Examining IMS for Health and Medical Systems: MaHIM and MSCC

1. Examining IMS for Health and Medical Systems:MaHIM and MSCC Joseph Barbera, MD Anthony Macintyre, MD The George Washington University

2. Objectives • Explain the core concepts of IMS as they apply to health and medicine • Explain the utility of IMS for health and medicine • Lay the groundwork for an explanation of MaHIM and MSCC

3. View of traditional response IM No more Jurisdictional Management Needed Ops Log Plans F & A HCF Incident

4. Traditional response

5. Traditional areas of medical preparation • Training • Triage • Agents/event characteristics • Specific technologies • Eg. “Communications”

6. Traditional medical response preparedness

7. Demands Event generated demands • Pre-impact preparations • Search and rescue • Care of injured and ill • Welfare needs • Protection against continuing threat • Community order Response generated demands • Information management • Communication • Mobilization and utilization of resources • Coordination • Exercise of authority Quarantelli

8. Too Focused……

9. Demands Event generated Demands Management Operations Logistics Plans/Info Finance/Admin Response generated demands

10. Problems • Responder protection (safety function) • Coordination of strategies (management, plans and liaison functions) • Management of information (Plans/Info function)

11. Problems

12. Command versus Management • Willing to be managed if: • Enhanced collective security • Enhanced information management • Decreased confusion among responders (and victims)

13. What is a (response) System? • Definition: Clearly described functional structure, including defined processes, that coordinates otherwise diverse parts to achieve a common goal. • System description (How components are organized) • Concept of operations (How components interact)

14. IMS for Health and Medicine Develops goals and objectives Accomplishes goals and objectives Management Operations Logistics Plans/Info Finance/Admin Supports management and operations

15. ICS for Health and Medicine Management Operations Logistics Plans/Info Finance/Admin ICS 206 Medical Unit

16. ICS 206 • Incident medical aid stations • Ambulance services • Incident ambulances • Hospitals • Medical emergency procedures • Reviewed by safety officer

17. IMS and Health and Medicine ? Medical and Health Management ? Operations Logistics Plans/Info Finance/Admin Medical and Health

18. US&R Incident Support Team • Medical part of command staff • Responsibilities!

19. For this to work for health and medicine • Recognition that there is a larger “operating picture” • Learning • Qualifications

20. The Ideal at the jurisdictional level • Unified Incident Management with a senior advisory component Emergency Management Operations Law Enforcement Fire/EMS Public Health Public Works Acute Medical Care

21. The lead role in Unified Management

22. Two Important Functional Areas Management Operations Logistics Plans/Info Finance/Admin

23. What does planning mean? vs Preparedness Planning vs Incident Planning

24. Preparedness planning Describing response architecture Implementing response architecture Training Drills and exercises Adjustments as necessary Incident planning Establish response objectives Establish strategies and tactics (including assigning resources) Determine incident situation and status of resources Safety and communication messages What does planning mean?

25. Plans management • Coordinates incident planning activities • Provides the agenda for planning meetings • Runs planning meetings • Plans for • Long range • Contingencies • Demobilization

26. Must be a cyclical process (for any event longer than a few hours) • Allows objective evaluation of measures of success • Allows for reformulation of objectives • Allows for appropriate information management across all disciplines and all tiers of a response

27. NIMS Incident Planning • Understand the situation • Establish Incident Objectives and Strategy • Develop the Plan • Prepare and disseminate the plan • Evaluate and revise the plan

29. Response Plan • Move beyond just reporting situation and status • Want to include tactics • Safety • Communications

30. Good and Bad • Good • Promotes information management • Sharing of information • Bad • Time to prepare • Proprietary information • Health and medicine have difficulty changing plans (Part of managing public expectations).

31. “As event parameters will change, and the status of individual response resources will change, incident objectives and strategies will necessarily have to change as the response evolves” JAB/AGM

32. Resource Management • Resource • Descriptions • Inventory • Mobilization • Dispatch • Tracking • Demobilization

33. Resource Management

34. Resource Management

35. Stages of an Event • Baseline operations • Incident recognition • Activation/notification • Mobilization • Response • Demobilization • Transition to recovery Pro-active management through the planning cycle

36. Incident Recognition Washington DC, September 2002 Saudi Arabia, May 2003

37. The potential of IMS: Surge • Medical surge capacity • Medical surge capability

38. Why Has ICS/IMS Not Had Quicker Acceptance in Health and Medicine? • “I get hives every time I hear the phrase ‘Incident Command System’” • “A health event will never be managed utilizing the Incident Management System” • “There is no Incident Management System, there is only me.”

39. Acceptance • Poor explanations • Lack of understanding of utility • Command • Poor training

40. Established beach heads….. • Hospital Emergency Incident Command System (HEICS) • Veterans Health Administration (VHA) • Joint Commission on Accreditation of Healthcare Organizations (JCAHO) • National Association of County and City Health Officials (NACCHO)

41. Established beach heads….. Illinois Operational Headquarters and Notification Office (IOHNO) – TOPOFF 2

42. View of traditional response IM No more Jurisdictional Management Needed Ops Log Plans F & A HCF Incident

43. Future Response IM Ops Log Plans F & A HCF Incident