incident management for healthcare based upon emergency management institute ics- hc 100-200
TRANSCRIPT
Incident Management for Healthcare
Based upon Emergency Management Institute
ICS- HC 100-200
Minnesota Emergency Readiness Education and Training Program
(MERET)
MERET worked with partners in Minnesota to adapt curriculum to support the Hospital Incident Command System (HICS) training
MERET is a program designed to educate and train Minnesota’s health care workers in emergency preparedness, tailoring efforts to the unique needs of specific communities as they prepare for a health emergency or bioterrorism event. MERET is funded by the Office of the Assistant Secretary for Preparedness and Response (ASPR) of the U.S. Department of Health and Human Services, and is administered by the University of Minnesota Schools of Nursing and Public Health. Carol O’Boyle, PhD, RN, at the School of Nursing, is the Principal Investigator.
Minnesota Emergency Readiness Education and Training (MERET) is funded under grant #TO1HP06412 from the Office of the Assistant Secretary for Preparedness and Response (ASPR),DHHS, Bioterrorism Training and Curriculum Development Program.
Objectives
Name the four (4) phases of comprehensive incident management.
Recognize how objectives shift from the initial response phase to the extended response phase.
Name the order in which the Hospital Incident Command System (HICS) is usually activated.
Select the forms used by the Command and General Section Chief staff.
Identify the role of the Incident Commander. Select the appropriate span of control for any
leadership position in the HICS. Identify the purpose of the Incident Briefing.
What is the Hospital Incident Command System (HICS)? Created in the 1980’s as Hospital Emergency
Incident Command System (HEICS) and Evolved to HICS as a comprehensive incident management system for both emergent and non-emergent situations .
Foundation for more than 6,000 hospitals in the United States to prepare and respond to disasters
Hospital are seen as essential members of community preparedness and are recognized as “first responders” in emergency response.
The HICS provides a common structure and language for promoting interagency communication based on functions
Evolved from an Incident Command System (ICS) used by multiple agencies to manage events
Incident Command System (ICS) History
FIRESCOPE – 1970s NIIMS (National Interagency Incident
Management System) NIMS (National Incident Management System)
MnIMS (MN Incident Management System) OSHA (Occupational Safety and Health
Administration NFPA 1600 (National Fire Protection Association) The Joint Commission (formerly JCAHO)
Requires healthcare facilities to use community-congruent IMS
What is the Hospital Incident Command System (HICS)? Created in the 1980’s as Hospital Emergency
Incident Command System (HEICS) and Evolved to HICS as a comprehensive incident management system for both emergent and non-emergent situations .
Foundation for more than 6,000 hospitals in the United States to prepare and respond to disasters
Hospital are seen as essential members of community preparedness and are recognized as “first responders” in emergency response.
The HICS provides a common structure and language for promoting interagency communication based on functions
Evolved from an Incident Command System (ICS) used by multiple agencies to manage events
Homeland Security Presidential Directives (HSPDs)
Management of Domestic Incidents http://www.whitehouse.gov/news/releases/2003/02/20030228-9.html
HSPD-5HSPD-5
HSPD-8HSPD-8
National Incident Management System (NIMS)
National Response Plan (NRP)
National Preparedness Goal
National Preparedness http://www.ojp.usdoj.gov/odp/assessments/hspd8.htm
Mandates
Slide courtesy of FEMA
National Incident Management System/Components (NIMS)
NIMS: Standardizes incident management processes, protocols, and procedures for all responders. Mandates ICS
Command and Management ICS Multi-Agency Coordination Public Information Systems
Preparedness Resource Management Communications and Information Mgt. Supporting Technologies Ongoing management and Maintenance
Slide courtesy of FEMA
National Response PlanNational Response Plan
Establishes . .
• Incidents occur and are managed at the lowest level
• Provision of federal aid to support state and local efforts as requested.
• Unified, all-discipline, all-hazard, management approach
http://www.dhs.gov/xprepresp/committees/editorial_0566.shtm
NIMS & NRP Relationship
LocalSupport or Response
National Incident Management System (NIMS) Standardized process and procedures for
incident management
StateSupport or Response
FederalSupport or Response
NIMS aligns command & control, organization structure, terminology, communication protocols,
resources and resource typing
National Response Plan (NRP)Activation and proactive application of
integrated Federal resources
Incident
NRP is activated forIncidents of National
Significance
Resources, knowledge,
and abilities from all Federal agencies
DHS integratesand applies Federal
resources
http://www.nrt.org/production/NRT/NRTWeb.nsf/AllAttachmentsByTitle/A-319CharlieHessNIMS-NRPBrief/$File/Charlie_Hess_NIMS-NRP_Brief.ppt?OpenElement#324,6,NIMS & NRP Relationship
Weaknesses prior to ICS
Lack of accountability Poor communication Lack of planning process Overloaded commanders Interagency integration – ICS
purposely does not reflect agency-specific titles, etc. to avoid confusion
Cap
abili
ties
an
d R
eso
urc
es
Federal Response
Regional / Mutual Response SystemsState Response
Increasing magnitude and severity
Local Response, Municipal and County
Tiered Response Strategy
Minimal Low Medium High Catastrophic
'Medical Surge Capacity and Capability Handbook' by J. Barbera and A. Macintyre published by CNA Corporation.
Hospital Incident Management
What is meant by an “incident” in the Incident Command System?. . . an occurrence, either caused by human or natural phenomena, that requires response actions to prevent or minimize loss of life, or damage to property and/or the environment.
Photos courtesy of FEMA
Photos courtesy of FEMA
What is a ‘disaster’?
A disaster is when the demands of an ‘incident’ outstrip available resources
Goal: Get the…Right stuff / staff to theRight place at the Right time to prevent an incident from
becoming a…DISASTER
Incident management is the key!
Le Sueur Tornado
Photographer: D. Burgess. Photo courtesy of NOAA Photo Library
Red River Flood
Photographer: David Saville, Photos courtesy of FEMA
Photographer: Mark Wolfe, Photo courtesy of FEMA
Emergencies Present In 2 Ways…
Oklahoma City Bombing
Tornado
Hurricane Katrina
Midwest Floods
Pandemic FluNorthridge Earthquake
The Amount of Time We’re GivenTo Pre-Organize People and Pre-Stage Equipment
Can Drastically Change Our Response Effectiveness
Anticipatedand/or
With Warning
Anticipatedand/or
With Warning
Unanticipatedand/or
Without Warning
Unanticipatedand/or
Without Warning
Illustration courtesy of Pete Brewster – VA Medical System
Incident progression
BOOM!
Reactive PhaseRecognitionNotificationsInitial control and safety actionsEstablish ICP
Primary ToolsSOPsJob Action Sheets
Primary GoalPrevent incident expansionPrevent responder injury
Proactive PhaseSituation assessedObjectives establishedStrategies / tacticsResources requested
Primary ToolsICSIncident Action Planning
Primary GoalManage incident
Slide courtesy of John Hick Hennepin County Medical Center
Incidents Require you to …..
School Shooting
Image courtesy of FEMA, Photographed by Jocelyn Augustino
What is an Incident Command System (ICS)? Provides framework to:
Identify and assess the problem Develop plan to deal with the problem Implement the plan Procure and pay for necessary resources
A structured system for controlling: Personnel Facilities Equipment Communications
Photographer: Jocelyn Augustino, Photo courtesy of FEMA
Why use ICS? Greater efficiency in managing internal or external
crisis incidents of any kind or size Better coordination and communication within and
external to facility Standardization and flexibility which allows personnel
from different organizations to use a common management structure
To provide logistical & administrative support to ensure that operational staff can meet tactical objectives
To be effective in reducing costs by avoiding duplication of efforts
Photographer: Marvin Nauman, Photo courtesy of FEMA
When should ICS be used? ANY incident that requires
something OTHER than day-to-day organizational structure and function (e.g.: special event planning)
Utility of ICS depends on frequent use in order to maintain familiarity with structures/function
No correlation between the ICS organization & administrative agency structure; every incident requires different management functions
Incident Command System (ICS) Features… Common Terminology Modular Organization Management by
Objectives Reliance on an Incident
Action Plan (IAP) Chain of command &
unity of command Unified Command Manageable span of
control
Pre-designated incident locations & facilities
Resource Management Information & Intelligence
Management Integrated
Communications Transfer of Command Accountability Mobilization
Slide courtesy of FEMA
IMS Feature: Common Terminology Common terminology must be used! Plain English (not codes) Ensures efficient, clear communication Position titles, not person (e.g.: operations
chief, not ‘nursing supervisor’) – titles are a common standard for all users
Resource typing – ‘tanker’ Facility terminology – ex. ‘command post’
‘command center’ LIMIT what you say to essential info
Slide courtesy of FEMA
Basic ICS Structure –Modular Organization
INCIDENT COMMANDER
LIAISONOFFICER
SAFETYOFFICER
INFORMATIONOFFICER
LOGISTICSSECTION
PLANNINGSECTION
FINANCESECTION
OPERATIONSSECTION
Slide courtesy of FEMA
Incident Commander
The Incident Commander performs all major ICS command and staff responsibilities unless delegated and assigned.
SafetyOfficerSafetyOfficer
LiaisonOfficerLiaisonOfficer
Public InformationOfficer
Public InformationOfficer
Command Staff
IncidentCommander
IncidentCommander
OperationsSection ChiefOperations
Section ChiefPlanning
Section ChiefPlanning
Section ChiefLogistics
Section ChiefLogistics
Section ChiefFinance/AdminSection Chief
Finance/AdminSection Chief
General Staff
IncidentCommander
IncidentCommander
Slide courtesy of FEMA
Incident Commander Only position always staffed Ensures safe work practices Provides overall leadership for incident response Initial IC holds post until they delegate the post to
another qualified/more qualified person Demonstrates initiative by taking action
Motivates responders Communicates by providing specific instructions
and asking for feedback Supervises the scene of the action Delegates authority to others
Understands and accepts the need to be flexible, modify plans
Approves Incident Action Plan and evaluates its effectiveness
Slide courtesy of FEMA
Delegation of Authority
An Incident Commander's scope of authority is derived:
From existing responsibilities or agreements Through a delegation of authority from the
agency administrator or elected official in writing or verbally
Grants authority to carry out specific functions and provides overall objectives / guidance
Allows the Incident Commander to assume command.
Does NOT relieve the granting authority of the ultimate responsibility for the incident.
Delegation of authority comes from the governing board of your agency
Incident Commander
Hospital CEO
Slide courtesy of FEMA
Transfer of Command-Review The process of moving the responsibility
for incident command from one Incident Commander to another
Occurs when More qualified person / team arrives End of operational period / extended incident handoff Always includes transfer of command briefing
• Current situation• Response needs• Available resources
All personnel will be informed of the effective time and date of the transfer of command
Public Information Officer (PIO)
Advises Incident Commander on information dissemination and media relations. IC approves information releases by the PIO toexternal stakeholders
Incident Commander
Obtains information from and provides information to Planning Section for internal stakeholders.
Planning Section Chief
Public Information
Officer
Obtains information from and provides information to community and media.
Community and Media
Slide courtesy of FEMA
Safety Officer
Advises Incident Commander on issues regarding incident safety.
Incident Commander
Works with Operations to ensure safety of field personnel. Operations Section
Chief
Ensures safety of all incident personnel.Incident Personnel
Safety Officer
Slide courtesy of FEMA
Liaison Officer
Assists Incident Commander by serving as point of contact for agency representatives who are helping to support the operation (but are not directly under the ICS).
Incident Commander
Liaison Officer
Provides briefings to and answers questions from supporting agencies.
Agency Representative
Slide courtesy of FEMA
Expanding Incidents
Add to the supervisory layers as the incident expands
Divisions Groups
UnitsBranches
Single Resources
Sections
Incident Commander
Operations Section Chief
Command
AA BBAA BB
Slide courtesy of FEMA
General Staff General Staff in the ICS organizational
structure are appointed as the incident complexity expands
SafetyOfficerSafetyOfficer
LiaisonOfficerLiaisonOfficer
Public InformationOfficer
Public InformationOfficer
Command Staff
IncidentCommander
IncidentCommander
OperationsSection
OperationsSection
PlanningSection
PlanningSection
LogisticsSection
LogisticsSection
Finance/AdminSection
Finance/AdminSection
General Staff
Slide courtesy of FEMA
Incident Command System Span of Control
Relates to the supervisory structure of the organization and pertains to the number of individuals or resources one incident supervisor can effectively manage
1-5 is the recommended ratio Organizing resources into Sections, Branches, Groups,
Divisions, Units or Teams when the supervisory ratio will exceed 7 or demobilizing when the supervisory ratio falls below 3.
Slide courtesy of FEMA
Maintaining Span of Control
Divide an incident geographically.Example east and west wing of hospital
Describe functional areas of operation.Example, decontamination team
Used when the number of Divisions or Groups exceeds the span of control. Can be either geographical or functional.
DivisionsDivisions
GroupsGroups
BranchesBranches
The following supervisory levels can be added to help manage span of control: by organizing resources into Divisions, Groups, Branches or Sections
Slide courtesy of FEMA
Basic ICS Structure Organization
INCIDENT COMMANDER
LIAISON OFFICER SAFETY OFFICER
INFORMATION OFFICER
OPERATIONS SECTION
PLANNING SECTION
LOGISTICS SECTION
FINANCE SECTION
Responsible for determining the appropriate tactics for an incident, conduct of tactical operations, formulation of tactical objectives & organization, & direction of tactical resources Slide courtesy of FEMA
Operations Section: Divisions
Divided geographically Labeled using alphabet characters
(A, B, C, etc.). Managed by a Supervisor
Division A
Division B
https://intranet.ahc.umn.edu/ahcimages/Buildings/FrameSet.htm
Operations Section: GroupsEstablished based on the needs of an incident. Labeled according to the job that they are
assigned.Work wherever their assigned task is needed
and are not limited geographically.
DecontaminationGroup
DecontaminationGroup Patient Care GroupPatient Care Group
Operations SectionOperations Section
Slide courtesy of FEMA
Operations Section: Branches
Established if the number of Divisions or Groups exceeds the span of control.
Have functional or geographical responsibility for major parts of incident operations.
Branch Director
Medical CareBranch
Medical CareBranch
SecurityBranch
SecurityBranch
Business ContinuityBranch
Business ContinuityBranch
OperationsSection
OperationsSection
InfrastructureBranch
InfrastructureBranch
Slide courtesy of FEMA
Staging Manager is a new area for Hospital Incident Command
Operations Function Responsible for deploying resources May have several staging areas
Medications Staff (Labor pool) Transportation
Resources within the Staging Areas are available and ready for assignment (rest and repair areas are NOT located at staging)
Branches that are essential for maintaining hospital operations
Medical Care Branch Responsible for the provision of medical care of the
incident victims and patients already in the hospital Infrastructure Branch
Facilitates the acquisition and access to essential recovery resources
Security Branch Responsible for security for facility and staff,
liaison with local agencies Business Continuity Branch
Facilitates the acquisition and access to essential recovery resources
Operations Section:Specialized individual or team of individuals needed for the incident
Task forces – mixed resources, common mission ( task force, search and rescue task force)
Strike Teams – same resource (Code Blue,IV Team, water-mopping and mass immunization strike team)
Single Resources – individuals or team of individuals
Basic ICS Structure – Modular Organization
INCIDENT COMMANDER
LIAISON OFFICER SAFETY OFFICER
INFORMATION OFFICER
OPERATIONS SECTION
PLANNING SECTION
LOGISTICS SECTION
FINANCE SECTION
Slide courtesy of FEMA
Planning SectionChief
Situation UnitLeader
DocumentationUnit Leader
Resources UnitLeader
DemobilizationUnit Leader
PersonnelTrackingManager
Materiel TrackingManager
Patient TrackingManager
Bed TrackingManager
Planning Section
Prepares & documents the Incident Action Plan, collects & evaluates information, maintains resource status, & maintains documentation for incident record
Slide courtesy of FEMA
Planning Section: Resources Unit
Planning SectionPlanning Section
ResourcesUnit
ResourcesUnit
DemobilizationUnit
DemobilizationUnit
SituationUnit
SituationUnit
DocumentationUnit
DocumentationUnit
Conducts all check-in activities and maintains the status of all incident resources.
Plays major role in preparing the written Incident Action Plan and maintaining planning cycle.
Slide courtesy of FEMA
Planning Section: Situation Unit
Planning SectionPlanning Section
ResourcesUnit
ResourcesUnit
DemobilizationUnit
DemobilizationUnit
SituationUnit
SituationUnit
DocumentationUnit
DocumentationUnit
Planning SectionPlanning Section
Collects and analyzes information on the current situation.
Prepares situation displays and situation summaries.
Develops maps and projections. Patient and bed tracking functions
Slide courtesy of FEMA
Planning Section: Documentation Unit
Planning SectionPlanning Section
ResourcesUnit
ResourcesUnit
DemobilizationUnit
DemobilizationUnit
SituationUnit
SituationUnit
DocumentationUnit
DocumentationUnit
Planning SectionPlanning Section
Provides duplication services, including the written Incident Action Plan.
Maintains and archives all incident-related documentation.
Slide courtesy of FEMA
Planning Section: Demobilization Unit
Planning SectionPlanning Section
ResourcesUnit
ResourcesUnit
DemobilizationUnit
DemobilizationUnit
SituationUnit
SituationUnit
DocumentationUnit
DocumentationUnit
Assists in ensuring that resources are released from the incident in an orderly, safe, and cost-effective manner.
Planning SectionPlanning Section
Slide courtesy of FEMA
Planning Section: Technical Specialists
Provide special expertise useful in incident management and response.
May be assigned to work in the Planning Section or in other Sections.
Advise the Incident Commander and/or assigned Section on issues related to emergency response in their area of expertise
May be assigned as technical advisor in the HCC
May be assigned to advise and oversee specific hospital operations
Basic ICS Structure – Modular Organization
INCIDENT COMMANDER
LIAISON OFFICER SAFETY OFFICER
INFORMATION OFFICER
OPERATIONS SECTION
PLANNING SECTION
LOGISTICS SECTION
FINANCE SECTION
Slide courtesy of FEMA
Logistics Section - NIMS
Responsible for: Meeting the operational
objectives Communications Medical support to incident
personnel Food for incident personnel Supplies Facilities Ground support, Transportation
GroundUnit
GroundUnit
FoodUnit
FoodUnit
FacilitiesUnit
FacilitiesUnit
MedicalUnit
MedicalUnit
SupplyUnit
SupplyUnit
Commun.Unit
Commun.Unit
SupportBranchSupportBranch
ServiceBranchServiceBranch
Logistics SectionLogistics Section
Slide courtesy of FEMA
Logistics SectionChief
Support BranchDirector
IT/IS Unit Leader
Staff Food &Water Unit
Leader
CommunicationsUnit Leader
Family Care UnitLeader
Supply UnitLeader
Employee Health& Well-Being Unit
Leader
Facilities UnitLeader
TransportationUnit Leader
Labor Pool &Credentialing Unit
Leader
LogisticsLogisticsSectionSection
HICSHICS
Service BranchDirector
Slide courtesy of FEMA
IMS Feature: Resource Management Categories
Tactical Resources
Personnel and major equipment used in the operation
Support
All other resources required to support the incident e.g., communications, food, other equipment, or supplies
Photographer: Ed Edahl Photo courtesy of FEMA
Tactical Resources Classifications
Assigned: Currently working on an assignment under the direction of a supervisor
Available: Ready for immediate assignment and has been issued all required equipment
Out of Service: Not available or ready to be assigned
Slide courtesy of FEMA
Basic ICS Structure – Modular Organization
INCIDENT COMMANDER
LIAISON OFFICER SAFETY OFFICER
INFORMATION OFFICER
OPERATIONS SECTION
PLANNING SECTION
LOGISTICS SECTION
FINANCE SECTION
Slide courtesy of FEMA
Finance/Administration Section
Responsibilities includeTimekeeping Cost analysis / cost
dataHandling claims
related to property damage or fatalities
Finance/AdminSection
Finance/AdminSection
TimeUnitTimeUnit
Compensation/Claims Unit
Compensation/Claims Unit
ProcurementUnit
ProcurementUnit
Cost UnitCost Unit
Photos courtesy of FEMA
Incident Complexity Analysis
Safety issues Impacts to critical operating systems Potential need to evacuate Potential need to relocate services Impact on essential resources and
suppliers (e.g.: water supply) Impact on organization’s reputation Determine the objectives necessary
to manage an incident (Incident Action Planning)
Photos courtesy of FEMA
IMS Feature:Incident Action Planning (IAP)
Reflects the overall strategy for managing an incident within a prescribed timeframe – the operational period (e.g.: 7am-7pm)
IAP is primary source of objectives for action IAP often includes list of resources and
assignments IAP may initially be verbal, but should become
written soon in the process Monitors response to adjust for next period Documents results
Managing by Objectives Incident Action Plan (IAP)
There is only one Incident Action Plan at an incident which identifies WHAT must be done? WHO is responsible? How information will be COMMUNICATED? What if a responder is INJURED?
Overall Priorities • Life Saving• Incident stabilization• Property Preservation
Establish Incident Action Plan objectives, strategies, tactics
IAP Establishes Objectives, Strategies, and Tactics
State what will be accomplished (agency exec and IC)
Establish the general plan or direction for accomplishing the incident objectives (IC)
Tactics Specify how the strategies will
be executed. (Operations)
Incident Objectives
Strategies
Photos courtesy of FEMA
Operational TimesInitial response phase
Extended response phase
Initial Response Phase
Operational periods set by IC usual breakdown
Immediate 0-2 hours Intermediate 2-12 Extended over 12
hours Initiate planning cycle
Extended Response Phase
Incident requires additional operational period (incident duration>8-12 hour)
Determined by Situation
assessment Incident action
planning Resource
management
Incident Action Planning
Forms to include in the IAPHICS 201: Incident Briefing (may serve
as initial IAP)HICS 202: Incident ObjectivesHICS 203: Organization Assignment ListHICS 204: Branch Assignment ListHICS 205: Incident Communications LogHICS 206: Staff Medical PlanHICS 261: Incident Safety Analysis
HICS 201 Form (Incident Briefing)
1. Incident Name,2. Date of Briefing3. Time of Briefing4. Event History 5. Current Actions 6. Summary7. Current Organization8. Notes (Accomplishments, Issues, Directives)9. Name of the individual who prepared the document10. Facility Name
HICS 202 Form (Incident Objectives)1. Incident name
2. Date prepared
3. Time prepared
4. Operational period ( date & time)
5. General command & control objectives for the incident (including alternatives)
6. Weather/environmental implications during the period (forecast, wind speed/direction, daylight)
7. General safety/staff messages to be given
8. Attachments (ex. medical plan, facility system status)
9. Name of the individual who prepared the document
10. Approval of the Incident Commander
11. Facility name
Mobilization: Checking In/ Incident Briefing
Check In Officially logs you in at the incident
• To ensure personal accountability• Track resources• Receive assignment
• Know your responsibilities, (Job Action Sheets)
• Identify location for work, rest, staging areas
• Shift duration
• Procedure for getting staff/stuff
• Safety procedures and Personal Protective Equipment (if relevant)
• Receive an incident briefing from your supervisor
Job Action Sheets (JAS)1. Title2. Purpose3. To whom they report4. Critical action considerations5. Forms required by the job6. Broken into operational periods
Immediate 0-2 hoursIntermediate, 2-12 hoursExtended, >12h
JAS “prompts” the team member to take needed actions related to their roles and responsibilities
Activation of Organizational Elements
ICS organizational structure should include only the functions and positions needed to achieve the incident objectives
Organizational elements may be activated without activating the Section Chief.
In this case, the unit reports to the IC directly
Deputy positions can be found for the Incident Commander, Branch and Section Chiefs
SituationUnit
SituationUnit
Incident CommanderIncident Commander
Safety OfficerSafety Officer
Operations Section Operations Section
RescueGroup
RescueGroup
Medical Group Medical Group
Photos courtesy of FEMA
Supply and Facilities
Unit Leader
Supply and Facilities
Unit Leader
Things To AvoidDo not combine ICS positions to save on staffing.
Individuals may supervise multiple units, but the positions should remain distinct.
Do not use nonstandard titles or hybrid positions. These titles may be unrecognizable to assisting or cooperating personnel.
SupplyUnit Leader
SupplyUnit Leader
Facilities UnitLeader
Facilities UnitLeader
Bob Bob
Photos courtesy of FEMA
PlanningMeetingDevelop
strategies &tactics to
Accomplishobjectives
ImplementAction Plan
Assess progressusing measuresof effectiveness
ManagementMeeting
Evaluates& revisesincident
objectives
OperationsBriefingBriefs the
operationalleaders on the
Action Plan
Action Planpreparation& approval
Incident ManagerSets overall
incident objectives& priorities
On-goingsituation
assessment& information
processing
Incident isrecognized
Notifications,assessment,Immediate
needsare
addressed
United States Coast Guard
ICS Communication System
Improves communication – internally and externally Standardizes terminology Allows accountability Two Types of communication
Formal follow lines of authority when• Receiving and giving work assignments• Requesting support or additional resources• Reporting progress on assigned tasks
Informal communication does not follow lines of authority
• Is used to exchange incident or event information only
Allows for documentation on HICS Forms
Chain of Command (Single, Unity)
IncidentCommander
IncidentCommander
Command Staff
General Staff
OperationsSection ChiefOperations
Section ChiefPlanning
Section ChiefPlanning
Section ChiefLogistics
Section ChiefLogistics
Section ChiefFinance/AdminSection Chief
Finance/AdminSection Chief
HAZMAT BranchDirector
HAZMAT BranchDirector
Medical CareBranch Director
Medical CareBranch Director
SafetyOfficerSafetyOfficer
LiaisonOfficerLiaisonOfficer
Public InformationOfficer
Public InformationOfficer
Service Branch Director
Service Branch Director
SupportBranch Director
SupportBranch Director
Orderly Line of
Authority Single
Command
Unity of command
Means that each employee answers to ONE supervisorPhotos courtesy of FEMA
Single versusUnified Command
Single command
One organization and single IC has complete responsibility for incident (hospital receives victims from train crash)
Unified command
Multiple agencies / organizations share responsibility
Collective / collaborative approach
Single set of objectives for multiple agencies
Improved information flow and coordination
Agencies understand joint priorities and restrictions
Single IAP
Agency 1 Agency 2 Agency 3
Photos courtesy of FEMA
Information and Intelligence Within ICS
Establishes a process for gathering, sharing, and managing incident related information and intelligence
Assures that internal information is safeguarded but also ensures availability to those who need it to perform their jobs effectively and safely.
Often handled within Planning, Situation Unit However, in some situations may require:
As a branch within Operations Within the Command Staff As a separate General Staff Section
Types of Briefings/Meetings Staff-Level Briefings: Delivered to
resources assigned to non-operational and support tasks at the Incident Command Post or Base.
Section-Level Briefings: Delivered to an entire Section (e.g., the operational period briefing).
Field-Level Briefings: Delivered to individual resources or crews assigned to operational tasks and/or work at or near the incident site.
Photos courtesy of FEMA
ICS: Briefings/Meetings Essential to effective supervision and incident management Clearly stated objectives Short concise meetings, no long discussions or complex decision
making Allow manager or supervisor to pass along specific information
and expectations for the upcoming work period and to field questions related to that information
Task
What is to be done?
Purpose
Why it is to be done?
End State
How it should look when
done?
Photos courtesy of FEMA
Operational Period Briefing(Shift briefing) Conducted at the beginning of each
operational period Facilitated by the Planning Section Chief Operations Briefing is held to introduce
IAP to Branch Directors and Division/Group Supervisors
After the Operational Briefing, the Incident Action Plan is implemented
Schedule for Operations Briefing
Planning section chief reviews agenda and facilitates
▼
IC presents objectives (sometimes defers to Planning Chief to present)
▼
Off-going Operations Section Chief – provides current assessment and accomplishments during last ops period
▼
Oncoming Operations Section Chief – covers work assignments and staffing
▼
Technical Specialist -Safety Officer – Special Operations –present updates
▼
May have specific Unit Leaders present information
▼
Final IC comments
▼
Planning Section Chief announces next briefing time/location, adjourn
IMS Feature: Pre-designated Key Facilities and Locations
Incident Command Post – where the Incident Commander oversees the incident
Emergency Operations Center – multi-agency center supporting operations
Staging area / Labor pool – where available stuff or staff await assignmentSS
Photos courtesy of FEMA
IMS Feature: Pre-designated Key Facilities and Locations
Helibase Location from which helicopter-centered air
operations are conducted Helibases are generally used on a more long-term
basis and include such services as fueling and maintenance
Helispot Are more temporary locations at the incident, where
helicopters can safely land and take off. Multiple Helispots may be used
HH
H-3H-3
Photos courtesy of FEMA
IMS Features Summary
Common Terminology Modular Organization Management by
Objectives Reliance on an Incident
Action Plan (IAP) Chain of command &
unity of command Unified Command Manageable span of
control
◦ Pre-designated incident locations & facilities
◦ Resource Management◦ Information &
Intelligence Management
◦ Integrated Communications
◦ Transfer of Command◦ Accountability◦ Mobilization
4 Phases of Comprehensive Incident Management (CEM) Activities for “all hazard” planning
Preparedness
Build response capacity/capability
Example: buy dike plugs
Preparedness RecoveryResponseMitigation (Prevention)
Notification
Mitigation
(including prevention) Prevention
activities that reduce impact of hazard
Example: build dikes to prevent flood
Conduct public health surveillance, testing immunizations and quarantine for biological threats
Response
Gain control of an event
Examples: plug dike when a hole appears,
Emergency shelter, housing, food & water
Search and rescue Evacuation Emergency medical
services
Recovery
Return to pre-disaster state
Examples: Repair/replacement of dike, damaged public facilities (bridges, schools, hospitals)
Debris cleanup & removal
Temporary housing
Examples
NIMS slide adaptation
ICS Tools
Emergency Operations PlanHospital Policies and Procedures ManualICS FormsPosition Description and Job Action
SheetsOther resource materials
Are you Ready?
Are you now able to:Explain how the modular organization
expands and contracts?Given a scenario, recognize complicating
factors?Use a planning cycle?Create an incident action plan?
MERET Acknowledges its Partners:
1. Healthcare System Preparedness Program Partnersa. Minnesota Department of Health–Office of Emergency
Preparednessb. MDH Metropolitan Hospital Compactc. Regional Hospital Resource Center Focus Group:
• Michelle Allen, Northwest• Clyde Annala, Northeast• Jill Burmeister, South Central• Chuck Hartsfield, Central• Marla Kendig, Southeast• Emily Parsons, MDH-OEP• Justin Taves, West Central• Eric Weller, South Central
2. FEMA Independent Study Program
Elective Slides
Volunteer groups that may be deployment during an incident
Categories of MN Emergency Readiness Volunteers…
MN Disaster Medical Assistance Team (FEMA) http://www.mndmat.com/
Minnesota Responds/Medical Reserve Corp.
Community Emergency Response Teams (CERT)
Minnesota Responds
Pre-registers, manages and mobilizes volunteers to help communities respond to all types of disasters
Help communities cope up with medical and public health needs
Register through www.mnresponds.org Volunteers attend a program orientation or training Volunteers assigned according to training needs,
profession, or skills Anyone who has interest in volunteering during a
health emergency is encouraged to register*
Medical Reserve Corps (MRC) There are 13 MRC Units throughout Minnesota Apply through the
Minnesota Responds website Or your local public health agency. Your name will be stored in both the MN Responds
and MRC databases Many positions in Medical Reserve Corps do not
require a license, training and experience more valuable
If licensed, Medical Reserve Corps staff will verify status of license with appropriate licensing board
Volunteers assist with public health initiatives community activities if there is no emergency
Volunteers work in mass dispensing or vaccination clinics, serve as staff at local hospital or off-site care facility; and provide expert info. to local residents
Community Emergency Response Team (CERT) Trained civilians to assist with emergency
needs following a disaster Training programs are offered within
communities by first responders Concepts covered are
Immediate needs following a disaster Mitigation/preparedness activities Life saving, decision-making skills,and
rescuer safety Offer immediate services until professional
resources arrive
If you are assigned outside your facility
Assure that you have a sponsoring organization, travel, and housing
Authorization to leave, payroll, worker’s compensation issues
Personal and technical items packed (copies of licenses, etc)
Ensure that family knows where you will be and how you can be contacted