Transcript Document

H E I C S-
Hospital
Emergency
Incident
Command
System
Presented by:
Jersey City Medical Center
Emergency Medical Services
H E I C S- Establishing the Need
“As part of America's vital
health care infrastructure,
hospitals play a key role in
disaster readiness throughout
our country.”
Source: American Hospital Association Website
H E I C S- Establishing the Need
A New York hospital
responded to the
first outbreak of
West Nile Virus back
in 1999.
There was the
potential for a large
number of actual
patients, and many
people who had
“perceived”
symptoms.
H E I C S- Establishing the Need
The components of a
hospital network’s
emergency
preparedness plan were
put in place when the
first of a series of
devastating hurricanes
threatened the coast of
North Carolina in 1996.
H E I C S- Establishing the Need
A Virginia hospital treated
victims from the Pentagon on
September 11 and postal
workers that contracted
Anthrax in October 2001.
H E I C S- Current State of Preparedness
A recent study concluded that of the 30
hospitals in FEMA Region III (WV, PA, MD,
VA and DC)…
 0% able to handle a biologic event
 17% able to handle a chemical event
 17% able to handle a radiologic event
Source: Treat, K. , et al. (2001) . Hospital Preparedness for weapons of
mass destruction incidents (Annals of Emergency Medicine)
H E I C S- Current State of Preparedness
The same report also concluded that…
 73% had only ONE room for decontamination
 27% incorporated WMD preparedness into
their disaster plans
 50% had the ability to “lock down” the hospital
 96% had no awareness of the threat to hospital
as primary terrorist targets
H E I C S- A Local Perspective
Some factors to take into account in disaster planning:
Hudson County, with a
population of 610,000
residents is the most
densely populated of
New Jersey’s 21
counties
Brennan Court House- A Hudson County Landmark
Jersey City, alone,
has a surge
population of over 1
million people during
the day
H E I C S- A Local Perspective
The County serves as one of
the major transportation hubs
in the U.S.A., with direct
access to New York City via
the Lincoln and Holland
Tunnels, PATH and passenger
ferries.
The NJ Turnpike,
Interstates 78, 95 and 280,
routes 1&9 and the HudsonBergen Light Rail system all
run through the County
H E I C S- A Local Perspective
Hudson County is
home to 4 colleges
and seven parks,
including Liberty
State Park and the
Ellis Island National
Historic Landmark.
H E I C S- A Local Perspective
For all of it’s many
public attractions ,
landmarks and density
of population, Hudson
County has only 7
hospitals (only ONE of
which is a trauma
center) to deal with any
potential disasters.
Clearly there is a demonstrated need for a comprehensive
hospital disaster plan for the Liberty Health System
H E I C S- Current State of Preparedness
Our Disaster Recovery Plan
goes something like this…
H E I C S- Establishing the Need
Common problem areas
identified in hospital
disaster response
include:
 Communication break down
 Power failures
 Water supply depletion
 Water supply contamination
 Physical/structural damage
 HAZMAT exposure
 Unorganized evacuations
 Resource allocation
H E I C S- Current State of Preparedness
• Must improve
state of readiness
• All initial
response is
local!!
• Training and
equipment
lacking
H E I C S- Current State of Preparedness
• Lack training &
equipment
• Few hospitals are truly
OSHA hazmat
prepared
• Not well integrated
into city and county
disaster planning
• Not typically included
in the “funding loop”
H E I C S- What is HEICS?
Hospital Emergency
Incident Command
(HEICS) is a TOOL to help
hospitals manage an
emergency incident more
effectively and efficiently.
Always use the correct size tool for the job!
H E I C S- What is HEICS?
H E I C S- What is HEICS?
The benefits of using HEICS is
that the system includes…
»Logical Management Structure
»Defined Responsibilities
»Clear Reporting Channels
»Common nomenclature to help
unify hospitals with other
responders
H E I C S- What is HEICS?
COSTS
C
H
O
I
C
E
S
ISSUES
TIME
H E I C S- Tell me again WHY we need HEICS…
Because the Regulatory
Agencies are here to “help” us.
•OSHA
•EPA SARA Title III
•JCAHCO
•NFPA
•STATE Health Regulations
•Local Health Department
H E I C S- Tell me again WHY we need HEICS…
 Hospitals must develop written plans and
exercise them twice a year
 Plans must cover every employee and every
department in the institution
 Hospitals must coordinate with Local
Emergency Planning Committees (LEPC’s)
H E I C S- What is HEICS?

Based on ICS
–Developed and used by fire service in 70s
–Used for large and small scale operations

Hospital Council of Northern California
–Adaptation of ICS to hospital emergency
response functions completed in 1987
»Earthquake Preparedness Guidelines for Hospitals
served as cornerstone to HEICS implementation

California EMSA Grants Provided
–1991, 1992, 1998 (Third Edition)
H E I C S- What is HEICS?

Based on
– Organizational Chart
»Four Branches (Operations, Planning, Logistics,
Finance) overseen by an Incident Commander
Clearly
Defines a Chain of Command
– Clear Job Action Sheets
»Designed to direct the assigned individual in
disaster recovery tasks
»Job descriptions with list of emergency response
tasks
–
depending on size and
nature of event and staff resources available
H E I C S- What is HEICS?
The end goal of
HEICS is to provide
comprehensive
emergency
management in four
areas
Preparedness
Response
Mitigation
Recovery
H E I C S- The Basic Structure
INCIDENT
COMMANDER
LIAISON
OFFICER
SAFETY/SECURITY
OFFICER
Medical Staff Director
INFORMATION
OFFICER
RECORDERS
LOGISTICS
SECTION
PLANNING
SECTION
FINANCE
SECTION
OPERATIONS
SECTION
H E I C S- The Basic Structure
The organizational
chart structure
helps to promote
meaningful
communication
among those
managing an
incident.
H E I C S- The Five Main Functions
 Incident Command
 Finance
 Operations
 Logistics
 Planning
Operations
Chief
Note the
Incident Commander
Logistics
Chief
Finance
Chief
Planning
Chief
H E I C S- The Command Staff
Function:
To define and
plan the
mission and
ensure its
completion
LOGISTICS
CHIEF
INCIDENT
COMMANDER
LIAISON
OFFICER
SAFETY/SECURITY
OFFICER
RECORDER
INFORMATION
OFFICER
Medical Staff Director
PLANNING
CHIEF
FINANCE
CHIEF
OPERATIONS
CHIEF
H E I C S- The Logistics Section
Function:
To provide an
environment
and materials
for the overall
medical
objective or
incident needs
LOGISTICS
CHIEF
LOGISTICS
RECORDER
FACILITY
UNIT LEADER
DAMAGE ASSESSMENT
& CONTROL OFFICER
SANITATION SYSTEMS
OFFICER
COMMUNICATIONS
UNIT LEADER
TRANSPORTATION
UNIT LEADER
MATERIALS SUPPLY
UNIT LEADER
NUTRITIONAL SUPPLY
UNIT LEADER
H E I C S- The Planning Section
Function:
To develop the action
plan so as to
accomplish the
medical objectives;
collects and evaluates
information; maintains
the status of
resources
PLANNING
CHIEF
SITUATION - STATUS
UNIT LEADER
LABOR POOL
UNIT LEADER
MEDICAL STAFF
UNIT LEADER
NURSING
UNIT LEADER
PATIENT TRACKING
OFFICER
PATIENT INFORMATION
OFFICER
H E I C S- The Finance Section
Function:
Provide funding for
present objectives,
and stress facilitywide documentation
for later financial
recovery
FINANCE
CHIEF
TIME
UNIT LEADER
PROCUREMENT
UNIT LEADER
CLAIMS
UNIT LEADER
COST
UNIT LEADER
H E I C S- The Operations Section
OPERATIONS
CHIEF
MEDICAL CARE
DIRECTOR
IN-PATIENT AREAS
SUPERVISOR
ANCILLARY SERVICES
DIRECTOR
TREATMENT AREAS
SUPERVISOR
SURGICAL SERVICES
UNIT LEADER
TRIAGE
UNIT LEADER
MATERNAL - CHILD
UNIT LEADER
IMMEDIATE TREATMENT
UNIT LEADER
CRITICAL CARE
UNIT LEADER
DELAYED TREATMENT
UNIT LEADER
GENERAL NURSING CARE
UNIT LEADER
MINOR TREATMENT
UNIT LEADER
OUT PATIENT SERVICES
UNIT LEADER
DISCHARGE
UNIT LEADER
MORGUE
UNIT LEADER
HUMAN SERVICES
DIRECTOR
LABORATORY
UNIT LEADER
STAFF SUPPORT
UNIT LEADER
RADIOLOGY
UNIT LEADER
PSYCHOLOGICAL SUPPORT
UNIT LEADER
PHARMACY
UNIT LEADER
DEPENDENT CARE
UNIT LEADER
CARDIOPULMONARY
UNIT LEADER
H E I C S- The Operations Section
Function:
Conducts
Medical
Operations to
carry out
action plan.
Directs
allSTAFF
MEDICAL
DIRECTOR
direct patient
care
resources.
close up
OPERATIONS
CHIEF
MEDICAL CARE
DIRECTOR
ANCILLARY SERVICES
DIRECTOR
HUMAN SERVICES
DIRECTOR
H E I C S- The Operations Section
In-Patient
Medical
Branch
close up
OPERATIONS
CHIEF
MEDICAL STAFF
DIRECTOR
MEDICAL CARE
DIRECTOR
IN-PATIENT AREAS
SUPERVISOR
SURGICAL SERVICES
UNIT LEADER
MATERNAL - CHILD
UNIT LEADER
CRITICAL CARE
UNIT LEADER
GENERAL NURSING CARE
UNIT LEADER
OUT PATIENT SERVICES
UNIT LEADER
TREATMENT AREAS
SUPERVISOR
H E I C S- The Operations Section
close up
OPERATIONS
CHIEF
MEDICAL STAFF
DIRECTOR
MEDICAL CARE
DIRECTOR
IN-PATIENT AREAS
SUPERVISOR
TREATMENT AREAS
SUPERVISOR
TRIAGE
UNIT LEADER
IMMEDIATE TREATMENT
UNIT LEADER
Out-Patient
Medical
Branch
DELAYED TREATMENT
UNIT LEADER
MINOR TREATMENT
UNIT LEADER
DISCHARGE
UNIT LEADER
MORGUE
UNIT LEADER
H E I C S- The Operations Section
Human
Services
Branch
close up
HUMAN SERVICES
DIRECTOR
STAFF SUPPORT
UNIT LEADER
PSYCHOLOGICAL SUPPORT
UNIT LEADER
DEPENDENT CARE
UNIT LEADER
H E I C S- The Operations Section
Ancillary
Services
Branch
close up
MEDICAL CARE
DIRECTOR
ANCILLARY SERVICED
DIRECTOR
LABORATORY
UNIT LEADER
RADIOLOGY
UNIT LEADER
PHARMACY
UNIT LEADER
CARDIOPULMONARY
UNIT LEADER
H E I C S- The BIG Picture
Incident Commander
Public Information
Officer
Liaison
Officer
Medical Staff Director
Safety/Security
Officer
Recorder
Finance
Chief
Operations
Chief
Logistics
Chief
Time
Unit Leader
Facility
Unit Leader
Procurement
Unit Leader
Communications
Unit Leader
Claims
Unit Leader
Transporatation
Unit Leader
Cost
Unit Leader
Material Supply
Unit Leader
Nutritional Supply
Unit Leader
Medical Care
Director
Inpatient Areas
Supervisor
Ancillary Services
Director
Treatment Areas
Supervisor
Surgical Services
Unit Leader
Triage
Unit Leader
Maternal-Child
Unit Leader
Immediate Treatment
Unit Leader
Critical Care
Unit Leader
Delayed Treatment
Unit Leader
General Nursing
Unit Leader
Minor Treatment
Unit Leader
Outpatient Services
Unit Leader
Discharge
Unit Leader
Morgue
Unit Leader
Planning
Chief
Human Services
Director
Laboratory
Unit Leader
Staff Support
Unit Leader
Radiology
Unit Leader
Psychological Support
Unit Leader
Pharmacy
Unit Leader
Dependant Care
Unit Leader
Cardiopulmonary
Unit Leader
Situation-Status
Unit Leader
Labor Pool
Unit Leader
Medical Staff
Unit Leader
Nursing
Unit Leader
Patient Tracking
Officer
Patient Information
Officer
H E I C S- Job Action Sheets (JAS)
 One JAS for Each Position
 Mission (Function) Statement
with Focused Objective
 Prioritized Activity List
 To Be Customized to the
Organization (Except Title and
Mission Statement)
H E I C S- Job Action Sheets (JAS)
LOGISTICS SECTION CHIEF
Positioned Assigned To:
You Report To:
(Emergency Incident Commander)
Logistics Command Center:
Telephone:
Mission:
Organize and direct those operations associated with maintenance of the physical
environment, and adequate levels of food, shelter and supplies to support the medical
objectives.
Immediate
____ Receive appointment from the Emergency Incident Commander. Obtain packet
containing Section's Job Action Sheets, identification vests and forms.
____ Read this entire Job Action Sheet and review organizational chart on back.
____ Put on position identification vest.
____ Obtain briefing from Emergency Incident Commander.
____ Appoint Logistics Section Unit Leaders: Facilities Unit Leader, Communications
Unit Leader, Transportation Unit Leader, Material's Supply Unit Leader,
Nutritional Supply Unit Leader; distribute Job Action Sheets and vests. (May be
pre-established.)
____ Brief unit leaders on current situation; outline action plan and designate time for
next briefing.
____ Establish Logistics Section Center in proximity to E.O.C..
____ Attend damage assessment meeting with Emergency Incident Commander,
Facility Unit Leader and Damage Assessment and Control Officer.
____ Obtain information and updates regularly from unit leaders and officers; maintain
current status of all areas; pass status info to Situation-Status Unit Leader.
____ Communicate frequently with Emergency Incident Commander.
____ Obtain needed supplies with assistance of the Finance Section Chief,
Communications Unit Leader and Liaison Unit Leader.
____ Assure that all communications are copied to the Communications Unit Leader.
____ Document actions and decisions on a continual basis.
____ Observe all staff, volunteers and patients for signs of stress and inappropriate
behavior. Report concerns to Psychological Support Unit Leader. Provide for
staff rest periods and relief.
____ Other concerns:
Intermediate
Extended
Job
Action
Sheets
H E I C S- Supporting Forms
Forms Help
Drive Positions
 Aid in
Documentation

Activity Log
Action Plan
Personnel
time sheet
H E I C S- Position Vests
 Valuable for
Identification
 Valuable for
Organization
H E I C S- Emergency Ops Center (EOC)
The Emergency
Operations Center
(EOC) serves as the
“nerve center” of all
HEICS activities
H E I C S- Emergency Ops Center (EOC)
There are many factors to consider in setting up an EOC
Location
 Supplies
 Operating Protocols
 Communications

H E I C S- Emergency Ops Center (EOC)
Emergency Operations
Centers (EOC) should be
highly specialized
facilities primarily
designed to capture,
distribute, and assess
emergency information
to facilitate rapid and
accurate decisionmaking.
H E I C S- Implementation
Implementing HEICS means
taking the time to do it right!
 Administrative “buy-in”/support
 Staff education
 Adequate resources and funding
H E I C S- Questions?