ics review & response
DESCRIPTION
Overview of ICS and hospital response measuresTRANSCRIPT
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Review of the Incident Command
System&
Response MeasuresDavid Wood, Safety/Emergency Management Officer
Cook Children’s Northeast Hospital
August 2010
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m Objectives
• Develop a basic understanding of the Incident Command System
• Be able to write an Incident Action Plan• Be able to describe the Incident
Notification Process• Be able to distinguish between internal
and external Situation Analysis and Monitoring
• Establish Immediate Response Measures
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m What is the Incident Command System (ICS)?
• ICS (Incident Command System)– Is a standardized, on-scene all-hazard
incident management concept– Allows its users to adopt an
integrated organizational structure• Matching the complexities and demands
of single or multiple incidents• Not hindered by jurisdictional boundaries
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Purpose of ICS
• Using best practices, ICS ensures– Safety of responders and others– Achievement of tactical objectives– Efficient use of resources
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Basic Features of ICS
• Common terminology• Modular organization• Management by objectives• Reliance on an Incident Action Plan
(IAP)• Chain of command and unity of
command• Unified Command• Manageable span of control
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m ICS Management Functions
• Five management functions– Command– Operations– Planning– Logistics– Finance/
Administration
Incident Commander
Operations Chief Planning Chief Logistics Chief
PIO Safety Officer
Liaison OfficerTechnical Specialist
Finance/Admin Chief
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mICS Management:
Command• Command
– Sets the objectives– Devises strategies and priorities– Maintains overall responsibility for managing
the incident
• The Incident Commander – Is the only position always filled during
an incident regardless of its nature– May be able to accomplish all five
management functions alone on small scale incidents
– On larger incidents effective management may require that each function be established as a separate Section
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m ICS Command Staff
• The Command Staff include:– Public Information Officer– Safety Officer– Liaison Officer– Technical Specialist
• Chemical• Biological – Infectious Disease• Medical Ethicist• Legal
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m ICS Command Staff• Public Information Officer
– Advises the Incident Commander on information dissemination and media relations
– Obtains information from and provides information to the Planning Section
– Obtains information from and provides information to the community and media
• Safety Officer– Advises the Incident Commander on issues
regarding incident safety– Works with the Operations Section to ensure
the safety of field personnel– Ensures safety of all incident personnel
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ICS Command Staff
• Liaison Officer – Serves as a point of contact for agency
representatives supporting the operations– Provides briefings to and answers questions
from supporting agencies
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ICS Command Staff
• Technical Specialist – Specialist is different areas that provide technical
information to the incident commander• Biological – Infectious disease • Chemical• Legal• Radiological• Medical Ethics• Communications• Mass Casualty Management
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m ICS Management: Operations
• Operations – Conducts the tactical operations – Carries out the plan using defined objectives– Directs all needed resources
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m ICS Management: Planning
• Planning – Collects and evaluates information for
decision support– Maintains resource status– Prepares documents such as the Incident
Action Plan– Maintains documentation for incident reports
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m ICS Management: Logistics and Finance/Administration
• Logistics – Provides support, resources, and other
essential services to meet the operational objectives
• Finance/Administration – Monitors costs related to the incident – Provides accounting, procurement, time
recording, and cost analyses
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m Span of Control
• Refers to the number of individuals that one person can effectively manage
• Effective span of control ranges from 3 to 7 reporting elements per supervisor
• If the number of reporting elements is not within this range, expansion or consolidation of the organization may be needed
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m The Incident Planning Process
• Six Steps in Incident Planning1. Understanding policy and direction2. Assessing the situation3. Establishing incident objectives4. Determining appropriate strategies to
achieve the objectives
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• Six Steps in Incident Planning5. Providing tactical direction and
ensuring that it is followed • Example: The correct resources
assigned to complete a task and their performance monitored
6. Providing necessary back-up• Assigning more or fewer resources• Changing tactics
The Incident Planning Process
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m Key Points
• Benefits of ICS are:– Manages routine or planned events– Establishes a clear chain of command– Provides a a common structure – Provides logistical and administrative
support to operational personnel– Ensures key functions are covered and
eliminates duplication
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m Key Points
• ICS is modular and scalable to the scope and magnitude of the incident– Incident Commander always
activated– Other positions activated as needed
• There are five management functions– Command– Operations– Planning – Logistics– Finance/Administration
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m Key Points
• ICS provides a common terminology and position titles to enhance standardization among agencies and responders– Fire– Police– FBI– ATF– CDC
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m Incident Notification
An incident is– An emergent event that disrupts or
threatens to disrupt normal operations– A planned event in the hospital or
community– Notification may come from
• Law Enforcement • Radio or Television• Weather forecast• Public • Emergency Management
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m Incident Notification• Notification
– Communication to relevant personnel of important information regarding an actual or potential hazard impact and the response status of the organization
• Categories– Advisory: Potential need for a response– Alert: Elevated preparedness required as
response is likely or imminent
– Activation: Response action is required
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m Incident Notification
Critical information to obtain– Type of incident, including specific
hazard/agent– Location of incident– Numbers and types of injuries– Special actions being taken (e.g.,
decontamination)– Estimated time of arrival of first EMS
units/Walk-ins– Walk in patients may be your first
notification
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m Incident Notification
• Response– Measures to protect safety– Timely notification of incident
management personnel via multiple communication systems
– For incidents recognized by hospital, notification of appropriate external agencies, such as• Law Enforcement• Fire/EMS
– Requires planning and staff training on procedures, to include after-hours contact information for key personnel
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m Situation Analysis and Monitoring
• Sources of external situation information– EMS: incident reports by radio or
telephone, personnel– Patients– Law Enforcement– Health and Medical Services (ESF 8) in
local Emergency Operations Center (EOC)
– On-scene Incident Command Post– Local and national media
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m Situation Analysis and Monitoring
• Sources of internal situation information– Periodic updates from incident
management team members, as scheduled or as situation warrants
– Tours of affected areas within facility– Real-time or recorded surveillance of
critical areas
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m Simple Incidents
• Occur frequently• Routinely handled• Require few resources• Have “limited” command structure• Relatively short duration
Simple Incidents
Normal Influenza season
Busy, but manageable patient load
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m Complex Incidents
• May start as complex or become complex
• Prolonged duration• Requires large number of resources• High risk to staff/facility• More complex management
structure• Necessitates formal planningComplex Incidents
Natural disaster - Tornado
Mass-casualty
Terrorism
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m Incident Action Plan (IAP)
• Every incident should have an IAP– May be spoken or written– Should cover one (1) operational period
– Time of incident until relived of command (approx 2 hours)
• Incident complexity dictates the detail of the IAP– Spoken IAP is usually sufficient in simple
incidents– Complex incidents should have a written
IAP
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m Establishing an IAP
• Management of an incident begins with a basic oral IAP quickly put in place
• At a minimum covers:– The objectives to be achieved– What it is we want/need to accomplish
• The strategies/tactics to be used to achieve the objectives safely– How can we accomplish the objectives?
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HICS 202 – INCIDENT OBJECTIVES
1. INCIDENT NAME 2. DATE PREPARED 3. TIME PREPARED
4. OPERATIONAL PERIOD DATE/TIME
5. GENERAL COMMAND AND CONTROL OBJECTIVES FOR THE INCIDENT (INCLUDING ALTERNATIVES) ____________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________
6. NOTES (including accomplishments, warnings/directives) ____________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________
7. GENERAL SAFETY / STAFF MESSAGES TO BE GIVEN (Examples: Personal Protective Equipment (PPE), Precautions, Case Definitions (refer to HICS 261 Incident Action Plan Safety Analysis)
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
8. ATTACHMENTS (mark if attached)
Organization Assignment List - HICS 203 Medical Plan - HICS 206 Traffic Plan
Branch Assignment List - HICS 204 Facility System Status Report – HICS 251 Incident Map
Incident Communications Plan - HICS 205 Incident Action Plan Safety Analysis –HICS 261 Other__________________ 9. PREPARED BY (PLANNING SECTION CHIEF): 10. APPROVED BY (INCIDENT COMMANDER):
11. FACILITY NAME
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m Response Measures
• Gather as much information as possible– What impact could this event have– Prepare for worse case scenario
• Establish Incident Action Plan (IAP)• Contact AOC and, if needed local
authorities• Maintain overall responsibility for
managing the incident• No patient care
– Don’t get tunnel vision
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m Response Measures
• You will feel like there are 100 things to do– Actually there are closer to 1,000
• Prioritize the top 10 and complete them first– Keep a list and check off what has been done– Constantly reassess priorities
• Keep a timeline of events, document everything
• Manage by objectives
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m Response Measures
• Utilize the HICS Command Box in the boardroom– Preprinted forms, check sheets, clipboards, etc
• Wear the Incident Commander Vest– Other agencies (Fire/Police) will need to be
able to identify you at a glance
• If needed, Use two-way radios to communicate with staff– Keep communications short and to the point– No use of 10 codes
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m Response Measures
• Think ahead by asking yourself “What if”– What if another incident happens
• Make decisions with authority– Resist the temptation to let everyone “do
their own thing” or “they know what to do”
• Improvise• Use common sense• Keep patients & staff safe• Document, Document, Document
– You cannot over document an incident
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m Response Measures
• Use HICS-ICS forms to document event– 202 Incident Objectives– 203 Organizational Assignments– 206 Staff Medical Plan– 209 Incident Status Summary– 213 General Message– 215a Incident Action Plan Safety Analysis– 251 Facility System Status Report – 254 Disaster Victim Patient Tracking– 260 Patient Evacuation Tracking
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m Transfer of Command
• Moves the responsibility for incident command from one Incident Commander to another
• Must include a transfer of command briefing– Oral– Written– Both oral and written
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m FEMA On-Line Training
• http://training.fema.gov/IS/crslist.asp
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m Scenario
• At 3:00am a sprinkler head is accidentally knocked off by housekeeping in room 125 Soiled Utility
• Objectives– Stop the flow of water– Protect patients, staff, facility– Ensure safe patient care and medical
management– Evacuate the facility (partial or complete)
if needed
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m Scenario
• At 8:00pm a small fire is discovered in a trash can in UCC waiting
• Objectives– Implement RACE– Rescue and protect patients and staff– Implement partial evacuation– Communicate situation with staff and
patients
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m Scenario
• 10:00pm on a Friday night, a school bus full of high school band members (32) is rear-ended by a gravel truck at the intersection of Precinct Line and Mid Cities
• 28 of the band members present at the ER door. All have lacerations/bruising, some have broken arms/fingers.
• EMS and Fire are on-scene and the Fire Captain comes to the ER
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m Unified Command
• The hospital incident commander and Fire department incident commander work together to create and Incident Action Plan– EMS/UCC staff triage patients– Care for those that we have the resources
and staff – Stabilize those who need a higher level of
care– EMS Transport to a higher level of care– Notify school and parents – Prepare for an influx of parents and media
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m Did We Meet Our Objectives?
• Develop a basic understanding of the Incident Command System
• Be able to write an Incident Action Plan• Be able to describe the Incident
Notification Process• Be able to distinguish between internal
and external Situation Analysis and Monitoring
• Establish Immediate Response Measures
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Questions?