Hospital Incident Command System

1. Hospital Incident Command System Incident Action Planning Updated with May 2014 HICS Revisions 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 Understand the 9 steps of the Incident Action Planning process Identify Incident Action Plan components Exercise the development of an Incident Action Plan

3. Hospital Incident Management Team Review 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

4. Hospital Incident Action Planning Key to Effective Response and Recovery

5. Assess the Situation Set the Operational Period Determine Safety Priorities and Establish Incident Objectives Determine Branch/Section Objectives Determine Strategies and Tactics Determine Needed Resources Issue Assignments Implement Actions Reassess & Adjust Plans Incident Action Planning

6. #1 Assess the Situation • Type, location, magnitude, possible duration • On-going hazards and safety concerns • Determine initial priorities based on: 1 - Life saving 2 - Incident stabilization 3 - Property preservation • Establishes the Hospital Command Center • Sets the initial “Operational Period” The Incident Commander conducts the initial incident assessment:

7. An Operational Period is: The time period scheduled for execution 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 #2 Set the Operational Period

8. “Incident Objectives” Broad organizational objectives that are foundational and do not change during response and recovery; 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 hospital personnel #3 Determine Safety Priorities and Establish Incident Objectives

9. Individual Section/Branch Objectives More specific Branch/Section objectives to achieve overall Incident Objectives Steps during the defined Operational Period Should be tangible and measurable Example: Provide prophylaxis to 75% of direct patient care staff within 2 hours Decontaminate 50 victims within 1 hour #4 Determine Individual Section/Branch Objectives

10. #5 Determine Strategies and Tactics Strategy defined: • The general direction selected to accomplish incident objectives • 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. #6 Determine Needed Resources • Tactical resources may include: • Personnel • Equipment • Supplies • Pharmaceuticals • Vehicles • Available and needed resources to meet the objectives must be identified

12. #7 Issue Assignments • Hospital Command Center positions are activated according to incident needs • Staff are assigned to conduct incident specific operations: • Evacuation • Decontamination • Triage and treatment • Safety measures Once the objectives and needed resources are identified, assignments are issued:

13. The Planning Meeting The Planning Meeting is: • Led by the Planning Chief • Defines and finalizes operational period objectives, strategies, tactics, and resources as determined by each section for the next operational period

14. The Planning Meeting The Planning Meeting is conducted after: • Incident Commander has provided an incident briefing and determined the Incident Objectives and identified the Operational Period • Sections have met to discuss their response priorities and identified Section/Branch objectives

15. The Planning Meeting The Planning Meeting is: Based on a fixed agenda and includes a report out of section-specific objectives for the Operational Period, resources assigned, resource needs Attended by Incident Commander, Command and General Staff

16. The Planning Meeting At the end of the Planning Meeting: The Section Chiefs submit completed HICS Form 204 Assignment List The Safety Officer submits completed HICS Form 215A Incident Action Plan Safety Analysis

17. #8 Implement Actions Direct, monitor and evaluate response: • Constant monitoring of strategies and tactics for effectiveness • Assess the Branch/Section 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

18. #9 Evaluate and Revise Plans Conduct a current situation assessment • Update situation/incident information • Assess the impact on the hospital • Length and duration of incident • Resource availability • Assess the Incident Objectives • Assure objectives are achieved in a safe and timely manner • Revise objectives, strategies, tactics and resource needs for the upcoming operational period

19. Incident Action Plan Responsibilities The Incident Commander Provides overall Incident Objectives (HICS 202) Sets the Operational Period Develops major strategies (priorities) Activates Hospital Incident Management Team Establishes policy for resource orders Approves initial actions and the completed Incident Action Plan

20. The Safety Officer Advises the Incident Commander and Section Chiefs on safety issues and measures Develops the Safety Plan (HICS 215A) Oversees the safety of operations and tactics Incident Action Plan Responsibilities

21. 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

22. The Planning Section Chief Prepares for the Planning Meetings Gathers information for the Incident Action Plan (HICS 201, 202, 203, 204s and 215A) Develops demobilization plans 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

23. The Logistics Section Chief Determine tactics and resource requirements (204) Ensures resource ordering meets the needs Advises activated Logistics positions Ensures resources to support Incident Action Plan Develops plans that support the Incident Action Plan Communications Plans Transportation Plans Incident Action Plan Responsibilities

24. The Finance/Administration Section Chief Determine tactics and resource requirements (204) Provides cost implications of the Incident Objectives Ensures the Incident Action Plan is within cost limitations Advises the Incident Commander on Finance/Admin activated positions Incident Action Plan Responsibilities

25. The Incident Action Plan Provides Hospital Incident Management Team with direction for the Operational Period Uses the elements of Management by Objectives Developed by Command, General Staff provide input Essential for effective response and recovery Incident Action Plan Responsibilities

26. Questions?

27. Incident Planning Guides Active Shooter  Chemical Incident Earthquake  Evacuation, Shelter-in-Place, & Hospital Abandonment Explosive Incident Hostage or Barricade Incident Infectious Disease There are 18 Scenario-based Incident Response Guides :

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

29. Incident Response Guides 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

30. Section Review Incident Response Guides Are incident-specific tools to assist with planning, training and response/recovery Assist in meeting regulatory requirements Guide Command and General Staff with decision-making and actions Should be consistent with the Emergency Operations Plan Do not replace the Job Action Sheets

31. Questions?

32. HICS Forms

33. Serves as a road map in response: everyone acting from the same plan Serves as foundation for corrective action Ensures consistency and compliance with regulatory guidelines Complies with documentation for FEMA reimbursement The Value of Using HICS Forms

34. HICS Form 200Incident 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

35. 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

36. HICS Form 201Incident Briefing

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

38. HICS Form 202 Incident Objectives

39. 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

40. HICS Form 203:Organization Assignment List

41. 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

42. HICS Form 204: Assignment List

43. 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

44. HICS Form 215A: Incident Action Plan Safety Plan Analysis

45. Purpose: Provide standardized message recording Instructions: Response Required: Indicate a reply was requested and to whom reply addressed Priority: Indicate level of urgency Message: Keep all messages/requests brief, to the point, and very specific Transcribe complete, concise, and specific content of message Action Taken (if any) HICS Form 213: Incident Message Form

46. HICS Form 213: Incident Message Form

47. 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

48. HICS Form 214:Operational Log

49. 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

50. HICS Form IAP Quick Start