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1 HOSPITAL INCIDENT COMMAND SYSTEM Incident Action Planning This material has been developed for training purposes; do not share, distribute, transmit.

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Presentation on theme: "1 HOSPITAL INCIDENT COMMAND SYSTEM Incident Action Planning This material has been developed for training purposes; do not share, distribute, transmit."— Presentation transcript:

1 1 HOSPITAL INCIDENT COMMAND SYSTEM Incident Action Planning This material has been developed for training purposes; do not share, distribute, transmit or reproduce without prior written consent of California Hospital Association This course was developed by the CHA Hospital Preparedness Program with grant funds provided by the U.S. Department of Health & Human Services Assistant Secretary for Preparedness & Response Hospital Preparedness Program and awarded by the California Department of Public Health. No part of this course or its materials shall be copied or utilized for monetary gain.

2 2 OBJECTIVES Understand the 9 steps of the Incident Action Planning process Identify Incident Action Plan components Exercise the development of an Incident Action Plan

3 3 INCIDENT MANAGEMENT: TEAM REVIEW Operations Section Chief Planning Section Chief Logistics Section Chief Finance / Administration Section Chief Incident Commander Public Information Officer Liaison Officer Medical/ Technical Specialist(s) Safety Officer

4 4 HOSPITAL INCIDENT ACTION PLANNING Key to Effective Response and Recovery

5 5 1.Assess the Situation 2.Set the Operational Period 3.Determine Safety Priorities & Establish Incident Objectives 4.Determine Branch/Section Objectives 5.Determine Strategies & Tactics 6.Determine Needed Resources 7.Issue Assignments 8.Implement Actions 9.Reassess & Adjust Plans INCIDENT ACTION PLANNING

6 6 Type of incident, location, magnitude, and possible duration Ongoing hazards and safety concerns Determines initial priorities based on: 1) Life saving 2) Incident stabilization 3) Property preservation Establishes the Hospital Command Center The Incident Commander conducts the initial incident assessment from the information gathered: 1) ASSESS THE SITUATION

7 7 An Operational Period is: The period of time scheduled for execution of a given set of tactical actions in the Incident Action Plan Set by the Incident Commander The Operational Period is usually set in hours: Does not have to conform to shift times Can be long or short, depending on the intensity of the incident or amount of information available 2) SET THE OPERATIONAL PERIOD

8 8 General Command Objectives are: Broad organizational objectives that are foundational and do not change during response and recovery. These objectives define where the system wants to be at the end of the response Not limited to an Operational Period Examples: Provide adequate care to all patients who present as a result of the incident Provide for the safety of staff, patients and visitors 3) DETERMINE SAFETY PRIORITIES & ESTABLISH INCIDENT OBJECTIVES

9 9 Section/Branch Objectives are: More specific objectives to achieve overall incident objectives Steps during the defined Operational Period Should be tangible and measurable Example: Provide prophylaxis to 75% of hospital staff in this operational period Decontaminate 25 victims in 2 hours 4) DETERMINE SECTION/BRANCH OBJECTIVES

10 10 5) DETERMINE STRATEGIES AND TACTICS Strategy Defined: The general direction selected to accomplish incident objectives (NIMS) The approach to achieving the objectives Tactics Defined: Specific actions, sequence of actions, procedures, tasks, assignments to meet strategies and objectives The “boots on the ground” or “doers”

11 11 Tactical resources may include: Personnel Equipment Supplies Pharmaceuticals Vehicles Available and needed resources to meet the tactical objectives must be identified 6) DETERMINE NEEDED RESOURCES

12 12 Additional HICS positions are activated according to incident needs Staff are assigned to conduct incident specific operations : Evacuation Decontamination Triage and treatment Safety measures Once the tactical objectives and necessary resources are identified, assignments are issued: 7) ISSUE ASSIGNMENTS

13 13 THE INCIDENT ACTION PLANNING MEETING The Incident Action Planning Meeting is: Led by the Planning Chief Defines and finalizes branch/section objectives, strategies, tactics, and resources as determined by each section for the next operational period The Section Chiefs submit completed HICS Form 204 Branch Assignment List and the Safety Officer submits completed HICS Form 215A IAP Safety Analysis

14 14 Direct, monitor and evaluate response efforts: Constant monitoring of strategies and tactics for effectiveness Assess the Operational Period Objectives Are the objectives being achieved? Is the strategy/tactics safe? Is the strategy/tactics effective? Evaluation is an ongoing process throughout response and recovery 8) IMPLEMENT ACTIONS

15 15 9) REASSESS & ADJUST PLANS Conduct a Current Situation Assessment: Update situation/incident information Assess the impact on the hospital Length and duration of continued/resolving incident Resource availability Assess the Incident Objectives Make sure they are achieved in a safe and timely manner Revise objectives, strategies, tactics and resource needs for the upcoming operational period

16 16 INCIDENT ACTION PLAN RESPONSIBILITIES The Incident Commander: Provides general Command and Control Objectives (HICS 202 Incident Objectives) Sets the Operational Period Develops major strategies (priorities) Activates Incident Management Team positions Establishes policy for resource orders Approves initial actions and the completed Incident Action Plan

17 17 The Safety Officer: Advises the Incident Commander and Section Chiefs on safety issues and measures Develops the Safety Plan (HICS 215A Incident Action Safety Plan Analysis) Oversees the safety of operations and tactics INCIDENT ACTION PLAN RESPONSIBILITIES

18 18 The Planning Section Chief: Prepares for the Planning Meetings Gathers information for the Incident Action Plan (HICS 201, 202, 203, 204’s and 215A) Develops demobilization plan Conducts the Planning Meeting Coordinates and submits the Incident Action Plan to the Incident Commander for approval Disseminates the Incident Action Plan INCIDENT ACTION PLAN RESPONSIBILITIES

19 19 The Operations Section Chief: Determines/assesses areas of operation Advises Incident Commander of activated Operations positions and work assignments Determines tactics (HICS 204) Determines resource requirements (HICS 204) and communicates needs with Logistics INCIDENT ACTION PLAN RESPONSIBILITIES

20 20 The Logistics Section Chief: Ensures resource ordering meets the needs Advises Incident Commander on activated Logistics positions Ensures resources to support the Incident Action Plan Develops plans that support the Incident Action Plan Communications Plans Transportation Plans INCIDENT ACTION PLAN RESPONSIBILITIES

21 21 The Finance/Administration Section Chief: Provides cost implications of the Command and Control, and Operational Period Objectives Ensures the Incident Action Plan is within cost limitations Advises the Incident Commander on Finance/Admin activated positions INCIDENT ACTION PLAN RESPONSIBILITIES

22 22 The Incident Action Plan: Provides Incident Management Team personnel with direction for the Operational Period Incident Action Planning is a process of Management by Objectives Essential for effective response and recovery INCIDENT ACTION PLAN SECTION REVIEW

23 23 QUESTIONS?

24 24 Incident Response Guides Active Shooter Chemical Incident Earthquake Evacuation, Shelter-in-Place, & Hospital Abandonment Explosive Incident Hostage or Barricade Incident Infectious Disease There are 16 Scenario-based Incident Response Guides :

25 25 Incident Response Guides (continued) Information Technology (IT) Failure Mass Casualty Incident Missing Person Radiation Incident Severe Weather with Warning Staff Shortage Tornado Utility Failure Wildland Fire

26 26 Provides Incident-specific: Directions Incident Objectives Management tasks by function and timeframes Sample Hospital Incident Management Teams Should compliment: Emergency Operations Plan and Job Action Sheets Can be used as documentation Incident Response Guides

27 27 HICS FORMS USED IN THE INCIDENT ACTION PLAN

28 28 HICS Form 200 Incident Action Plan Cover Sheet Purpose: Provides a cover sheet and a checklist for HICS Forms and other documents included in the operational period Incident Action Plan Origination: Incident Commander or Planning Section Chief Copies to: Command and General Staff and Documentation Unit Leader Helpful Tips: Additions may be made to the form to meet the organization’s needs

29 29 HICS Form 201 Incident Briefing Purpose: Documents initial response information & actions 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

30 30 HICS Form 201 Incident Briefing

31 31 Purpose: Defines incident objectives Instructions: Include - Weather/Environmental Implications General Safety/Safety Messages Attachments Prepared by Planning Section Chief Approved by: Incident Commander HICS Form 202 Incident Objectives

32 32 HICS Form 202 Incident Objectives

33 33 Purpose: To document Hospital Command Center staffing Origination: The Planning Section Chief or designee (Resources Unit Leader) Copies to: Command Staff and General Staff Branch Directors and Agency Staff Documentation Unit Leader HICS Form 203: Organizational Assignment List

34 34 HICS Form 203: Organization Assignment List

35 35 Purpose: Document branch assignments, objectives, strategies/tactics and resource needs Origination: Section Chief or Branch Director Copies to: Command, General Staff and Documentation Unit Leader Prepared by: Branch Director When to complete: At the start of each operational period HICS Form 204: Assignment List

36 36 HICS Form 204: Assignment List

37 37 HICS Form 215A: Incident Action Plan Safety Plan Analysis Purpose: Document hazards and mitigation Origination: Safety Officer Copies to: Command and General Staff, Sections, and Branches Prepared by: Safety Officer Approved by: Incident Commander When to complete: Prior to safety briefing during the Operations Briefing and at transfer of role

38 38 HICS Form 215A: Incident Action Plan Safety Plan Analysis

39 39 Purpose: Document Incident issues encountered Decisions made Notifications conveyed Origination: Command and General Staff When to complete: Continuously, from activation through demobilization HICS Form 214: Activity Log

40 40 HICS Form 214: Operational Log

41 41 Purpose: A short form combining forms 201, 202, 203, 204 and 215A. May be used in place of full forms to document initial actions or short incidents, and can expand to the full forms as needed. Origination: Incident Commander or Planning Section Chief HICS Form IAP Quick Start

42 42 HICS Form IAP Quick Start

43 43 Application of Incident Action Plan – Infectious Disease Hospital Incident Command System This material has been developed for training purposes; do not share, distribute, transmit or reproduce without prior written consent of California Hospital Association This course was developed by the CHA Hospital Preparedness Program with grant funds provided by the U.S. Department of Health & Human Services Assistant Secretary for Preparedness & Response Hospital Preparedness Program and awarded by the California Department of Public Health. No part of this course or its materials shall be copied or utilized for monetary gain.

44 44 Incident Action Planning 1.Assess the Situation 2.Set the Operational Period 3.Determine Safety Priorities & Establish Incident Objectives 4.Determine Branch/Section Objectives 5.Determine Strategies & Tactics 6.Determine Needed Resources 7.Issue Assignments 8.Implement Actions 9.Reassess & Adjust Plans

45 45 Influenza season has begun and hospitals and primary care see an increase in the number of influenza-like illness (ILI) cases presenting for care including a family of 5 with symptoms of ILI. Emergency departments and community health centers see a surge in ILI cases presenting, and admissions increase over 10% with acute respiratory illnesses. PHD is stating there is evidence of an emerging infectious disease with respiratory spread and that hospitals should prepare for significant surge. Scenario

46 46 First Actions Time: 0900 Weather: Clear, 68º F, no winds Is this an incident? What are your first actions? Who is in charge?

47 47 Use HICS form 214: Operational Log Complete HICS form 201: Incident Briefing Event History and Current Actions Summary Begin form 202: Incident Objectives Weather/environmental implications for period Step 1: Assess the Situation Incident Action Planning

48 48 Which Positions to Activate?

49 49 Immediate Time Period PositionImmediateIntermediateExtendedRecovery Incident CommanderXXXX Public Information OfficerXXXX Liaison OfficerXXXX Safety OfficerXXXX Operations Section ChiefXXXX Medical Care Branch DirectorXXXX Infrastructure Branch DirectorXXXX Security Branch DirectorXXXX Business Continuity Branch DirectorX Patient Family Assistance Branch Dir.X Planning Section ChiefXXXX Resources Unit LeaderXXXX Situation Unit LeaderXXXX Documentation Unit LeaderXXX Demobilization Unit LeaderXX Logistics Section ChiefXXXX Service Branch DirectorXXXX Support Branch DirectorXXXX Finance /Administration Section ChiefXXXX Time Unit LeaderXXX Procurement Unit LeaderXXX Compensation/Claims Unit LeaderX Cost Unit LeaderXXX

50 50 The Incident Commander names the incident If the incident is a community-based incident, the appropriate jurisdiction will name the incident (e.g., county, city, EMS) The incident name should be documented on all forms Naming the Incident

51 51 HICS form 202: Incident Objectives Operational Period Date/Time Incident Commander sets the Operational Period o Based on number of simultaneous activities o How quickly the situation is changing An Operational Period breaks the incident down into manageable timeframes Step 2: Set the Operational Period Incident Action Planning

52 52 Identify the Incident Objectives (these are the broad objectives that will last throughout the response or are the priorities) HICS form 202: Incident Objectives Step 3: Determine Safety Priorities & Establish Incident Objectives Incident Action Planning

53 53 Utilize the Incident Response Guide Infectious Disease: Identify, triage, isolate and treat infectious patients Protect patients and staff from exposure and injury Assure safety and security for patients, staff, visitors and the hospital Admit a large number of infectious patients while protecting other (uninfected) patients Incident Objectives

54 54 It is reported the several of the patients with ILI symptoms in your hospital are requiring ICU level care and ventilator support. Scenario Update #1

55 55 Assess the Safety issues What hazards exist and what precautions need to be taken Complete the 215A – Incident Action Plan Safety Analysis Side Note: Safety Officer Tasks

56 56 Prepare a statement for the media Prepare a statement for the staff, patients and visitors (e.g., situation, status, safety precautions, next update time) The statements need approval from the Incident Commander Coordinate consistent messaging with the Joint Information Center (JIC) Side Note: Public Information Officer task

57 57 Make contact with the Public Health Department, EMS Agency or through the local EOC (MHOAC) if activated Who should be notified? Who is the source of resources in your local plan? (e.g., local EMS Department Operations Center, PHD Department Operations Center, County/City Emergency Operations Center) These contacts/processes should be identified prior to any incident Side Note: Liaison Officer

58 58 Utilize HICS forms Operational Log Side Note: Documenting your Actions

59 59 Document on HICS 204 – Assignment List They are based on the Incident Objectives These are based on what is desired to be achieved by the Branch/Section in that operational period Objectives need to be SMART (Simple, Measurable, Achievable, Realistic, Time Sensitive & Task Oriented) Incident Action Planning Step 4: Determine Branch/Section Objectives

60 60 Review IRG Branch/Section Objectives

61 61 Strategies & tactics are how your Branch/Section is going to achieve the objectives What actions do you need to take? Use your facility response plans and Incident Response Guides Record strategies & tactics on form 204 – Assignment List Incident Action Planning Step 5: Determine Strategies & Tactics

62 62 What space resources are needed? What personnel resources do you need? What equipment and/or supplies do you need? What resources do you need in the patient collection/holding area? What transport resources do you need? Document resource activities: Resources assigned (form 204) Resource requests (form 213) Actions taken to utilize and obtain resources (form 214) Step 6: Determine Needed Resources Incident Action Planning

63 63 Who will be assigned to the units? Fill in assignments on form 204 – Assignment List Are there other branches or units that need activated? Step 7: Issue Assignments Incident Action Planning

64 64 For the first Operational Period the Incident Action Plan should be done within minutes What makes up the Incident Action Plan? Incident Briefing Incident Objectives Incident Assignments Branch Assignments 215A - Incident Action Plan Safety Analysis The Planning Section compiles the forms to create the Incident Action Plans Incident Action Planning

65 65 IAP Quick Start New form Can be used for small incidents Or for a rapid start to a large incident and then expand out on individual HICS forms Great for smaller pre-planned events

66 66 Put your activities / plans into action What are some of these activities? Step 8: Implement Actions Incident Action Planning

67 67 Your hospitals ICU is at full capacity. Patients will ILI symptoms continue to arrive at a high rate. There are only 3 ventilators left available in the hospital. Scenario Update #2

68 68 Towards the end of the operational period, you will need to evaluate status Repeat steps 1-8 Update the forms Evaluate and/or update your Branch/Section Objectives This creates your Incident Action Plan (game plan) for the next operational period Step 9: Reassess & Adjust Plans Incident Action Planning

69 69 What are things we need to remember to do? Share information Recovery / Restoration After Action Report Corrective Actions Plan How are we doing?

70 70 Questions?


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