Command and Control in Evacuations

Command and Control in EvacuationsOSHA Training Institute Region IXUniversity of California, San Diego (UCSD) - Extension

OSHA Training Institute

Purpose:

To ensure you learn effective training and presentation techniques well enough to become an effective outreach trainer of command and control during health care facility evacuations


ObjectivesState how the National Incident Management System influences large scale evacuationsDiscuss the development of Standard Emergency Management System and how it works in disaster managementIdentify how the Hospital Incident Command System (HICS) or Incident Command System (ICS) are used in evacuationsIdentify three purposes of HICS or ICS


National Response PlanAt the federal level, the National Response Plan (NRP) provides a framework for how the federal government is to assist states and localities in managing domestic incidents, including both incidents of national significance and those of lesser severity.

GAO Report; GAO-06-826, Congressional Quarterly, Inc. July 20, 2006


National Incident Management System (NIMS)a consistent nationwide approach for federal, state, tribal, and local governments to work effectively and efficiently together to prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size, or complexity. -HSPD-5


NIMS - Synopsis NIMS What it isCore set of:DoctrineConceptsPrinciplesTerminologyOrganizational processesApplicable to all hazards NIMS What it is notNot an operational or resource allocation planNot a terrorism or WMD-specific planNot designed for international eventsFEMA. NIMS. SEMS Advisory Committee Meeting, Mather, CA March 2005


NIMSOverall conceptual framework for incident management applicable to all hazardsFEMA. NIMS. SEMS Advisory Committee Meeting, Mather, CA March 2005


NIMS ComponentsCommand and ManagementPreparednessResource ManagementCommunications and Information ManagementSupporting TechnologiesOngoing Management and MaintenanceFEMA. NIMS. SEMS Advisory Committee Meeting, Mather, CA March 2005


Relationship: NIMS and NRPNational Incident Management System(NIMS)LocalResponseStateResponse or SupportFederalResponse or Support.National Response Plan (NRP) provides support at the Federal level and is activated for events of national significance.Incident Used for all events

FEMA. NIMS. SEMS Advisory Committee Meeting, Mather, CA March 2005


SEMSStandardized Emergency Management System (SEMS) Developed in CaliforniaLocal entities must use SEMS in order to be eligible for State funding for response related personnel costs in California


The History of ICSDeveloped in the 1970s following devastating California fires. Resulted in deaths, injuries and huge property losses. Resources and tactical ability were availableInadequate management resulted in:Lack of accountabilityPoor communication Lack of a planning processOverloaded Incident CommandersNo method to integrate interagency requirements


SEMS was Developed to Improve:Coordination between/among agenciesThe flow of information and resourcesThe rapid mobilization, resource tracking and deployment


SEMS FrameworkSEMS includes the:Incident Command System (ICS)Multi-agency or inter-agency coordinationMaster Mutual Aid Agreement (MMAA) and systemThe operational area concept


Legal Basis for SEMS in CaliforniaGovernment Code Section 8607 became effective 1993The intent of the code is to improve coordination of State and local emergency response in California


What Is ICS and HICS?The Incident Command System (ICS):Is a flexible standardized, on-scene, all-hazard incident management concept that can be expanded to handle the demands and potential complexities of single or multiple incidentsICS in healthcare is called Hospital Incident Command System (HICS) and is based on the 2006 version of the Hospital Emergency Incident Command System (HEICS)


Hospital Incident Command System Organizational core of a crisis management systemBuilt on the principles and structure of ICS It is the same crisis management system used by other response agencies Offers a universal link with outside resourcesHICS


How HICS WorksChain of commandCommon languageFlexibility Job action sheetsMutual aid Documentation for financial recovery


Why Use the Incident Command System in the Hospital?

Efficiency

Coordination

Communication


ICS PurposesICS helps to ensure:Achievement of tactical objectivesEfficient use of resourcesSafety of responders and othersHospital Exercise using HICS


ICS FeaturesCommon terminologyOrganizational resourcesManageable span of controlOrganizational facilitiesUse of position titlesReliance on an Incident Action PlanIntegrated communicationsAccountabilitySlide Credit: FEMA IS100-HC


Structure of ICS and HICSFlexible Built on successful business practiceBuilt on decades of lessons learned from the management and organization needed in emergency incidents


ICS StructureSafetyOfficerLiaisonOfficerInformationOfficerFinanceLogisticsOperationsPlansIncident Commander


Chain of CommandChain of command is an orderly line of authority within the ranks of the incident management organization. AuthorityThere is only one person in charge until replaced by the next qualified person


The Span of Control under ICSThe span of control refers to the supervisory structure of the organization and the number of individuals or resources one incident supervisor can manage effectivelyThe optimal reporting element is 5 elements per supervisor but may vary from 3 - 7

SupervisorResource 1Resource 2Resource 3Resource 4Resource 5


Incident Operations OrganizationSmall IncidentLarge IncidentMultiple layers as needed for span of control


Management by ObjectivesICS is managed by objectivesObjectives are communicated throughout the entire ICS organization through the incident planning process


Reliance on an Incident Action PlanEvery incident should have an Incident Action Plan (IAP) that:

Specifies the incident objectives.Lists the actions based on objectivesMeasurable strategic operations to support the objectives and be achieved within operational period


Elements of an Incident Action PlanEvery IAP must have four elements:What do we want to do? Who is responsible for doing it? How do we communicate with each other? What is the procedure if someone is injured?

Slide credit - FEMA IS 100 HC


Incident CommanderOnly the positions needed are filled to manage the incident. The expansion of incidents may require the delegation of authority to Operations, Planning, Logistics and Finance/Admin sections. IncidentCommanderPublic InformationOfficerLiaisonOfficerSafetyOfficerCommand StaffOperationsSection ChiefPlanningSection ChiefLogisticsSection ChiefFinance/AdminSection ChiefGeneral Staff


Incident CommanderThe Incident CommanderProvides overall leadership for incident response.Established Command PostBased on the requirements and complexity of the incidentDelegates authority to othersTakes general direction from agency administrator/officialAssesses need for staff


Incident CommanderEstablishes incident objectivesDirects staff to develop the Incident Action Plan (IAP)Is assisted by the Command Staff


Public Information OfficerMember of the Command StaffConduit between internal and external stakeholders, including media interactionsPublic Information Systems are required by National Incident Management System (NIMS)


Safety OfficerMember of the Command staff Monitors safety conditions Develops measures for assuring the safety of all assigned personnel


Liaison OfficerCommand StaffPrimary contact for supporting agencies and organizations that are assisting at an incident, but are NOT participating within the ICS


HICS Functional AreasOperations section Planning sectionLogistics sectionFinance / Administration section


Operations Section ChiefConducts, develops, directs all tactical objectives, operations and resourcesIn HICS, the word tactical refers to the business of managing patient care and is not a reference to security


Operations Section in HICSCarries out the medical objectives to the best of the staffs abilityThe Medical Care Branch covers Clinical CareAncillary ServicesPatient Registration


Planning Section Chief

Manages the planning process by gathering, analyzing and disseminating information and intelligence.Compiles the information that is included in the Incident Action Plan


Planning SectionThe Planning section also maintains status and situational reports, and patient tracking under the HICS structure


Logistics Section ChiefDirects the resources and services required to support incident activitiesMay include ensuring personnel have a place to rest, are fed, have medical support, communications and transportation


Logistics SectionThe Labor Pool is managed under the Logistics Section in HICS. This is a change from the previous structure in which the labor pool was the responsibility of the Planning Section.

Staging Area/Labor Pool is the location where personnel and equipment are staged while waiting for tactical assignment


Finance/Administration Section ChiefManages costs related to incidentPerforms accounting, procurement, time payroll recording and cost analysisFunds medical objectives under HICSDocuments costs to maximize financial recovery and reduce liability


Accountability Principles in ICSCheck-In All responders must report in and assignments are given in accordance with the procedures established by the Incident CommanderIncident Action Plan Response operations must be coordinated as outlined in the Incident Action PlanUnity of Command Principle that each individual will be assigned to only one supervisorFEMA IS - 100-HC


Check-In PurposeAccounts for personnel.Tracks resourcesPrepares personnel for assignmentsLocates personnel in case of an emergency Organizes the demobilization process


SummaryNIMS is an overall conceptual framework for incident management applicable to all hazardsNRP provides a federal framework to assist states and localities during disastersICS is flexible, can handle large or small eventsHICS is ICS in a healthcare setting and will be used in evacuations


ReferencesFEMA. National Incident Management System. SEMS Advisory Committee Meeting, Mather, CA March 24, 2005. Slide SetFEMA National Incident Management System (NIMS), An Introduction IS 700. http://training.fema/govHomeland Security. Quick Reference Guide for the National Response Plan May 22, 2006, Version 4.0


TRAINER SAYS: The primary purpose for this training session is to make sure that you as a participant in this train the trainer class learn effective training and presentation techniques well enough to become an effective outreach trainer. The objective is to show you some simple yet powerful presentation and training techniques. By the end of the session you should be able to

NRPNRP an operational plan spelling out how efforts and resources of participants are integrated into a cohesive response operation.Forms the basis of how the federal government interfaces with state, local, tribal governments and the private sector. Includes planning assumptions, roles and responsibilities, concept of operations and preparedness guidelines.Details missions, policies, structures, responsibilities of federal agencies responding to Incidents of National Significance.Outlines functions of each Emergency Response Function coordinators, primary agencies and support agencies.

Builds on what works from previous plans and incident responseIntegrates emergency response and law enforcement elements into a single national strategyForges new approaches and mechanisms to address todays threatsAddresses the complete spectrum of incident management activities (unlike FRP)Uses NIMS to establish a framework for coordination among federal, state, local, tribal, non-governmental, and private-sector organizations

This is the basis for the NIMS program. Currently used in Californiaincludes ICS priciplesdkdkdkdkd vc fffDiscuss the difference between the command staff and the general staff (Functional Areas)

Command and Control in Evacuations

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