[CM] [JHA] [E3] [PB] [CS] [1] During-Crisis Steps for Severe Haze Scenario

Severe Haze Crisis Management Playbook for Jamiyah Home for the Aged (JHA)

Chapter 3: Detailed Steps During the Crisis

Detailed Response and Care Continuity Steps

Introduction

During severe haze, JHA prioritises protecting life, reducing exposure, maintaining essential residential care, and obtaining additional support before its care capacity becomes unsafe.

This procedure begins when JHA activates enhanced haze precautions or its crisis management arrangements. The Superintendent directs the response, while each shift continues resident care under an identified duty manager.

The responsibilities and review intervals below are proposed arrangements for JHA to approve. Clinical actions must follow individual care plans and instructions from qualified healthcare professionals.

Step 1: Verify the Situation and Activate the Appropriate Response

Responsible: Duty Manager and Superintendent.

Actions

1. Check the latest official haze readings, forecast, and health advisories.
2. Establish what is happening within JHA:
   • Are any residents or staff unwell?
   • Are occupied rooms adequately protected?
   • Are air cleaning, cooling and utilities functioning?
   • Can the available staff maintain essential care?
3. Compare conditions with JHA’s approved activation card.
4. Notify the Superintendent or designated deputy.
5. Activate the appropriate response level and record:
   • Activation time.
   • Reason for activation.
   • Person authorising activation.
   • Immediate instructions.
   • Time of the next review.
6. Escalate promptly if resident health or care capacity deteriorates, regardless of the outdoor air quality category.

Required record: Activation entry in the incident log.

Control check: Every shift knows the current response level and who is directing operations.

Step 2: Address Immediate Threats to Life and Health

Responsible: Resident Care Lead, Duty Manager and trained responders.

Actions

1. Identify residents or staff showing serious distress.
2. For severe breathing difficulty, collapse, or another suspected medical emergency, call emergency services immediately.
3. Provide first aid within staff training and follow emergency-service instructions.
4. Reduce exposure where possible without delaying urgent care.
5. Assign a staff member to meet and guide responders.
6. Prepare identification, relevant medical information, medication records and care needs for handover.
7. Arrange an escort where appropriate and maintain care coverage for residents remaining at JHA.
8. Inform the Superintendent and authorised contacts.

Required record: Individual care entry, emergency handover and incident report.

Control check: Emergency care proceeds without waiting for a crisis meeting, expenditure approval, or paperwork completion.

Step 3: Establish Crisis Leadership and Working Arrangements

Responsible: Superintendent / Crisis Leader.

Actions

1. Confirm the Crisis Leader and deputy.
2. Activate the required team members, using remote participation where appropriate.
3. Assign immediate responsibilities for:
   • Resident welfare.
   • Clinical liaison.
   • Facilities.
   • Staffing.
   • Supplies and transport.
   • Communications.
   • Incident recording.
4. Establish a coordination point that does not obstruct care.
5. Confirm the communication channel and backup method.
6. Set the first situation review and reporting schedule.
7. Inform Jamiyah Singapore management of activation, immediate risks and anticipated support needs.

Required record: Activated team list and initial action allocation.

Control check: Every action has an identified owner; operational staff receive consistent instructions.

Step 4: Account for Every Resident and Staff Member

Responsible: Shift Supervisors and Resident Care Lead.

Actions

1. Reconcile the current resident register against actual locations.
2. Identify residents:
   • Within JHA.
   • Attending appointments.
   • In hospital.
   • On authorised outings.
   • In transit.
3. Confirm the welfare and return arrangements of residents outside the Home.
4. Check staff attendance and available skills.
5. Record visitors and contractors on the premises.
6. Investigate discrepancies immediately.
7. Update accountability records whenever a resident changes rooms, leaves for treatment or relocates.

Required record: Current resident location and staff deployment registers.

Control check: The duty manager can establish each resident’s location and responsible carer.

Step 5: Apply Immediate Exposure-Reduction Measures

Responsible: Resident Care Lead and Facilities Lead.

Actions

1. Review outdoor activities and outings against current official advice and individual care needs.
2. Move suitable activities indoors.
3. Assist residents to designated protected areas where required.
4. Reduce unnecessary movement through exposed areas.
5. Keep external doors and windows appropriately managed under the approved facilities procedure.
6. Operate suitable air cleaners and cooling systems.
7. Maintain emergency exits, accessibility and supervision.
8. Check that movement has not created overcrowding, fall hazards or distress.

MOH advises vulnerable persons to avoid strenuous outdoor activity when one-hour PM2.5 is Elevated and avoid outdoor activity when it is High or Very High. Individual clinical needs may require earlier precautions. Ministry of Health

Required record:  Activity changes and resident room allocations.

Control check: Residents receive appropriate protection while retaining access to toilets, care and emergency assistance.

Step 6: Confirm That Indoor Care Areas Remain Suitable

Responsible: Facilities Lead, supported by Resident Care Lead.

Actions

1. Check occupied areas for:
   • Functioning air cleaners.
   • Suitable cooling and ventilation.
   • Excessive heat or discomfort.
   • Smoke ingress.
   • Safe occupancy and unobstructed access.
2. Check equipment settings, fault indicators and filter condition according to manufacturer instructions.
3. Use indoor monitoring equipment where available and properly maintained. Record readings, locations and times.
4. Apply approved facilities action thresholds; do not treat an indoor monitor reading as equivalent to an official outdoor PSI.
5. Report room or equipment failures immediately.
6. Move affected residents to an assessed alternative area if necessary.
7. Obtain competent technical advice before changing mechanical ventilation arrangements.

NEA notes that haze particles can enter air-conditioned buildings and accumulate indoors. Air conditioning alone therefore does not demonstrate that a room is adequately protected. nea.gov.sg

Required record: Indoor conditions and equipment inspection log.

Control check: JHA reassesses occupied rooms throughout the event rather than relying on the initial inspection.

Step 7: Monitor Resident Health and Escalate Concerns

Responsible: Resident Care Lead and designated healthcare professional.

Actions

1. Review the resident vulnerability register at the start of each shift.
2. Apply individual observation instructions.
3. Watch for new or worsening symptoms and changes from the resident’s usual condition, including difficulty communicating distress.
4. Record:
   • Symptoms and time observed.
   • Relevant observations made by trained personnel.
   • Advice sought and received.
   • Action taken.
   • Required follow-up.
5. Seek medical advice for residents who become unwell, particularly those with existing heart or lung conditions.
6. Increase observation when directed by the appropriate healthcare professional.
7. Arrange urgent assessment or emergency assistance when indicated.
8. Consider causes other than haze; do not assume every new symptom is haze-related.

MOH advises people who feel unwell, especially elderly persons and those with chronic heart or lung conditions, to seek medical advice. Ministry of Health

Required record: Individual care notes and clinical escalation tracker.

Control check: Every unresolved health concern has an assigned follow-up action and responsible person.

Step 8: Maintain Essential Personal Care and Supervision

Responsible: Resident Care Lead and Shift Supervisors.

Actions

1. Confirm delivery of:
   • Personal hygiene and toileting.
   • Meals and feeding assistance.
   • Hydration consistent with individual care instructions.
   • Medication support.
   • Mobility assistance and fall prevention.
   • Day and night supervision.
   • Safeguarding.
2. Adjust staffing when residents move to different rooms.
3. Keep call systems and assistance arrangements accessible.
4. Record delayed or missed care, assess its effect and arrange corrective action.
5. Escalate immediately if essential care cannot be delivered safely.
6. Maintain privacy and dignity in shared spaces.
7. Continue necessary infection prevention measures alongside haze precautions.

Required record: Essential care checklist and exception log.

Control check: Reduced activities do not reduce supervision or leave care needs unmet.

Step 9: Manage Medicines and Essential Healthcare

Responsible: Authorised care personnel and clinical liaison officer.

Actions

1. Continue prescribed medicines and treatments according to authorised instructions.
2. Keep necessary medicines accessible when residents move rooms.
3. Check stock, storage conditions and replenishment needs.
4. Record administration through normal authorised procedures.
5. Refer concerns about missed doses, deterioration or treatment changes to the appropriate healthcare professional.
6. Review scheduled appointments individually.
7. Consult the treating service before postponing essential treatment.
8. Prepare medicines, records and escorts for necessary journeys.

Required record: Medication records, stock exceptions and appointment decisions.

Control check: Operational disruption does not lead to unauthorised changes to treatment.

Step 10: Manage Essential Outdoor Movement and Masks

Responsible: Resident Care Lead and Transport Coordinator.

Actions

1. Confirm whether a journey is essential and whether an alternative arrangement is clinically suitable.
2. Check current conditions immediately before departure.
3. Arrange appropriate transport, sheltered boarding where available, and minimal outdoor waiting.
4. Confirm escorts, mobility assistance, and acceptance by the receiving service.
5. Apply individual clinical advice on respiratory protection.
6. If an appropriate mask is used, help it fit correctly and monitor tolerance.
7. If the resident experiences discomfort, move to a suitable protected area and seek advice as necessary.
8. Record departure, destination, escort and expected return.

MOH advises consulting a doctor before N95 use for elderly persons or those with severe heart or lung problems who experience breathing difficulty. Anyone who feels discomfort while wearing one should take a break. Ministry of Health

Required record: Essential journey and resident movement log.

Control check: Mask availability does not replace assessment of whether the journey is necessary and safe.

Step 11: Support Residents’ Understanding and Emotional Well-Being

Responsible: Resident Care Lead and care staff.

Actions

1. Explain changes in familiar language and simple terms.
2. Reassure residents about meals, care, medicines and access to assistance.
3. Offer suitable indoor activities and social contact.
4. Retain familiar routines where practicable.
5. Identify distress caused by unfamiliar rooms, restricted outings or disrupted visits.
6. Provide individual support for residents with cognitive or communication difficulties.
7. Facilitate contact with authorised relatives or representatives where appropriate.
8. Escalate significant behavioural changes for assessment.

Required record: Relevant welfare observations and individual support actions.

Control check: Residents understand how to obtain help and are not left isolated by precautionary measures.

Step 12: Maintain Safe Staffing and Staff Welfare

Responsible: Staffing Lead and Superintendent.

Actions

1. Review available staff and skills against current resident needs.
2. Deploy relief personnel through the approved arrangements.
3. Brief incoming personnel before assigning duties.
4. Ensure tasks requiring specific competence remain with authorised staff.
5. Monitor fatigue, illness, breaks and extended working hours.
6. Provide suitable indoor rest areas and access to meals.
7. Assess any essential outdoor work and apply current workplace precautions.
8. Escalate projected staffing gaps before the next shift begins.

Required record: Live roster, relief requests and staffing risk log.

Control check: Extra shifts do not become the sole response to a prolonged staffing shortage.

Step 13: Sustain Supplies, Utilities and Equipment

Responsible: Facilities and Logistics Lead.

Actions

1. Check critical stock and consumption rates.
2. Estimate how long supplies will last at current use.
3. Reorder before approved thresholds are reached.
4. Confirm delivery times and activate alternative suppliers when necessary.
5. Track filters, medicines, food and personal care items separately where shortages would have different consequences.
6. Monitor utilities and equipment faults.
7. Mobilise repair or replacement support promptly.
8. Inform the Crisis Leader of the expected time until any shortage or failure becomes unsafe.

Required record: Resource status report, purchase decisions and fault log.

Control check: Management receives advance warning of resource failure, with options and lead times.

Step 14: Issue Situation Reports and Make Decisions

Responsible: Crisis Leader and Incident Recorder.

Actions

1. Compile a situation report covering:
   • Official air quality and forecast.
   • Resident welfare and medical transfers.
   • Indoor conditions.
   • Staffing.
   • Utilities and equipment.
   • Supplies.
   • External support.
   • Decisions required.
2. Hold short reviews at an approved interval and whenever a significant change occurs. Adopt an initial two-hourly review, then adjust to conditions.
3. Decide whether to maintain, increase or reduce response measures.
4. Assign each action an owner and deadline.
5. Record major decisions, reasons, advice considered and next review.
6. Share a concise operational update with shift supervisors.

Required record: Situation reports, decision log and action tracker.

Control check: Reports result in decisions and completed actions.

Step 15: Communicate with Management, Authorities and Stakeholders

Responsible: Communications Lead and Superintendent.

Actions

1. Keep Jamiyah Singapore management informed of significant risks and support needs.
2. Apply JHA’s verified notification requirements and relevant authority directions.
3. Record notifications, recipients, times, instructions and follow-up.
4. Update authorised relatives or representatives about significant care changes through approved channels.
5. Explain visiting arrangements and alternatives.
6. Use a designated spokesperson for public enquiries.
7. Protect resident confidentiality.
8. State when the next update will be provided, even if the situation is unchanged.

Required record: Communication and notification log.

Control check: Messages are consistent, factual and authorised.

Step 16: Assess and Implement Relocation if Necessary

Responsible: Superintendent, supported by Jamiyah Singapore management and relevant authorities.

Actions

1. Compare the risks of remaining with the risks of movement.
2. Consider relocation when safe accommodation, essential care or critical utilities cannot be sustained.
3. Obtain clinical, facilities and regulatory advice as applicable.
4. Consider partial relocation where it provides a safer, manageable solution.
5. Confirm receiving capacity, staffing, transport and care arrangements before movement whenever circumstances permit.
6. Prepare each resident’s identification, medicines, care summary and essential belongings.
7. Assign escorts and accountability responsibilities.
8. Reconcile residents at departure and arrival.
9. Complete a documented care handover.
10. Continue oversight of residents remaining at JHA.

Required record: Relocation decision, movement register and receiving-site handover.

Control check: A high outdoor reading alone does not automatically trigger evacuation; the decision considers the actual safety and care environment.

Step 17: Maintain Shift Handover and Review Readiness for Recovery

Responsible: Outgoing and Incoming Duty Managers.

Actions

1. Conduct a structured handover covering:
   • Resident locations and unresolved health concerns.
   • Current response measures.
   • Staffing and care gaps.
   • Equipment faults and room restrictions.
   • Supplies and expected deliveries.
   • Outstanding decisions and notifications.
2. Confirm the incoming manager accepts responsibility.
3. Continue monitoring even when readings improve.
4. Ask the Crisis Leader to assess readiness for recovery only when improvement is sustained and care capacity is stable.
5. Record the formal decision to transition; retain measures still required for individual residents.

Required record: Signed shift handover and transition decision.

Control check: One improved reading or a shift change does not end protective measures.

During-Crisis Management Dashboard

Click the icon for the crisis management playbook for the three stages: Pre-, During-, and Post-crisis 

Introduction	Pre-Crisis	During Crisis	Post-Crisis
Managing Severe Haze Scenario	Preparedness and Prevention/ Reduction	Response, Recovery and Resumption	Recovery, Restore and Return Home

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