Hospital Incident Command System

1. Hospital Incident Command System Updated with May 2014 HICS Revisions HICS Basics Part 1 Management System and Tools for Events 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. Objectives Learn the principal concepts and features of the Hospital Incident Command System Understand the roles and relationships of the Hospital Incident Management Team Understand the principles of Incident Action Planning

3. HICS Overview Assists in emergency management planning, response, and recovery capabilities for unplanned and planned events Consistent with ICS and the National Incident Management System (NIMS) principles Logical management structure Defined responsibilities Clear reporting channels Common nomenclature

4. What HICS is Not HICS is not: • HICS does not replace or supplant daily hospital operations • The HICS Guidebook does not replace the hospital’s Emergency Operations Plan

5. HICS Features Hospital Incident Management Team Chart All hazard approach Incident Action Planning Job Action Sheet Incident Planning Guides Incident Response Guides HICS Forms Promotes Recovery

6. Where do I find HICS information? www.emsa.ca.gov/disaster_medical_services_division_hospital_incident_command_system www.calhospitalprepare.org www.hicscenter.org HICS Resources

7. Basic Incident Command Structure Incident Commander Public Information Officer Safety Officer Medical/ Technical Specialist(s) Liaison Officer Planning Section Chief Finance/ Administration Section Chief Operations Section Chief Logistics Section Chief Modular Organization: Functional Sections Activated as Needed

8. Hospital Incident Command System The system is scalableso that more or fewer positions--depending on the emergency--may be implemented

9. Command Command functions Maintain overall management of the incident Sets incident objectives and priorities Devise and approve strategies Ensure mission completion Command consists of: Incident Commander Command Staff

10. Command Incident Commander Public Information Officer Safety Officer Medical/ Technical Specialist(s) Liaison Officer • Chemical • Clinic Administration • Biological/Infectious Disease • Hospital Administration • Legal Affairs • Medical Ethicist • Medical Staff • Pediatric Care • Radiological • Risk Management

11. Incident Commander Description/Duties: Determine scope and magnitude of event and facility impact Activate and direct the Hospital Command Center Give overall strategic direction for the hospital Initiate and approve the Incident Action Plan Authorize total facility evacuation if warranted Only position always activated

12. Public Information Officer Description/Duties: Communicate with internal and external stakeholders including: Staff Visitors and family Media Determine information to be released Collaborate with local community officials (Joint Information Center) for consistent content Obtains Incident Commander approval on all messages Reports to: Incident Commander

13. Safety Officer • Description/Duties: • Ensure safety of staff, patients and visitors • Monitor and have authority over the safety of rescue operations and hazardous conditions • Determine safety risks • Initiate corrective/protective actions • Completes the HICS form 215A, Incident Action Plan Safety Analysis • Has authority to halt any operation that poses immediate threat to life and health Reports to:Incident Commander

14. Liaison Officer Description/Duties: Hospital Command Center contact for supporting agencies and organizations Make facility needs and requests for assistance and resources Reports to:Incident Commander

15. Description/Duties: Medical/Technical Specialist • Subject matter experts that advise the Incident Commander and/or assigned section. • May be assigned as technical advisor in the Hospital Command Center • May be assigned to advise and oversee specific hospital operations • Example: Decontamination operations during a chemical exposure situation Reports to:Incident Commander

16. Biological Infectious Disease Chemical Radiological Legal Affairs Risk Management Medical/Technical Specialist Examples Include: • Medical Staff • Pediatric Care • Medical Ethicist • Clinical Administration • Hospital Administration Reports to: Incident Commander

17. Command Review The Incident Commander is responsible for: Management of the Incident Activities within the Hospital Command Center Continuing as Incident Commander until authority is delegated to another The Command Staff consists of: Public Information Officer (PIO) Liaison Officer Safety Officer Medical/Technical Specialist(s)

18. Sections Incident Commander Public Information Officer Safety Officer Medical/ Technical Specialist(s) Liaison Officer Finance / Administration Section Chief Operations Section Chief Planning Section Chief Logistics Section Chief

19. Sections include: Operations Planning Logistics Finance/Administration Sections are led by a Chief Section Chiefs are called General Staff Sections

20. Operations

21. Operations Section Mission: Manage tactical operations Direct all tactical resources Carry out the mission and Incident Action Plan Operations Section • Directs all tactical resources • Led by a Section Chief

22. The Section includes: Staging Area Medical Care Branch Patient Family Assistance Branch Infrastructure Branch HazMat Branch Security Branch Business Continuity Branch Operations Section

23. Staging Manager Organize and manage the deployment of supplementary resources, including personnel, vehicles, equipment, supplies, and medications Mission:

24. Mission: Organize and manage the delivery of emergency, inpatient, outpatient, and casualty care, and clinical support services Duties: Address provision of acute and continuous care Work with Logistics for resource acquisition Work with Staging Manager for delivery of resources to areas Medical Care Branch Director

25. Supervises: Inpatient Unit Leader (all inpatient units) Outpatient Unit Leader (all outpatient services) Casualty Care Unit Leader (Emergency Department) Behavioral Health Unit Leader Clinical Support Unit Leader (i.e., Lab, Diagnostic Imaging, Pharmacy, Morgue, Blood Donor) Patient Registration Unit Leader Medical Care Branch Director

26. Mission: Organize and manage the services required to sustain and repair the hospital’s infrastructure operations Duties: Maintain overall facility operations and operating capacity Identify and fixes utility service-delivery failures Assign personnel to address damage Infrastructure Branch Director

27. Supervises: Power/Lighting Unit Leader Water/Sewer Unit Leader HVAC Unit Leader Building/Grounds Unit Leader Medical Gases Unit Leader Infrastructure Branch Director

28. Mission: Coordinate activities related to internal and external personnel and facility security Duties: Implement facility security measures Ensure security and access control of the Hospital Command Center Liaison with responding law enforcement Oversee search and rescue operations Security Branch Director

29. Supervises: Access Control Unit Leader Crowd Control Unit Leader Traffic Control Unit Leader Search Unit Leader Law Enforcement Interface Unit Leader Security Branch Director

30. Mission: Organize and direct hazardous material incident response activities Technical, and emergency decontamination; and facility and equipment decontamination Duties: Oversee hazmat event Decontamination of victims, staff, facility Safe and appropriate use of PPE Clean up operations Collaborates with Medical Care Branch Director HazMat Branch Director

31. Supervises: Detection and Monitoring Unit Leader Spill Response Team Unit Leader Victim Decontamination Unit Leader Facility/Equipment Decontamination Unit Leader HazMat Branch Director

32. Mission: Ensure business functions are maintained, restored or augmented Duties: Facilitate acquisition and access to essential recovery resources, including business records Coordinate IT services with Logistics Section Assist Branches and impacted areas to restore normal operations Business Continuity Branch Director

33. Supervises: IT Systems and Applications Unit Leader Service Continuity Unit Leader Records Management Unit Leader Business Continuity Branch Director

34. Patient Family Assistance Branch Director Mission: • Organize and manage assistance for patient family care needs, including communication, lodging, food, health care, spiritual, and emotional needs that arise during the incident. Duties: • Ensure patient family assistance resources • Coordinate external community resource requests • Ensure Family reunification, Social Service, Cultural and Spiritual needs • Communication with law, government and non-governmental agencies, and media through the Liaison Officer and Public Information Officer

35. Supervises: Social Services Unit Leader Family Reunification Unit Leader Patient Family Assistance Branch Director

36. Operations Section Review The Operations Section is responsible for: The tactical objectives and organization All tactical operations Directing all tactical resources • Operations is led by a Chief • Operations positions are activated as needed by the incident

37. Logistics

38. Logistics Section Section Mission: • Organize and direct maintenance of the physical environment – providing human resources, material, and services to support the incident. • Provides support(stuff)to other sections • Acquires resources from internal and external sources • Through Liaison, links to local Emergency Operations Center for resource requests • Led by a Section Chief

39. Scope and Responsibilities overlap Logistics Supply Unit and Operations’ Infrastructure Branch Labor Pool and Credentialing Unit and Staging Manager– Personnel Tracking Manager Logistics and Operations Logistics and Operations are closely linked and must work collaboratively • Logistics Section are the “getters” • Operations Section are the “doers”

40. Logistics Section The Section includes: Service Branch Support Branch

41. Mission: Organize and manage services to maintain hospital communication, food and water supply and information technology and systems Service Branch Director Oversees: • Communications Unit Leader • IT/IS and Equipment Unit Leader • Food Services Unit Leader

42. Mission: Manage supplies, facilities, transportation, and labor pool. Provide logistical, psychological, and medical support to hospital staff and their dependents Oversees: Employee Health and Well-Being Unit Leader Employee Family Care Unit Leader Supply Unit Leader Transportation Unit Leader Labor Pool and Credentialing Unit Leader Support Branch Director

43. The Logistics Section is responsible for: Organizing and directing internal and external resources to support the incident Providing support to other sections Logistics supports the incident resource requirements Logistics has two branches: Support Service Logistics is led by a Chief who works closely with the Operations Section Logistics Section Review

44. Planning Section

45. Mission: Collect, evaluate, and disseminate incident action information and intelligence to Incident Commander Prepare status report Develop the Incident Action Plan Led by a Section Chief Planning Section

46. Planning Section Chief • Supervises: • Resources Unit Leader • Personnel Tracking • Materiel Tracking • Situation Unit Leader • Patient Tracking • Bed Tracking • Documentation Unit Leader • Demobilization Unit Leader

47. Planning Section Chief • The Planning Section is responsible for: • Collecting, evaluating and disseminating incident situation information to the Hospital Command Center • Maintaining resource status • Developing the Incident Action Plan (IAP) and obtaining Incident Commander approval on IAP • Archiving response and recovery documentation • Assisting with After-Action Report development

48. Finance Section

49. Finance/Administration Section Chief Mission: Monitor the utilization of financial assets and the accounting for financial expenditures. Supervise the documentation of expenditures and cost reimbursement.

50. Supervises: Time Unit Leader Procurement Unit Leader Compensation/Claims Unit Leader Cost Unit Leader Finance/Administration Section Chief