1. Command and Control in Evacuations
OSHA Training Institute – Region IX
University of California, San Diego (UCSD) - Extension
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Purpose:
To ensure you learn effective training and presentation techniques well enough to become an effective outreach trainer of command and control during health care facility evacuations
TRAINER SAYS:
The primary purpose for this training session is to make sure that you as a participant in this train the trainer class learn effective training and presentation techniques well enough to become an effective outreach trainer.
The objective is to show you some simple yet powerful presentation and training techniques.
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Objectives
State how the National Incident Management System influences large scale evacuations
Discuss the development of Standard Emergency Management System and how it works in disaster management
Identify how the Hospital Incident Command System (HICS) or Incident Command System (ICS) are used in evacuations
Identify three purposes of HICS or ICS
By the end of the session you should be able to…
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4. National Response Plan
“At the federal level, the National Response Plan (NRP) provides a framework for how the federal government is to assist states and localities in managing domestic incidents, including both incidents of national significance and those of lesser severity.”
GAO Report; GAO , Congressional Quarterly, Inc. July 20, 2006
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5. National Incident Management System (NIMS)
“…a consistent nationwide approach for federal, state, tribal, and local governments to work effectively and efficiently together to prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size, or complexity.” -HSPD-5
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NIMS - Synopsis
NIMS What it is…
Core set of:
Doctrine
Concepts
Principles
Terminology
Organizational processes
Applicable to all hazards
NIMS What it is not…
Not an operational or resource allocation plan
Not a terrorism or WMD-specific plan
Not designed for international events
NRP
NRP an operational plan spelling out how efforts and resources of participants are integrated into a cohesive response operation.
Forms the basis of how the federal government interfaces with state, local, tribal governments and the private sector.
Includes planning assumptions, roles and responsibilities, concept of operations and preparedness guidelines.
Details missions, policies, structures, responsibilities of federal agencies responding to Incidents of National Significance.
Outlines functions of each Emergency Response Function coordinators, primary agencies and support agencies.
FEMA. NIMS. SEMS Advisory Committee Meeting, Mather, CA March 2005
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NIMS
Overall conceptual framework for incident management applicable to all hazards
FEMA. NIMS.
SEMS Advisory Committee Meeting,
Mather, CA March 2005
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NIMS Components
Command and Management
Preparedness
Resource Management
Communications and Information Management
Supporting Technologies
Ongoing Management and Maintenance
FEMA. NIMS. SEMS Advisory Committee Meeting, Mather, CA March 2005
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9. Relationship: NIMS and NRP
National Incident Management System
(NIMS) .
National Response Plan (NRP) provides support at the Federal level and is activated for events of national significance.
Used for all events
Incident
Local
Response
State
Response or Support
Builds on what works from previous plans and incident response
Integrates emergency response and law enforcement elements into a single national strategy
Forges new approaches and mechanisms to address today’s threats
Addresses the complete spectrum of incident management activities (unlike FRP)
Uses NIMS to establish a framework for coordination among federal, state, local, tribal, non-governmental, and private-sector organizations
Federal
Response or Support
FEMA. NIMS. SEMS Advisory Committee Meeting, Mather, CA March 2005
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SEMS
Standardized Emergency Management System (SEMS)
Developed in California
Local entities must use SEMS in order to be eligible for State funding for response related personnel costs in California
This is the basis for the NIMS program. Currently used in California—includes ICS priciples
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The History of ICS
Developed in the 1970s following devastating California fires.
Resulted in deaths, injuries and huge property losses.
Resources and tactical ability were available
Inadequate management resulted in:
Lack of accountability
Poor communication
Lack of a planning process
Overloaded Incident Commanders
No method to integrate interagency requirements
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12. SEMS was Developed to Improve:
Coordination between/among agencies
The flow of information and resources
The rapid mobilization, resource tracking and deployment
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SEMS Framework
SEMS includes the:
Incident Command System (ICS)
Multi-agency or inter-agency coordination
Master Mutual Aid Agreement (MMAA) and system
The operational area concept
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14. Legal Basis for SEMS in California
Government Code Section 8607 became effective 1993
The intent of the code is to improve coordination of State and local emergency response in California
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What Is ICS and HICS?
The Incident Command System (ICS):
Is a flexible standardized, on-scene, all-hazard incident management concept that can be expanded to handle the demands and potential complexities of single or multiple incidents
ICS in healthcare is called Hospital Incident Command System (HICS) and is based on the 2006 version of the Hospital Emergency Incident Command System (HEICS)
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HICS
Hospital Incident Command System
Organizational core of a crisis management system
Built on the principles and structure of ICS
It is the same crisis management system used by other response agencies
Offers a universal link with outside resources
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How HICS Works
Chain of command
Common language
Flexibility
Job action sheets
Mutual aid
Documentation for financial recovery
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18. Why Use the Incident Command System in the Hospital?
Efficiency
Coordination
Communication
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ICS Purposes
ICS helps to ensure:
Achievement of tactical objectives
Efficient use of resources
Safety of responders and others
Hospital Exercise using HICS
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ICS Features
Common terminology
Organizational resources
Manageable span of control
Organizational facilities
Use of position titles
Reliance on an Incident Action Plan
Integrated communications
Accountability
Slide Credit: FEMA IS100-HC
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21. Structure of ICS and HICS
Flexible
Built on successful business practice
Built on decades of lessons learned from the management and organization needed in emergency incidents
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ICS Structure
Incident Commander
Safety
Liaison
Officer
Officer
Information
Officer
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Finance
Logistics
Operations
Plans
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Chain of Command
Chain of command is an orderly line of authority within the ranks of the incident management organization.
Authority
There is only one person in charge until replaced by the next qualified person
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24. The Span of Control under ICS
The span of control refers to the supervisory structure of the organization and the number of individuals or resources one incident supervisor can manage effectively
The optimal reporting element is 5 elements per supervisor but may vary from 3 - 7
Supervisor
Resource 5
Resource 1
Resource 4
Resource 3
Resource 2
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Incident Operations Organization
Large Incident
Small Incident
Multiple layers as needed for span of control
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26. Management by Objectives
ICS is managed by objectives
Objectives are communicated throughout the entire ICS organization through the incident planning process
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27. Reliance on an Incident Action Plan
Every incident should have an Incident Action Plan (IAP) that:
Specifies the incident objectives.
Lists the actions based on objectives
Measurable strategic operations to support the objectives and be achieved within operational period
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28. Elements of an Incident Action Plan
Every IAP must have four elements:
What do we want to do?
Who is responsible for doing it?
How do we communicate with each other?
What is the procedure if someone is injured?
Slide credit - FEMA IS 100 HC
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29. Incident Commander
Incident
Commander
Only the positions needed are filled to manage the incident. The expansion of incidents may require the delegation of authority to Operations, Planning, Logistics and Finance/Admin sections.
Public Information
Officer
Liaison
Officer
Command Staff
Safety
Officer
Discuss the difference between the command staff and the general staff (“Functional Areas”)
General Staff
Operations
Section Chief
Planning
Section Chief
Logistics
Section Chief
Finance/Admin
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Incident Commander
The Incident Commander
Provides overall leadership for incident response.
Established Command Post
Based on the requirements and complexity of the incident
Delegates authority to others
Takes general direction from agency administrator/official
Assesses need for staff
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Incident Commander
Establishes incident objectives
Directs staff to develop the Incident Action Plan (IAP)
Is assisted by the Command Staff
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32. Public Information Officer
Member of the Command Staff
Conduit between internal and external stakeholders, including media interactions
Public Information Systems are required by National Incident Management System (NIMS)
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Safety Officer
Member of the Command staff
Monitors safety conditions
Develops measures for assuring the safety of all assigned personnel
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Liaison Officer
Command Staff
Primary contact for supporting agencies and organizations that are assisting at an incident, but are NOT participating within the ICS
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HICS Functional Areas
Operations section
Planning section
Logistics section
Finance / Administration section
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36. Operations Section Chief
Conducts, develops, directs all tactical objectives, operations and resources
In HICS, the word “tactical” refers to the business of managing patient care and is not a reference to security
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37. Operations Section in HICS
Carries out the medical objectives to the best of the staff’s ability
The Medical Care Branch covers
Clinical Care
Ancillary Services
Patient Registration
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38. Planning Section Chief
Manages the planning process by gathering, analyzing and disseminating information and intelligence.
Compiles the information that is included in the Incident Action Plan
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Planning Section
The Planning section also maintains status and situational reports, and patient tracking under the HICS structure
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40. Logistics Section Chief
Directs the resources and services required to support incident activities
May include ensuring personnel have a place to rest, are fed, have medical support, communications and transportation
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Logistics Section
The Labor Pool is managed under the Logistics Section in HICS. This is a change from the previous structure in which the labor pool was the responsibility of the Planning Section.
Staging Area/Labor Pool is the location where personnel and equipment are staged while waiting for tactical assignment
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42. Finance/Administration Section Chief
Manages costs related to incident
Performs accounting, procurement, time payroll recording and cost analysis
Funds medical objectives under HICS
Documents costs to maximize financial recovery and reduce liability
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43. Accountability Principles in ICS
Check-In
All responders must report in and assignments are given in accordance with the procedures established by the Incident Commander
Incident Action Plan
Response operations must be coordinated as outlined in the Incident Action Plan
Unity of Command
Principle that each individual will be assigned to only one supervisor
FEMA IS HC
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Check-In Purpose
Accounts for personnel.
Tracks resources
Prepares personnel for assignments
Locates personnel in case of an emergency
Organizes the demobilization process
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Summary
NIMS is an overall conceptual framework for incident management applicable to all hazards
NRP provides a federal framework to assist states and localities during disasters
ICS is flexible, can handle large or small events
HICS is ICS in a healthcare setting and will be used in evacuations
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References
FEMA. National Incident Management System. SEMS Advisory Committee Meeting, Mather, CA March 24, Slide Set
FEMA National Incident Management System (NIMS), An Introduction IS –
Homeland Security. Quick Reference Guide for the National Response Plan May 22, 2006, Version 4.0
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