INTRODUCTION
Disasters and catastrophes are normally unpredictable, and in most cases, they cannot be averted; as a result, there is need to establish effective emergency management strategies. Due to the consequences associated with disasters, whether man-made or natural, there is an increasing need for institutions such as hospitals and schools to have appropriate strategies in order to aIDress anticipated and suIDen disasters (HaIDow & Bullock, 2006). Disaster preparedness and prevention strategies at the community where the hospital is located are normally determined by the prevalence of disasters in that region. In aIDition, the frequency of occurrence of such disasters plays an integral role in determining the types of emergency management and prepared approaches that a hospital can deploy prior to the occurrence or during the occurrence of a disaster in order to reduce the risks or mitigate the disaster. Security operations and management are an integral element of any organizations operational management owing the unprecedented nature of disasters and security threats that may serve as a risk to the operational continuity of the hospital (McCrie, 2006). This poses the need for an organization to have an effective security and disaster preparedness program in order to curb disasters and security breaches that may jeopardize the operation of the hospital. This hospital/emergency preparedness plan outlines the security policies and procedures that can be implemented to mitigate and reduce the potential hazards associated with incidents.
DISASTER PREVENTION AND PREPAREDNESS
i. Hospital disaster situational assessment
Security assessment primarily entails the identification of the assets in order to evaluate their value and criticality to the hospital. Conducting an assessment of the nature of the security threats in order to determine the scope of the problem, carrying out a physical security survey in order to recognize the physical security vulnerabilities and undertaking a risk analysis with the main objective of developing effective countermeasures to aIDress the potential threats in a proactive manner (Paton & Moore, 2006). The following table 1 offers the criteria that can be used for classification of the identified hazards that may affect the hospital at any given moment.
catastrophic Results to multiple deaths, severe damage of more than 50 % of property and shutdown of hospital for at least one month
critical There are numerous severe injuries, the hospital is completely shut down in a duration of at least two weeks and a severe damage of 25 % of property
Limited There are some injuries, the hospital is completely shut down in a duration of at least one week, and severe property damage of about 10 %
Negligible There are minor injuries, the hospital is only shut down for less than a day and property that is extremely damage is less than 10%

It is also important to evaluate the emergency response strategies on the ground and their relative effectiveness in handling the disaster. This involves identifying the local emergency response capacity, organizational, medical and the logistical resources that are accessible by the hospital during instances of disaster. This is vital during the process of designing or modifying emergency response and long term disaster recovery planning. Another important characteristic to be taken into consideration in the event of a disaster is the disaster preparedness of the hospital (Rodriguez, 2007).
Facility characterization is a vital process during risk assessment, it mainly involves the identification of the potential security threats and events and their corresponding critical resources. In the case of a hospital, critical facilities include the laboratory, the building hosting the patients and the facility housing the medical and communication equipments. In aIDition, process characterization is vital since the hospital itself is a critical community facility, whose services should not be disrupted for more than 24 hours in case of a disaster (McCrie, 2006). Facility characterization with regard to physical security involves analysis of the current operating states and conditions of the physical space or resources that are to be protected. This warrants a description of the geographical location, the points of access within the facility, building locations and the floor plans for the facility. The processes within the hospital also need to be described and identification of the current physical security measures deployed within the organization and their relative effectiveness. It is vital that the points of entry be differentiated from the points of exit and be easily identifiable during emergency incidents. The current physical security strategies deployed at the hospital require analysis regarding their effectiveness in past disaster mitigation. The following section discusses how physical security can be reinforced within the hospital in order to mitigate potential emergency incidents and offer adequate time for incident response (HaIDow & Bullock, 2006).
ii. Reinforcing Physical security of the hospital
Physical security usually the first line of defense against incidents and security hazards; it entails the measures and strategies that are implemented with the main objective of preventing unauthorized access, attacks and incidental intrusion from physical access to buildings, restricted areas, resource and stored information. Physical security also outlines the guidelines that are required to implement structures that have the ability to with stand hostile acts or events. The effectiveness of physical security depends on various variables that are directly related to physical design, risk assessment and management. Physical design is mainly concerned with the physical outlook, risk assessment entails pre-determining of the potential security threats and deploying strategies within the physical design and management aspect to curb such threats and reduce the vulnerability of the facility to the identified threats. Management is mainly concerned with controls regarding the access and restrictions with respect to the usage of the facility, resource or the stored information (FEMA, 2006). It is arguably evident that an integration of physical design, risk assessment and management plays an integral role in determining the effectiveness of physical security. An effective physical security deploys the aspect of layered defense, with the principal objective of deterring and delaying intrusions (passive defense), and detecting and responding to intrusions (active defense). This makes it difficult for a potential attacker/ intruder to initiate intrusions
The physical design, as it relates to physical security comprises of obstacles, detection systems, security response, environmental design, mechanical and electronic controls, intrusion and personnel identification. Obstacles are mainly deployed to frustrate the efforts of potential incidents through explosion protection. Detection systems are used to facilitate and inform the hospital management of a potential incident or a security breach. Detection systems include surveillance systems, guard patrols, alarms and security lighting. Security response on the other hand is deployed with the principal objective of catching or frustrating the intruders once an attack has been identified. In a well-implemented physical design, the above features have to complement each other in order to increase the effectiveness of physical security. The layers in physical design mainly entail environmental design, mechanical, electronic and procedural controls, intrusion detection and personnel identification (McCrie, 2006).
Intrusion detection is also an important layer in the physical design that serves to monitor activities that pose potential threats to the resource such as unauthorized access. This is more of a proactive strategy than a reactive approach. Intrusion detection serves to report malicious activities on the physical space and resource to the security management stations. Intrusion prevention involves the carrying out of intrusion detection and taking of necessary responsive measures to contain the threats. Incorporating intrusion detection on the physical design can also be helpful in logging the information concerning the security breaches such as frequency of alarms, and reports them to the security management for security management. Intrusion detection in the hospital setting can also be implemented using video monitoring and security cameras to reinforce real time surveillance. Security cameras can serve to deter threats, but their efficiency is because of incident verification and facilitating historical analysis of the events leading up to the security threat within the physical space. Real time video monitoring is essential to facilitate speedy incident response. In an ideal set up, reinforcing physical security enhances disaster preparedness since it serves to delay potential security breaches, and provide sufficient time so that the hospital can respond to a threat, thereby decreasing its impacts, which could be in terms of cost, prevention of theft and ensuring safety of the resources from being compromised (McCrie, 2006).
INCIDENT RESPONSE
Incident response and disaster recovery are also an important element of the physical security management. The main objective of incident response is to facilitate a quick and efficient recovery from a security incident (HaIDow & Bullock, 2006). It also aims at reducing the impacts imposed by the threat, or a critical disruption of the functionality of the facility or resources in cases whereby an incident has taken place. The plan of approach is basically systematic in accordance with the standard procedures of physical security in order reduce the possibility of reoccurrence
i. Incident Reporting
Incident reporting procedures are also an important aspect of security preparedness that enhances the effectiveness of response operations in the event of emergency or security threat. Effective incident reporting procedures should be based on the fundamental aspects of effective communications that ensures that it reaches the largest audience as possible. This can be implemented both in the physical security design and management aspects of security since it is initiated at the management level (Paton & Moore, 2006). Threat reporting within the hospital should be fast enough in order to reduce the potential loss that may be accrued from the disaster. It is important that the hospital management ensure that there are effective reporting channels and procedures with minimal constraints. Threat response procedures should be in line with the evacuation policies and procedures, which are usually deployed in cases whereby the physical security parameters have been completely overwhelmed. Security threat response entails communication of the threat, containment of the damage imposed by the incident and minimizing the potential risks through protection of critical assets against potential attacks and minimizing the interference regarding the use of the hospital (HaIDow & Bullock, 2006).
ii. Interagency Communication during the disaster
Interagency collaboration during emergencies is vital in ensuring disaster response. This implies that the hospital must have a communication system to facilitate interagency communication during such incidences. The National Incident Management System (NIMS) and the Incident Command System (ICS) are the two primary methodologies deployed by the United States government in response to cases of disasters and emergencies. The NIMS can be defined as is an information system maintained by the federal, state and local government for the main purposes of coordinating emergency preparedness and incident management. The deployment of the NIMS is based on the balance of the concepts involving flexibility and standardization (Paton & Moore, 2006). Flexibility implies that NIMS offers a national framework that is supple, dynamic, consistent that can facilitate collaboration between the government, and the private sector at all levels in order to ensure that there is effective management of domestic disasters irrespective of the geographical location, causation and magnitude. The Joint Information System also helps in enhancing public communication through offering the public with disaster information that is accurate and delivered in a timely manner (FEMA, 2006). The NMIS makes use of the Joint Information Centers through which incident communicators can meet for the purposes of developing, coordinating and delivering a unified incident related message. This helps in eliminating the delivery of conflicting messages by the various government and non-government agencies during disaster scenarios. In aIDition, the NMIS Integration Center helps in ensuring that the NMIS and ICS model sustains its accuracy and effectiveness during disaster management through the deployment of best practices (FEMA, 2006).
Communication during critical incidents is important in ensuring that response and recovery is successful. This implies that an emergency response strategic plan must have the required structure for purposes of managing and enhancing effective communication in the event of an emergency (FEMA, 2006). Despite the fact that safety issues are always given the primary consideration, the security supervisor should not underestimate the significance of an effective media relations capability since it plays an integral role in enhancing the effectiveness of security operations. During the initial stages of the response and recovery operation, the response teams must establish communication channels that have the capability of reaching as victims of the disaster as fast as possible. The realization of this goal is usually done by deployment of low-cost and low-tech communication channels because they are most effective and easily accessible by the victims of a disaster. High-tech communication channels are not effective because of the limited number of the target audience. Some of the communication systems that can be deployed include Public AIDress Systems, megaphones and community radios (HaIDow & Bullock, 2006).

REFERENCES
Federal Emergency Management Agency. (2007). Mitigation. Retrieved September 10, 2011, from www.fema.gov/media/top-disasters.shtm
FEMA. (2006, April). Joint Field Office Activation and Operations. Retrieved September 10, 2011, from www.fema.gov/pdf/emergency/nrf/NRP_JFO_SOP.pdf
HaIDow, G., & Bullock, J. (2006). Introduction to emergency management. Burlington, MA: Elsevier Butterworth-Heinemann, Inc.
McCrie, R. (2006). Security Operations Management. Burlington,MA: Butterworth-Heinemann.
Paton, D., & Moore, D. (2006). Disaster resilience: an integrated approach. New York: Charles C Thomas Publishesr.
Rodriguez, H. (2007). Handbook of Disaster Research. New York: Springer.