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National Incident Management System (NIMS) National Response Framework (NRF) Hospital Incident Command System (HICS) IS 100.HC, 200.a, 700.a, 800.b The.

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Presentation on theme: "National Incident Management System (NIMS) National Response Framework (NRF) Hospital Incident Command System (HICS) IS 100.HC, 200.a, 700.a, 800.b The."— Presentation transcript:

1 National Incident Management System (NIMS) National Response Framework (NRF) Hospital Incident Command System (HICS) IS 100.HC, 200.a, 700.a, 800.b 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 NIMS National Incident Management System A standardized, all-hazard incident and resource management concept. A comprehensive, national approach to incident management that is applicable to all jurisdictional levels and across functional disciplines. ( ) The intent is to be applicable across a full spectrum of potential incidents and hazard scenarios, regardless of size or complexity. ( ) Designed to improve coordination and cooperation between public and private entities in domestic management activities. Response actions will be based on the ICS system. All First Responders comply with NIMS training requirements.

3 NIMS National Incident Management System Established to create uniformity: –Organization Structure (ICS) –Plans –Training/Exercises Organization –Resources –Communications/Technology

4 NIMS Implementation Activities for Hospitals Similar to expectations placed on government agencies Consists of 14 objectives for FY 2009 We will cover all requirements in detail in the next section: “Update on NIMS Requirements”.

5 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 Initial compliance date Oct 1, 2006 pushed back to Oct 1, Annual FY requirements and 5-year plan ( )

6 National Response Framework Went into effect in March Updated and revised the National Response Plan. The NRF establishes... Federal coordination structures/mechanisms Direction for incorporation of existing plans Consistent approach to managing incidents Coordination ( )

7 NIMS  Aligns command, control, organization structure, terminology, communication protocols, & resources/resource-typing  Used for all events Knowledge Abilities Resources State Response or Support Federal Response or Support Incident NRF  Integrates & applies Federal resources, knowledge, & abilities before, during, & after an incident  Implemented for incidents requiring Federal coordination Local Response Relationship: NIMS vs. NRF ( )

8 NRF Applicability The NRF applies to all Federal departments and agencies that have primary jurisdiction for or participate in operations requiring a Federal response, including: Major disasters, emergencies, and terrorist incidents including threats Other events of lesser severity requiring a coordinated Federal response

9 Incidents of National Significance The NRF distinguishes between: –Incidents that require the Secretary of Homeland Security to manage the Federal response, termed Incidents of National Significance, and, –The majority of incidents occurring each year that are handled by responsible jurisdictions or agencies DHS Secretary must declare an event as an Incident of National Significance

10 NRF Structure Support Annexes Incident Annexes Appendixes Base Framework Describes the domestic incident management structures and processes Include acronyms, definitions, authorities, and a compendium of national interagency plans Describe the structures and responsibilities for coordinating incident resource support Provide guidance for the functional processes and administrative requirements Address contingency or hazard situations requiring specialized application of the NRF Emergency Support Function Annexes - 15

11 Scope of Emergency Support Functions ESF #1 – Transportation Department of Transportation ESF #1 – Transportation Department of Transportation Aviation/airspace management and control Transportation safety Restoration/recovery of transportation infrastructure Movement restrictions Damage and impact assessment Aviation/airspace management and control Transportation safety Restoration/recovery of transportation infrastructure Movement restrictions Damage and impact assessment ESF #2 – Communications Homeland Security/NCS ESF #2 – Communications Homeland Security/NCS ESF #3 – Public Works and Engineering Department of Defense US Army Corps of Engineers ESF #3 – Public Works and Engineering Department of Defense US Army Corps of Engineers ESF #4 – Firefighting Department of Agriculture ESF #4 – Firefighting Department of Agriculture Coordination with telecommunications and information technology industries Restoration and repair of telecommunications infrastructure Protection, restoration, and sustainment of national cyber and information technology resources Oversight of communications within the Federal incident management and response structures Coordination with telecommunications and information technology industries Restoration and repair of telecommunications infrastructure Protection, restoration, and sustainment of national cyber and information technology resources Oversight of communications within the Federal incident management and response structures Coordination of Federal firefighting activities Support to wildland, rural, and urban firefighting operations Coordination of Federal firefighting activities Support to wildland, rural, and urban firefighting operations Infrastructure protection and emergency repair Infrastructure restoration Engineering services and construction management Emergency contracting support for life-saving and life- sustaining services Infrastructure protection and emergency repair Infrastructure restoration Engineering services and construction management Emergency contracting support for life-saving and life- sustaining services

12 ESF #5 – Emergency Management Homeland Security/FEMA ESF #5 – Emergency Management Homeland Security/FEMA ESF #6 – Mass Care, Emergency Assistance, Housing, and Human Services Homeland Security/FEMA ESF #6 – Mass Care, Emergency Assistance, Housing, and Human Services Homeland Security/FEMA ESF #7 – Logistics Management and Resource Support Homeland Security/FEMA ESF #7 – Logistics Management and Resource Support Homeland Security/FEMA ESF #8 – Public Health and Medical Services Dept Health & Human Srvcs. ESF #8 – Public Health and Medical Services Dept Health & Human Srvcs. Coordination of incident management and response efforts Issuance of mission assignments Resource and human capital Incident action planning Financial management Coordination of incident management and response efforts Issuance of mission assignments Resource and human capital Incident action planning Financial management Mass care Emergency assistance Disaster housing Human services Mass care Emergency assistance Disaster housing Human services Comprehensive, national incident logistics planning, management, and sustainment capability Resource support (facility space, office equipment and supplies, contracting services, etc.) Comprehensive, national incident logistics planning, management, and sustainment capability Resource support (facility space, office equipment and supplies, contracting services, etc.) Public health Medical Mental health services Mass fatality management Public health Medical Mental health services Mass fatality management Scope of Emergency Support Functions

13 ESF #9 – Search and Rescue Homeland Security/FEMA ESF #9 – Search and Rescue Homeland Security/FEMA Life-saving assistance Search and rescue operations Life-saving assistance Search and rescue operations ESF #10 – Oil and Hazardous Materials Response EPA ESF #10 – Oil and Hazardous Materials Response EPA ESF #11 – Agriculture and Natural Resources Department of Agriculture ESF #11 – Agriculture and Natural Resources Department of Agriculture ESF #12 – Energy Department of Energy ESF #12 – Energy Department of Energy Oil and hazardous materials (chemical, biological, radiological, etc.) response Environmental short- and long-term cleanup Oil and hazardous materials (chemical, biological, radiological, etc.) response Environmental short- and long-term cleanup Nutrition assistance Animal and plant disease and pest response Food safety and security Natural and cultural resources and historic properties protection and restoration Safety and well-being of household pets Nutrition assistance Animal and plant disease and pest response Food safety and security Natural and cultural resources and historic properties protection and restoration Safety and well-being of household pets Energy infrastructure assessment, repair, and restoration Energy industry utilities coordination Energy forecast Energy infrastructure assessment, repair, and restoration Energy industry utilities coordination Energy forecast Scope of Emergency Support Functions

14 ESF #13 – Public Safety and Security Department of Justice ESF #13 – Public Safety and Security Department of Justice ESF #14 – Long-Term Community Recovery Homeland Security/FEMA ESF #14 – Long-Term Community Recovery Homeland Security/FEMA ESF #15 – External Affairs Homeland Security/FEMA ESF #15 – External Affairs Homeland Security/FEMA Facility and resource security Security planning and technical resource assistance Public safety and security support Support to access, traffic, and crowd control Facility and resource security Security planning and technical resource assistance Public safety and security support Support to access, traffic, and crowd control Social and economic community impact assessment Long-term community recovery assistance to States, local governments, and the private sector Analysis and review of mitigation program implementation Social and economic community impact assessment Long-term community recovery assistance to States, local governments, and the private sector Analysis and review of mitigation program implementation Emergency public information and protective action guidance Media and community relations Congressional and international affairs Tribal and insular affairs Emergency public information and protective action guidance Media and community relations Congressional and international affairs Tribal and insular affairs Scope of Emergency Support Functions

15 ICS Incident Command System

16 HICS is: A Proven Emergency Management System Based on Military and Fire Management Chains of Command Designed for all hazards and all sizes of response, as necessary Flexible and adaptable – only activate what is needed. Manages routine or planned events Provides logistical & administrative support to operational personnel Improves Communication – Formal and Informal Cost effective – avoids duplication of effort Allows for adaptation into a common response structure ( ; ; /7)

17 Characteristics of ICS Common Terminology ( /9) Modular organization Reliance on an Incident Action Plan (IAP) Management by objectives Chain of command and Unity of command ( ) Unified Command ( ) Manageable Span of Control ( /21; ) Emergency Operations Centers Resource Management Information, Intelligence and Communications

18 ICS Terminology Sections Divisions Groups Branches Task Forces Strike Teams Resources

19 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

20 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

21 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

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

23 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

24 Resources Single: An individual(s) or piece of equipment with its personnel complement; or, A crew or team of individuals with an identified supervisor Staging Areas hold resources waiting for operational assignment. ( ; ) Typing: Identifies size, capability and staffing qualifications. ( ) Assigned, Available or Out-of-Service ( )

25 ICS Supervisory Titles Organizational Level TitleSupport Position Incident Command CommanderDeputy (* Able to assume command!) Command StaffOfficerAssistant General Staff (Section) ChiefDeputy BranchDirectorDeputy Division/GroupSupervisorN/A UnitLeaderManager Strike Team/Task Force LeaderSingle Resource Boss 1.Distinct titles = most qualified 2. Standard titles = easy requests 3. Titles = common standard ( ; ; )

26 Other Command Issues & Terms Initiation of Command Transfer of Command Termination of Command Demobilization ( , pg 121 ) - Facilitates accountability Credentialing ( , pg 129 ) - Competence and proficiency Area Command, On-Scene Command ( , pg 155 ) - multiple incidents handled by separate IC orgs.

27 Specific Command Issues Initiation of Command: IC or Temporary IC need to know what they do Must be able to recognize the need to activate HICS Need a list of criteria to make the decision Have a group or select staff to ask for advice Update EOP with “Activation” section Need to understand “Transfer of Command”

28 Specific Command Issues Transfer of Command : Follow EOP guidelines after “Initiation of Command” Upon arrival, the higher ranking individual will assume command, maintain command or reassign to a third party. ( ) Delegation of authority can occur if the scope of the response is complex or beyond capabilities or authority. ( ) All with a need to know should be told the effective time and date of the transfer. ( )

29 Specific Command Issues Termination of Command: IC needs to know what they do Must be able to recognize the time to de-activate HICS Need a list of criteria to make the decision Have a group or select staff to ask for advice Update EOP with “Activation” section Need to understand demobilization and what is involved

30 Specific Command Issues Demobilization : The process of standing down Getting back to a normal schedule and routine Replacing equipment and supplies Adjusting personnel back to routine Planning begins at the same time as mobilization Facilitates accountability and efficiency Occurs in the Planning Section ( )

31 Specific Command Issues Credentialing: Evaluation and documentation of an individual's: Current certification, license, or degree Training and experience Competence or proficiency Critical for health care agencies National, state, local AND agency requirements Legal implications ( )

32 Specific Command Issues Area Command : Creates to oversee the management of: Multiple incidents that are each being handled by an Incident Command System organization A very large incident that has multiple Incident Management Teams assigned to it Designed to ensure the effective management of assigned incidents ( )

33 Incident Occurs Tactical Response ICS Launched Incident Reported & Identified Management by Objectives Chiefs Meeting: Develop Strategy & Tactics to Meet Objectives Incident Action Plan IC Sets Objectives Tactical Response Initiated Operation Reports Tactical Results, Needs, Engage Liaison, Logistics, Planning, Finance for support Planning Evaluates Progress Reports Chiefs & Officers Set Meeting with IC to Re-evaluate ( /18) ( ) ( )

34 ICS Form 201 – Incident Briefing Form An eight-part form that provides an Incident Command/Unified Command with basic information that can be used to brief incoming resources, an incoming Incident Commander or team, or an immediate supervisor. The basic information includes the: Incident situation (map and significant events). Incident objectives. Summary of current actions. Status of resources assigned to or ordered for the incident or event. Can serve as the initial Incident Action Plan (IAP) for the first shift change and will remain in force and continue to develop until the response ends, or until a Planning Section has been established and generates, at the direction of the Incident Commander, an IAP. Suitable for briefing assigned and newly arriving Command and General Staff members. ( )

35 ICS Form 201 Page 1 of 8 pages See handouts

36 Incident Command System Organizational Charts Theoretically, your ICS chart should not correlate with any administrative organizational chart in you facility: Creates confusion over position titles and duties. ( ) In reality, for hospitals, an HICS chart that matches (or comes close to matching) your day-to-day organizational chart is much more effective and understood during an event.

37 Incident Commander Public Information Officer Logistics Section Chief Incident Command System (ICS) Model Liaison Officer Safety & Security Officer Planning Section Chief Finance/Admin Section Chief Operations Section Chief Command Staff General Staff ( ; ; ) ( )

38 HOSPITAL INCIDENT COMMAND SYSTEM HICS (2003)

39 HOSPITAL INCIDENT COMMAND SYSTEM HICS (2006)

40 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.

41 Incident Commander Public Information Officer Logistics Section Chief ICS – Command Section Liaison Officer Safety & Security Officer Planning Section Chief Finance/Admin Section Chief Operations Section Chief Command Staff General Staff

42 Manages all emergency activities, including development, implementation, and review of strategic decisions from the Command Post, as well as post event assessment during recovery. Top priority = Safety! ( ; ; ; ) Serves as the authority for all emergency response efforts and supervisor to the Public Information Officer (PIO), Liaison Officer, Safety Officer, Operations Section Chief, Planning Section Chief, Logistics Section Chief, and Finance & Administration Section Chief. May serve as any or all of the positions in the Command and General Staff depending on the complexity of the event. Is IC until authority is transferred to another person. ( ) The only position ALWAYS staffed in an ICS activation. ( ) Incident Commander

43 Responsible for relaying incident related information to the public, other organizations and the media. ( ; ) Participate in a Joint Information System (JIS) and work in the local Joint Information Center (JIC) when activated. Communicates with other agencies’ public information officers. Be the organizer of correct information. Manage the facility’s Public Information Plan. Public Information Officer

44 Monitors, evaluates and recommends procedures for all incident operations for hazards and unsafe conditions. Monitors, evaluates and recommends procedures for all incident operations, including the health and safety of emergency responder personnel. Organizes and reinforces scene/facility protection and traffic. Establish a security command post. ( ) Safety & Security Officer

45 Is responsible for coordinating with external partners, such as the city, state, federal agencies, and public and private resource groups, as well as other Health Care Facilities. Serves as the incident contact person for representatives from other agencies and may work from the local Emergency Operations Center. Communicates into and out of the hospital. Works closely with the IC and PIO ( ; /12) Liaison Officer

46 Provides legal and ethical advice to the IC, Command Staff, General Staff and the agency. Brought about by recent issues in hospitals in New Orleans post Katrina. Legal Officer

47 Incident Commander Public Information Officer Logistics Section Chief Incident Command System (ICS) Model Liaison Officer Safety & Security Officer Planning Section Chief Finance/Admin Section Chief Operations Section Chief Command Staff General Staff

48 Logistics Section “Boy, do I need stuff”

49 Logistics Chief Organize and direct operations associated with the maintenance of the physical environment: –Food –Shelter –Supplies –Comms Equipment –Transportation –Medical support ( ; )

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

51 Incident Commander Public Information Officer Logistics Section Chief Incident Command System (ICS) Model Liaison Officer Safety & Security Officer Planning Section Chief Finance/Admin Section Chief Operations Section Chief Command Staff General Staff

52 Planning

53 Planning Chief Organize and direct all aspects of the planning section - Incident Action Plan Usually runs the Operational Period briefing (Team Chief strategy meeting) 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. ( /24; )

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

55 Incident Commander Public Information Officer Logistics Section Chief Incident Command System (ICS) Model Liaison Officer Safety & Security Officer Planning Section Chief Finance/Admin Section Chief Operations Section Chief Command Staff General Staff

56 Finance Section $$ MONEY

57 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. Pre-planning for a rainy day Business RECOVERY ( /47; )

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

59 Incident Commander Public Information Officer Logistics Section Chief Incident Command System (ICS) Model Liaison Officer Safety & Security Officer Planning Section Chief Finance/Admin Section Chief Operations Section Chief Command Staff General Staff

60 Operations Section Day to Day activities – On Steroids! Provision of Care – “Your Hospital’s Mission” Known as the Tactical Response: Operations, Objectives and Direction. ( /5) ( ) ( )

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

62 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

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

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

65 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!!!

66 Public Health ICS System (PHICS)

67 Incident Commander Public Information Officer Safety and Security Officer Liaison Officer -Internal Logistics ChiefPlanning ChiefFinance ChiefOperations Chief PHICS Liaison Officer - External Legal Officer

68 Safety and Security OfficerPublic Information Officer Incident Commander ADPH Incident Command System Positions Chart January 4, 2010 Incident Management Advisory Group/ CEP Materials Supply & Nutrition Unit Leader Transportation Unit Leader Damage Assessment Unit Leader Communications Unit Leader Planning Chief Situation Status Unit Leader Human Resources Unit Leader Strategic Epidemiology & Surveillance Unit Leader Finance Chief Time Unit Leader Procurement Unit Leader Logistics ChiefOperations Chief Liaison Officer ExternalLegal OfficerLiaison Officer Internal Operations Section continued on next page

69 Safety and Security OfficerPublic Information Officer Legal Officer Incident Commander Incident Management Advisory Group/ CEP Liaison Officer InternalLiaison Officer External Food Safety Group Patient Management Group EMS Group Patient Placement Unit Medical Needs Shelter Pharmaceutical Support Pharmacy Social Service Coordination Branch Laboratory Branch Environmental Group Medical Care Branch Field Surveillance Branch Subject Matter Experts Biological Chemical Radiation Zoonotic Infection Control Operations Chief Pharmaceutical Support Vaccination Laboratory Branch ADPH Incident Command System Positions Chart - Operations January 4, 2010

70 TRAINING

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79 Questions


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