
4. A "Bottom-up" Approach: A key component of CEEP's role is to bring a front-line perspective to decision making bodies and planning structures. Our membership reflects the front line providers across Canada and is designed to inform and complement the excellent work done by "top-down" emergency planners at municipal, provincial and federal levels.
   
5. National Mandate: CEEP's mandate is national, as reflected in its membership. This means that our output will be inclusive and applicable and reflect distinctly Canadian issues regarding preparedness for natural and man-made threats. Our goal is to provide and integrate standards, processes and programs across jurisdictions, to promote consistency and seamlessness across Canada.

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What CEEP Will Provide (Our "Products")

Broadly speaking, the mandate of CEEP is to support and inform existing structures and processes in achieving a standard of excellence in health emergency preparedness. This consists of asking practical questions defined by our stakeholders and researching the answers based on the best available evidence. It may involve sharing best practice from one jurisdiction to others, or researching the literature on best practice outside of Canada and adapting it to our specific environments. Needs assessment tools will be created, to allow gaps in preparedness to be identified, and educational programs developed to address the gaps.

Standards, tools, educational programs and position papers will be produced according to need. Many of these do not need to be created from scratch - they already exist in many forms throughout the country. In these circumstances, CEEP will serve as a clearing house for expertise, and a forum to build consensus based on best practices, to promote this consensus through federal and provincial agencies and achieve a high standard of consistency and seamlessness in knowledge and in practice.

CEEP is a non-profit organization dependent on grants from funding agencies and cost-recovery from consultative and educational relationships with public and private organizations.

Summary

The Canadian Centre of Excellence in Emergency Preparedness is committed to facilitating and maintaining optimal Canadian health emergency preparedness by providing expert consensus based on evidence and best practice. Our membership is provider-focused and national. We will respond to stakeholders at municipal, provincial and national levels by providing high quality, evidence-based standards, tools, programs, position papers and documents which will facilitate quality, consistency, integration and seamlessness in Canadian health care emergency planning and response.

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