Incident Management Systems for Hospitals
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Incident Management Systems Incident Management Systems for Hospitals for Hospitals Kristi L Koenig, MD, FACEP Kristi L Koenig, MD, FACEP Professor of Clinical Emergency Medicine Professor of Clinical Emergency Medicine Director of Public Health Preparedness Director of Public Health Preparedness University of California at Irvine University of California at Irvine
Transcript of Incident Management Systems for Hospitals
Incident Management Systems Incident Management Systems for Hospitalsfor Hospitals
Kristi L Koenig, MD, FACEPKristi L Koenig, MD, FACEPProfessor of Clinical Emergency MedicineProfessor of Clinical Emergency MedicineDirector of Public Health PreparednessDirector of Public Health PreparednessUniversity of California at IrvineUniversity of California at Irvine
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Why Management Aspects?Why Management Aspects?
Incident Management new to health Incident Management new to health care systemscare systems–– Not traditionally used in some types of Not traditionally used in some types of
events, e.g. biological, nursing strikeevents, e.g. biological, nursing strikeClinical is relatively familiarClinical is relatively familiar““Emergency ManagementEmergency Management”” unfamiliar unfamiliar to most cliniciansto most cliniciansED is ED is ““soft targetsoft target””
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Are We Prepared?Are We Prepared?
Post 9/11Post 9/11–– Prior Secretary of Department of Prior Secretary of Department of
Homeland Security said Homeland Security said ““yes!yes!””–– Experts quoted in New York Times said Experts quoted in New York Times said
““no!no!””
Lack of BenchmarksLack of Benchmarks
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Why do hospitals need to be prepared?Why do hospitals need to be prepared?
Disaster are Local!Disaster are Local!–– Most casualties arrive to the hospital Most casualties arrive to the hospital
within 1 within 1 ½½ hourshours–– Civilian volunteers and local first Civilian volunteers and local first
responders rescue most victimsresponders rescue most victims(95%) within first 24 hours(95%) within first 24 hours
–– Critical care and trauma surgery managed Critical care and trauma surgery managed without State or Federal assistancewithout State or Federal assistance
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Disaster CasualtiesDisaster Casualties
Most planning focuses on Most planning focuses on injuriesinjuriesVictims need treatment for other Victims need treatment for other conditionsconditions–– Lack of access to primary careLack of access to primary care–– Exacerbation of chronic conditionsExacerbation of chronic conditions–– Psychological effectsPsychological effects–– Increased incidence of childbirth, heart Increased incidence of childbirth, heart
attacksattacks
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Sudden Impact EventsSudden Impact EventsStudy of 29 U.S. DisastersStudy of 29 U.S. Disasters
Most trauma victims have Most trauma victims have minorminorinjuriesinjuries–– Accidents occur during recovery phaseAccidents occur during recovery phase
1010--15% of victims hospitalized15% of victims hospitalized–– Half admitted for nonHalf admitted for non--medical reasonsmedical reasons–– Sent home next daySent home next day
6% supply shortages6% supply shortages2% personnel shortages2% personnel shortages
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Lack of Resources?Lack of Resources?
Studies of recent disasters in the US Studies of recent disasters in the US show a lack of a show a lack of a management systemmanagement system to to organize available resourcesorganize available resourcesHurricane KatrinaHurricane Katrina–– An exception?An exception?
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Key PrinciplesKey Principles
AllAll--HazardHazard–– Hazards Vulnerability Analysis (HVA)Hazards Vulnerability Analysis (HVA)
Comprehensive Emergency ManagementComprehensive Emergency Management–– MitigationMitigation–– PreparednessPreparedness–– ResponseResponse–– RecoveryRecovery
Incident Management SystemIncident Management System
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Why Incident Management Why Incident Management Systems for Hospitals?Systems for Hospitals?
Continuity of Business Operations PlanContinuity of Business Operations Plan–– Meet responsibilities to employees, patients, and Meet responsibilities to employees, patients, and
communitycommunity–– Reduce insurance/workers compensation costsReduce insurance/workers compensation costs–– Protect capital investmentProtect capital investment–– Regulatory complianceRegulatory compliance
Ultimate goal to reduce morbidity and Ultimate goal to reduce morbidity and mortalitymortalityJCAHO requirementJCAHO requirement
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
JCAHO RequirementsJCAHO RequirementsJanuary 2001January 2001
AllAll--HazardHazard–– Hazard Vulnerability Analysis (HVA)Hazard Vulnerability Analysis (HVA)
Comprehensive Emergency ManagementComprehensive Emergency ManagementCommunityCommunity--Wide PlanningWide PlanningIncident Management SystemIncident Management System
Example Example -- Hospital Emergency Incident Hospital Emergency Incident Command System (HEICS)Command System (HEICS)Consistent with Consistent with communitycommunity standardsstandards
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Incident Management SystemIncident Management System
Command, Control, LeadershipCommand, Control, LeadershipFlexible process for ongoing assessmentFlexible process for ongoing assessment–– Incident Action PlansIncident Action Plans
Unified CommandUnified Command for multifor multi--jurisdictional eventsjurisdictional eventsFederal LevelFederal Level–– National Incident Management System (NIMS)National Incident Management System (NIMS)
Hospital LevelHospital Level–– Hospital Emergency Incident Command System (HEICS)Hospital Emergency Incident Command System (HEICS)–– Change to Hospital Incident Command System (HICS)Change to Hospital Incident Command System (HICS)
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Disaster Disaster Management Management AgenciesAgencies
Federal Federal StructureStructurePre 9/11Pre 9/11
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
National Incident National Incident Management System (NIMS)Management System (NIMS)
Established post 9/11 by Homeland Established post 9/11 by Homeland Security Presidential Directive 5Security Presidential Directive 5Ensures all levels of government have Ensures all levels of government have capability to work efficiently together capability to work efficiently together using a national approach to domestic using a national approach to domestic incident managementincident management
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Incident Command System Incident Command System (ICS)(ICS)
Component of the National Incident Component of the National Incident Management System (NIMS)Management System (NIMS)Provides a universal structure and Provides a universal structure and process to manage the organizationprocess to manage the organization’’s s response and recovery activitiesresponse and recovery activities
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
External ScenariosExternal Scenarios
1.1. Nuclear DetonationNuclear Detonation——1010--Kiloton Improvised Nuclear DeviceKiloton Improvised Nuclear Device2.2. Biological AttackBiological Attack——Aerosol AnthraxAerosol Anthrax3.3. Biological Disease OutbreakBiological Disease Outbreak——Pandemic InfluenzaPandemic Influenza4.4. Biological AttackBiological Attack——PlaguePlague5.5. Chemical AttackChemical Attack——Blister AgentBlister Agent6.6. Chemical AttackChemical Attack——Toxic Industrial ChemicalsToxic Industrial Chemicals7.7. Chemical AttackChemical Attack——Nerve AgentNerve Agent8.8. Chemical AttackChemical Attack——Chlorine Tank ExplosionChlorine Tank Explosion9.9. Natural DisasterNatural Disaster——Major EarthquakeMajor Earthquake10.10. Natural DisasterNatural Disaster——Major HurricaneMajor Hurricane11.11. Radiological AttackRadiological Attack——Radiological Dispersal DevicesRadiological Dispersal Devices12.12. Explosives AttackExplosives Attack——Bomb Using Improvised Explosive DeviceBomb Using Improvised Explosive Device13.13. Biological AttackBiological Attack——Food ContaminationFood Contamination14.14. Cyber AttackCyber Attack
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Internal ScenariosInternal Scenarios
1.1. Bomb ThreatBomb Threat2.2. Evacuation, Complete or Partial FacilityEvacuation, Complete or Partial Facility3.3. FireFire4.4. Hazardous Material SpillHazardous Material Spill5.5. Hospital OverloadHospital Overload6.6. Hostage/BarricadeHostage/Barricade7.7. Infant/Child AbductionInfant/Child Abduction8.8. Internal FloodingInternal Flooding9.9. Loss of Heating/Ventilation/Air ConditioningLoss of Heating/Ventilation/Air Conditioning10.10. Loss of PowerLoss of Power11.11. Loss of WaterLoss of Water12.12. Severe WeatherSevere Weather13.13. Work StoppageWork Stoppage
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
ICS ICS -- ComponentsComponents
Adaptable to any type of emergencyAdaptable to any type of emergencyCommon organizational/procedural Common organizational/procedural standardsstandardsCommon TerminologyCommon Terminology–– Integrated CommunicationsIntegrated Communications
Modular OrganizationModular OrganizationUnified Command StructureUnified Command Structure–– Maintains autonomy of jurisdictionMaintains autonomy of jurisdiction
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
ICS ICS -- ComponentsComponents
Manageable Span of ControlManageable Span of ControlConsolidated Action PlansConsolidated Action Plans–– Represent Incident Action Planning ProcessRepresent Incident Action Planning Process
Comprehensive Resource Comprehensive Resource ManagementManagementDesignated Incident FacilitiesDesignated Incident Facilities
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ICSICS5 Major Functional Areas5 Major Functional Areas
Command or ManagementCommand or ManagementOperationsOperationsPlanning Planning LogisticsLogisticsFinanceFinance
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Operations
‘Doers'
Planning
Address"what if?"
Logistics
Supports Operations
Requirements
Finance / Admin
Tracks Expenses
Incident Command
Leadership & DirectionAuthorization of Expenses
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Health Care FacilitiesHealth Care Facilities
Victims arrive unannouncedVictims arrive unannouncedMay not arrive by EMSMay not arrive by EMSFamily and friends overwhelm system Family and friends overwhelm system with inquirieswith inquiriesVolunteersVolunteersMediaMedia
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Health Care FacilitiesHealth Care Facilities
Convergence of injured persons, Convergence of injured persons, relatives & friends, the general public relatives & friends, the general public (volunteers), off(volunteers), off--duty staff & medical duty staff & medical personnel, and mediapersonnel, and mediaNotNot a Scarcity of Resourcesa Scarcity of ResourcesLack of Lack of Incident Management SystemIncident Management System
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Critical Hospital ResourcesCritical Hospital Resources
Physical plantPhysical plantPersonnelPersonnelSupervisionSupervisionSupplies and EquipmentSupplies and EquipmentCommunicationCommunicationTransportationTransportation
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Brief History of HEICSBrief History of HEICS
19801980’’s s –– FIRESCOPEFIRESCOPE–– Southern California wildfires use ICSSouthern California wildfires use ICS
1987 1987 -- Hospital Council of Northern Hospital Council of Northern California adapts ICS to hospitalsCalifornia adapts ICS to hospitals1991 1991 -- HEICS IHEICS I1992/93 1992/93 –– HEICS IIHEICS II19981998-- HEICS IIIHEICS III20062006-- HEICS IVHEICS IVAugust 2006August 2006-- HICSHICS GuidebookGuidebook
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
HEICS I HEICS I -- IIIIII
Areas needing improvementAreas needing improvement–– Not NIMS compliantNot NIMS compliant–– Medical Officer not directly under ICMedical Officer not directly under IC–– Labor pool in Planning, not OperationsLabor pool in Planning, not Operations–– Damage assessment in Logistics, not OperationsDamage assessment in Logistics, not Operations–– Operations sectionOperations section
Only focus on medical requirementsOnly focus on medical requirementsDesigned around department, not incident functionsDesigned around department, not incident functions
–– No concept of Incident Action PlanningNo concept of Incident Action Planning–– Existed separately from hospital disaster planExisted separately from hospital disaster plan
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
The New HICSThe New HICS
HEICS IV/HICS has different HEICS IV/HICS has different organizational chartorganizational chart–– Simpler and smallerSimpler and smaller–– More flexible and adaptableMore flexible and adaptable
NIMS compliantNIMS compliantEnhanced Job Action SheetsEnhanced Job Action Sheets–– Extended operations and recovery sectionsExtended operations and recovery sections
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
HICS GuidebookHICS Guidebook
#1: High#1: High--level guidance for developing a hospital level guidance for developing a hospital Emergency Management Program (EMP)Emergency Management Program (EMP)
Key considerationsKey considerationsPlanning and response assumptionsPlanning and response assumptionsProvides guidance for use of the incident command Provides guidance for use of the incident command systemsystem
–– Adapted to incident specific situationsAdapted to incident specific situations–– Modular and scalable based on availability of Modular and scalable based on availability of
personnelpersonnel
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
HICS GuidebookHICS Guidebook
#2: A HICS training curriculum #2: A HICS training curriculum Specific instructional guidance and teaching Specific instructional guidance and teaching outlines outlines Curriculum materials designed to provide variable Curriculum materials designed to provide variable methods of training hospital staffmethods of training hospital staff
–– Emergency response principlesEmergency response principles–– Incident commandIncident command
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
New HICS ElementsNew HICS Elements
A more compact and versatile incident A more compact and versatile incident management team structuremanagement team structure–– ModularModular–– Scalable to the eventScalable to the event
Updated Job Action Sheets (JAS)Updated Job Action Sheets (JAS)Revised, National Incident Management Revised, National Incident Management System (NIMS) consistent forms System (NIMS) consistent forms
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
New HICS ElementsNew HICS Elements
Incident Planning Guides (IPG)Incident Planning Guides (IPG)–– Assist in evaluating and writing emergency plansAssist in evaluating and writing emergency plans–– Scenario basedScenario based
Incident Response Guides (IRG)Incident Response Guides (IRG)–– Key considerations and response actions for Key considerations and response actions for
command staffcommand staff–– Scenario basedScenario based
Expanded information and toolsExpanded information and tools–– Guidebook and Appendices Guidebook and Appendices –– ResourcesResources
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
HICS SummaryHICS Summary
The HEICS IV/HICS project updated HEICS III to The HEICS IV/HICS project updated HEICS III to current emergency management practices and current emergency management practices and principlesprinciplesDeveloped by hospital and incident command expertsDeveloped by hospital and incident command expertsHICS Guidebook assists hospitals in implementationHICS Guidebook assists hospitals in implementationHICS provides new materialsHICS provides new materials–– Job Action SheetsJob Action Sheets–– Incident Planning GuidesIncident Planning Guides–– Incident Response GuidesIncident Response Guides
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Hospital ICSHospital ICS
Public Information OfficerCommunity Relations Mgr
SecuritySecurity Director
Safety OfficerIndustrial Hygeine
LiaisonEmergency Manager
FacilitiesCommunicationsTransportation
Supply
LogisticsFacilities Director
SituationLabor Pool
Medical StaffPatient Tracking
PlanningVP Admininstration
Medical careAncillary SrvicesHuman Services
OperationsVP Operations
TimeProcurement
ClaimsCost
FinanceCFO
Incident CommanderAdministrator
Public Information OfficerCommunity Relations Mgr
SecuritySecurity Director
Safety OfficerIndustrial Hygeine
LiaisonEmergency Manager
FacilitiesCommunicationsTransportation
Supply
LogisticsFacilities Director
SituationLabor Pool
Medical StaffPatient Tracking
PlanningVP Admininstration
Medical careAncillary SrvicesHuman Services
OperationsVP Operations
TimeProcurement
ClaimsCost
FinanceCFO
Incident CommanderAdministrator
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Command SectionCommand Section
LeadershipLeadershipIncident CommanderIncident Commander–– Organize and direct Emergency Organize and direct Emergency
Operations Center and all positions Operations Center and all positions throughout the ICS structurethroughout the ICS structure
–– Overall direction for hospital operationsOverall direction for hospital operations–– Authorizes evacuationsAuthorizes evacuations
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Command (Management) Command (Management) SectionSection
Responsible for overall incident Responsible for overall incident managementmanagementCommand Staff PositionsCommand Staff Positions–– Information (Public Affairs) OfficerInformation (Public Affairs) Officer–– Safety OfficerSafety Officer–– Liaison OfficerLiaison Officer
Single vs. Unified CommandSingle vs. Unified Command
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Operations SectionOperations Section
Reduction of immediate hazardReduction of immediate hazardEstablish situation controlEstablish situation controlRestore normal operationsRestore normal operationsFunctionsFunctions–– Staging areasStaging areas–– ResourcesResources–– Organization of operations divisions, Organization of operations divisions,
groups, and branchesgroups, and branches
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Operations SectionOperations SectionKey ComponentsKey Components
Business ContinuityBusiness ContinuityEquipmentEquipmentPlant and UtilitiesPlant and UtilitiesSafety and SecuritySafety and SecurityHealth and MedicalHealth and Medical
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Planning SectionPlanning Section
Collection, evaluation and dissemination of Collection, evaluation and dissemination of tactical information about the incidenttactical information about the incidentMaintains information on current and Maintains information on current and forecasted situationforecasted situationTracks status of resourcesTracks status of resourcesPrimary unitsPrimary units–– Section chief/deputy, resources unit, situation unit, Section chief/deputy, resources unit, situation unit,
documentation unit, demobilization unit, technical documentation unit, demobilization unit, technical specialistsspecialists
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Logistics SectionLogistics Section
Provide support to incidentProvide support to incidentOrder all resources from offOrder all resources from off--incident incident locationslocationsProvide facilities, transportation, supplies, Provide facilities, transportation, supplies, equipment maintenance, fueling, feeding, equipment maintenance, fueling, feeding, communication and medical services for communication and medical services for respondersrespondersSectionsSections–– Chief/deputy, supply unit, facilities unit, ground Chief/deputy, supply unit, facilities unit, ground
support/transportation unitsupport/transportation unit
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Finance SectionFinance Section
Procurement UnitProcurement UnitTime UnitTime UnitCompensation/Claims UnitCompensation/Claims UnitCost UnitCost Unit–– Capture costs for FEMA Capture costs for FEMA
reimbursements during State or reimbursements during State or Federal disaster declarationsFederal disaster declarations
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
ICS ICS –– Translated!Translated!
Command/ManagementCommand/Management……PointersPointers–– PlansPlans………………………………………………ThinkersThinkers–– LogisticsLogistics……………………………………..Getters..Getters–– FinanceFinance…………………………………………CountersCounters–– OperationsOperations………………………………...Doers...Doers
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
ICS Functional ResponsibilityICS Functional Responsibility
CommandCommand–– Strategy, global responsibilityStrategy, global responsibility–– Define mission, ensure completionDefine mission, ensure completion
OperationsOperations–– Implement plan, direct tacticsImplement plan, direct tactics
PlanningPlanning–– Collect/analyze data, direct planningCollect/analyze data, direct planning–– Continuity of operationsContinuity of operations
LogisticsLogistics–– Support responseSupport response–– Environment and materialsEnvironment and materials
FinanceFinance–– Track money, ensure documentationTrack money, ensure documentation–– Maximize recovery, reduce liabilityMaximize recovery, reduce liability
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
ICS ImplementationICS Implementation
Unfolds in a modular fashionUnfolds in a modular fashion–– Based on incident type and sizeBased on incident type and size–– Single individual can simultaneously Single individual can simultaneously
manage all major functional areas or manage all major functional areas or independent management requiredindependent management required
Used to plan, organize, staff, direct and Used to plan, organize, staff, direct and control emergency situationscontrol emergency situations
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
ICS ImplementationICS Implementation
Incidents without warning (earthquake, Incidents without warning (earthquake, explosion)explosion)–– Leadership and direction initially provided by any Leadership and direction initially provided by any
employee who first recognizes the dangeremployee who first recognizes the danger
Incidents with warning (severe weather, cloud Incidents with warning (severe weather, cloud of hazardous materials approaching facility)of hazardous materials approaching facility)–– Director or designee provides initial leadership Director or designee provides initial leadership
and directionand direction
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
ICS ImplementationICS ImplementationIncident Management TeamIncident Management Team
Police and/or Safety ServicePolice and/or Safety ServiceSafety and Security Group LeaderSafety and Security Group Leader
Chief of StaffChief of StaffHealth and Medical Group LeaderHealth and Medical Group Leader
Facilities/EngineeringFacilities/EngineeringEquipment/Plant/Utilities Group LeaderEquipment/Plant/Utilities Group Leader
Associate DirectorAssociate DirectorBusiness Continuity Group LeaderBusiness Continuity Group LeaderStaffed based on incidentStaffed based on incidentOperations Section ChiefOperations Section Chief
Fiscal ServiceFiscal ServiceFinance Section ChiefFinance Section Chief
Acquisitions and Material Acquisitions and Material Management ServiceManagement Service
Logistics Section ChiefLogistics Section Chief
Emergency ManagementEmergency ManagementPlanning Section ChiefPlanning Section Chief
DirectorDirector’’s Offices OfficeIncident CommanderIncident Commander
Hospital Position/ServiceHospital Position/ServiceIMT PositionIMT Position
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Command PostCommand Post
Consider establishing for incident that Consider establishing for incident that involves a distinct scene within the involves a distinct scene within the facility or its groundsfacility or its groundsAdAd--hoc location where decisions are hoc location where decisions are made concerning control of incidentmade concerning control of incident
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Emergency Operations CenterEmergency Operations Center
PrePre--designated location within facilitydesignated location within facilityLocation where activates related to Location where activates related to information collection, interinformation collection, inter--service service coordination, strategic decisioncoordination, strategic decision--making making and resource allocation are managedand resource allocation are managedNot all incidents require the use of an Not all incidents require the use of an EOCEOC
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
EOC ActivitiesEOC Activities
Gather information through ongoing Gather information through ongoing assessmentsassessmentsBrief EOC staffBrief EOC staffEstablish shiftsEstablish shiftsSet overall objectives for each shiftSet overall objectives for each shiftDetermine resource requirementsDetermine resource requirementsDevelop communications and traffic plansDevelop communications and traffic plansKeep complete documentationKeep complete documentation
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Life Cycle of an IncidentLife Cycle of an Incident
–– Event recognitionEvent recognition–– Incident notificationIncident notification–– Situation analysis and monitoringSituation analysis and monitoring–– Emergency Operations Plan (EOP) activationEmergency Operations Plan (EOP) activation–– Operation of the Hospital Command Center (HCC)Operation of the Hospital Command Center (HCC)–– Staffing the Incident Management TeamStaffing the Incident Management Team–– Incident Action PlanningIncident Action Planning–– Communication and CoordinationCommunication and Coordination–– DemobilizationDemobilization–– System RecoverySystem Recovery
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
ItIt’’s 3 a.m. and Disaster Strikess 3 a.m. and Disaster Strikes……
Response ActionsResponse Actions–– Control the sceneControl the scene–– Establish a Command PostEstablish a Command Post–– Conduct internal notificationsConduct internal notifications–– Develop initial strategy for protecting life and Develop initial strategy for protecting life and
propertyproperty–– Determine what resources are needed to control Determine what resources are needed to control
the problemthe problem–– Continue to organize and manage the situation Continue to organize and manage the situation
until relieveduntil relieved
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
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
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
Summary Summary –– Hospital ICSHospital ICS
All HazardAll Hazard–– Hazard Vulnerability AnalysisHazard Vulnerability Analysis–– Comprehensive Emergency ManagementComprehensive Emergency Management
Convergence at hospitalsConvergence at hospitalsNeed for Need for management systemmanagement system, not just , not just resourcesresourcesFunction basedFunction based–– Command: Plans, Logistics, Finance, OperationsCommand: Plans, Logistics, Finance, Operations
University of California at IrvineUniversity of California at IrvineDepartment of Emergency MedicineDepartment of Emergency Medicine
ReferencesReferences
VA Emergency Management Program VA Emergency Management Program Guidebook (updated 6/28/05)Guidebook (updated 6/28/05)–– http://www1.va.gov/emshg/page.cfm?pg=114http://www1.va.gov/emshg/page.cfm?pg=114
Emergency Management Principles and Emergency Management Principles and Practices for Healthcare SystemsPractices for Healthcare Systems–– http://www.va.gov/emshghttp://www.va.gov/emshg
California EMS AuthorityCalifornia EMS Authority–– http://www.emsa.ca.gov/hics/hics.asphttp://www.emsa.ca.gov/hics/hics.asp
