introduction to: incident command system (ics) hospital emergency incident command system (heics)...
TRANSCRIPT
Introduction to:
Incident Command System (ICS)
Hospital Emergency Incident Command System (HEICS)
National Incident Management System (NIMS)
(IS 100, 200, 700)
The University of South AlabamaCenter for Strategic Health Innovation
© University of South Alabama Center For Strategic Health Innovation. All Rights Reserved.These slides are a part of the ARRTC program and cannot be reproduced for commercial purposes.
ICS is:
• A Proven Crisis Management System Based on Military and Fire Management Systems
• Common Language between agencies - (Fire, Police, EMA, Hospitals, Public Health…)
• Manages routine or planned events
• Provides logistical and administrative support to operational personnel
• Improves Communication
• Flexible, adaptable system
NIMS is:
• Comprehensive federal system directing response agencies to function in an organized manner
• Established to coordinate:– Plans– Organization Structure– Training and Exercises– Resources– Communications and Technology
NIMS Compliance
• HSPD-5 issued in 2004• For disaster response agencies and departments,
NIMS made a condition for Federal assistance• Confusion over initial NIMS compliance for
hospitals and healthcare facilities• DHS/HRSA letter of May 26, 2006 explains
newest issues
NIMS Implementation Activities for Hospitals
• Similar to expectations placed on government agencies
• Consists of seven categories and seventeen elements
• The Hospital Emergency Incident Command System (HEICS) incorporates NIMS terminology, principles and practices
NIMS Compliance
1. Adopt NIMS at your agency2. Revise disaster plans to incorporate NIMS3. Become familiar with National Response Plan4. Adopt ICS (HEICS) and make it a part of your
Disaster Response Plan5. Coordinate with local response agencies and
use a Multi-Agency Coordination system6. Develop Mutual Aid agreements
NIMS Compliance
7. Participate in local Public Information Plans
8. Coordinate and implement federal funding and demonstrate commitments
9. Select personnel need IS 100, 200, 700, and 800 Courses – later in presentation (www.fema.gov/emergency/nims/)
10. NIMS compliance phased in over next 2 years
11. Compliance with first set of objectives is September 30, 2007. (Changed from 9/30/06)
NIMS Components
1. Command and Management - ICS
2. Preparedness – Plans/Exercises/Training
3. Resource Management – Stuff/People
4. Communications and Information Management - AIMS
5. Supporting technologies – IT
6. Ongoing maintenance and management – Periodic NIMS updates/requirements
National Response PlanEmergency Support Functions (ESFs)
1. TransportationDepartment of Transportation
2. CommunicationsHomeland Security
3. Public Works and EngineeringDepartment of DefenseArmy Corps of Engineers
4. FirefightingDepartment of Agriculture
5. Emergency ManagementHomeland Security/FEMA
6. Mass Care, Housing,Human ServicesHomeland Security/FEMA
7. Resource SupportGeneral Services Administration
8. Public Health and Medical ServicesDepartment of Health and Human Services
9. Urban Search and RescueHomeland Security/FEMA
10. Oil & Hazardous Materials ResponseEnvironmental Protection Agency
11. Agriculture and Natural ResourcesDepartment of Agriculture
12. EnergyDepartment of Energy
Response PlanEmergency Support Functions
13. Public Safety and SecurityDepartment of Justice
14. Long-Term Community RecoveryHomeland Security/FEMA
15. External AffairsHomeland Security
ICS
Basic Features of ICS
• Modular organization• Management by objectives• Reliance on an Incident Action Plan (IAP)• Chain of command • Manageable span of control• Unity of command• Unified Command
History of ICS
Weaknesses in incident management before ICS– Lack of accountability– Poor communication– Lack of a planning process– Overloaded Incident Commanders– No method to integrate interagency
requirementsICS provides an organized system to manage
incidents and addresses these weaknesses
ICS Terminology
Unified CommandSectionsDivisionsGroupsBranchesTask ForcesStrike TeamsSingle ResourcesTransfer of command
Unified Command
• Enables all responsible agencies to manage an incident
• Establishes a common set of incident objectives and strategies
• Allows Incident Commanders to make joint decisions by establishing a single command structure
• Maintains unity of command– Each employee only reports to one supervisor
Sections
• Organizational levels with responsibility for a major functional area of the incident
• Operations• Planning• Logistics• Finance/Administration
• The person in charge is the Chief
Divisions and GroupsDivisions
– Divide an incident geographically – Is led by a Supervisor
Groups– Established based on the needs of an
incident. – Labeled according to the job that they are
assigned– Managed by a Supervisor– Work wherever their assigned task is
needed and are not limited geographically
Branches and UnitsBranches
– Established if the number of Divisions or Groups exceeds the span of control
– Have functional or geographical responsibility for major parts of incident operations
– Managed by a Branch Director
Units– Organizational elements that have
functional responsibility for a specific activity
Task Forces
• Task Forces are a combination of mixed resources with common communications
• Operate under the direct supervision of a Task Force Leader
Strike Teams
Strike Teams are a set number of resources– Of the same kind and type– With common communications – Operate under the direct supervision of a
Strike Team Leader
Single Resources
• An individual(s) or piece of equipment with its personnel complement; or,
• A crew or team of individuals with an identified supervisor
ICS Supervisory Titles
Organizational
Level
Title Support Position
Incident Command Incident Commander
Deputy
Command Staff Officer Assistant
General Staff (Section)
Chief Deputy
Branch Director Deputy
Division/Group Supervisor N/A
Unit Leader Manager
Strike Team/Task Force
Leader Single Resource Boss
Transfer of Command
• Moves the responsibility for incident command from one Incident Commander to another
• Must include a transfer of command briefing– Oral– Written– Both oral and written
Incident Commander
Public Information Officer
Safety and Security Officer
Logistics Chief Planning Chief Finance Chief Operations Chief
ICS
Liaison Officer
Incident Commander
Public Information Officer
Safety and Security Officer
Logistics Chief Planning Chief Finance Chief Operations Chief
HEICS
Liaison Officer
HOSPITAL EMERGENCY INCIDENT COMMAND SYSTEM
HEICS
Incident Occurs
Tactical Response
ICS LaunchedIncident Reported
& Identified
ICS Management Process
Chiefs Meeting:Develop Strategy& Tactics to Meet
ObjectivesAction Plan Preparation
IC Sets Objectives
Tactical ResponseInitiatedOperation Reports
Tactical Results, Needs,Engage Liaison,
Logistics, Planning,Finance for support
Planning EvaluatesProgress Reports
Chiefs & OfficersMeet with IC to
Evaluate Reports
The Five Sections
• Command = the buck stops here
• Planning = creates & develops incident plan
• Operations = implement the plan.
• Logistics = supports the plan.
• Finance = pays for the plan.
Incident Commander
Public Information Officer
Safety and Security Officer
Logistics Chief Planning Chief Finance Chief Operations Chief
Liaison Officer
Command Section
?? Legal ??
The Incident Commander
Gives overall direction for hospital operations.
Mission: to organize and directthe EOC (Emergency Operations Center) and all the positions through the ICS structure
Safety/Security Officer
• Organize and reinforce scene/facility protection and traffic.
• Establish a security command post.
Mission: Monitor and have authority over the safety of operations and hazardous
conditions.
Public Information Officer
• Mission: to function as the public information source for your agency.
• Be the organizer of correct information• COMMUNICATE with other
public information officers • Participate in a JIC
Liaison Officer
• Mission: to function as the incident contact person for representatives from other agencies.
• COMMUNICATE into and out of the hospital.
Legal & Ethics
• Mission: to provide legal advice to the IC and your agency.
• Think recent issues in
New Orleans
Incident Commander
Public Information Officer
Safety and Security Officer
Logistics Chief Planning Chief Finance Chief Operations Chief
HEICS
Liaison Officer
Logistics Section
“Boy, do I need stuff”
Logistics Chief
• Organize and direct operations associated with the maintenance of the physical environment:
– Food
– Shelter
– Supplies
– Comms Equipment
Support the medical objectives
Logistics Chief
Facility Unit Leader
Communications Unit Leader
Transport Unit Leader
Materials Supply Unit Leader
Nutritional Supply Unit Leader
Incident Commander
Public Information Officer
Safety and Security Officer
Logistics Chief Planning Chief Finance Chief Operations Chief
HEICS
Liaison Officer
Planning Section
Planning Chief
• Organize and direct all aspects of the planning section - Action Plan
• Document and distribute the facility action plan.• Ensure distribution of critical information/data.• Compile scenario projections from all section
chiefs and effect long range planning.• Ensure adequate personnel for response.
Planning Chief
Labor Pool Unit Leader
Medical Staff Unit Leader
Patient Tracking Officer
Patient Information Officer
Situation Status Unit Leader
Situation-Status Unit Leader
• Maintain current information regarding the incident status.
• Ensure a written record of the hospital’s emergency planning and response.
• Develop the hospital’s internal information network.
• Monitor the maintenance and
preservation of the computer system.
Labor Pool Unit Leader
• Collect and inventory available staff to a central point.
• Receive requests and assign available personnel as needed.
• Maintain adequate numbers of medical and non-medical personnel.
• Assist in the maintenance of staff morale.
Medical Staff Unit Leader
• Collect available physicians at a central point. • Credential volunteer medical staff as
necessary.• Assist in the assignment of available medical
staff as needed.• Often moved to Operations under
Medical Staff Director
Patient Tracking vs Information
Tracking Officer:
• Maintain the location of patients at all times within the hospital’s patient care system.
Information Officer:
• Provide information to visitors and family on status and location of patients.
Incident Commander
Public Information Officer
Safety and Security Officer
Logistics Chief Planning Chief Finance Chief Operations Chief
HEICS
Liaison Officer
Finance Section
$$ $$
MONEY MONEY
MONEY MONEY
Finance Section
• Monitor the utilization of financial assets.• Oversee the acquisition of supplies and services
to carry out the medical mission.• Supervise the documentation of expenditures
relevant to the emergency incident.• Business RECOVERY
Finance Chief
Time Unit Leader
Procurement Unit Leader
Claims Unit Leader
Cost Unit Leader
Incident Commander
Public Information Officer
Safety and Security Officer
Logistics Chief Planning Chief Finance Chief Operations Chief
HEICS
Liaison Officer
Operations Section
• Day to Day activities – On Steroids!• Provision of Care – “Your Hospital’s
Mission”• Known as the Tactical Response
Operations Chief
Medical Staff Director
Medical Care Director
Ancillary Services Director
Human Services Director
Operations ChiefMedical Staff Director Medical Care Director
In-Patient Areas Supervisor
Treatment Areas Supervisor
Surgical ServicesUnit Leader
General NursingUnit Leader
Out-Patient Services Leader
Maternal & ChildUnit Leader
Critical CareUnit Leader
Delayed TxUnit Leader
Immediate TxUnit Leader
TriageUnit Leader
Minor TxUnit Leader
MorgueUnit Leader
Discharge Unit Leader
Operations Chief
Human Services Director
Staff SupportUnit Leader
Psychological SupportUnit Leader
Dependent Care Unit Leader
Operations Chief
Ancillary Services Director
Laboratory Unit Leader
Radiology Unit Leader
Pharmacy Unit Leader
Cardiopulmonary Unit Leader
Job Action Sheets
• Each role’s assignments
• Checklists
• Prioritizes duties
• No duplication of duties
• Responsibilities outlined
• Important that staff know to read their Job Action Sheet at the START!!!
Using Functions Lists to Build Readiness:
• Look at the function – is it something your facility would do?
• If no, who is responsible for it?
• If maybe, how would be adjust?
• If yes, who would undertake this task?
• How would this task be accomplished?
• Do you have an Operating Instructions or a Policy/Procedures Guide?
Job Action Sheets
• Job Action Sheets: should be customized to your organization but…
Never alter the job title or mission statement.
Until Later!
HEICS Implementation
It is a process
HINT: It really never ends!
Other ICS Systems
Incident Commander
Public Information Officer
Safety and Security Officer
Liaison Officer -Internal
Logistics Chief Planning Chief Finance Chief Operations Chief
PHEICS
Liaison Officer - External
Legal Officer
Public Health Emergency Incident Command System
Safety and Security OfficerPublic Information Officer
Social Services Coordination Branch
Leader
Laboratory Branch Leader
Environmental Branch Leader
Incident Commander
ADPH Incident Command System Positions Chart May 22, 2006
Incident ManagementAdvisory Group/
CEP
Nutrition Supply Unit Leader
Materials Supply Unit Leader
Transportation Unit Leader
Damage Assessment Unit
Leader
Communications Unit Leader
Planning Chief
Situation Status Unit Leader
Human Resources Unit Leader
Strategic Epidemiology Unit
Leader
Strategic Surveillance Unit
Leader
Finance Chief
Time Unit Leader
Patient Tracking Unit Leader
Procurement Unit Leader
Logistics Chief Operations Chief
Liaison Officer ExternalLegal OfficerLiaison Officer Internal
Surveillance & Epidemiology
Investigation Branch Leader
Medical Branch Leader
Subject Matter Experts Biological Chemical Radiation Zoonotic Infection Control
Safety and Security OfficerPublic Information Officer
Legal Officer
Incident Commander
ADPH Incident Command SystemPositions Chart - OperationsMay 22, 2006
Incident ManagementAdvisory Group/
CEP
Liaison Officer Internal Liaison Officer External
Montgomery LabGroup
Food Safety Group
Patient Management Group
EMS Group
Patient Transfer Unit
Mass Prophylaxis & SNS Group
Shelter Group
Staging Unit
Mass Prophylaxis & Vaccinations Group
Birmingham LabGroup
Mobile LabGroup
Social Service Coordination Branch
LaboratoryBranch
EnvironmentalBranch
Medical Branch
Surveillance/Epidemiology Investigation Branch
Subject Matter Experts Biological Chemical Radiation Zoonotic Infection Control
Operations Chief
Safety and Security OfficerPublic Information Officer
Legal Officer
Incident Commander
ADPH Incident Command SystemFunctions ChartMay 22, 2006
Incident ManagementAdvisory Group/
CEP
Liaison Officer Internal Liaison Officer External
Logistics Chief Planning Chief Finance Chief
Damage Assessment
Provide materials
and supplies
SNS, VMI, Chem Packs,
transportation and supply
Transportation support
Nutrition supply
Situational awareness
Monitor situation
Repeat risk assessment process
Long-term follow up
Provides personnel/ volunteers support
Strategic epidemiology
Strategic surveillance
Emergency credentialing
Time/ cost tracking
Track patients helped by ADPH
Manage mutual aid, emergency purchases
Comm/Tech Infrastructure
Support
Operations Chief
Expanded Operations Section
Next slide
Subject Matter Experts Biological Chemical Radiation Zoonotic Infection Control
Safety and Security OfficerPublic Information Officer
Legal Officer
Incident Commander
ADPH Incident Command SystemFunctions Chart - OperationsMay 22, 2006
Incident ManagementAdvisory Group/
CEP
Liaison Officer Internal Liaison Officer External
Montgomery LabRegional Support
Food Safety Group
Birmingham LabRegional Support
Mobile LabRegional Support
Social Service Coordination Branch
LaboratoryBranch
EnvironmentalBranch
Operations Chief
Mental Health Support
Staff & Volunteer Care
Community Resources
Tribal Support
Federal Social Service Special Programs
Special Needs Populations
Non English Speaking Populations
Hearing Impaired Populations
Shelters
Field Kitchens
Food Establishments
Health Care Facilities
Congregated Living Facilities
Sanitation
Water Safety
Garbage Removal
Vector Control
Shelters -Environmental
ContinuedNext
Page
Surveillance/Epidemiology Investigation Branch
Surveillance of Illnesses and Injuries
Subject Matter Experts: Biological Chemical Radiation Zoonotic Infection Control
ADPH Incident Command SystemFunctions Chart - OperationsMay 22, 2006
Operations Chief
Medical Branch
Mass Prophylaxis & Vaccinations Group
Mass Prophylaxis & SNS Group
Staff & Volunteers Field Management
Patient Tracking
Mass Shelter Support
Coordinate with Logistics
MNS Supplies / Equipment: initial & re-
supply
Team Deployment
Staff & Volunteers Deployment
Coordinate Patient Transportation
Coordinate EMS Support for MNS
Locations
Pre-hospital Triage/Treatment
Locations
Field Hospitals
Non-traditional Treatment Centers
Evacuee/Patient Reception Centers
Health Departments
Coordinate w/PTU –Arrange medical
care for evacuees
Mass Vaccination Clinics
Community Support
Pharmaceuticals
Community Support
SNS
Support/Coordinate Statewide Health
Care System
Protect & Support Statewide Health Care Resources
Manage Patient Transfer Requests
Statewide
Monitor Health Care Capacity (AIMS)
Statewide
Coordinate State Health Care System & Federal Assets
Protect Medical Community
Patient Transfer Unit (PTU)
Patient Management Group
Staging Unit
Shelter Group
EMS Group
Subject Matter Experts: Biological Chemical Radiation Zoonotic Infection Control
ContinuedPrevious
Page
Incident Commander
Public Information Officer
Safety and Security Officer
Logistics Chief Planning Chief Finance Chief Operations Chief
CHEICS
Liaison Officer
Incident Commander
Public Information Officer
Safety and Security Officer
Logistics Chief Planning Chief Finance Chief Operations Chief
CHEICS
Liaison Officer
AncillaryServices
Medical Care
HumanServices
TRAINING
Questions