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Command and Control in Evacuations
OSHA Training Institute – Region IXUniversity of California, San Diego (UCSD) - Extension
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Purpose:
To ensure you learn effective training and presentation techniques well enough to become an effective outreach trainer of command and control during health care facility evacuations
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Objectives State how the National Incident Management
System influences large scale evacuations Discuss the development of Standard
Emergency Management System and how it works in disaster management
Identify how the Hospital Incident Command System (HICS) or Incident Command System (ICS) are used in evacuations
Identify three purposes of HICS or ICS
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National Response Plan
“At the federal level, the National Response Plan (NRP) provides a framework for how the federal government is to assist states and localities in managing domestic incidents, including both incidents of national significance and those of lesser severity.”
GAO Report; GAO-06-826, Congressional Quarterly, Inc. July 20, 2006
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National Incident Management System (NIMS) “…a consistent nationwide approach for federal,
state, tribal, and local governments to work effectively and efficiently together to prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size, or complexity.” -HSPD-5
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NIMS - Synopsis
NIMS What it is…Core set of:DoctrineConceptsPrinciplesTerminologyOrganizational
processesApplicable to all
hazards
NIMS What it is not…
Not an operational or resource allocation plan
Not a terrorism or WMD-specific plan
Not designed for international events
FEMA. NIMS. SEMS Advisory Committee Meeting, Mather, CA March 2005
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NIMS
Overall conceptual framework for incident management applicable to all hazards
FEMA. NIMS. SEMS Advisory Committee Meeting, Mather, CA March 2005
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NIMS Components
Command and Management Preparedness Resource Management Communications and Information Management Supporting Technologies Ongoing Management and Maintenance
FEMA. NIMS. SEMS Advisory Committee Meeting, Mather, CA March 2005
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National Incident Management System(NIMS)
Relationship: NIMS and NRP
LocalResponse
StateResponse or Support
FederalResponse or Support
.
National Response Plan (NRP) provides support at the Federal level and is activated for events of
national significance.
Incident
Used for all events
FEMA. NIMS. SEMS Advisory Committee Meeting, Mather, CA March 2005
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SEMS
Standardized Emergency Management System (SEMS) Developed in California
Local entities must use SEMS in order to be eligible for State funding for response related personnel costs in California
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The History of ICS Developed in the 1970s following devastating
California fires. Resulted in deaths, injuries and huge property losses. Resources and tactical ability were available Inadequate management resulted in:
Lack of accountability Poor communication Lack of a planning process Overloaded Incident Commanders No method to integrate interagency requirements
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SEMS was Developed to Improve: Coordination between/among agencies The flow of information and resources The rapid mobilization, resource tracking and
deployment
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SEMS Framework
SEMS includes the: Incident Command System (ICS) Multi-agency or inter-agency coordination Master Mutual Aid Agreement (MMAA) and
system The operational area concept
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Legal Basis for SEMS in California
Government Code Section 8607 became effective 1993
The intent of the code is to improve coordination of State and local emergency response in California
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What Is ICS and HICS?
The Incident Command System (ICS): Is a flexible standardized, on-scene, all-hazard
incident management concept that can be expanded to handle the demands and potential complexities of single or multiple incidents
ICS in healthcare is called Hospital Incident Command System (HICS) and is based on the 2006 version of the Hospital Emergency Incident Command System (HEICS)
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Hospital Incident Command System Organizational core of a crisis management
system Built on the principles and structure of ICS It is the same crisis management system used
by other response agencies Offers a universal link with outside resources
HICS
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How HICS Works
Chain of command Common language Flexibility Job action sheets Mutual aid Documentation for financial recovery
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Why Use the Incident Command System in the Hospital?
Efficiency
Coordination
Communication
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ICS Purposes
ICS helps to ensure:Achievement of
tactical objectivesEfficient use of
resourcesSafety of responders
and othersHospital Exercise using HICS
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ICS Features Common terminology Organizational resources Manageable span of control Organizational facilities Use of position titles Reliance on an Incident Action Plan Integrated communications Accountability
Slide Credit: FEMA IS100-HC
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Structure of ICS and HICS
Flexible Built on successful
business practice Built on decades of
lessons learned from the management and organization needed in emergency incidents
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ICS Structure
SafetyOfficer
LiaisonOfficer
InformationOfficer
Finance Logistics Operations Plans
Incident Commander
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Chain of CommandChain of command is an orderly line of authority within the ranks of the incident management organization.
Authority
There is only one person in charge until replaced by the next qualified person
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The Span of Control under ICS The span of control refers to the supervisory
structure of the organization and the number of individuals or resources one incident supervisor can manage effectively
The optimal reporting element is 5 elements per supervisor but may vary from 3 - 7
SupervisorSupervisor
Resource 1Resource 1
Resource 2Resource 2 Resource 3Resource 3 Resource 4Resource 4
Resource 5Resource 5
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Incident Operations Organization
COMMAND
SINGLERESOURCES
SINGLE RESOURCES
COMMAND
SECTIONS
BRANCHES
DIVISONS/GROUPS
RESOURCES
Small IncidentLarge Incident
Multiple layers as needed for span of control
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Management by Objectives ICS is managed by
objectives Objectives are
communicated throughout the entire ICS organization through the incident planning process
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Reliance on an Incident Action Plan Every incident should have an Incident
Action Plan (IAP) that:
Specifies the incident objectives. Lists the actions based on objectives Measurable strategic operations to
support the objectives and be achieved within operational period
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Elements of an Incident Action Plan Every IAP must have four
elements:What do we want to do? Who is responsible for doing
it? How do we communicate
with each other? What is the procedure if
someone is injured?
Slide credit - FEMA IS 100 HC
Incident Commander
Only the positions needed are filled to manage the incident. The expansion of incidents may require the delegation of authority to Operations, Planning, Logistics and Finance/Admin sections.
IncidentCommander
IncidentCommander
Public InformationOfficer
Public InformationOfficer
LiaisonOfficerLiaisonOfficer
SafetyOfficerSafetyOfficer
Command Staff
OperationsSection ChiefOperations
Section ChiefPlanning
Section ChiefPlanning
Section ChiefLogistics
Section ChiefLogistics
Section ChiefFinance/AdminSection Chief
Finance/AdminSection Chief
General Staff
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Incident Commander
The Incident Commander Provides overall leadership
for incident response. Established Command Post
Based on the requirements and complexity of the incident
Delegates authority to others Takes general direction from
agency administrator/official Assesses need for staff
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Incident Commander
Establishes incident objectives
Directs staff to develop the Incident Action Plan (IAP)
Is assisted by the Command Staff
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Public Information Officer Member of the
Command Staff Conduit between internal
and external stakeholders, including media interactions
Public Information Systems are required by National Incident Management System (NIMS)
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Safety Officer
Member of the Command staff
Monitors safety conditions
Develops measures for assuring the safety of all assigned personnel
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Liaison Officer
Command Staff Primary contact for
supporting agencies and organizations that are assisting at an incident, but are NOT participating within the ICS
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HICS Functional Areas
Operations section
Planning section Logistics section Finance /
Administration section
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Operations Section Chief
Conducts, develops, directs all tactical objectives, operations and resources
In HICS, the word “tactical” refers to the business of managing patient care and is not a reference to security
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Operations Section in HICS
Carries out the medical objectives to the best of the staff’s ability
The Medical Care Branch covers Clinical Care Ancillary Services Patient Registration
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Planning Section Chief
Manages the planning process by gathering, analyzing and disseminating information and intelligence.
Compiles the information that is included in the Incident Action Plan
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Planning Section
The Planning section also maintains status and situational reports, and patient tracking under the HICS structure
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Logistics Section Chief
Directs the resources and services required to support incident activities
May include ensuring personnel have a place to rest, are fed, have medical support, communications and transportation
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Logistics Section The Labor Pool is
managed under the Logistics Section in HICS. This is a change from the previous structure in which the labor pool was the responsibility of the Planning Section.
Staging Area/Labor Pool is the location where personnel and equipment are staged while waiting for tactical assignment
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Finance/Administration Section Chief
Manages costs related to incident
Performs accounting, procurement, time payroll recording and cost analysis
Funds medical objectives under HICS
Documents costs to maximize financial recovery and reduce liability
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Accountability Principles in ICS Check-In
All responders must report in and assignments are given in accordance with the procedures established by the Incident Commander
Incident Action Plan Response operations must
be coordinated as outlined in the Incident Action Plan
Unity of Command Principle that each individual
will be assigned to only one supervisor
FEMA IS - 100-HC
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Accounts for personnel. Tracks resources Prepares personnel for
assignments Locates personnel in
case of an emergency Organizes the
demobilization process
Check-In Purpose
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Summary
NIMS is an overall conceptual framework for incident management applicable to all hazards
NRP provides a federal framework to assist states and localities during disasters
ICS is flexible, can handle large or small events HICS is ICS in a healthcare setting and will be
used in evacuations
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References
FEMA. National Incident Management System. SEMS Advisory Committee Meeting, Mather, CA March 24, 2005. Slide Set
FEMA National Incident Management System (NIMS), An Introduction IS – 700. http://training.fema/gov
Homeland Security. Quick Reference Guide for the National Response Plan May 22, 2006, Version 4.0