Business Impact Analysis Handbook
Business Impact AnalysishandbookNovember 2015health.wa.gov.au
ContentsWhat is a Business Impact Analysis3Process3Templates and tools5Carrying out the BIA6Step 1 Preparation and set-up6Step 2 Dependencies Assessment7Consolidated dependencies profile9Step 3 Impact assessment10Consolidated BIA profile and priorities12Step 4 Business continuity strategies and resource requirements13Attachment 1 Impact Reference Table16Attachment 2 Dependency Rating Table17Attachment 3 Consolidated Dependencies Assessment – People and Infrastructure18Attachment 4 Consolidated Dependencies Assessment – Systems and Applications19Attachment 5 Consolidated BIA Profile202
BIA HandbookNovember 2015PurposeThe purpose of this handbook is to provide guidance on how to undertake aBusiness Impact Analysis (BIA) using the templates and tools that have beendeveloped for healthcare facilities in the Department of Health. There is, however, norequirement to standardise the BIA – health services and divisions are free to useother BIA methodologies and tools that are deemed appropriate so long as theobjectives of the BIA are met. These objectives are described in the sections below.What is a Business Impact AnalysisThe BIA is a structured and formal process for determining the priorities for theresumption and continuity of services / business activities following a disruption.Whilst all the daily activities1 carried out in a healthcare facility are important, not allthese activities are “time critical”. In the event of a major disruption, some of theseactivities could temporarily be suspended with little or no negative consequences onpatient care or the broader health system. On the other hand, some activities havevery low tolerances for disruption because the consequences of disruption on theorganisation are unacceptable, even for a few minutes or hours. The BIA allows youto prioritise the activities from a time perspective, separating those that are timecritical from those that are not.The BIA is an important process as it allows the organisation to determine the scopethat will form the cornerstone for the development of business continuity strategiesand response plans.ProcessThe BIA is a 4-step process as illustrated in Figure 1 below:The term ‘activities’ is used broadly to include services, functions and processes that areundertaken in a business area13
BIA HandbookNovember 2015Figure 1 Business Impact Analysis ProcessStep 1Preparation and set-up Identify the activities that are undertaken by each unit / businessareaStep 2Dependencies assessment Identify the resources that are used by each of the activities undernormal operations, and assess the level of dependency that theactivity has on a given resource.Step 3Impact assessment Assess the potential business impact of a disruption to businessactivities, determine the maximum amount of time that the activitiesmay be disrupted for before the business impact becomesintolerable, and prioritise the activities for recoveryStep 4Business continuity strategies and resource requirements Identify the strategies, interdependencies and resourcerequirements for the continuity of priority activities4
BIA HandbookNovember 2015ApproachThe BIA should be conducted with managers who have overall responsibility for adepartment, unit, or business area. They must be able to “stand back” and providean organisation-wide perspective when assessing the impacts of disruption, andhave the authority to make an educated determination of the recovery priorities foractivities within their department or unit.Inputs should be sought from multiple participants so that the analysis is balancedand not based on the opinions of a single person. For this reason, the BIA is bestconducted in a facilitated workshop setting with department and unit managers.BIA workshops should be conducted for each directorate. Depending on the size ofthe directorate, you may need to have separate workshops for each department /unit to keep it manageable. The BIA is conducted bottom-up – i.e. information iscollected at the unit / business area level, and then rolled-up and consolidated at thedepartment / directorate and organisation-wide level.Templates and toolsThe templates and tools for conducting the BIA are: oooooooImpact Reference Table2 (see Attachment 1)Dependency Rating Table (see Attachment 2)BIA template, consisting of the 7 worksheetsWS1 Listing of activitiesWS2A Dependencies assessment – people and infrastructureWS2B Dependencies assessment – systems and applicationsWS3 Impact assessmentWS4A Business continuity strategiesWS4B Resource requirementsWS4C Interdependencies2The Impact Reference Table is a subset of the Consequence Description Table found inthe RiskBase (version 3) DoH Data Definitions document. The table has been simplified byremoving the impact categories that are not relevant for business continuity. Note thatRiskBase will be discontinued from March 2016.5
BIA HandbookNovember 2015Carrying out the BIAThe following tables describe the process for carrying out each step of the BIA. Thisis to be used with the BIA template.Step 1 Preparation and set-upTemplate /tool:Objectives:WS1 Listing of ActivitiesWho shouldprovide inputs:Unit / business area managersKey tasks:1. Identify the directorates and units / Business Areas in theorganisation, and the managers responsible for these areas.2. Identify the sub-units (if appropriate) under each Unit /Business Area.3. Identify the activities that are performed in each Sub-unit (orUnit / Business Area if Sub-units are not applicable).AdditionalnotesWhen identify activities that are performed in each Sub-unit,care should be taken to ensure that they are not listed at toohigh or too low a level. The following are some generalguidelines:To identify the activities that are undertaken by each businessarea Identify what is done or what service is provided, not how itis carried outIf you start to going into a process or procedural breakdown,you have gone too farIf a set of tasks must be carried out in sequence in order tomeet an objective, complete a job or deliver a service, youcan probably group these into one activity rather than listingthem as several activitiesA sample list of activities is presented in Attachment 5.6
BIA HandbookNovember 2015Step 2 Dependencies AssessmentTemplate /tool:Objectives:Who shouldprovide inputs:WS2A Dependencies Assessment – People andInfrastructure WS2B Dependencies Assessment – Systems andApplications Dependencies Rating TableTo Identify the resources that are used by each of the activities(identified in Step 1) under normal operations, and assess thelevel of dependency that the activity has on a given resource Approach:Senior staff members with good operational knowledge. Resultsare to be reviewed by the respective Unit / Business AreamanagersOne-on-one / small group interview with facilitatorKey tasks:WS2A Dependencies Assessment – People and Infrastructure1. Identify the dependencies (people, utilities / essentialservices, office equipment and telecommunications, medicalequipment, specialised equipment and key consumables)that are used by each activity2. For each activity, rate the level of dependency (using thedropdown menu) that it has on each of the resources listed.Refer to the Dependency Rating Table for the definitions ofthe ratingsWS2B Dependencies Assessment – Systems and Applications1. Identify the systems / applications that are used by eachactivity2. For each activity, rate the level of dependency (using thedropdown menu) that it has on each of the system /application listed. The Dependency Rating Table is to beused with this worksheet3. When all the activities have been assessed, return to the listof systems / applications. For each system / application:4. Determine the “system off-line duration”– the maximumduration that a system / application may be unavailablebefore the impact becomes unacceptable using thedropdown menu5. Determine the “data loss duration” – the maximum data lossthat can be tolerated before it becomes unacceptable usingthe dropdown menu.7
BIA HandbookAdditionalnotes:November 2015 Upon completion of the assessment, the ratings will providean indication of what the critical dependencies for each Unit /Business Area are, and a separate exercise may beundertaken to risk assess these dependencies and toimplement further preventative controls or contingencymeasures where necessary8
BIA HandbookNovember 2015Consolidated dependencies profileTemplate /tool:Objectives:NoneWho shouldprovide inputs:The person who is coordinating business continuity across thehealthcare facility will consolidate the information when all theunits / business areas have completed Step 1.Key tasks:WS2A Dependencies Assessment – People and InfrastructureTo present a consolidated view of the resource dependenciesacross the healthcare facility1. For smaller healthcare facilities, the assessments conductedfor each unit / business unit on WS2A may be simply bemerged into a single worksheet2. For larger healthcare facilities, the assessments at theactivity level may be rolled up to a unit / business area levelby selecting the highest dependency rating for eachresource as being representative of the overall rating for theunit / business areaA sample output is presented in Attachment 3WS2B Dependencies Assessment – Systems and Applications1. Similar to WS2A, the assessments at the activity level maybe rolled up to a unit / business area level by selecting thehighest dependency rating for each system / application asbeing representative of the overall rating for the unit /business areaA sample output is presented in Attachment 49
BIA HandbookNovember 2015Step 3 Impact assessmentTemplate /tool:Objectives: WS3 Impact Assessment Impact Reference TableTo assess the potential business impact of a disruption toactivities, determine the maximum amount of time that theactivities may be disrupted for before the impact becomesintolerable, and prioritise the activities for recoveryWho shouldprovideinputs:Managers for the respective Units / Business Areas. Results to bereviewed and endorsed by the DirectorApproach:Facilitated workshopKey tasks:For each service / activity identified:1. Discuss how a disruption could impact the organisation, usingthe impact categories in the Impact Reference Table as aguide (not all the impact categories would be relevant for everyactivity). Use column C, “Impact of disruption”, to make notesof key points discussed and note the relevant impactcategories in column D.2. Score the impact over various timeframes (i.e. minutes, hours,days, weeks) using the severity level rating 1 to 5 (dropdownmenu) as defined in the Impact Reference Table, taking intoconsideration the impact categories discussed earlier. Answerthe question, “What would the severity level rating be if thisactivity was disrupted for minutes, hours, days and weeks?”3. Determine the Maximum Tolerable Period of Disruption(MTPD)3 in column I by selecting the appropriate timeframe (2hours, 4 hours, 8 hours, 1 day, 3 days, 1 week, 2 weeks and 1month ) in the dropdown menu. The MPTD should be guidedby the severity level ratings in the previous task - a score of 4or 5 indicates an unacceptable level of impact (this is the “cutoff” score). The MPTD should therefore fall within thetimeframes where the score is a 4 or 5 in the time columns(see examples and table below).Example 1 - the cut-off score of 4 appears in the ‘Days’ column,hence the MTPD fall within 1 to 7 days. The specific MTPD isarrived at based on discussion and agreement with the workshop3MTPD refers to the maximum amount of time that an activity can tolerate a disruptionbefore the impact on the organisation becomes unacceptable10
BIA HandbookNovember 2015participantsExample 2 – the cut-off score of 4 appears in the ‘Weeks’ column,hence the MTPD should fall within 1 week to a month. The specificMTPD is arrived at based on discussion and agreement with theworkshop participantsExample 3 – the cut-off score of 4 does not appear in any of thetime columns. This indicates that this activity could be stopped forweeks with little impact on the organisation, and the MTPD will bemore than a month. The specific MTPD is arrived at based ondiscussion and agreement with the workshop participantsExamples:Impact ratingsMins Hrs Days Wks MTPD23453 days12342weeks11123monthsExample 1Example 2Example 34. Repeat the assessment for each service / activity listed.5. Upon conclusion of all the assessments, every activity in theUnit / Business Area should have an associated MTPD. TheMPTDs thus provide the basis for you to prioritise recovery ofthese activities following a disruption.Additionalnotes:The following ground rules should be observed when performingthe assessment: Assess the impact from an organisation-wide perspective, i.e.how would a disruption impact the organisation, rather than onthe individual Unit / Business AreaThe cause of the disruption is immaterial – it may be a poweroutage, roof collapse, fire, etc. – the focus is on the impact of adisruption, rather than the cause of the disruptionDo not take into consideration any contingency arrangementsthat may already be in place or measures that could beimplemented to mitigate the impact – these will be addressedin the strategy phase of the BCM process11
BIA HandbookNovember 2015Consolidated BIA profile and prioritiesTemplate /tool:Objectives:NoneWho shouldprovide inputs:The Business Continuity Coordinator for the healthcare facility isresponsible for consolidating the information when all the units /business areas have completed Step 3.Key tasks:1. Upon completing the impact assessments for all theDirectorates, the results (from WS3) should be consolidatedand presented to the Executive for endorsement.2. As a general guideline, all activities with MTPDs of 2 weeksor less are considered as “priority activities” and must fallwithin the scope of the organisation’s business continuitystrategies and response plansTo present the consolidated findings of the impact assessmentfor Executive management endorsementA sample output is presented in Attachment 5.Additionalnotes:It is important that Executive endorsement is obtained beforeproceeding to Step 4.12
BIA HandbookNovember 2015Step 4 Business continuity strategies and resource requirementsTemplate /tool:Objectives: WS4A Business continuity strategies WS4B Resource requirements WS4C InterdependenciesTo identify the strategies, interdependencies and resourcerequirements for the continuity of priority activitiesWho shouldprovide inputs:Managers for the respective Units / Business Areas. Results tobe reviewed and endorsed by the DirectorApproach:Facilitated workshopKey tasks:WS4A Business continuity strategiesThe purpose of WS4A is to document the high level strategiesfor the continuity of priority activities (i.e. those with MTPD of 2weeks or less as identified in Step 3)For each priority service / activity:1. Identify the Immediate Continuity Strategy (column E) forresponding to a disruption and the duration that this strategycan be maintained for (column F). This is a short termstrategy designed to provide a bare minimum or basic levelof service in order to contain or minimise the impact of thedisruption on stakeholders until a more sustainable level ofservice can be provided.2. Identify the Sustainable Continuity Strategy (column G) thatwill provide a higher level of service that can be sustainedbeyond the Immediate Continuity Strategy, and the durationthat this strategy can be maintained for (column H)Note: There may be instances where the Immediate andSustainable continuity strategies are the same Examples of strategies include (not exhaustive)o Temporary suspension of an activityo Redirecting the activity to another facilityo Transferring resources to another facilityo Redirecting patients to alternate care optionso Using alternate procedures / workaroundso Stopping altogether until full recovery can beachieved, etc.13
BIA HandbookNovember 2015WS4B Resource requirementsThe purpose of WS4B is to capture the minimum levels ofresources required by a sub-unit / unit over various timeframes(8 hours, 1 day, 3 days, 1 week, 2 weeks and 1 month orgreater) to implement the business continuity strategiesidentified in WS4A.The information is collected at an overall sub-unit / unit /business area level rather than activity level as the sameresources are likely to be shared or deployed across a numberof services / activities. The resource information collected inStep 2 on WS2A will automatically be transferred to thisworksheet.You may or may not need to create multiple copies of thistemplate, depending on the number of sub-units you have andhow resources are deployed. As a general guide: If the sub-units are fairly autonomous and have their ownpool of personnel, each sub-unit will require its ownworksheet.If the sub-units are largely dependent on the same pool ofpersonnel who share duties and responsibilities across subunits, you can combine the sub-units and have a singleworksheet for the unit / business area.In the example within the spreadsheet, Operation TheatreServices, Central Sterilisation Services and Day Stay Unit are 3autonomous sub-units. Each of them will require its ownworksheet.People1. For each category / position (e.g. Manager, Medical Officer,Nurse, etc.) that are in the sub-unit / unit / business area,identify the number of staff that you have under normal, dayto-day, conditions (column B)2. For each timeframe (i.e. 8 hours, 1 day, 3 days, etc.) incolumn B, identify the minimum number of staff in each ofthe categories / positions that will be required to support thecontinuity strategies of priority activities identified in WS4Office equipment and telecommunications, medical equipment,specialized equipment and key consumables, systems /applications and utilities / essential services14
BIA HandbookNovember 20151. For each type of resource listed, identify the normal quantitythat are in use, and the minimum quantities that are requiredover time (i.e. 8 hours, 1 day, 3 days, etc.) to support thecontinuity strategies of priority activities identified in WS42. If a resource that is required is not quantifiable, use ‘Y’ (foryes) to indicate that it is neededWS4C InterdependenciesThe purpose of WS4C is to capture the internal and externaldependencies of a sub-unit / unit / business area in relation tothe priority activities. Like WS4B, the information is collected atan overall sub-unit / branch / business are level rather thanactivity level as multiple activities are likely to have the sameinterdependencies.The same guidelines from WS4B on the need for multiplecopies apply for this worksheet.1. Internal Interdependencies - identify the internal parties /stakeholders (outside the branch / business area) within theorganisation with whom you have interdependencies with. Upstream – are parties whom you are dependent on toperform your activities Downstream – are parties who are dependent on you toperform their activities2. External Interdependencies - identify the external parties /stakeholders (outside the health facility, such as otheragencies, suppliers, service providers, etc.) with whom thebranch / business area have interdependencies with. Upstream – are parties whom you are dependent on toperform your activities Downstream – are parties who are dependent on you toperform their activities15
Attachment 1 Impact Reference TableSEVERITY LEVEL CONSEQUENCECATEGORIESFL FINANCIAL LOSS(Destruction, Theft, orLitigation / penalties)RI REPUTATION ANDIMAGENC atastrophicLess than 5,000.Non-headline exposure.Not at fault. Settledquickly. No impact.Innocent proceduralbreach. Evidence of goodfaith by degree of care /diligence. One off minorlegal matter. Little impact.Increased level of care(minimal). No increase inlength of stay. Notdisabling.HP HEALTH IMPACTON PATIENT(S) /STAKEHOLDERSOOORGANISATIONALOBJECTIVESLittle or no noticeableimpact on patient care**.Little impact. 5,000 to less than 100,000. 100,000 to less than 3M.Non-headline exposure.Clear fault. Settled quicklyby Departmental response.Negligible impact.Repeated non-headlineexposure. Slow resolution.Ministerial enquiry / briefing.Qualified Accreditation.Breach, objection/complaintlodged. Minor harm withinvestigation. Evidence ofgood faith arguable.Breach of contractual orstatutory obligations, orprobity infringements. Lackof good faith evident. Noncompliance results inperformance review.Increased level of care(minimal). Increased lengthof stay (up to 72 hours).Recovery withoutcomplication or permanentdisability.Inconvenience & minordelays to individuals but littleor no impact on overallservice delivery**Inconvenient delays.Increased level of care(moderate). Extended lengthof stay (72 hours to oneweek). Recovery withoutsignificant complication orsignificant permanentdisability.Moderate impacts on anumber of individuals,resulting in noticeable impacton overall service delivery**Material delays. Marginalunder achievement of targetperformance. 3M to less than 20M.Headline profile. Repeatedexposure. At fault orunresolved complexitiesimpacting public or keygroups. Ministerialinvolvement. High priorityrecommendation to preserveaccreditation.Major breach of contractualor statutory obligations. Noncompliance results intermination of process orimposed penalties, formalinvestigation or disciplinaryaction. Ministerialinvolvement.Increased level of care(significant).Extended length of stay(greater than one week).Significant complicationand/or significant permanentdisability.ALL SAC 1 EVENTSSerious impacts onsignificant numbers ofindividuals, resulting innoticeable impact on overallservice delivery**Significant delays.Performance significantlyunder target. 20M .Maximum multiple high-levelexposure. Ministerialcensure. Direct intervention.Loss of credibility and public/ key stakeholder support.Accreditation withdrawn.Serious breach of contractualor statutory obligations. Noncompliance results in loss ofaccreditation, litigation orprosecution with significantpenalty. Dismissal.Ministerial censure. PublicenquiryDeath, permanent totaldisability.ALL SAC 1 EVENTS.Major / debilitating and longterm impacts on individualsand overall delivery ofservices**Non-achievement ofobjective / outcome. Totalperformance failure.*Note: Table is a subset of the Consequence description table in the Riskbase DOH Data Definition. Text in italics added to provide clearer contextualreference for the purpose of the BCM Business Impact Analysis16
Attachment 2 Dependency Rating TableLevelDescription1MinimaldependencyThere is minimal dependency on this resource. Resource is nice to have; successful delivery of criticalservices or completion of a task is possible without this resource2LowdependencyThere is low dependency on this resource for the successful provision of critical services or completion ofa task; an outage will have minimal material impact; the task can still be successfully completed usingmanual workarounds or alternative resources as a stop gap measure until the resource is available again.3OccasionaldependencySuccessful delivery of critical services or completion of a task is occasionally dependant on this resource;an outage may cause some inconvenient delays in completion of a task but parts of the task can besuccessfully completed using manual procedures or alternative resources for a period of time.4HighdependencySuccessful delivery of a critical service is fully dependant on this resource; resource is used regularly forprocessing; an outage may result in significant knock on effects; there is low tolerance of an outagebefore the impact becomes unacceptable; limited manual workaround or alternative resource may beused for a short period of time as a stop gap measure.CriticaldependencySuccessful delivery of a critical service is fully dependant on this resource; resource is used continuouslyfor processing or to provide real time feedback/information; resource must be operational 24 x 7; anoutage may result in serious knock on effects; there is close to zero tolerance of an outage before itbecomes unacceptable; there are no or very limited manual workaround or alternative resources.517
Attachment 3 Consolidated Dependencies Assessment – People and Infrastructure 45555553453554254333543335353355555Mobile phone5Desk phoneDocument scannerFax machinePhotocopierPrinter (colour)Printer (black and white)5Tablet5Laptop computerVentilation5Personal computerMedical suction5Air-conditioning / HeatingMedical air45Internet access5555Pager5255Medical equipmentDECT Phones555Medical carbon dioxide4Medical Nitrous Oxide2Office equipment and telecommunicationsMedical oxygenTechnicians4Natural gasLiquid petroleum gas(LPG)Administration staff5WaterOrderlies5PowerNursing staffService AreaOperation Theatre servicesCentral SterilisationServices DeptDay Stay Unit servicesAdministration and MedicalRecordsNursingAllied HealthAged Care ServicesCommunity Mental HealthEmergency DepartmentInpatient Medical & NursingCareMaternityHospital ManagementHome Nursing DischargeServicesPharmacy and SupplyFood ServicesLaundry ServicesUtilities / Essential servicesClinical staffPeopleSpecialised equipmentKey consumables53355318
Attachment 4 Consolidated Dependencies Assessment – Systems and Applications (Sample)9530 mi03442554311301415555530 445eReferralsCardiobaseEnterprise Bed Management (EBM)Diet ManagementHealthPoint (Sharepoint Intranet)Haematology & Oncology Protocols &Prescriptions (HOPP)MS ExchangeWA Nephrology Database d Health System (AHS)Quality of Care Registry (QoCR)Transition Care (TCP)MS r2823dN/ANursing Hours per Patient Days(NHpPD)821w1w4Laundry ServicesFood ServicesPharmacy and SupplyHome Nursing DischargeServicesHospital ManagementMaternityEmergency DepartmentCommunity Mental HealthAged Care ServicesAllied HealthNursingAdministration and MedicalRecordsDay Stay Unit servicesInpatient Medical & Nursing CareApplicationsHealth Records Management Scanning and eForms (eHRM)WebPASClinical Pathology (Ultra/LIS)Theatre Management System (TMS)InternetCentral Sterilisation ServicesDept# ServicesSystemDataLevel ofusing thisofflinelossdependencyapplicationduration durationOperation Theatre servicesBusiness areas5122411141243555532115553211555532115519
BIA HandbookNovember 2015Attachment 5 Consolidated BIA Profile (Sample)MTPDBranch / BusinessAreaPerioperative UnitGeneral WardSub UnitInpatient medical andnursing careHospiceOutpatientsAdministration4 hrs8 hrsEmergency DepartmentPharmacyOutpatientsAdministration1 day3 days1 wk2 wks 1 mth xxxxxxxAcute surgicalxAcute medicalPaediatricsEducation and training for staffLiaising with aged care facilitiesAcute antenatal careBirthing including emergency carePost natal carePalliative care - terminal illnessPalliative care specialists clinicsReferral to consultancy and alliedservicesTriage and registrationResuscitation including traumaAcute careFast trackShort stay observationPharmacy2 hrsOperation theatre services Perioperative careCentral sterilisation services Decontamination of surgical andmedical equipmentSterilisation of surgical and medicalequipmentStorage of sterile non-disposableequipmentDay Stay Unit servicesElective day surgery proceduresEmergency bed responseDay infusion proceduresMaternityEmergencyDepartmentService / activityxxxxxxxxxxxxxxxClinical pharmacy servicesPharmacy technical servicesxxCommunity child healthSchool healthContinenceEnuresisImmunisationDietetics (In patient)Occupational therapy (In patient)Physiotherapy (In patient)Speech pathology (In patient)PodiatrySocial workCommunity Mental HealthInitiating patient flows (wayTelephoneswitchboard/communicationsReceive incoming deliveriesMedical record data entry and othermedical records functionsAccount payments20xxxxxxxxxxxxxxxxxx
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Step 3 Impact assessment Template / tool: WS3 Impact Assessment Impact Reference Table Objectives: To assess the potential business impact of a disruption to activities, determine the maximum amount of time that the activities may be disrupted for before the impact becomes intolerab
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