2ICS is:A Proven Crisis Management System Based on Military and Fire Management SystemsCommon Language between agencies - (Fire, Police, EMA, Hospitals, Public Health…)Manages routine or planned eventsProvides logistical and administrative support to operational personnelImproves CommunicationFlexible, adaptable system
3NIMS is:Comprehensive federal system directing response agencies to function in an organized mannerEstablished to coordinate:PlansOrganization StructureTraining and ExercisesResourcesCommunications and Technology
4NIMS Compliance HSPD-5 issued in 2004 For disaster response agencies and departments, NIMS made a condition for Federal assistanceConfusion over initial NIMS compliance for hospitals and healthcare facilitiesDHS/HRSA letter of May 26, 2006 explains newest issues
5NIMS Implementation Activities for Hospitals Similar to expectations placed on government agenciesConsists of seven categories and seventeen elementsThe Hospital Emergency Incident Command System (HEICS) incorporates NIMS terminology, principles and practices
6NIMS Compliance Adopt NIMS at your agency Revise disaster plans to incorporate NIMSBecome familiar with National Response PlanAdopt ICS (HEICS) and make it a part of your Disaster Response PlanCoordinate with local response agencies and use a Multi-Agency Coordination systemDevelop Mutual Aid agreements
7NIMS Compliance Participate in local Public Information Plans Coordinate and implement federal funding and demonstrate commitmentsSelect personnel need IS 100, 200, 700, and 800 Courses – later in presentation (www.fema.gov/emergency/nims/)NIMS compliance phased in over next 2 yearsCompliance with first set of objectives is September 30, (Changed from 9/30/06)
8NIMS Components Command and Management - ICS Preparedness – Plans/Exercises/TrainingResource Management – Stuff/PeopleCommunications and Information Management - AIMSSupporting technologies – ITOngoing maintenance and management – Periodic NIMS updates/requirements
9National Response Plan Emergency Support Functions (ESFs) 1. TransportationDepartment of Transportation2. CommunicationsHomeland Security3. Public Works andEngineeringDepartment of DefenseArmy Corps of Engineers4. FirefightingDepartment of Agriculture5. Emergency ManagementHomeland Security/FEMA6. Mass Care, Housing,Human Services7. Resource SupportGeneral Services Administration8. Public Health and Medical ServicesDepartment of Health and HumanServices9. Urban Search and RescueHomeland Security/FEMA10. Oil & Hazardous MaterialsResponseEnvironmental Protection Agency11. Agriculture and Natural ResourcesDepartment of Agriculture12. EnergyDepartment of EnergyUnder the Federal Response Plan, 12 Emergency Support Functions exist to group types of Federal assistance a State is most likely to needEach ESF is headed by a primary agency, which has been selected based on its authorities, resources and capabilities in the particular functional areaThe 12 ESF’s serve as the primary mechanism through which Federal response assistance will be provided to the affected State
10Response Plan Emergency Support Functions 13. Public Safety and SecurityDepartment of Justice14. Long-Term Community RecoveryHomeland Security/FEMA15. External AffairsHomeland SecurityUnder the Federal Response Plan, 12 Emergency Support Functions exist to group types of Federal assistance a State is most likely to needEach ESF is headed by a primary agency, which has been selected based on its authorities, resources and capabilities in the particular functional areaThe 12 ESF’s serve as the primary mechanism through which Federal response assistance will be provided to the affected State
12Basic Features of ICS Modular organization Management by objectives Reliance on an Incident Action Plan (IAP)Chain of commandManageable span of controlUnity of commandUnified Command
13History of ICS Weaknesses in incident management before ICS Lack of accountabilityPoor communicationLack of a planning processOverloaded Incident CommandersNo method to integrate interagency requirementsICS provides an organized system to manage incidents and addresses these weaknesses
14ICS Terminology Unified Command Sections Divisions Groups Branches Task ForcesStrike TeamsSingle ResourcesTransfer of command
15Unified Command Enables all responsible agencies to manage an incident Establishes a common set of incident objectives and strategiesAllows Incident Commanders to make joint decisions by establishing a single command structureMaintains unity of commandEach employee only reports to one supervisor
16SectionsOrganizational levels with responsibility for a major functional area of the incidentOperationsPlanningLogisticsFinance/AdministrationThe person in charge is the Chief
17Divisions and Groups Divisions Divide an incident geographically Is led by a SupervisorGroupsEstablished based on the needs of an incident.Labeled according to the job that they are assignedManaged by a SupervisorWork wherever their assigned task is needed and are not limited geographically
18Branches and Units Branches Established if the number of Divisions or Groups exceeds the span of controlHave functional or geographical responsibility for major parts of incident operationsManaged by a Branch DirectorUnitsOrganizational elements that have functional responsibility for a specific activity
19Task ForcesTask Forces are a combination of mixed resources with common communicationsOperate under the direct supervision of a Task Force Leader
20Strike Teams Strike Teams are a set number of resources Of the same kind and typeWith common communicationsOperate under the direct supervision of a Strike Team Leader
21Single ResourcesAn individual(s) or piece of equipment with its personnel complement; or,A crew or team of individuals with an identified supervisor
23Transfer of CommandMoves the responsibility for incident command from one Incident Commander to anotherMust include a transfer of command briefingOralWrittenBoth oral and written
24Public Information Officer Safety and Security Officer ICSIncident CommanderPublic Information OfficerLiaison OfficerSafety and Security OfficerLogistics ChiefPlanning ChiefFinance ChiefOperations Chief
25Public Information Officer Safety and Security Officer HEICSIncident CommanderPublic Information OfficerLiaison OfficerSafety and Security OfficerLogistics ChiefPlanning ChiefFinance ChiefOperations Chief
26HOSPITAL EMERGENCY INCIDENT COMMAND SYSTEM HEICS
27ICS Management Process Tactical Results, Needs, IncidentOccursIncidentReported& IdentifiedTacticalResponseICS LaunchedChiefs Meeting:Develop Strategy& Tactics to MeetObjectivesIC SetsObjectivesAction PlanPreparationChiefs & OfficersMeet with IC toEvaluate ReportsTactical ResponseInitiatedOperation ReportsTactical Results, Needs,Engage Liaison,Logistics, Planning,Finance for supportPlanning EvaluatesProgress Reports
28The Five Sections Command = the buck stops here Planning = creates & develops incident planOperations = implement the plan.Logistics = supports the plan.Finance = pays for the plan.
29Safety and Security Officer Public Information Officer Command SectionIncident CommanderSafety and Security OfficerLiaison Officer?? Legal ??Public Information OfficerLogistics ChiefPlanning ChiefFinance ChiefOperations Chief
30The Incident Commander Gives overall direction for hospital operations.Mission: to organize and directthe EOC (Emergency Operations Center) and all the positions through the ICS structure
31Safety/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.
32Public Information Officer Mission: to function as the public information source for your agency.Be the organizer of correct informationCOMMUNICATE with other public information officersParticipate in a JIC
33Liaison OfficerMission: to function as the incident contact person for representatives from other agencies.COMMUNICATE into and out of the hospital.
34Legal & EthicsMission: to provide legal advice to the IC and your agency.Think recent issues inNew Orleans
35Public Information Officer Safety and Security Officer HEICSIncident CommanderPublic Information OfficerLiaison OfficerSafety and Security OfficerLogistics ChiefPlanning ChiefFinance ChiefOperations Chief
37Logistics Chief Food Shelter Supplies Comms Equipment Organize and direct operations associated with the maintenance of the physical environment:FoodShelterSuppliesComms EquipmentSupport the medical objectives
38Logistics Chief Facility Unit Leader Communications Unit Leader Transport Unit LeaderMaterials Supply Unit LeaderNutritional Supply Unit Leader
39Public Information Officer Safety and Security Officer HEICSIncident CommanderPublic Information OfficerLiaison OfficerSafety and Security OfficerLogistics ChiefPlanning ChiefFinance ChiefOperations Chief
41Planning ChiefOrganize and direct all aspects of the planning section - Action PlanDocument 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.
42Planning Chief Situation Status Unit Leader Labor Pool Unit Leader Medical Staff Unit LeaderPatient Tracking OfficerPatient Information Officer
43Situation-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 andpreservation of the computer system.
44Labor Pool Unit LeaderCollect 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.
45Medical 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 underMedical Staff Director
46Patient 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.
47Public Information Officer Safety and Security Officer HEICSIncident CommanderPublic Information OfficerLiaison OfficerSafety and Security OfficerLogistics ChiefPlanning ChiefFinance ChiefOperations Chief
49Finance 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
50Finance Chief Time Unit Leader Procurement Unit Leader Claims Unit LeaderCost Unit Leader
51Public Information Officer Safety and Security Officer HEICSIncident CommanderPublic Information OfficerLiaison OfficerSafety and Security OfficerLogistics ChiefPlanning ChiefFinance ChiefOperations Chief
52Operations Section Day to Day activities – On Steroids! Provision of Care – “Your Hospital’s Mission”Known as the Tactical Response
53Operations Chief Medical Staff Director Medical Care Director Ancillary Services DirectorHuman Services Director
54Operations Chief Medical Staff Director Medical Care Director In-Patient AreasSupervisorTreatment AreasSupervisorSurgical ServicesUnit LeaderTriageUnit LeaderDischargeUnit LeaderMaternal & ChildUnit LeaderImmediate TxUnit LeaderMorgueUnit LeaderCritical CareUnit LeaderDelayed TxUnit LeaderGeneral NursingUnit LeaderMinor TxUnit LeaderOut-PatientServices Leader
56Operations Chief Ancillary Services Director Laboratory Unit Leader PharmacyUnit LeaderRadiologyUnit LeaderCardiopulmonaryUnit Leader
57Job Action Sheets Each role’s assignments Checklists Prioritizes dutiesNo duplication of dutiesResponsibilities outlinedImportant that staff know to read their Job Action Sheet at the START!!!
58Using 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?
59Never alter the job title or mission statement. Job Action SheetsJob Action Sheets: should be customized to your organization but…Never alter the job title or mission statement.Until Later!
60HINT: It really never ends! HEICS ImplementationIt is a processAllow 1 Year!HINT: It really never ends!
62PHEICS Incident Commander Liaison Officer - External Public Health Emergency Incident Command SystemPHEICSIncident CommanderLiaison Officer - ExternalPublic Information OfficerLiaison Officer -InternalSafety and Security OfficerLegal OfficerLogistics ChiefPlanning ChiefFinance ChiefOperations Chief
63ADPH Incident Command System Positions Chart May 22, 2006 Incident ManagementAdvisory Group/CEPIncident CommanderADPH Incident Command SystemPositions ChartMay 22, 2006Subject Matter ExpertsBiologicalChemicalRadiationZoonoticInfection ControlPublic Information OfficerSafety and Security OfficerLiaison Officer InternalLegal OfficerLiaison Officer ExternalLogistics ChiefPlanning ChiefFinance ChiefOperations ChiefCommunications Unit LeaderSituation Status Unit LeaderTime Unit LeaderSocial Services Coordination Branch LeaderPatient Tracking Unit LeaderDamage Assessment Unit LeaderHuman Resources Unit LeaderLaboratory Branch LeaderProcurement Unit LeaderStrategic Epidemiology Unit LeaderEnvironmental Branch LeaderTransportation Unit LeaderMedical Branch LeaderMaterials Supply Unit LeaderStrategic Surveillance Unit LeaderSurveillance & Epidemiology Investigation Branch LeaderNutrition Supply Unit Leader
64Safety and Security Officer Incident ManagementAdvisory Group/CEPIncident CommanderPublic Information OfficerSafety and Security OfficerSubject Matter ExpertsBiologicalChemicalRadiationZoonoticInfection ControlLiaison Officer InternalLegal OfficerLiaison Officer ExternalOperationsChiefSocial Service Coordination BranchLaboratoryBranchEnvironmentalBranchMedicalBranchSurveillance/Epidemiology Investigation BranchMontgomery LabGroupFood Safety GroupShelter GroupStaging UnitBirmingham LabGroupMass Prophylaxis & Vaccinations GroupMobile LabGroupMass Prophylaxis & SNS GroupEMS GroupPositions Chart - OperationsMay 22, 2006ADPH Incident Command SystemPatient Management GroupPatient Transfer Unit
66Safety and Security Officer Incident ManagementAdvisory Group/CEPIncident CommanderPublic Information OfficerSafety and Security OfficerSubject Matter Experts:BiologicalChemicalRadiationZoonoticInfection ControlLiaison Officer InternalLegal OfficerLiaison Officer ExternalOperationsChiefSocial Service Coordination BranchLaboratoryBranchEnvironmentalBranchSurveillance/Epidemiology Investigation BranchMental Health SupportFood Safety GroupMontgomery LabRegional SupportSanitationSurveillance of Illnesses and InjuriesStaff & Volunteer CareWater SafetySheltersBirmingham LabRegional SupportTribal SupportGarbage RemovalField KitchensCommunity ResourcesVector ControlMobile LabRegional SupportFood EstablishmentsContinuedNextPageShelters -EnvironmentalFederal Social Service Special ProgramsHealth Care FacilitiesSpecial Needs PopulationsCongregated Living FacilitiesADPH Incident Command SystemFunctions Chart - OperationsMay 22, 2006Non English Speaking PopulationsHearing Impaired Populations
67ADPH Incident Command System Functions Chart - Operations May 22, 2006 Subject Matter Experts:BiologicalChemicalRadiationZoonoticInfection ControlOperationsChiefContinuedPrevious PageMedical BranchShelter GroupStaging UnitPatient Management GroupPatient Transfer Unit (PTU)Mass Prophylaxis & Vaccinations GroupStaff & Volunteers Field ManagementPre-hospital Triage/Treatment LocationsMass Vaccination ClinicsTeam DeploymentSupport/Coordinate Statewide Health Care SystemStaff & Volunteers DeploymentPatient TrackingCommunity SupportEvacuee/Patient Reception CentersProtect & Support Statewide Health Care ResourcesMass Shelter SupportEMS GroupMass Prophylaxis & SNS GroupField HospitalsManage Patient Transfer Requests StatewideCoordinate with LogisticsNon-traditional Treatment CentersPharmaceuticalsCoordinate Patient TransportationSNSMNS Supplies / Equipment: initial & re-supplyCoordinate EMS Support for MNS LocationsHealth DepartmentsMonitor Health Care Capacity (AIMS) StatewideCommunity SupportCoordinate w/PTU –Arrange medical care for evacueesCoordinate State Health Care System & Federal AssetsADPH Incident Command SystemFunctions Chart - OperationsMay 22, 2006Protect Medical Community
68Public Information Officer Safety and Security Officer CHEICSIncident CommanderPublic Information OfficerLiaison OfficerSafety and Security OfficerLogistics ChiefPlanning ChiefFinance ChiefOperations Chief
69Public Information Officer Safety and Security Officer CHEICSIncident CommanderPublic Information OfficerLiaison OfficerSafety and Security OfficerLogistics ChiefPlanning ChiefFinance ChiefOperations ChiefMedicalCareAncillaryServicesHumanServices