HOSPITAL EMERGENCY INCIDENT COMMAND SYSTEM

Third Edition

 

EXECUTIVE SUMMARY

January, 1998

 

Confusion and chaos are commonly experienced by the hospital at the onset of a medical disaster. However, these negative effects can be minimized if management responds quickly with structure and a focused direction of activities. The Hospital Emergency Incident Command System (HEICS) is an emergency management system that employs a logical management structure, defined responsibilities, clear reporting channels, and a common nomenclature to help unify hospitals with other emergency responders. There are clear advantages to all hospitals using this particular emergency management system.

 

Based upon public safety’s Incident Command System, HEICS has already proved valuable in helping hospitals serve the community during a crisis and resume normal operations as soon as possible. A survey of California hospitals in the spring of 1997, reveals a significant number of hospitals have, or will be incorporating HEICS within their emergency plans. HEICS is fast becoming the standard for health care disaster response and offers the following features:

 

• Predictable chain of management
• Flexible organizational chart allows flexible response to specific emergencies
• Prioritized response checklists
• Accountability of position function
• Improved documentation for improved accountability and cost recovery
• Common language to promote communication and facilitate outside assistance
• Cost effective emergency planning within health care organizations

 

The 1996 Edition of the National Fire Protection Association, Health Care Facilities Handbook states in chapter 11-4.3, "The disaster planning committee shall model the disaster plan on the incident command system (ICS)." The American Society for Healthcare Engineering of the American Hospital Association in an August, 1997 Healthcare Facilities Management Series states "One of the best examples of emergency preparedness through checklists can be found in The Hospital Emergency Incident Command System..." In California, public hospitals seeking financial recovery following a declared disaster are required to implement the 1993 mandates of the Standardized Emergency Management System. The utilization of the HEICS plan is recognized as partial compliance with this act.

HEICS and all of its support material are offered without charge. Implementation templates and instructional materials are free and make the cost of converting to the HEICS system minimal. HEICS is financially prudent as it assists the medical facility in staying open following a disaster and promotes the restoration of day-to-day hospital function. It is an efficient method for managing emergencies of disastrous proportions, as well as those of a lesser degree.

 

For More Information...

About the Hospital Emergency Incident Command System contact the California Emergency Medical Services Authority at (916) 322-4336; or visit the web site at http://www.emsa.cahwnet.gov/.

 

HEICS is an emergency management system made up of positions on an organizational chart. Each position has a specific mission to address an emergency situation. Each position represented above has an individual checklist designed to direct the assigned individual in disaster recovery tasks. The HEICS plan includes forms to enhance this overall system and promote accountability.

 

The HEICS plan is flexible. Only those positions, or functions, that are needed should be activated. The HEICS plan allows for the addition of needed positions, as well as the deactivating of positions at any time. This equates to promoting efficiency and cost effectiveness. The above chart may be fully activated for a large, extended disaster such as an earthquake. However, full activation may take hours or even days. The majority of disasters or emergencies will require the activation of far fewer positions.

 

More that one position may be assigned to an individual. Situations of a critical nature may require an individual to perform multiple tasks until additional support can be obtained. This is made possible with the use of the individual position checklists.

MINIMAL STAFFING

A bus crash in the early A.M. hours will find hospital management and staff at a minimum. The HEICS system allows a minimum activation of positions necessary to care for the arriving injured. The 5 positions with double-boxed borders are those that should be immediately activated upon notice of the crash. The other positions can be added as more personnel arrive. It should be remembered that a person might be required to perform more than one job. As more staff becomes available they relieve the individual with multiple assignments. For example: the Night Supervisor initially becomes the Incident Commander and Labor Pool Unit Leader. Tasks (positions) that are assigned a high priority may be divided among arriving (available) individuals.

 

 

FLEXIBILITY

The activation of positions for a mass casualty accident will be different than those activated for a hazardous material spill or an impending labor strike. HEICS will flex to accommodate the unique needs of each emergency. The above chart illustrates those positions, which may be opened to address issues associated with a storm alert. This pre-disaster activation allows alerted staff to be in a "stand-by" mode in the event future positions need to be filled. Keep in mind that each emergency has its own set of priorities and circumstances. With easy to understand, pre-written checklists, almost anyone can assume a role after a few minutes of reading.

 

COST EFFECTIVE

COST EFFECTIVE ACTIVATION - of a facility’s emergency plan will occur as a result of more efficient use of available personnel resource. Financial resources are saved by activating only those positions that are necessary.

 

COST EFFECTIVE IMPLEMENTATION - previous years of development and testing have created proven universal forms and procedures that need only to be customized for the facility. Disaster planning activities also serve as tangible disaster mitigation efforts.

 

COST EFFECTIVE TRAINING - is generic and basic to all hospital employees. Most training can be done in the annual update format of each facility. Employees coming from other institutions may already be schooled in the Incident Command System.

 

 

For More Information...

About the Hospital Emergency Incident Command System contact the California Emergency Medical Services Authority web site at http://www.emsa.cahwnet.gov/ or telephone the Authority at (916) 322-4336.