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Introduction to: Incident Command System (ICS) Hospital Emergency Incident Command System (HEICS) National Incident Management System (NIMS) (IS 100, 200,

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Presentation on theme: "Introduction to: Incident Command System (ICS) Hospital Emergency Incident Command System (HEICS) National Incident Management System (NIMS) (IS 100, 200,"— Presentation transcript:

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 1.Adopt NIMS at your agency 2.Revise disaster plans to incorporate NIMS 3.Become familiar with National Response Plan 4.Adopt ICS (HEICS) and make it a part of your Disaster Response Plan 5.Coordinate with local response agencies and use a Multi-Agency Coordination system 6.Develop Mutual Aid agreements

7 NIMS Compliance 7.Participate in local Public Information Plans 8.Coordinate and implement federal funding and demonstrate commitments 9.Select personnel need IS 100, 200, 700, and 800 Courses – later in presentation (www.fema.gov/emergency/nims/)www.fema.gov/emergency/nims/ 10.NIMS compliance phased in over next 2 years 11.Compliance with first set of objectives is September 30, (Changed from 9/30/06)

8 NIMS Components 1.Command and Management - ICS 2.Preparedness – Plans/Exercises/Training 3.Resource Management – Stuff/People 4.Communications and Information Management - AIMS 5.Supporting technologies – IT 6.Ongoing maintenance and management – Periodic NIMS updates/requirements

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 Homeland Security/FEMA 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

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

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 TitleSupport Position Incident CommandIncident Commander Deputy Command StaffOfficerAssistant General Staff (Section) ChiefDeputy BranchDirectorDeputy Division/GroupSupervisorN/A UnitLeaderManager Strike Team/Task Force LeaderSingle 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 Incident Commander Public Information Officer Safety and Security Officer Logistics ChiefPlanning ChiefFinance ChiefOperations Chief ICS Liaison Officer

25 Incident Commander Public Information Officer Safety and Security Officer Logistics ChiefPlanning ChiefFinance ChiefOperations Chief HEICS Liaison Officer

26 HOSPITAL EMERGENCY INCIDENT COMMAND SYSTEM HEICS

27 Incident Occurs Tactical Response ICS Launched Incident Reported & Identified ICS Management Process Chiefs Meeting: Develop Strategy & Tactics to Meet Objectives Action Plan Preparation IC Sets Objectives Tactical Response Initiated Operation Reports Tactical Results, Needs, Engage Liaison, Logistics, Planning, Finance for support Planning Evaluates Progress Reports Chiefs & Officers Meet with IC to Evaluate 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 Incident Commander Public Information Officer Safety and Security Officer Logistics ChiefPlanning ChiefFinance ChiefOperations Chief Liaison Officer Command Section ?? Legal ??

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 Incident Commander Public Information Officer Safety and Security Officer Logistics ChiefPlanning ChiefFinance ChiefOperations Chief HEICS Liaison Officer

36 Logistics Section “Boy, do I need stuff”

37 Logistics Chief 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 Incident Commander Public Information Officer Safety and Security Officer Logistics ChiefPlanning ChiefFinance ChiefOperations Chief HEICS Liaison Officer

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

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 Incident Commander Public Information Officer Safety and Security Officer Logistics ChiefPlanning ChiefFinance ChiefOperations Chief HEICS Liaison Officer

48 Finance Section $$ 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 Incident Commander Public Information Officer Safety and Security Officer Logistics ChiefPlanning ChiefFinance ChiefOperations Chief HEICS Liaison Officer

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

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

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

61 Other ICS Systems

62 Incident Commander Public Information Officer Safety and Security Officer Liaison Officer -Internal Logistics ChiefPlanning ChiefFinance ChiefOperations Chief PHEICS Liaison Officer - External Legal Officer Public Health Emergency Incident Command System

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

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

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

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

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

68 Incident Commander Public Information Officer Safety and Security Officer Logistics ChiefPlanning ChiefFinance ChiefOperations Chief CHEICS Liaison Officer

69 Incident Commander Public Information Officer Safety and Security Officer Logistics ChiefPlanning ChiefFinance ChiefOperations Chief CHEICS Liaison Officer Ancillary Services Medical Care Human Services

70 TRAINING

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76 Questions


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