Presentation is loading. Please wait.

Presentation is loading. Please wait.

Center for HICS Education and Training Hospital Incident Command System Train-The-Trainer Course National Disaster Medical System (NDMS) Conference March.

Similar presentations


Presentation on theme: "Center for HICS Education and Training Hospital Incident Command System Train-The-Trainer Course National Disaster Medical System (NDMS) Conference March."— Presentation transcript:

1 Center for HICS Education and Training Hospital Incident Command System Train-The-Trainer Course National Disaster Medical System (NDMS) Conference March 16-18, 2007

2 Center for HICS Education and Training Course Expectations Why are you here today?

3 Center for HICS Education and Training Course Objectives Outline the historical development of HEICS and HICS Discuss NIMS Implementation Activities for hospitals Learn the principal concepts and features of HICS Understand the roles and relationships of the Incident Management Team

4 Center for HICS Education and Training Course Objectives (2) Understand the application and use of the HICS elements Conduct a facilitated, scenario-based exercise Discuss train-the-trainer strategies for implementing and teaching HICS

5 Center for HICS Education and Training This course is presented by: The Center for HICS Education and Training The Center is a collaborative effort between the ER 1 Institute at Washington Hospital Center and Kaiser Permanente Our mission is to provide information, education and training on HICS The Centers Advisory Board consists of National Workgroup and Ex-officio members from the HEICS 4 project The Center sponsors a webpage for additional info and updates on HICS utilization at

6 Center for HICS Education and Training Course Faculty Craig DeAtley, PA-C Director – Institute for Public Health Emergency Readiness, Washington Hospital Center Ann Potter, RN, CEM Chief, Disaster Preparedness Division Office of Emergency Services and Homeland Security Peter Brewster Education/Training Manager Department of Veterans Affairs Emergency Management Strategic Healthcare Group Craig Thorne, MD, MPH Medical Director, Employee Health & Safety University of Maryland Medical Center

7 Center for HICS Education and Training Housekeeping Notes All technology to silent or vibrate please If you must take or make a call –Wait for a break –Leave the room for calls We will have regular breaks during the course –Please stay within the announced break times Restroom location(s) Emergency exits There will be time for Q&A- save your questions to the announced periods Please consult with the instructors during breaks if needed Your evaluations are important to us! Complete the evaluation form by the end of the day!

8 Center for HICS Education and Training Day 1 Agenda NIMS Implementation Activities for Hospital and Healthcare Organizations Origins of HICS Overview of HICS Components The Hospital Incident Command System Job Actions Sheets Incident Planning & Response Guides Forms Discuss relationship of the hospital to its community partners Learn about adapting HICS to rural and small facilities Course Evaluation and Wrap Up

9 Center for HICS Education and Training Course Copyright The HICS course materials are proprietary and cannot be duplicated, reproduced or utilized without written permission of The Center No cameras or video taping or recording of this program are permitted

10 Center for HICS Education and Training Emergency Response Is Not Business as Usual !

11 Center for HICS Education and Training What is the Hospital Goal? Preparedness –Develop effective Emergency Management and Operations Plans Response –Ensure safety of patients, personnel and facility –Triage, treat, transfer and disposition victims –Ensure business continuity Recovery –Operational/Business Recovery –Financial recovery –Restoration of normal operations

12 Center for HICS Education and Training NIMS Implementation Activities for Hospitals and Healthcare Systems

13 Center for HICS Education and Training NIMS Implementation Activities for Hospitals and Healthcare Systems Document September 12, 2006 –Developed by NIC and DHHS –Outlines the 17 Implementation Activities for hospitals –National Bioterrorism Hospital Preparedness Program (HBHPP), administered through HRSA, outlines compliance for FY 2006 funding cycle Training: ICS 100 and 200 and IS 700

14 Center for HICS Education and Training NIMS Implementation Activities for Hospitals and Healthcare Systems Implementation document outlines: –The element –Elements association to NIMS –Implementation Guidance –Implementation Example –References

15 Center for HICS Education and Training NIMS Implementation Activities for Hospitals and Healthcare Systems NIMS Implementation Activities have seven categories: –Organizational Adoption of NIMS –Command and Management –Preparedness Planning –Preparedness Training –Preparedness Exercises –Resource Management –Communication and Information Management

16 Center for HICS Education and Training NIMS Implementation Elements Organizational Adoption Element 1– Adoption of NIMS –Adopt NIMS throughout the organization –Implementation Guidance: Plan for full implementation A Phased In Approach Hospitals should develop a plan, strategy and timeline to implement the elements –It can be implemented over time!!! Not immediate or all at once! NBHPP outlines implementation elements –Example: All 17 elements are included in the hospitals Emergency Management Program (EMP)

17 Center for HICS Education and Training NIMS Implementation Elements Command and Management Element 2 – Incident Command System –Manage all emergency incidents, exercises and preplanned events in accordance with ICS –Must include Incident Action Planning (IAP) Common communication plans –Adopting HICS will ensure element compliance –Example: Emergency Operations Plan (EOP) explains the use of ICS, IAP and common communication planning

18 Center for HICS Education and Training NIMS Implementation Elements Command and Management Element 3 – Multiagency Coordination System –Develop and coordinate connectivity capability with the HCC and the local ICP, 911 centers, EOCs and the State EOC and others, if applicable –Implementation Guidance: Once local/regional MAC is established, hospitals should participate in collaborative planning Exercises and training should be conducted –Example: The EOP demonstrates the management and coordination between the HCC and multiagency coordination system entities

19 Center for HICS Education and Training NIMS Implementation Elements Command and Management Element 4 – Public Information System –Implements plans to communicate through a JIS or JIC –Implementation Guidance: Hospital should identify at least one PIO, representative or spokesperson responsible for media and public info Establish pre-event working relationships with local media, emergency management, law enforcement, public health, EMS etc. –Example: The EOP explains the management of public info with partners

20 Center for HICS Education and Training NIMS Implementation Elements Preparedness Planning Element 5 – NIMS Implementation Tracking –Hospitals and healthcare systems will track NIMS implementation annually as part of the EMP –Implementation Guidance: Hospital must self certify compliance Designate a NIMS implementation designee –Example: The hospital will track implementation activities annually with a goal of improving emergency management capability

21 Center for HICS Education and Training NIMS Implementation Elements Preparedness Planning Element 6 – Preparedness Funding –Develop and implement a system to coordinate hospital preparedness funding to employ NIMS across the organization –Implementation Guidance: Collaborate with state and local government and hospital associations to identify and obtain preparedness funding –State Department of Health –State Office of Homeland Security –State Office of Emergency Management –Local public health –Local emergency management

22 Center for HICS Education and Training NIMS Implementation Elements Preparedness Planning Element 6 – Preparedness Funding (continued) –Example: The EMP includes information on local, state and federal preparedness grants received and deliverables to be achieved

23 Center for HICS Education and Training NIMS Implementation Elements Preparedness Planning Element 7 – Revise and Update Plans –Revise EOP and Standard Operating Procedures (SOPs) to incorporate NIMS Planning Training Response Exercises Equipment Evaluation and corrective actions –Implementation Guidance and Example: The EMP work plan reflects status of revisions to EOPs

24 Center for HICS Education and Training NIMS Implementation Elements Preparedness Planning Element 8 – Mutual Aid Agreements/MOUs –Participate in and promote interagency mutual aid agreements (public and private sector and NGOs) –Implementation Guidance: Establish mutual aid agreements/MOUs with: –Neighboring hospitals/healthcare systems –Public health departments –HazMat Response Teams –Local Fire and Law Enforcement –Area pharmacies –Medical supply vendor Share agreements with local emergency management prior to an incident occurring

25 Center for HICS Education and Training NIMS Implementation Elements Preparedness Planning Element 8 – Mutual Aid Agreements (Continued) –Example: EMP documentation includes information supporting any mutual aid agreements and/or MOUs that the facility has

26 Center for HICS Education and Training NIMS Implementation Elements Preparedness Training Element 9 – IS-700: NIMS: An Introduction –Complete IS-700 –Implementation Guidance: IS-700 should be completed by hospital personnel in a leadership role in emergency preparedness, incident management, filling ICS/HICS roles and/or emergency response Phased in training Train others as indicated (MDs, RNs, others) –Example: The EMP training records track completion of IS-700.

27 Center for HICS Education and Training NIMS Implementation Elements Preparedness Training Element 10 – IS-800.A: NRP –Complete IS-800 –Implementation Guidance: IS 800 should be completed by personnel whose primary responsibility is emergency management Hospital must track training –Example: Emergency preparedness program training records track completion of IS 800 or equivalent Training by individual(s) responsible for the hospitals emergency management program

28 Center for HICS Education and Training NIMS Implementation Elements Preparedness Training Element 11 – ICS 100 HC and 200 HC –Complete ICS 100 and 200 training or equivalent courses –Implementation: IS 100: Completed by hospital personnel that would have a direct role in emergency preparedness, incident management and/or designated to fulfill ICS roles IS 200: Completed by personnel whose primary responsibility is emergency management –Including middle management and administration –Personnel designated to fulfill ICS roles

29 Center for HICS Education and Training Recommended Levels of Training for Hospital Personnel* IS 100 or equivalent IS 200 or equivalent IS 300 or equivalent IS 400 or equivalent IS 700 or equivalent IS 800 or equivalent Hospital personnel who are likely to assume an ICS position in the Hospital Command Center or have a primary responsibility for emergency management XX X Emergency Program Manager XX XX Hospital Emergency Preparedness Committee Members/persons responsible for the Emergency Management Plan XX X Emergency Management Training Requirements for Hospital Personnel Training to be completed by August 31, 2007 * References: 1) NIMS Integration Center, NIMS Alert: NIMS Implementation Activities for Hospitals and Healthcare Systems, September 12, ) Health Resources and Services Administration, National Hospital Bioterrorism Preparedness Program, Fiscal Year 2005 Continuation Guidance, HRSA Announcement Number 5-U3R

30 Center for HICS Education and Training NIMS Integration Center Required training resources –Emergency Management Institute –Self-developed/State certified courses (equivalent courses) –Center for HICS Education and Training For questions or correspondence on NIMS –NIMS Integration Center

31 Center for HICS Education and Training NIMS Implementation Elements Preparedness Exercises Element 12 – Training and Exercises –Incorporate NIMS/ICS into internal and external local, regional and state emergency management training and exercises –Implementation Guidance: Include NIMS and ICS into trainings and exercises Review plans with staff to ensure competency –Example: The EMP documentation reflects the use of NIMS/ICS

32 Center for HICS Education and Training NIMS Implementation Elements Preparedness Exercises Element 13 – All-Hazards Exercise Program –Participate in all-hazards exercises with response partners –Implementation Guidance: Participate in local, regional and/or state multidiscipline/agency exercises 2/year to every 2 years. Exercise (drills, tabletops, functional or full-scale) –Internal and external communications –Receiving, triage, treatment and transfer of mass casualties –Progress of casualties through the system –Resource management –Security –Specialty lab testing –Site/facility safety –Example: EMP documents reflects participation

33 Center for HICS Education and Training NIMS Implementation Elements Preparedness Exercises Element 14 – Corrective Actions –Hospitals will incorporate corrective actions into response plans and procedures –Implementation Guidance: After exercises, develop a corrective action report –Actions to correct the issue/deficiency –Responsible person/group to implement the action –Due date for completion –Incorporate correction into P&P –Example: EMP documents a corrective action process

34 Center for HICS Education and Training NIMS Implementation Elements Resource Management Element 15 – Response Inventory –Maintain an inventory of organizational response assets –Implementation Guidance: Determine emergency par levels for supplies and equipment Consider stockpiling Develop MOUs for supply and resupply –Example: EMP documentation includes a resource inventory Medical/surgical supplies Pharmaceuticals PPE Equipment Staffing Etc.

35 Center for HICS Education and Training NIMS Implementation Elements Resource Management Element 16 – Resource Allocation –As permissible, incorporate national standards and guidance into acquisition programs –Implementation Guidance: As possible, establish common equipment, communications and data interoperability resources with other local response partners –Example: EMP emphasizes interoperability

36 Center for HICS Education and Training NIMS Implementation Elements Communications and Information Management Element 17 – Standard and Consistent Terminology –Apply standard and consistent terminology, in plain English standards –Implementation Guidance: Establish common language consistent with local emergency management, public safety and public health Use plain language (internal Emergency Codes OK) –Example: EMP emphasizes the use of plain English by staff during emergencies

37 Center for HICS Education and Training Section Summary NIMS Activities for Hospitals and Healthcare System –Include 17 elements of activities –Adopting these elements will improve a hospitals Preparedness Response Recovery Mandated elements by August 31, 2007: –Training of selected key personnel in ICS 100 HC and 200 HC IS 700: NIMS IS 800: NRP

38 Center for HICS Education and Training Questions?

39 Center for HICS Education and Training The Hospital Incident Command System

40 Center for HICS Education and Training Origins of HICS How did HICS evolve and why is it important to your hospital?

41 Center for HICS Education and Training Inception of HEICS in 1980s with 2 revisions in 1990s Over 6000 hospitals across the country utilize HEICS as their response model Obvious needs surfaced pre- and post 9/11 All hazards approach Coordinated, community planning From HEICS to HICS

42 Center for HICS Education and Training Key concept: Revision of previous models Incident Management System for: –Daily operations –Preplanned events –Non-emergent situations A systems approach to managing an incident HEICS became HICS –Not just for emergencies anymore HEICS IV Project

43 Center for HICS Education and Training Intent and Objectives Maintain the fundamental concepts ­ Predictable chain of command ­ Modular and scalable to the incident ­ Position accountability ­ Common language Use the Incident Command System (ICS) principles and practices ICS adapted to the unique hospital setting HEICS IV Project

44 Center for HICS Education and Training Intent and Objectives Intended Outcomes ­ Incorporate current emergency management practices ­ Address NIMS compliance issues ­ Integrate CBRNE events ­ Maintain system scalability for all ­ Develop core materials ­ Address instructor qualifications HEICS IV Project

45 Center for HICS Education and Training National Working Group ­ Hospital subject matter experts Ex-Officio Members ­ AHA, JCAHO, DHS, DHHS, ASHE, NIC, EMI, HRSA Secondary Review Group ­ Subject matter experts from the healthcare community Executive Group ­ California EMS Authority and Contract Support Group Contract Support Group ­ ER One Institute at the Washington Hospital Center ­ Kaiser National Healthcare Continuity Management HEICS IV Project Team

46 Center for HICS Education and Training All-hazards and systems approach A management tool Emphasizes preparedness efforts with community partners Scalable and adaptable for all hospitals Assists with NIMS compliance for hospitals and healthcare systems Whats New in HICS?

47 Center for HICS Education and Training Uses the Incident Command System (ICS) principles and practices ICS adapted to the unique hospital setting Approved by the NIMS Integration Center (NIC), HRSA and Joint Commission Whats New in HICS?

48 Center for HICS Education and Training HICS Guidebook Incident Management Team Chart ­ Replaces the HEICS Organizational Chart ­ Revised for consistency with NIMS Updated Job Action Sheets Incident Planning and Response Guides Updated HICS Forms –Consistent with NIMS / Standard ICS HICS Educational Materials NIMS Implementation Activities New HICS Products

49 Center for HICS Education and Training Comply with regulatory standards and nongovernmental guidelines –The Joint Commission Environment of Care 4.10 ­ Health Resources and Services Administration Cooperative Agreements oNIMS compliance and Training requirements ­ Emergency Medical Treatment and Active Labor Act ­ Health Insurance Portability and Accountability Act Why Is HICS Important to Your Hospital?

50 Center for HICS Education and Training Why Is HICS Important to Your Hospital? Comply with regulatory standards and nongovernmental guidelines ­ OSHA o 29 CFR Part Hazardous Materials Regulations ­ Centers for Medicare and Medicaid Services ­ National Fire Protection Association (NFPA 1600) o Standard 99 - Healthcare facilities o Standard 1600 – Disaster/Emergency Management ­ American Society for Testing and Materials (ATSM) o F-1288 – Guide for Planning and Response to an MCI ­ Superfund Amendments and Reauthorization Act

51 Center for HICS Education and Training Assists in coordinating the hospitals planning and response efforts and actions ­ Sets direction and goals in initial efforts ­ Assists with Incident Action Planning ­ Mission focused Manages the incident using the Incident Command System –Defines roles and responsibilities –Facilitates community responder communication and mutual aid Why Is HICS Important to Your Hospital?

52 Center for HICS Education and Training Why Is HICS Important to Your Hospital? Facilitates coordination with partners ­ Local and community (sister or buddy) hospitals and healthcare systems ­ Regional Hospital Coordination Centers ­ Public safety agencies ­ Local Emergency Management ­ Nongovernmental organizations (NGO)

53 Center for HICS Education and Training Serves as the foundation for your Emergency Operations Plan –HICS is NOT the EOP –HICS is a system management tool Why Is HICS Important to Your Hospital?

54 Center for HICS Education and Training HICS Resources HICS Guidebook and materials –California Emergency Medical Services Authority website at: –The Center for HICS Education and Training

55 Center for HICS Education and Training Section Summary HICS is useful for daily operations, preplanned events and non-emergent situations HICS uses the Incident Command System (ICS) principles and practices ICS adapted to the unique hospital setting HICS complies with regulatory mandates Assists in coordinating the hospitals internal and external planning, response and recovery

56 Center for HICS Education and Training Questions?

57 Center for HICS Education and Training The Hospital Incident Command System

58 Center for HICS Education and Training The HICS Guidebook

59 Center for HICS Education and Training The HICS Guidebook Explains the critical components of HICS Describes the use of HICS products and materials Assists with emergency management planning Guide for: –Hospital planners and responders –Community responders to understand and integrate hospitals into larger response

60 Center for HICS Education and Training The HICS Guidebook The Guidebook is NOT –The definitive text on emergency preparedness –Designed to comprehensively teach the principles of incident command –Not the Emergency Management or Operations Plan

61 Center for HICS Education and Training Chapter 1 - Introduction to HICS –History of the HEICS IV Project and transition to HICS –Scope and applicability –HEICS IV Project Team Chapter 2 - Principles of Incident Command –History of ICS –Incident management functions –Incident action planning process The HICS Guidebook

62 Center for HICS Education and Training Chapter 3 - NIMS Compliance for Hospitals –NIMS organizational system overview –NIMS compliance activities for hospitals Chapter 4 - Hospital Emergency Management Program –Program development –All-hazards Emergency Operations Plan –Hazard Vulnerability Analysis –Planning Partners The HICS Guidebook

63 Center for HICS Education and Training Chapter 5 - Hospital Incident Command System –Incident Management Team Command Operations Planning Logistics Finance / Administration –Incident Command Principles and Practice The HICS Guidebook

64 Center for HICS Education and Training Chapter 6 - Life Cycle of an Incident –Alert and Notification Situation Assessment and Monitoring Emergency Operations Plan Implementations Establishing the Hospital Command Center Building the ICS Structure Incident Action Planning Communications and Coordination Staff Health and Safety Operational Considerations Legal and Ethical Considerations Demobilization System Restoration Response Evaluation and Organizational Learning The HICS Guidebook

65 Center for HICS Education and Training Appendices –A: Incident Planning Considerations B: HICS Incident Management Team Chart C: Using the Job Action Sheets D: Using the HICS Forms E: HEICS to HICS: Implementation Steps F: Potential Candidates for HICS Command Positions The HICS Guidebook

66 Center for HICS Education and Training The HICS Guidebook Appendices G: HEICS III to HICS Position Crosswalk H: Working with the Scenarios, Incident Planning and Response Guides I: NIMS Implementation Activities for Hospitals and Healthcare Systems J: Recommended Resources K: HEICS IV revision project organization

67 Center for HICS Education and Training The HICS Guidebook Educational materials –Module based Power Points presentations highlighting key HICS concepts –Print materials to accompany the power points – 27 scenarios to use to assist with exercise planning 14 External scenarios 13 Internal scenarios

68 Center for HICS Education and Training HICS is a living document and system –Grows and evolves as practices and hospital needs change Modifications made as lessons are learned Adapted for your hospitals unique needs Continue to advance hospital preparedness and emergency management standardization The Future of HICS

69 Center for HICS Education and Training Section Summary The HICS Guidebook provides –The critical components of HICS –An overview of Emergency Management principles –Guidance on how to use the HICS products and materials

70 Center for HICS Education and Training Questions?

71 Center for HICS Education and Training Building the Incident Management Team

72 Center for HICS Education and Training HICS IMT The IMT –Depicts hospital management functions and how authority and responsibility is distributed –Each of the 5 management functions is color coded Command (white or grey) Operations (red) Planning (blue) Logistics (yellow) Finance/Administration (green)

73 Center for HICS Education and Training HICS IMT Hierarchy Note: Divisions and Groups are used in ICS but not reflected in the HICS IMT

74 Center for HICS Education and Training IMT Titles The IMT titles are distinct and standardized. This serves three important purposes: ** –Allows for filling IMT positions with the most qualified persons and not by rank –Assists with requesting outside resources to staff these positions –Assists with clarifying the activities undertaken by specific personnel

75 Center for HICS Education and Training IMT Hierarchy The Incident Commander –Is the only position always activated for every incident** –Has overall responsibility to manage the incident Command Staff –Title: Officer –Positions: Public Information Officer Safety Officer Liaison Officer Medical/Technical Specialists

76 Center for HICS Education and Training IMT Hierarchy General Staff**: –Organizational Component: Section –Title: Section Chief –Role: Responsible for major functional areas of the incident –IMT Positions: Operations Planning Logistics Finance/Administration

77 Center for HICS Education and Training IMT Hierarchy Deputy Chief Role: –The individual assuming the Deputy role will assist the Command Staff, Section Chiefs or Branch Directors** by performing delegated job activities or tasks as outlined by that JAS Assistant Role: –A subordinate to a Command Staff or Section Chiefs who performs technical capabilities and responsibilities –They may also be assigned to a Unit Leader as situational needs dictate and resources allow

78 Center for HICS Education and Training IMT Hierarchy Branches: –Title: Branch Director –Role: Branches can be established –Geographically or functionally** –When the number of Divisions or Groups exceed the span of control for the Section Chief* Branches may also be established* –In multi-disciplinary incident –In multi-jurisdictional incidents –Very large incidents –IMT Positions: Specific to the Sections duties Example: –Medical Care Branch Director in Operations –Service Branch Director in Logistics

79 Center for HICS Education and Training IMT Hierarchy Divisions/Groups: –Title: Division Supervisor –Role: Division: Divide the incident geographically –Example: first floor and second floor Group: Divide the structure into functional areas of operation by the resources to perform the function –IMT Positions: Divisions and Groups are not commonly used in the hospital setting Divisions and Groups are NOT REFLECTED in the HICS IMT

80 Center for HICS Education and Training IMT Hierarchy Units: –Title: Unit Leader –Role: Functional responsibility for a specific incident activity under a Section and Branch –IMT Positions: Specific to the Branchs duties Example: –Inpatient Unit Leaders in the Medical Care Branch in the Operations Section –Situation Unit Leader in the Planning Section –Labor Pool and Credentialing Unit in the Support Branch in the Logistics Section

81 Center for HICS Education and Training IMT Hierarchy Single Resources, Strike Teams, Task Forces –Title: Leader –Role: Single Resources: –An individual or piece of equipment with its personnel complement (i.e., perfusionist) –A crew or team of individuals with a identified supervisor Strike Teams: –A set number of similar resources (i.e., burn RNs) Task Forces: –A combination of mixed resources (i.e., RNs, MDs, Techs, Secretaries) –IMT Positions: These are NOT REFLECTED on the HICS IMT Can be employed by the hospital as dictated by the incident These teams report to the Unit Leader

82 Center for HICS Education and Training The Incident Commander is responsible for building the Incident Command Team The IMT is built according to the incident: –Scope and magnitude of the event –Potential/real impact to the hospital –Hospital size –Available resources –Special response needs (i.e., HazMat, biological, legal, IT) Building the IMT

83 Center for HICS Education and Training Building the IMT Every incident requires certain management functions be performed –The incident/problem must be evaluated –A plan must be developed to address the problems –The necessary resources must be assigned –Outcomes and effectiveness must be evaluated Management by objectives is essential for successful Incident Action Planning**, response and recovery

84 Center for HICS Education and Training Building the IMT The IC should appoint properly trained persons to critical Command and General Staff positions Incident Commander Operations Section Chief Planning Section Chief Logistics Section Chief Finance/Administration Section Chief Public Information Officer Safety Officer Liaison Officer Medical/Technical Specialist

85 Center for HICS Education and Training Building the IMT Once appointed: –Section Chiefs and Branch Directors staff their own sections IMT position titles are standardized –Describe the positions role and mission rather than the person –Allows the position to be filled by the most qualified rather than by seniority –Facilitates requests for outside qualified personnel

86 Center for HICS Education and Training Building the IMT The IMT reflects a reasonable Span of Control –Definition: The number of individuals or resources one supervisor can effectively manage** –Ratio of 3-7 reporting elements per 1 supervisor The IMT structure does not exactly mirror the daily administrative structure –This is purposeful –Reduces role and title confusion during the response** HICS IMT Crosswalk suggests position assignments

87 IMT Crosswalk

88 Center for HICS Education and Training Building the IMT Positions appointed to meet the incident needs do not have to be sequential from the top down* –Appoint those positions to meet the immediate needs of the incident Example……..

89 Center for HICS Education and Training Building the IMT - Example Situation: It is 4:00 am and a large fire erupts in the laboratory, located very close to two patient care areas with a high census. IC activates IMT positions needed immediately! I am needed to call in additional staff to assist with evacuation I will oversee the medical care I ensure HVAC, Med Gases and assess damage I ensure safety of the patients, staff and facility

90 Center for HICS Education and Training IMT Communications Communication and information-sharing in the IMT should occur: –Up and down the chain of command –Across Sections to the appropriate Section/Branch/Unit** Information should be displayed on status boards and easily accessed Communications should be documented for accountability and archiving

91 Center for HICS Education and Training Section Summary Incidents may be different but the IMT fundamentals remain the same: –Positions activated and structure of IMT meet the needs of the incident –Positions are filled by qualified and trained personnel Based on qualifications rather than by seniority The HICS IMT has a defined hierarchy and chain of command and reporting

92 Center for HICS Education and Training Questions?

93 Center for HICS Education and Training Command

94 Center for HICS Education and Training Command Command functions –Maintain overall management of the incident –Set the incident objectives and priorities –Devise and approve strategies –Ensure mission completion Incident Commander in charge Command consists of: –Command staff –General staff

95 Center for HICS Education and Training Command

96 Center for HICS Education and Training Incident Commander Mission: –Organize and direct the Hospital Command Center (HCC). Give overall strategic direction for hospital incident management and support activities, response and recovery. Authorize total facility evacuation if warranted –The first Incident Commander is responsible until the authority is delegated to another person**

97 Center for HICS Education and Training Incident Commander Duties: –Ensure incident safety * –Initiate HICS and activation of the HCC –Determine scope and magnitude of event and potential impacts on the facility –Determine and activate appropriate IMT positions –Initiate and approve the IAP –Providing information services to internal and external stakeholders* –Liaison with Governing Board and other organizations*

98 Center for HICS Education and Training Public Information Officer Mission: –Serve as the conduit for information to internal and external stakeholders**, including staff, visitors and families, and the news media, as approved by the Incident Commander Duties: –Determine parameters of information release from the IC –Determine any restrictions in content (sensitive materials) –Collaborate with local community officials (JIC) on risk communication messages for consistent content –Maintain contact with Situation Unit Leader for current information and facility status –Schedule regular media briefings and press releases Report to: Incident Commander

99 Center for HICS Education and Training Safety Officer Mission: –Ensure safety of staff, patients, and visitors, monitor and correct hazardous conditions. Have authority to halt any operation that poses immediate threat to life and health Duties: –Determine safety risks of the incident to personnel, the hospital facility, and the environment –Initiate corrective/protective actions for safety issues Report to: Incident Commander

100 Center for HICS Education and Training Liaison Officer Mission: –Function as the incident contact person in the Hospital Command Center for representatives from other agencies Duties: –Is the primary contact for supporting agencies and organizations assisting at an incident but not participating in the HCC/ICS structure** –Establish contacts with liaison counterparts in each assisting and cooperating agency (including other hospitals, RHCCs, EOCs and others) –Update governmental liaisons on the hospital status and response –Make facility needs and requests for assistance and resources Reports to: Incident Commander

101 Center for HICS Education and Training Medical/Technical Specialists The Specialist Position is new and unique to HICS –A category of personnel w/specialized expertise –Activated based on situational need –Primarily are consultants but can have delegated authority –Can have more than one in activated at a time –May report to any position in the IMT Hospitals can create other categories as needed

102 Center for HICS Education and Training Medical/Technical Specialists Specialist Roles – Biological/Infectious disease – Chemical – Radiological – Clinic Administration – Hospital Administration – Legal affairs – Risk management – Medical Staff – Pediatric Care – Medical Ethicist – ** Others can be developed as needed by the hospital

103 Center for HICS Education and Training Medical/Technical Specialists Mission: –Advise the Incident Commander and/or assigned Section on issues related to emergency response in their area of expertise Duties: –May be assigned as technical advisor in the HCC –May be assigned to advise and oversee specific hospital operations Example: Decontamination operations during a chemical exposure situation

104 Center for HICS Education and Training Section Summary The Incident Commander is the only position that will ALWAYS be activated The Incident Commander has overall responsibility for: –Management of the Incident –Activities within the HCC –Continuing as IC until authority is delegated to another The Command Staff consists of: –PIO –Liaison Safety Officer Medical/Technical Specialists

105 Center for HICS Education and Training Questions?

106 Center for HICS Education and Training Lets talk about Sections

107 Center for HICS Education and Training Sections Sections are: –Operations –Planning –Logistics –Finance/Administration Sections are led by a Chief Section Chiefs are known as General Staff **

108 Center for HICS Education and Training The Operations Section

109 Center for HICS Education and Training Operations Section Section Mission: –Manage tactical operations** –Direct all tactical resources –Carry out the mission and Incident Action Plan Lead by a Section Chief Largest section of resources to marshal and coordinate –Tactical resources are classified**: Assigned Available Out-of-Service

110 Center for HICS Education and Training Operations Section The Section includes: –Staging Area –Medical Care Branch –Infrastructure Branch –HazMat Branch –Security Branch –Business Continuity Branch

111 Center for HICS Education and Training Operations Section Chief Mission: –Develop and implement strategy and tactics to carry out the objectives established by the Incident Commander. Organize, assign, and supervise Staging, Medical Care, Infrastructure, Security, Hazardous Materials, and Business Continuity Branch resources Duties: –Appoint Section personnel as indicated by event –Conduct Section briefings, update Unit Leaders –Maintain current status of all areas in the Section –Communicate with and advise the IC on Section issues/needs

112 Center for HICS Education and Training Operations Section Chief Supervises: –Staging Manager –Medical Care Branch Director –Infrastructure Branch Director –HazMat Branch Director –Security Branch Director –Business Continuity Branch Director

113 Center for HICS Education and Training Staging Manager Mission: –Organize and manage the deployment of supplementary resources, including personnel, vehicles, equipment, supplies, and medications Supervises: –Personnel Staging Team –Vehicle Staging Team –Equipment/Supply Staging Team –Medication Staging Team

114 Center for HICS Education and Training Staging Manager Duties: –Coordinate delivery of needed resources to requesting area Once resources are acquired by Logistics, they are then staged with the Staging Manager –Establish a staging area in a central location Area must be large enough to stage resources –Works closely with the Logistics Section –If staging area resources become too great, appoint appropriate Team Leaders

115 Center for HICS Education and Training Medical Care Branch Director Mission: –Organize and manage the delivery of emergency, inpatient, outpatient, and casualty care, and clinical support services Duties: –Addresses provision of acute AND continuous care –Works closely with Logistics Section to ensure resource acquisition –Works closely with Staging Manager for delivery of resources to areas

116 Center for HICS Education and Training Medical Care Branch Director Supervises: –Inpatient Unit Leader (all inpatient units) –Outpatient Unit Leader (all outpatient services) –Casualty Care Unit Leader (Emergency Dept.) –Mental Health Unit Leader –Clinical Support Unit Leader (Lab, Diagnostic Imaging, Pharmacy, Morgue, Blood Donor) –Patient Registration Unit Leader Reports to the Operations Section Chief

117 Center for HICS Education and Training Infrastructure Branch Director Mission: –Organize and manage the services required to sustain and repair the hospitals infrastructure operations Duties: –Maintains overall facility operations and normal operating capacity –Identify and fix utility service-delivery failures Coordinate the acquisition of parts or contractors with the Logistics Section –Assign a strike team to address damage to the facility as needed

118 Center for HICS Education and Training Infrastructure Branch Director Supervises: –Power/Lighting Unit Leader –Water/Sewer Unit Leader –HVAC Unit Leader –Building/Grounds Unit Leader –Medical Gases Unit Leader –Medical Devices Unit Leader –Environmental Services Unit Leader –Food Services Unit Leader (for inpatients) Reports to Operations Section Chief

119 Center for HICS Education and Training HazMat Branch Director Mission: –Organize and direct hazardous material incident response activities: detection and monitoring; spill response; victim, technical, and emergency decontamination; and facility and equipment decontamination Duties: –Oversee the operations involving a hazmat event Decontamination of victims, staff, facility Safe and appropriate use of PPE Clean up operations –Collaborates closely with Medical Care Branch Director

120 Center for HICS Education and Training HazMat Branch Director Supervises: –Detection and Monitoring Unit Leader –Spill Response Team Unit Leader –Victim Decontamination Unit Leader –Facility/Equipment Decontamination Unit Leader Reports to Operations Section Chief

121 Center for HICS Education and Training Security Branch Director Mission: –Coordinate all of the activities related to internal and external personnel and facility security Duties: –Implement facility security measures –Ensure security and access control of the HCC –Liaison with responding law enforcement personnel –Oversee search and rescue operations for the facility

122 Center for HICS Education and Training Security Branch Director Supervises –Access Control Unit Leader –Crowd Control Unit Leader –Traffic Control Unit Leader –Search Unit Leader –Law Enforcement Interface Unit Leader Reports to the Operations Section Chief

123 Center for HICS Education and Training Business Continuity Branch Director Mission: –Ensure business functions are maintained, restored or augmented to meet designated Recovery Time Objectives (RTO) and provide limited interruptions to continuity of essential business operations –Can be activated immediately or as needed during the response Duties: –Facilitate the acquisition of and access to essential recovery resources, including business records –Support Branches with relocation to alternate business sites –Coordinate IT services with Logistics Section –Assist Branches and impacted areas to restore normal operations

124 Center for HICS Education and Training Business Continuity Branch Director Supervises: –Information Technology Unit Leader Mission: Ensure IT business functions are maintained, restored or augmented Works closely with Logistics Section IT/IS Unit –Service Continuity Unit Leader Mission: Ensure business/clinical/ancillary service functions are maintained, restored or augmented

125 Center for HICS Education and Training Business Continuity Branch Director Supervises: –Records Preservation Unit Leader Mission: Ensure vital business/medical records are maintained and preserved –Business Function Relocation Unit Leader Mission: Ensure business functions are moved to alternative work sites

126 Center for HICS Education and Training Section Summary The Operations Section is responsible for –All tactical operations,** –The tactical objectives and organization –Directing all tactical resources Operations Section is led by a Chief Operations Section positions are activated as needed by the incident

127 Center for HICS Education and Training Questions?

128 Center for HICS Education and Training The Logistics Section

129 Center for HICS Education and Training Logistics Provides support to other sections Acquires resources from internal and external sources –Activate existing MOUs, contracts and vendor agreements –Employs standard and emergency procurement and contracting procedures With Liaison, links to local EOC and/or Regional Hospital Coordination Center for resource requests

130 Center for HICS Education and Training Logistics and Operations Logistics and Operations are closely linked and must work collaboratively together –Logistics Section is the getters –Operations Section is the doers Scope and Responsibilities overlap –Logistics Supply Unit and Operations Infrastructure Branch –Labor Pool and Credentialing Unit and Staging Manager– Personnel Team Leader

131 Center for HICS Education and Training Logistics Section Chief Mission: –Organize and direct those operations associated with maintenance of the physical environment and with the provision of human resources, materiel, and services to support the incident activities. Participate in Incident Action Planning Duties: –Oversee the acquisition of resources –Maintain current status of all areas in the section

132 Center for HICS Education and Training Logistics Section Chief Supervises: –Service Branch Director –Support Branch Director Reports to the Incident Commander

133 Center for HICS Education and Training Service Branch Director Mission: –Organize and manage the services required to maintain the hospitals communication system, food and water supply for staff, and information technology and systems Oversees: Communications Unit Leader IT/IS Unit Leader Staff Food and Water Unit Leader

134 Center for HICS Education and Training Service Branch Unit Leaders Communications Unit Leader –Mission: Organize and coordinate internal and external communications connectivity IT/IS Unit Leader –Mission: Provide computer hardware, software and infrastructure support to staff –Coordinates closely with Operations Section Business Continuity Branch, IT Unit Staff Food and Water Unit Leader –Mission: Organize food and water stores and prepare for rationing during periods of anticipated or actual shortage –Coordinates closely with Operations Section Infrastructure Branch, Food Services Unit

135 Center for HICS Education and Training Support Branch Director Mission: –Organize and manage the services required to maintain the hospitals supplies, facilities, transportation, and labor pool. Ensure the provision of logistical, psychological, and medical support of hospital staff and their dependents. Oversees: –Employee Health and Well-Being Unit Leader –Family Care Unit Leader –Supply Unit Leader –Facilities Unit Leader –Transportation Unit Leader –Labor Pool and Credentialing Unit Leader

136 Center for HICS Education and Training Support Branch Unit Leaders Employee Health and Well Being Unit (Known as the Medical Unit in ICS**) –Mission: Provide medical screening, evaluation and follow-up of employees who are assigned to the incident** Ensure the availability of medical care for injured or ill staff Ensure the availability of behavioral and psychological support services to meet staff needs during and following an incident. Coordinate mass prophylaxis/vaccination/immunization of staff, if required. Coordinate medical surveillance program for employees Family Care Unit –Mission: Ensure the availability of medical, logistic and mental health and day care for the families of staff members. Coordinate mass prophylaxis/vaccination/immunization of family members if required

137 Center for HICS Education and Training Support Branch Unit Leaders Supply Unit –Mission: Acquire, inventory, maintain, and provide medical and non-medical care equipment, supplies, and pharmaceuticals Facility Unit –Mission: Organize, manage and support building systems, equipment and supplies. Ensure proper cleaning and disinfection of hospital environment.

138 Center for HICS Education and Training Support Branch Unit Leaders Transportation Unit –Mission: Organize and coordinate the transportation of all ambulatory and non-ambulatory patients. Arrange for the transportation of human and materiel resources within or outside the facility Labor Pool and Credentialing Unit –Mission: Collect and inventory available staff and volunteers at a central point (Labor Pool) for assignment by the Staging Officer. Maintain adequate numbers of both medical and non-medical personnel. Assist in the maintenance of staff morale Coordinates closely with Operations Section Staging Manager

139 Center for HICS Education and Training Section Summary The Logistics Section supports the resource requirements of the response Logistics Section has two branches: –Support –Service The Logistics Section is led by a Chief** Logistics works closely with the Operations Section

140 Center for HICS Education and Training Questions?

141 Center for HICS Education and Training Planning Section

142 Center for HICS Education and Training Planning Section Section Mission: –Collect, evaluate, and disseminate incident action information and intelligence to Incident Commander* –Prepare status report and display various information –Develop the Incident Action Plan (IAP) Lead by a Section Chief

143 Center for HICS Education and Training Planning Section Chief Mission: –Oversee all incident-related data gathering and analysis regarding incident operations and assigned resources, develop alternatives for tactical operations, conduct planning meetings, and prepare the Incident Action Plan (IAP) for each operational period Duties: –Ensure distribution of critical information/data –Compile scenario projections from all Section Chiefs and effect long range planning –Document and distribute the facility action plan –Conduct Section briefings, update Unit Leaders –Maintain current status of all Sections

144 Center for HICS Education and Training Planning Section Chief Supervises: –Resources Unit Leader –Situation Unit Leader –Documentation Unit Leader –Demobilization Unit Leader

145 Center for HICS Education and Training Resource Unit Leader Mission: –Maintain information on the status, location, and availability of personnel, teams, facilities, supplies, and major equipment to ensure availability of use during the incident. Maintain a master list of all resources assigned to incident operations Oversees: –Personnel Tracking Leader –Materiel Tracking Leader

146 Center for HICS Education and Training Tracking Leaders Personnel Tracking Leader –Mission: Maintain information on the status, location, and availability of on-duty staff and volunteer personnel Materiel Tracking Leader –Mission: Maintain information on the status, location, and availability of equipment and supplies within the hospital inventory and additional materiel received from outside agencies in support of the incident

147 Center for HICS Education and Training Situation Unit Leader Mission: –Collect, process, and organize ongoing situation information; prepare situation summaries; and develop projections and forecasts of future events related to the incident. Prepare maps and gather and disseminate information and intelligence for use in the Incident Action Plan (IAP) Focus is on current and future situation management Writes and maintains situation updates and IAPs Maintains the HCC Status Boards

148 Center for HICS Education and Training Situation Unit Leader The Situation Unit is very busy! –Staff with lots of clerical assistance –Staff with people to monitor TV, media –Networks closely with the Liaison Officer Supervises: –Patient Tracking Leader –Bed Tracking Leader

149 Center for HICS Education and Training Tracking Leaders Patient Tracking Leader: –Mission: Monitor and document the location of patients at all times within the hospital's patient care system, and track the destination of all patients departing the facility Bed Tracking Leader: –Mission: Maintain information on the status, location, and availability of all patient beds, including disaster cots and stretchers

150 Center for HICS Education and Training Documentation Unit Mission: –Maintain accurate and complete incident files, including a record of the hospitals/HCC response and recovery actions and decisions; provide duplication services to incident personnel; and file, maintain, and store incident files for legal, analytical, and historical purposes Duties: –Collects, organizes and archives all response and recovery documentation and paperwork (forms) –Assists in writing the Incident Action Plan (IAP) –Assists in preparing the After-Action Report and Corrective/Improvement Plan based on lessons learned** –Works closely with the Situation Unit Leader

151 Center for HICS Education and Training Demobilization Unit Mission: –Develop and coordinate an Incident Demobilization Plan that includes specific instructions for all staff and resources that will require demobilization Duties: –Responsible for drafting demobilization and system/business recovery plan for the incident approved by the Command Staff/Incident Commander –Demobilization starts EARLY in the response!

152 Center for HICS Education and Training Section Summary The Planning Section is responsible for: –Collecting, evaluating and disseminating incident situation information and intelligence to the HCC –Maintaining resource status –Developing the Incident Action Plan (IAP) ** –Archiving all response and recovery documentation –Assisting with development of the After-Action Report The Planning Section is led by a Chief

153 Center for HICS Education and Training Questions?

154 Center for HICS Education and Training Finance/Administration Section

155 Center for HICS Education and Training Section Mission: –Account for costs incurred from the outset of the response –Account for expenses from multiple cost centers –Monitor, track and report personnel, time, repair, purchase, and replacement expenses and lost revenue –Modify or expand daily (usual) accounting practices to meet the needs of the incident and outlined in the EOP Section led by a Chief Finance/Administration Section

156 Center for HICS Education and Training Finance/Administration Section Chief Mission: –Monitor the utilization of financial assets and the accounting for financial expenditures. Supervise the documentation of expenditures and cost reimbursement activities Duties: –Oversee the acquisition of supplies and services to carry out the medical mission –Supervise the documentation of expenditures relevant to the emergency incident –Directs financial RECOVERY

157 Center for HICS Education and Training Finance/Administration Section Chief Supervises: –Time Unit Leader –Procurement Unit Leader –Compensation/Claims Unit Leader –Cost Unit Leader

158 Center for HICS Education and Training Time Unit Leader Mission: –Responsible for the documentation of personnel time records. Monitor and report on regular and overtime hours worked/volunteered Adjusts reports and tracking to meet the needs of the incident –Tracking of altered or expanded work periods/shifts –Developing specialized tracking forms to capture response and recovery time

159 Center for HICS Education and Training Procurement Unit Leader Mission: –Responsible for administering accounts receivable and payable to contract and non-contract vendors Initiates emergency contracts Agreements should be already in place Confirm existing vendors can deliver in emergencies Confirm payment arrangements Manages purchase orders

160 Center for HICS Education and Training Compensation/Claims Unit Leader Mission: –Responsible for receiving, investigating and documenting all claims reported to the hospital during the emergency incident, which are alleged to be the result of an accident or action on hospital property Duties: –Manages claims and workers compensation issues Injury/illness to staff, volunteers and visitors Should have comprehensive line of duty death procedure to implement if needed Follow up coverage/compensation/benefits clearly outlined and shared with staff member

161 Center for HICS Education and Training Cost Unit Leader Mission: –Responsible for providing cost analysis data for the declared emergency incident and maintenance of accurate records of incident cost Duties: –Track and pay response and recovery costs –Projects lost revenue –Prepares documents for state/federal reimbursement when applicable –Tracks payments Patient insurance and reimbursement Government

162 Center for HICS Education and Training Section Summary The Finance/Administration Section** –Manages costs related to the incident –Provides Accounting Procurement Time recording Cost analysis The Section is led by a Chief**

163 Center for HICS Education and Training Questions?

164 Center for HICS Education and Training Job Action Sheets

165 Center for HICS Education and Training Purpose of the JAS An incident management tool to familiarize the user with critical aspects of the command position he or she is assuming. The series of action steps are intended to prompt the incident management team members to take needed actions related to their roles and responsibilities

166 Center for HICS Education and Training Use of the JAS HICS provides 78 Job Action Sheets In most cases only a portion of these positions will be necessary for a successful response Activation of HICS positions may be based on: –Scope and magnitude of the event –Hospital size –Available resources –Response needs

167 Center for HICS Education and Training JAS Format The key format considerations for each JAS are the same and include the following information: –Command Title – the name of the position –Mission – a brief statement summarizing the basic purpose of the job –Fundamental Information Box – Date and times Highlights reporting relationships Records to whom the position is assigned Location of the HCC or position Contact information and radio title

168 Center for HICS Education and Training JAS Format OPERATIONS SECTION CHIEF Mission: Develop and implement strategy and tactics to carry out the objectives established by the Incident Commander. Organize, assign, and supervise Staging, Medical Care, Infrastructure, Security, Hazardous Materials, and Business Continuity Branch resources. Date: Start: End: Position Assigned to: Initial: Position Reports to: Incident Commander Signature: Hospital Command Center (HCC) Location: Telephone: Fax: Other Contact Info: Radio Title:

169 Center for HICS Education and Training JAS Format Action Steps and Considerations –JAS provides position action steps and considerations Actions listed by operational periods –Immediate 0–2 hours –Intermediate 2–12 hours –Extended Beyond 12 hours –Demobilization/System Recovery (New)

170 Center for HICS Education and Training JAS Format The JAS format enables users to: –Document each action undertaken with initials –Record decision and action timeframes Many action steps are common to all positions –Read the entire JAS –Put on position identification –Notify your usual supervisor of your HICS position –Document using forms –Coordinate with other HICS positions –Include considerations for shift change report

171 Center for HICS Education and Training Immediate Actions – Operations Chief Immediate (Operational Period 0-2 Hours) TimeInitial Receive appointment and briefing from the Incident Commander. Obtain packet containing Operations Section Job Action Sheets. Read this entire Job Action Sheet and review organization chart (HICS Form 207). Put on position identification. Notify your usual supervisor of your HICS assignment. Determine need to appoint Staging Manager, Branch Directors, and Unit Leaders in Operations Section; distribute corresponding Job Action Sheets and position identification. Complete the Branch Assignment List (HICS Form 204). Brief Operations Section Branch Directors and Staging Manager on current situation and incident objectives; develop response strategy and tactics; outline Section action plan and designate time for next briefing. Participate in Incident Action Plan preparation, briefings, and meetings as needed; assist in identifying strategies; determine tactics, work assignments, and resource requirements. Obtain information and updates regularly from Operations Section Branch Directors and Staging Manager; maintain current status of all areas; inform Situation Unit Leader of status information.

172 Center for HICS Education and Training Intermediate Actions – Operations Chief Intermediate (Operational Period 2-12 Hours) TimeInitial Communicate regularly with the Incident Commander, Public Information Officer and Liaison Officer; brief regularly on the status of the Operations Section. Designate time(s) for briefings and updates with Operations Section leadership to develop or update the Section action plan. Initiate the Resource Accounting Record (HICS Form 257) to track equipment used during the response. Schedule planning meetings with Branch Directors and Staging Manager to update the Section action plan and demobilization procedures. Coordinate patient care treatment standards and case definitions with public health officials, as appropriate. Ensure that the Operations Section is adequately staffed and supplied. Coordinate personnel needs with Labor Pool & Credentialing Unit Leader, supply and equipment needs with the Supply Unit Leader, projections and needs with the Planning Section, and financial matters with the Finance/Administration Section. Ensure coordination with any assisting or cooperating agency.

173 Center for HICS Education and Training Extended Actions – Operations Chief Extended (Operational Period Beyond 12 Hours) TimeInitial Continue to monitor Operations Section personnels ability to meet workload demands, staff health and safety, resource needs and documentation practices. Continue to maintain the Resource Accounting Record (HICS Form 257) to track equipment used during the response. Conduct regular situation briefings with Operations Section Branch Directors and Staging Manager. Address issues related to ongoing patient care: Ongoing patient arrival Bed availability Patient transfers Patient tracking Staff health and safety Mental health for patients, families, staff, incident management personnel Fatality management Staffing Staff prophylaxis Medications Medical equipment and supplies Personnel and resource movement through Staging Area Linkages with the medical community, area hospitals, and other healthcare facilities Documentation Upon shift change, brief your replacement on the status of all ongoing operations, issues, and other relevant incident information.

174 Center for HICS Education and Training Demobilization/System Recovery Actions Operations Chief Demobilization/System Recovery TimeInitial As needs decrease, return Operations Section staff to their usual jobs and combine or deactivate positions in a phased manner, in coordination with the Demobilization Unit Leader. Coordinate patient care restoration to normal services. Coordinate final reporting of patient information with external agencies through Liaison Officer and Public Information Officer. Work with Planning and Finance/Administration Sections to complete cost data information. Debrief staff on lessons learned and procedural/equipment changes needed. Upon deactivation of your position, brief the Incident Commander on current problems, outstanding issues, and follow-up requirements. Upon deactivation of your position, ensure all documentation and Operational Logs (HICS Form 214) are submitted to the Documentation Unit. Submit comments to the Incident Commander for discussion and possible inclusion in an after-action report; topics include: Review of pertinent position descriptions and operational checklists Recommendations for procedure changes Section accomplishments and issues Participate in stress management and after-action debriefings. Participate in other briefings and meetings as required.

175 Center for HICS Education and Training JAS Format Documents/Tools – –A listing of pertinent HICS forms this position is responsible for using Forms noted in JAS action steps –Other tools that will help them fulfill their role and responsibilities Hospital plans, policies and procedures Technology tools Other adjuncts

176 Center for HICS Education and Training Documents/Tools – Operations Chief Documents/Tools Incident Action Plan HICS Form 204 – Branch Assignment Sheet HICS Form 207 – Organization Chart HICS Form 213 – Incident Message Form HICS Form 214 – Operational Log HICS Form 257 – Resource Accounting Record Hospital emergency operations plan Hospital organization chart Hospital telephone directory Radio/satellite phone

177 Center for HICS Education and Training Role of Deputies and Assistants No JAS has been written for a Deputy Chief or assistants –They work from the JAS of the position they assume Deputy Chief: –Assigned for Command or General Staff Assistant: –Assigned for Command or General Staff –Assigned to Unit Leaders as needed and resources allow

178 Center for HICS Education and Training JAS Use The format allows for the JASs to be used –To preliminarily document actions taken during the incident –To develop a chronology of events, problems encountered, and decisions made Use the Operational Log (HICS Form 214) continuously to detail actions, decisions and activities

179 Center for HICS Education and Training JAS Use JASs are used continuously during the response –Actions in all operational periods should be continued and monitored JAS should transfer to your replacement and actions continued –Upon shift change or position change

180 Center for HICS Education and Training JAS Customization The JASs are designed to be customized for the needs of each hospital –Hospitals can use the HICS JASs as prepared –Hospitals can modify the HICS JASs based on : Hospital size Available resources Response needs –Hospitals can craft their own, unique JAS

181 Center for HICS Education and Training JAS Customization Hospitals are encouraged to use the HICS JAS model as a template for customized JASs –Maintain the prescribed format and terminology to ensure the standardization benefit of NIMS –Modify the Operational Period Actions and Documents/Tools section appropriately for the facility and community

182 Center for HICS Education and Training JAS Customization Processes Review all HICS Job Action Sheets –Convene subject matter experts and stakeholders from within institution to review job action sheets –Engage persons/staff who would fill those roles in an event –Ensure JASs meet hospital needs Revise content as necessary with details (e.g. correct telephone numbers, etc) –Place own hospital logo on each JAS if desired

183 Center for HICS Education and Training JAS Training and Exercising JASs should be used in trainings and exercising –Enhance familiarity of position description, mission and actions Conduct focused drills with Branches and Sections to enhance understanding of the incident management team structure

184 Center for HICS Education and Training Section Summary The Job Action Sheets are: –An incident management tool –A series of actions to meet the incident response –Are divided in time phases Immediate 0-2 hours Intermediate – 2-12 hours Extended – Greater than 12 hours Demobilization/System Recovery –Standardized to facilitate interagency response –Customizable for the unique facility needs/roles

185 Center for HICS Education and Training Questions?

186 Center for HICS Education and Training Incident Action Planning

187 Center for HICS Education and Training Incident Action Plans Incidents Action Plans: –Provide all IMT personnel with direction for actions based on the objectives during the operational period** –Are a means of communicating the overall incident objectives, including: Operational activities Support activities –A tool to successful transition of operational activities to HCC relief staff Incident action planning requires an understanding the hospitals policy and direction Incident action planning is essential for a successful response and recovery

188 Center for HICS Education and Training Incident Action Plans IAP processes use Management by Objectives –Setting the Operational Period –Determining overall priorities –Establishing specific, measurable, attainable objectives –Selecting effective strategies and tactics to accomplish objectives –Identify needed resources –Develop and issue assignments –Direct, monitor and evaluate response efforts to enhance response in the next op period –Document results –Corrective actions

189 Center for HICS Education and Training Incident Action Planning The IAP covers an Operational Period Elements of an IAP –What must be done –Who is responsible –How information is communicated –What should be done if someone is injured

190 Center for HICS Education and Training Incident Action Planning Process The Incident Commander sets times for IAP meetings The Section Chiefs develop their Sections action plan for the next operational period –Input from Branch and Unit staff Section IAP submitted to Planning Chief –Assimilated into a single HCC IAP –Documentation and Situation Unit Leaders compile the IAP

191 Center for HICS Education and Training Incident Action Planning Process Incident Action Planning Meeting conducted by the IC –Command Staff and General Staff attend the meeting IAP is discussed and modified, as needed Next Action Planning Meeting is determined IC Approved and final IAP is distributed to HCC staff –Distribution by the Documentation Unit Leader

192 Center for HICS Education and Training Incident Action Planning The IAP should be developed ASAP after the HCC is operational –It becomes the preliminary guidance for a defined, short operational period HICS forms to utilize: –HICS Form 201 – Incident Briefing –HICS Form 202 – Incident Objectives** –HICS Form 203 – Organizational Assignment List –HICS Form 261 – Incident Action Plan Safety Analysis

193 Center for HICS Education and Training Section Summary The IAP provides all IMT personnel with direction for actions based on the objectives during the operational period** Incident Action Planning uses the elements of Management by Objectives Incident Action Planning is done by Command and General Staff Incident Action Planning is essential for effective response and recovery

194 Center for HICS Education and Training Questions?

195 Center for HICS Education and Training Incident Planning Guides & Incident Response Guides

196 Center for HICS Education and Training Incident Specific Planning During the initial response period, activities are guided by: –Emergency Operations Plan –Incident-specific guides These plans/guides assist the IC: –To conduct a situation assessment –Set initial objectives –Establish the HCC/ICS organization

197 Center for HICS Education and Training HICS IPGs and IRGs An incident-specific scenario sets the stage for the IPGs and IRGs 13 internal scenarios –Based on most likely internal hospital incidents 14 external scenarios –Based on the Department of Homeland Security National Planning Scenarios

198 Center for HICS Education and Training Internal Guides Bomb Threat Evacuation Fire HazMat Spill Hospital Overload Hostage/Barricade Infant/child abduction Internal flooding Loss of HVAC Loss of Power Loss of Water Severe weather Work stoppage All-Hazards Guide External Guides Nuclear Detonation Biological attack - Anthrax Biological disease outbreak -Pandemic Influenza Biological Attack – Plague Chemical Attack – Blister Agent Chemical Attack – Toxic Industrial Chemicals Chemical Attack - Nerve agent Chemical Attack – Chlorine Natural Disaster – Earthquake Natural Disaster – Hurricane Radiological Attack – RDD Explosives Attack – IED Biological Attack – Food Contamination Cyber Attack Incident Planning and Response Guides

199 Center for HICS Education and Training Introductory Scenario Example: Internal Scenario - Fire Your hospital is in the middle of the annual flu season. It is mid winter and it is unusually cold outside. The time is 10:30 PM. The hospital inpatient beds are at 95% capacity and there are patients holding in the ED to be admitted. A fire has broken out and has engulfed the laboratory area, and the fire sprinkler system in that area has activated. The fire department quickly responds and extinguishes the fire before it can spread beyond the laboratory area. The fire department assists with the smoke and water removal. Two staff members from the laboratory are injured with burns and smoke inhalation, one seriously and one in critical condition. The lab is totally destroyed and is unusable. The extensive smoke and water damage has spread to the ICU and the patient rooms above the lab. The staff are asking if they should evacuate the hospital. The local press is now on scene and is demanding information and access to the hospital.

200 Center for HICS Education and Training IPGs and IRGs Hospitals use these incident-specific guides –According to the facility HVA –The community HVA Additional IRGs and IPGs may need to be developed by the facility to address a hazard

201 Center for HICS Education and Training Incident Planning Guides

202 Center for HICS Education and Training Incident Planning Guides –Outline strategic planning considerations for incident-specific situations –Formatted to the emergency management phases Mitigation (including prevention) Preparedness Response Recovery –Used to evaluate the facilitys Emergency Operations Plan –Used to develop Incident Response Guides

203 Center for HICS Education and Training IPG: Example - Fire Does your Emergency Management Plan Address the following issues? Mitigation & Preparedness Does the fire alarm and overhead announcement sound loudly enough to be heard in all locations? Does the fire alarm system include both audible and visual systems (e.g. alarm tone and flashing strobe lights)? Does the hospital have lighted emergency exits in all areas? Does the fire alarm automatically notify the local fire department? Does the hospital have a fire plan that includes closing and securing all doors and windows? Does the hospital have procedures to immediately shut off valves that control oxygen and other gases?

204 Center for HICS Education and Training Incident Response Guides

205 Center for HICS Education and Training Incident Response Guides –Are incident-specific –Are activated during response –Provide critical considerations and actions for the Command and General Staff –Are time based: Immediate – 0-2 hours Intermediate – 2-12 hours Extended – Greater than 12 hours Demobilization/System Recovery

206 Center for HICS Education and Training Incident Response Guides Should complement –Emergency Operations Plan They complement the EOP but not replace the EOP –Job Action Sheets Can be used as initial documentation

207 Center for HICS Education and Training IRG – Example: Fire Mission: To reduce the loss of life and property during an internal fire incident. Directions Read this entire response guide and review incident management team chart Use this response guide as a checklist to ensure all tasks are addressed and completed Objectives Confine the fire/reduce the spread of the fire Rescue and protect patients and staff Implement internal emergency management plan – fire

208 Center for HICS Education and Training IRG – Example: Fire Immediate Actions (Operational Period 0-2 Hours) COMMAND (Incident Commander): -- Activate the facility emergency operations plan and the Incident Command structure -- Appoint Command Staff and Section Chiefs -- Consider the formation of a unified command with hospital and fire officials -- Determine need for and type of evacuation (PIO): -- Establish a media staging area -- Conduct regular media briefings to update situation status and provide appropriate patient and employee information -- Oversee patient family notifications of incident and evacuation/relocation, if ordered

209 Center for HICS Education and Training IRGs and IPGs Uses of the Guides –To evaluate the EOP –A training tool –Tabletop exercises –As a planning basis for a functional exercise Guides will promote more immediate and higher quality decision-making

210 Center for HICS Education and Training JAS versus IRGs & IPGs The IRGs are not intended to be a replacement for Job Action Sheets –IRGs Overview position actions and decision making Are Incident Specific –JASs Detail position actions, decisions and activities Are all-hazards focused

211 Center for HICS Education and Training Section Summary IPGs and IRGs –Are incident-specific tools to assist hospitals with planning, training and response/recovery efforts –Assist in meeting regulatory requirements –Guide Command and General Staff with decision- making and action-taking –Should be consistent with the EOP –Do not replace the JAS

212 Center for HICS Education and Training Questions?

213 Center for HICS Education and Training HICS Forms

214 Center for HICS Education and Training Using the HICS Forms Purpose: –To provide the incident management team with the documents needed to manage a response Use: –Each form has a specific purpose identified at the bottom of the form –Instruction sheets for each form can be printed on reverse side of each form, if desired Forms have been modified from existing FEMA ICS forms for use in hospitals

215 Center for HICS Education and Training Value of Using HICS Forms Your facility will be consistent with other healthcare facilities and community responders Information can be more easily shared among all responders Documentation guides your response and assists in your recovery efforts

216 Center for HICS Education and Training Value of Using HICS Forms Serves as a road map in response: everyone acting from the same plan Serves as a foundation for corrective action Ensures consistency and compliance with regulatory guidelines Complies with NIMS Publications Management Standard*

217 Center for HICS Education and Training Using the HICS Forms Forms format includes: –Form number –Name of form –Who is responsible for completion –When form is to be completed 20 HICS forms –Found in the Guidebook Appendix D Utilize current facility forms + HICS forms for response Develop additional forms to meet the incidents

218 Center for HICS Education and Training Using HICS Forms Appropriate HICS forms completed by each HCC position –Forms can be done electronically or hand-written –Write legibly and clearly –Complete all areas on the form Completed forms distributed with a copy to the Planning Section –Forms will be archived to document response Forms and other incident documentation used to craft the AAR

219 Center for HICS Education and Training No.NameResponsible 201Incident BriefingIncident Commander 202Incident ObjectivesSection Chiefs 203Organizational Assignment ListResource Unit Leader 204Branch Assignment ListBranch Directors 205Communications LogCommunications Unit Leader 206Staff Medical PlanSupport Branch Director 207Organization ChartIncident Commander 213Incident Message FormAll Positions 214Operational LogCommand Staff and General Staff 251Facility System Status ReportInfrastructure Branch Director HICS Forms

220 Center for HICS Education and Training No.NameResponsible 252Section Personnel Time SheetSection Chiefs 253Volunteer Staff RegistrationLabor Pool & Credentailiting Unit Leader 254Disaster Victim / Pt Tracking FormPatient Tracking Manager 255Master Pt Evacuation Tracking FormPatient Tracking Manager 256Procurement Summary ReportProcurement Unit Leader 257Resource Accounting RecordSection Chiefs 258Hospital Resource DirectoryResource Unit Leader 259Hospital Casualty / Fatality ReportPatient Tracking Manager 260Patient Evacuation Tracking FormInpt Unit Leader Outpt Unit Leader, Casualty Care Unit Leader 261Incident Action Plan Safety AnalysisSafety Officer

221 Center for HICS Education and Training HICS 201 – Incident Briefing Purpose –Documents initial response information and actions taken at start-up Origination –Incident Commander Copies to –Command staff, Section Chiefs, and Documentation Unit Leader When to Complete – Prior to briefing the current operational period Helpful Tips – Distribute to all staff before initial briefing

222 Center for HICS Education and Training HICS 201 – Incident Briefing Instructions –Print legibly and enter complete information Incident Name Date of briefing Time of Briefing Event History and Current Actions Taken Current Organization Notes (warnings, directives, etc.) Prepared by (name and position) Facility Name

223 Center for HICS Education and Training

224

225 Lab/West Wing Fire Fire broke out at 7:00 am in the main laboratory on the 2 nd floor. Large amount of smoke with foul odor. Fire sprinklers activated Fire department arrived and unified command established HCC activated. EOP activated. Fire department enroute. Positions activated: Safety Officer, Operations Chief, Infrastructure Branch Director and Medical Care Branch Director Evacuation of patient care areas near the lab in progress. All depts instructed to send casualty reports to HCC.

226 Center for HICS Education and Training J. Smith B. WaltersL. Henson A. Doe C. BartonN. DeGuzmanR. OReilly A. Greenspan

227 Center for HICS Education and Training HICS 202 – Incident Objectives Purpose –Defines objectives and issues for operational period Origination –Planning Section Chief Copies to –Command staff, General Staff and Documentation Unit Leader When to Complete –Prior to briefing the current operational period Helpful Tips –Serves as a roadmap to incident management

228 Center for HICS Education and Training HICS 202 – Incident Objectives Instructions –Print legibly and enter complete information Incident Name Date prepared Time prepared Operational Period Date and Time General Command and Control Objectives for the Incident Weather / Environmental Implications for the Period General Safety / Safety Messages Attachments Prepared by (Planning Chief: use proper name) Approved by (Incident Commander) Facility Name

229 Center for HICS Education and Training

230 Lab/West Wing Fire Winds from NE at 12 mph. Low fog remains, expected to dissipate by Temperatures currently 41 degrees; high of 55 expected with overnight temps to high 30s. Rain forecast by weekend. 1.Ensure communications links to Fire Department, community hospitals and emergency operations center are functioning 4. Establish alternate care sites as needed for patient evacuations 3. Assess injuries to patients, visitors and staff 2. Initiate structural assessment of hospital

231 Center for HICS Education and Training HICS 203: Organization Assignment List J Smith Barbara Walters Lab/West Wing Fire L. Henson Jane Doe Clara Barton

232 Center for HICS Education and Training HICS 203: Organization Assignment List Radar OReilly John Q. Public

233 Center for HICS Education and Training HICS Form 204: Branch Assignment List

234 Center for HICS Education and Training HICS Form 204: Branch Assignment List

235 Center for HICS Education and Training HICS Form 213: Incident Message Form Call from the laboratory manager. States that the lab will not be functional due to major equipment damage from heat and smoke. Laboratory non-functional. Request transportation of stat lab specimens to the community laboratory for testing R. OReilly, LogisticsC Barton, Operations

236 Center for HICS Education and Training HICS Form 213: Incident Message Form Community Laboratory called and will accept specimens and blood tubes for testing. Transporation van will pick up specimens and transport to the community lab at IMA Vampire1100

237 Center for HICS Education and Training HICS Form Lab/West Wing Fire Operations, Medical Care Branch 0820Position Activated and situation briefing obtained West Unit patient care unit with major smoke damage. Patients with respiratory symptoms and anxiety. Ordered evacuation of the wing 0900 Clara Barton

238 Center for HICS Education and Training HICS Form 254 Lab/West Wing Fire Brad PittM34ED Transfer

239 Center for HICS Education and Training HICS Form 255

240 Center for HICS Education and Training HICS Form 257

241 Center for HICS Education and Training HICS Form 258

242 Center for HICS Education and Training HICS Form 258

243 Center for HICS Education and Training HICS Form 258

244 Center for HICS Education and Training HICS Form 261

245 Center for HICS Education and Training Section Summary The HICS forms: –Provide the Incident Management Team with the documents needed to manage a response –Assist in communication with external agencies and resources –Assist in communication with hospital staff –Provide documentation for response and recovery activities

246 Center for HICS Education and Training Questions?

247 Center for HICS Education and Training External Agency Coordination Hospitals can no longer plan for emergencies in a silo –Effective preparedness and response requires integration with other community responders –Include local, regional and state responders –Joint Commission requires community-wide planning and collaboration with responders

248 Center for HICS Education and Training External Agency Coordination Hospitals should be actively engaged in community planning and preparedness –Public Safety Law enforcement/Medical Examiner or Coroner Fire EMS –Public health –Emergency Management (local agency) –Behavioral/Mental Health –Other public and private agencies

249 Center for HICS Education and Training Community Planning Meetings with response partners serve to: –Increase understanding of response roles and limitations –Develop regional response plans and procedures –Plan, conduct and evaluate collaborative exercises –Conduct multi-disciplinary training –Build personal relationships across disciplines for better communication and response

250 Center for HICS Education and Training Hospital Collaboration Hospitals must also plan and prepare with other healthcare partners –Within the corporate healthcare system –Other community hospitals –Clinics –Long-term care facilities –Regional Hospital Coordination Centers –Regional Hospital Associations

251 Center for HICS Education and Training Hospital Collaboration Hospitals in a community should meet regularly –Cooperative planning and training –Conduct joint exercises Standardization between hospitals –Terminology –Use of HICS –Mutual aid and scarce resource sharing –Integrated plans and procedures

252 Center for HICS Education and Training Hospital Collaboration Develop and sign mutual aid agreements or MOUs –How to request assistance from sister hospitals –Sharing of resources Hospital resources Community resources –Credentialing of staff/volunteers –Initiation of patient transfers –Standardizing purchases of equipment and supplies (cost savings and increased capacity)

253 Center for HICS Education and Training Hospital Collaboration Achieving the hospital collaboration points will meet four NIMS elements –Element 1: Organizational adoption of NIMS –Element 2: Utilization of ICS –Element 3: Multi-agency coordination systems –Element 17: Standardized and consistent terminology

254 Center for HICS Education and Training Healthcare Provider Collaboration Hospital collaboration with non-hospital facilities –Clinics –Urgent Care Centers and MD offices –Long-term care facilities Include these providers in planning, training and exercises –They can provide valuable resources –Can augment healthcare capacity and preserve acute care hospitals for acute care

255 Center for HICS Education and Training Hospital Command Center Activation Once the HCC is activated –Communication and information sharing with partners is vital –Liaison Officer is the formal line of communications into and out from the facility But some positions also have communication and coordination lines with community providers and responders….

256 Center for HICS Education and Training HICS Guidebook, Chapter 4, Page 21

257 Center for HICS Education and Training HICS and Unified Command Single agency command ** –One agency involved in the response –Hospitals using HICS are single agency command structures

258 Center for HICS Education and Training HICS and Unified Command Unified command is instituted ** –When more than one responding agency is present or, –The situation crosses political jurisdictions –Leaders from the agency are co-located for collaborative decision making –A unified IAP is developed –Unified command may occur when hospitals are asked to respond to the incident scene

259 Center for HICS Education and Training HICS and Unified Command When does unified command apply to hospitals? –When the hospital is the scene of the incident and other responders come to the facility –Example: Hostage situation – Law Enforcement Hospital Fire – Fire Bomb threat –Bomb Squad/Law Enforcement Building collapse – Fire and Search & Rescue Water outage/rupture – Public Works

260 Center for HICS Education and Training HICS and Unified Command Unified command in the HCC –A Unified Incident Management Team (UIMT) would be formed in the HCC Bomb Threat--- Hospital IC and Law Enforcement IC The UIMT facilitates –Information sharing –Individual agencies provide input into IAP Each agency retains individual authority over its assets and responsibilities Although there is equality, there still is a final authority –In our example– who would that be?

261 Center for HICS Education and Training HICS and Area Command Area command is defined as: –A command structure to oversee the management of large or multiple incidents with individual ICS structures The area command structure –Sets overall strategies and priorities –Allocates critical resources –Ensure incidents are properly managed –Ensures overall objectives are achieved

262 Center for HICS Education and Training HICS and Area Command Hospital example: –A large healthcare organization with multiple buildings on the facility grounds Main hospital Womens hospital Multiple clinics –A tornado occurs with scattered areas of activity and damage to multiple facilities All buildings activate their incident command structures/HCC –The Main hospital serves as area command for all facilities, but each facility maintains an ICS structure

263 Center for HICS Education and Training Section Summary Hospitals must plan collaboratively with community responders for effective emergency response and recovery Establishing and rehearsing pre-event MOUs or mutual aid agreements will ensure effective response Hospitals may utilize unified command and area command structures in certain situations

264 Center for HICS Education and Training Questions?

265 Center for HICS Education and Training HICS for Small and Rural Facilities

266 Center for HICS Education and Training Rural and Small Hospital Challenges Preparedness apathy: –It cant happen here! Relative isolation: –Geography/distance may isolate the facility –Remote distance from resources may delay assistance Limited resources and surge capacity: –Fewer resources in the hospital and community –Local government resources limited –Limited reliable and redundant communications

267 Center for HICS Education and Training Small and Rural Hospital Challenges Limited healthcare personnel resources –Overlapping community roles Healthcare providers serving on EMS units –Reliance on community volunteers Limited funding –Government grants based on population –Population bases do not account for seasonal surge (i.e., vacation time, concerts, large events)

268 Center for HICS Education and Training Small and Rural Hospital Challenges Rural areas may be the destination for urban residents during an incident! –Large numbers will quickly overwhelm resources National guidelines and recommendations –Mostly focus on urban and suburban regions –Do not account for variances in rural communities Yet, rural and small hospitals must meet all standards or recommendations!

269 Center for HICS Education and Training Using HICS in Smaller and Rural Hospitals! It Can Be Done!

270 Center for HICS Education and Training

271 HICS for Smaller Facilities Adapt HICS to your facility –Consolidate positions Maintain the basic command structure

272 Center for HICS Education and Training HICS for Smaller Facilities Adapt HICS to your facility –Combine the duties of like positions under the Branches Condense the JAS with critical duties for like positions listed Concentrate on the main Sections and Branches or critical Unit Leaders

273 Center for HICS Education and Training Example Adapted IMT

274 Center for HICS Education and Training HICS For Smaller Facilities When adapting the IMT and consolidating positions, –Create JASs for each position –Include critical actions In mission statement In JAS elements Suggest having the full IMT JAS available –If a large incident and help arrives Each position can then be activated

275 Center for HICS Education and Training Section Summary The HICS IMT can be adapted for smaller and rural facilities JASs can be created for consolidated positions –Maintaining mission statements and title Remember, you only activate positions as needed to meet the incident Keep all HICS JAS in the event positions need to be expanded

276 Center for HICS Education and Training Questions?

277 Center for HICS Education and Training Summary of the Day Today we have learned about: –NIMS and ICS concepts and principles –NIMS Implementation Activities for Hospitals –The origins of HICS –The Hospital Incident Command System Incident Management Team Command and General Staff All HICS positions

278 Center for HICS Education and Training Summary of the Day Today we learned about: –The importance of Incident Action Planning –HICS Materials Job Action Sheets Incident Planning and Response Guides Forms The importance of Incident Action Planning –Relationship of the Hospital to Community Responders –HICS for Rural and Small Hospitals

279 Center for HICS Education and Training Evaluation of the Day How was the course so far????

280 Center for HICS Education and Training


Download ppt "Center for HICS Education and Training Hospital Incident Command System Train-The-Trainer Course National Disaster Medical System (NDMS) Conference March."

Similar presentations


Ads by Google