H OSPITAL I NCIDENT C OMMAND S YSTEM (HICS) OVERVIEW

1. HOSPITAL INCIDENT COMMAND SYSTEM (HICS) OVERVIEW Developed under DHHS Grant #070016-01-00

2. Incidents happen… both small and large

3. What types of incidents could impact our hospital? • Public Health related (widespread disease outbreak) • Natural (hurricane, flood) • Manmade (bomb threat, terrorism) • Chemical/Nuclear/Biological • Mass Casualty Event

4. How could these situations affect the hospital? • Increase in the amount of patients, including those with special needs • Increase in the severity of injuries • Damage to the building or infrastructure • Need to integrate with other organizations to respond to the situation

5. NationalIncidentManagementSystem On February 28, 2003, President Bush issued Homeland Security Presidential Directive-5. HSPD-5 directed the Secretary of Homeland Security to develop and administer a National Incident Management System, commonly referred to as NIMS. The Incident Command System (ICS)was identified as the incident management system to be used nationally, across disciplines.

6. History of ICS • ICS was developed in response to a series of wildfires in California in the 1970s which resulted in loss of life and property • Major response problems were identified including: • Lack of effective management structure • Poor communications • Lack of accountability and clear chain of command • No integration of agencies into management structure and planning

7. Strengths of ICS • A standard Incident Management System allows all responding agencies to work together in a common framework • Allows for rapid response • Response is organized and efficient • Built on best practices • Adaptable to an incident of any size – theresponse expands or contracts with the incident • Quicker restoration of services

8. HICS = H + ICS Remember, HICS is the “hospital version” of Incident Command System. HICS uses the sameresponse system but adds in elements that are specific to the hospital environment. ICS

9. Supervisor Resource 3 Resource 1 Resource 2 HICS “at a glance” • Based on an organized response structure • Unity of command – each individual/resource is assigned to one supervisor • Chain of command – orderly line of authority • Span of control – supervisors should manage between 3-7 individuals/resources, with 5 being optimal • Uses common language

10. HICS “at a glance” • ICS structure develops from top down (Incident Commander is the only position always filled). Other positions and sections are activated as necessary. • Positions are filled by the most qualified persons, not most senior ranking. • As complexity increases, the ICS organization expands • Used in planned events, exercises and actual incidents.

11. When is HICS used in the hospital? • When patient care or routine care cannot be maintained because of the number of injuries or the severity of injuries • When the hospital facility is compromised as a result of mechanical failure; a chemical event; natural event; manmade threats • In management of planned and unplanned events

12. Emergency Response in the Hospital All hospitals in Rhode Island use standard Emergency Codes. These codes are posted throughout the hospital and giveinstruction on howto respond to variedincidents. When “Code Triage” is called, the Emergency Operations Plan is activated and the hospital uses HICS to respond NOTE:What may be considered an emergency for one hospital may be routine for another (i.e. surge capacity)

13. What will happen when Code Triage is called? • HICS positions are filled as necessary (scaled to size and nature of event) • Emergency Management Plan goes into effect • HICS is activated • Hospital Command Center is activated NOTE: When CODE TRIAGE STANDBY is called, theEmergency Management Plan is in effect, and HICSnotification and departments are on standby due to a potential threat.

14. Assumes command of theincident; Will activate other positions as necessary. NOTE: This is the only position that is ALWAYS filled HICS Response Positions--Command Staff Serves as the point person to communicateinformation about the event Incident Commander Public Information Officer Liaison Officer Medical/Technical Specialists Safety Officer Monitors safety conditions; ensuresresponder safety Group that providesmedical/technical subject matter expertise Acts as the point person for assisting or coordinating agencies

15. HICS Response Sections ICS Response is broken into four sections. Each section has specific responsibilities and positions within the section to carry out tasks: Conducts tacticaloperations Develops the Incident ActionPlan for response Acquires necessaryresources Manages costsrelated to the incident “Workers” “Planners” “Getters” “Payers”

16. What should I expect? • Normal hospital operations will be impacted (i.e. increase in patients, increase in severity or amount of injuries, facility may be impacted) • You may report to someone other than your supervisor • You may be asked to fill a role other than your normal position

17. HICS Staff Plan • During day time working hours: • Stay in your work area • Your Manager will call the Labor Pool • Reports available staff and requests additional staff if needed. • After day time hours and weekends: • The employee call back system will be put in place. • If you are called in, park in the main lot and report to the Labor Pool. Clinical Staff reports to their units.

18. HICS Location Plan • Under HICS, various locations in the hospital will be identified as the following: • Command Center • Administration Conference Room • Media Area • Medical Staff Auditorium • Inpatient Discharge Area • Dining Room 3 • Disaster Patients’ Discharge Area • Coffee Shop • Labor Pool Reporting Area • Physical Therapy Gym • Mental Health/Families of Victims Area • Sayles Conference Area

19. QUESTIONS