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Introduction to: Incident Command System (ICS)

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1 Introduction to: Incident Command System (ICS)
Hospital Emergency Incident Command System (HEICS) National Incident Management System (NIMS) (IS 100, 200, 700) The University of South Alabama Center for Strategic Health Innovation © University of South Alabama Center For Strategic Health Innovation. All Rights Reserved. These slides are a part of the ARRTC program and cannot be reproduced for commercial purposes.

2 ICS is: A Proven Crisis Management System Based on Military and Fire Management Systems Common Language between agencies - (Fire, Police, EMA, Hospitals, Public Health…) Manages routine or planned events Provides logistical and administrative support to operational personnel Improves Communication Flexible, adaptable system

3 NIMS is: Comprehensive federal system directing response agencies to function in an organized manner Established to coordinate: Plans Organization Structure Training and Exercises Resources Communications and Technology

4 NIMS Compliance HSPD-5 issued in 2004
For disaster response agencies and departments, NIMS made a condition for Federal assistance Confusion over initial NIMS compliance for hospitals and healthcare facilities DHS/HRSA letter of May 26, 2006 explains newest issues

5 NIMS Implementation Activities for Hospitals
Similar to expectations placed on government agencies Consists of seven categories and seventeen elements The Hospital Emergency Incident Command System (HEICS) incorporates NIMS terminology, principles and practices

6 NIMS Compliance Adopt NIMS at your agency
Revise disaster plans to incorporate NIMS Become familiar with National Response Plan Adopt ICS (HEICS) and make it a part of your Disaster Response Plan Coordinate with local response agencies and use a Multi-Agency Coordination system Develop Mutual Aid agreements

7 NIMS Compliance Participate in local Public Information Plans
Coordinate and implement federal funding and demonstrate commitments Select personnel need IS 100, 200, 700, and 800 Courses – later in presentation (www.fema.gov/emergency/nims/) NIMS compliance phased in over next 2 years Compliance with first set of objectives is September 30, (Changed from 9/30/06)

8 NIMS Components Command and Management - ICS
Preparedness – Plans/Exercises/Training Resource Management – Stuff/People Communications and Information Management - AIMS Supporting technologies – IT Ongoing maintenance and management – Periodic NIMS updates/requirements

9 National Response Plan Emergency Support Functions (ESFs)
1. Transportation Department of Transportation 2. Communications Homeland Security 3. Public Works and Engineering Department of Defense Army Corps of Engineers 4. Firefighting Department of Agriculture 5. Emergency Management Homeland Security/FEMA 6. Mass Care, Housing, Human Services 7. Resource Support General Services Administration 8. Public Health and Medical Services Department of Health and Human Services 9. Urban Search and Rescue Homeland Security/FEMA 10. Oil & Hazardous Materials Response Environmental Protection Agency 11. Agriculture and Natural Resources Department of Agriculture 12. Energy Department of Energy Under the Federal Response Plan, 12 Emergency Support Functions exist to group types of Federal assistance a State is most likely to need Each ESF is headed by a primary agency, which has been selected based on its authorities, resources and capabilities in the particular functional area The 12 ESF’s serve as the primary mechanism through which Federal response assistance will be provided to the affected State

10 Response Plan Emergency Support Functions
13. Public Safety and Security Department of Justice 14. Long-Term Community Recovery Homeland Security/FEMA 15. External Affairs Homeland Security Under the Federal Response Plan, 12 Emergency Support Functions exist to group types of Federal assistance a State is most likely to need Each ESF is headed by a primary agency, which has been selected based on its authorities, resources and capabilities in the particular functional area The 12 ESF’s serve as the primary mechanism through which Federal response assistance will be provided to the affected State

11 ICS

12 Basic Features of ICS Modular organization Management by objectives
Reliance on an Incident Action Plan (IAP) Chain of command Manageable span of control Unity of command Unified Command

13 History of ICS Weaknesses in incident management before ICS
Lack of accountability Poor communication Lack of a planning process Overloaded Incident Commanders No method to integrate interagency requirements ICS provides an organized system to manage incidents and addresses these weaknesses

14 ICS Terminology Unified Command Sections Divisions Groups Branches
Task Forces Strike Teams Single Resources Transfer of command

15 Unified Command Enables all responsible agencies to manage an incident
Establishes a common set of incident objectives and strategies Allows Incident Commanders to make joint decisions by establishing a single command structure Maintains unity of command Each employee only reports to one supervisor

16 Sections Organizational levels with responsibility for a major functional area of the incident Operations Planning Logistics Finance/Administration The person in charge is the Chief

17 Divisions and Groups Divisions Divide an incident geographically
Is led by a Supervisor Groups Established based on the needs of an incident. Labeled according to the job that they are assigned Managed by a Supervisor Work wherever their assigned task is needed and are not limited geographically

18 Branches and Units Branches
Established if the number of Divisions or Groups exceeds the span of control Have functional or geographical responsibility for major parts of incident operations Managed by a Branch Director Units Organizational elements that have functional responsibility for a specific activity

19 Task Forces Task Forces are a combination of mixed resources with common communications Operate under the direct supervision of a Task Force Leader

20 Strike Teams Strike Teams are a set number of resources
Of the same kind and type With common communications Operate under the direct supervision of a Strike Team Leader

21 Single Resources An individual(s) or piece of equipment with its personnel complement; or, A crew or team of individuals with an identified supervisor

22 ICS Supervisory Titles
Organizational Level Title Support Position Incident Command Incident Commander Deputy Command Staff Officer Assistant General Staff (Section) Chief Branch Director Division/Group Supervisor N/A Unit Leader Manager Strike Team/Task Force Single Resource Boss

23 Transfer of Command Moves the responsibility for incident command from one Incident Commander to another Must include a transfer of command briefing Oral Written Both oral and written

24 Public Information Officer Safety and Security Officer
ICS Incident Commander Public Information Officer Liaison Officer Safety and Security Officer Logistics Chief Planning Chief Finance Chief Operations Chief

25 Public Information Officer Safety and Security Officer
HEICS Incident Commander Public Information Officer Liaison Officer Safety and Security Officer Logistics Chief Planning Chief Finance Chief Operations Chief

26 HOSPITAL EMERGENCY INCIDENT COMMAND SYSTEM
HEICS

27 ICS Management Process Tactical Results, Needs,
Incident Occurs Incident Reported & Identified Tactical Response ICS Launched Chiefs Meeting: Develop Strategy & Tactics to Meet Objectives IC Sets Objectives Action Plan Preparation Chiefs & Officers Meet with IC to Evaluate Reports Tactical Response Initiated Operation Reports Tactical Results, Needs, Engage Liaison, Logistics, Planning, Finance for support Planning Evaluates Progress Reports

28 The Five Sections Command = the buck stops here
Planning = creates & develops incident plan Operations = implement the plan. Logistics = supports the plan. Finance = pays for the plan.

29 Safety and Security Officer Public Information Officer
Command Section Incident Commander Safety and Security Officer Liaison Officer ?? Legal ?? Public Information Officer Logistics Chief Planning Chief Finance Chief Operations Chief

30 The Incident Commander
Gives overall direction for hospital operations. Mission: to organize and direct the EOC (Emergency Operations Center) and all the positions through the ICS structure

31 Safety/Security Officer
Organize and reinforce scene/facility protection and traffic. Establish a security command post. Mission: Monitor and have authority over the safety of operations and hazardous conditions.

32 Public Information Officer
Mission: to function as the public information source for your agency. Be the organizer of correct information COMMUNICATE with other public information officers Participate in a JIC

33 Liaison Officer Mission: to function as the incident contact person for representatives from other agencies. COMMUNICATE into and out of the hospital.

34 Legal & Ethics Mission: to provide legal advice to the IC and your agency. Think recent issues in New Orleans

35 Public Information Officer Safety and Security Officer
HEICS Incident Commander Public Information Officer Liaison Officer Safety and Security Officer Logistics Chief Planning Chief Finance Chief Operations Chief

36 Logistics Section “Boy, do I need stuff”

37 Logistics Chief Food Shelter Supplies Comms Equipment
Organize and direct operations associated with the maintenance of the physical environment: Food Shelter Supplies Comms Equipment Support the medical objectives

38 Logistics Chief Facility Unit Leader Communications Unit Leader
Transport Unit Leader Materials Supply Unit Leader Nutritional Supply Unit Leader

39 Public Information Officer Safety and Security Officer
HEICS Incident Commander Public Information Officer Liaison Officer Safety and Security Officer Logistics Chief Planning Chief Finance Chief Operations Chief

40 Planning Section

41 Planning Chief Organize and direct all aspects of the planning section - Action Plan Document and distribute the facility action plan. Ensure distribution of critical information/data. Compile scenario projections from all section chiefs and effect long range planning. Ensure adequate personnel for response.

42 Planning Chief Situation Status Unit Leader Labor Pool Unit Leader
Medical Staff Unit Leader Patient Tracking Officer Patient Information Officer

43 Situation-Status Unit Leader
Maintain current information regarding the incident status. Ensure a written record of the hospital’s emergency planning and response. Develop the hospital’s internal information network. Monitor the maintenance and preservation of the computer system.

44 Labor Pool Unit Leader Collect and inventory available staff to a central point. Receive requests and assign available personnel as needed. Maintain adequate numbers of medical and non-medical personnel. Assist in the maintenance of staff morale.

45 Medical Staff Unit Leader
Collect available physicians at a central point. Credential volunteer medical staff as necessary. Assist in the assignment of available medical staff as needed. Often moved to Operations under Medical Staff Director

46 Patient Tracking vs Information
Tracking Officer: Maintain the location of patients at all times within the hospital’s patient care system. Information Officer: Provide information to visitors and family on status and location of patients.

47 Public Information Officer Safety and Security Officer
HEICS Incident Commander Public Information Officer Liaison Officer Safety and Security Officer Logistics Chief Planning Chief Finance Chief Operations Chief

48 Finance Section $$ $$ MONEY MONEY MONEY MONEY

49 Finance Section Monitor the utilization of financial assets.
Oversee the acquisition of supplies and services to carry out the medical mission. Supervise the documentation of expenditures relevant to the emergency incident. Business RECOVERY

50 Finance Chief Time Unit Leader Procurement Unit Leader
Claims Unit Leader Cost Unit Leader

51 Public Information Officer Safety and Security Officer
HEICS Incident Commander Public Information Officer Liaison Officer Safety and Security Officer Logistics Chief Planning Chief Finance Chief Operations Chief

52 Operations Section Day to Day activities – On Steroids!
Provision of Care – “Your Hospital’s Mission” Known as the Tactical Response

53 Operations Chief Medical Staff Director Medical Care Director
Ancillary Services Director Human Services Director

54 Operations Chief Medical Staff Director Medical Care Director
In-Patient Areas Supervisor Treatment Areas Supervisor Surgical Services Unit Leader Triage Unit Leader Discharge Unit Leader Maternal & Child Unit Leader Immediate Tx Unit Leader Morgue Unit Leader Critical Care Unit Leader Delayed Tx Unit Leader General Nursing Unit Leader Minor Tx Unit Leader Out-Patient Services Leader

55 Psychological Support
Operations Chief Human Services Director Staff Support Unit Leader Psychological Support Unit Leader Dependent Care Unit Leader

56 Operations Chief Ancillary Services Director Laboratory Unit Leader
Pharmacy Unit Leader Radiology Unit Leader Cardiopulmonary Unit Leader

57 Job Action Sheets Each role’s assignments Checklists
Prioritizes duties No duplication of duties Responsibilities outlined Important that staff know to read their Job Action Sheet at the START!!!

58 Using Functions Lists to Build Readiness:
Look at the function – is it something your facility would do? If no, who is responsible for it? If maybe, how would be adjust? If yes, who would undertake this task? How would this task be accomplished? Do you have an Operating Instructions or a Policy/Procedures Guide?

59 Never alter the job title or mission statement.
Job Action Sheets Job Action Sheets: should be customized to your organization but… Never alter the job title or mission statement. Until Later!

60 HINT: It really never ends!
HEICS Implementation It is a process Allow 1 Year! HINT: It really never ends!

61 Other ICS Systems

62 PHEICS Incident Commander Liaison Officer - External
Public Health Emergency Incident Command System PHEICS Incident Commander Liaison Officer - External Public Information Officer Liaison Officer -Internal Safety and Security Officer Legal Officer Logistics Chief Planning Chief Finance Chief Operations Chief

63 ADPH Incident Command System Positions Chart May 22, 2006
Incident Management Advisory Group/ CEP Incident Commander ADPH Incident Command System Positions Chart May 22, 2006 Subject Matter Experts Biological Chemical Radiation Zoonotic Infection Control Public Information Officer Safety and Security Officer Liaison Officer Internal Legal Officer Liaison Officer External Logistics Chief Planning Chief Finance Chief Operations Chief Communications Unit Leader Situation Status Unit Leader Time Unit Leader Social Services Coordination Branch Leader Patient Tracking Unit Leader Damage Assessment Unit Leader Human Resources Unit Leader Laboratory Branch Leader Procurement Unit Leader Strategic Epidemiology Unit Leader Environmental Branch Leader Transportation Unit Leader Medical Branch Leader Materials Supply Unit Leader Strategic Surveillance Unit Leader Surveillance & Epidemiology Investigation Branch Leader Nutrition Supply Unit Leader

64 Safety and Security Officer
Incident Management Advisory Group/ CEP Incident Commander Public Information Officer Safety and Security Officer Subject Matter Experts Biological Chemical Radiation Zoonotic Infection Control Liaison Officer Internal Legal Officer Liaison Officer External Operations Chief Social Service Coordination Branch Laboratory Branch Environmental Branch Medical Branch Surveillance/Epidemiology Investigation Branch Montgomery Lab Group Food Safety Group Shelter Group Staging Unit Birmingham Lab Group Mass Prophylaxis & Vaccinations Group Mobile Lab Group Mass Prophylaxis & SNS Group EMS Group Positions Chart - Operations May 22, 2006 ADPH Incident Command System Patient Management Group Patient Transfer Unit

65 Safety and Security Officer
Incident Management Advisory Group/ CEP Incident Commander Public Information Officer Safety and Security Officer Liaison Officer Internal Legal Officer Liaison Officer External Logistics Chief Planning Chief Finance Chief Operations Chief Comm/Tech Infrastructure Support Situational awareness Time/ cost tracking Subject Matter Experts Biological Chemical Radiation Zoonotic Infection Control Track patients helped by ADPH Monitor situation Damage Assessment Repeat risk assessment process Manage mutual aid, emergency purchases Provide materials and supplies Long-term follow up Expanded Operations Section Next slide SNS, VMI, Chem Packs, transportation and supply Provides personnel/ volunteers support Strategic epidemiology Transportation support Strategic surveillance Nutrition supply ADPH Incident Command System Functions Chart May 22, 2006 Emergency credentialing

66 Safety and Security Officer
Incident Management Advisory Group/ CEP Incident Commander Public Information Officer Safety and Security Officer Subject Matter Experts: Biological Chemical Radiation Zoonotic Infection Control Liaison Officer Internal Legal Officer Liaison Officer External Operations Chief Social Service Coordination Branch Laboratory Branch Environmental Branch Surveillance/Epidemiology Investigation Branch Mental Health Support Food Safety Group Montgomery Lab Regional Support Sanitation Surveillance of Illnesses and Injuries Staff & Volunteer Care Water Safety Shelters Birmingham Lab Regional Support Tribal Support Garbage Removal Field Kitchens Community Resources Vector Control Mobile Lab Regional Support Food Establishments Continued Next Page Shelters - Environmental Federal Social Service Special Programs Health Care Facilities Special Needs Populations Congregated Living Facilities ADPH Incident Command System Functions Chart - Operations May 22, 2006 Non English Speaking Populations Hearing Impaired Populations

67 ADPH Incident Command System Functions Chart - Operations May 22, 2006
Subject Matter Experts: Biological Chemical Radiation Zoonotic Infection Control Operations Chief Continued Previous Page Medical Branch Shelter Group Staging Unit Patient Management Group Patient Transfer Unit (PTU) Mass Prophylaxis & Vaccinations Group Staff & Volunteers Field Management Pre-hospital Triage/Treatment Locations Mass Vaccination Clinics Team Deployment Support/Coordinate Statewide Health Care System Staff & Volunteers Deployment Patient Tracking Community Support Evacuee/Patient Reception Centers Protect & Support Statewide Health Care Resources Mass Shelter Support EMS Group Mass Prophylaxis & SNS Group Field Hospitals Manage Patient Transfer Requests Statewide Coordinate with Logistics Non-traditional Treatment Centers Pharmaceuticals Coordinate Patient Transportation SNS MNS Supplies / Equipment: initial & re-supply Coordinate EMS Support for MNS Locations Health Departments Monitor Health Care Capacity (AIMS) Statewide Community Support Coordinate w/PTU –Arrange medical care for evacuees Coordinate State Health Care System & Federal Assets ADPH Incident Command System Functions Chart - Operations May 22, 2006 Protect Medical Community

68 Public Information Officer Safety and Security Officer
CHEICS Incident Commander Public Information Officer Liaison Officer Safety and Security Officer Logistics Chief Planning Chief Finance Chief Operations Chief

69 Public Information Officer Safety and Security Officer
CHEICS Incident Commander Public Information Officer Liaison Officer Safety and Security Officer Logistics Chief Planning Chief Finance Chief Operations Chief Medical Care Ancillary Services Human Services

70 TRAINING

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76 Questions


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