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Hospital Incident Command System

Incident Action Planning

This material has been developed for training purposes; do not share, distribute, transmit or reproduce without prior written consent of California Hospital Association This course was developed by the CHA Hospital Preparedness Program with grant funds provided by the U.S. Department of Health & Human Services Assistant Secretary for Preparedness & Response Hospital Preparedness Program and awarded by the California Department of Public Health. No part of this course or its materials shall be copied or utilized for monetary gain.

Updated with May 2014 HICS Revisions

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Objectives

• Understand the 9 steps of the Incident Action Planning process

• Identify Incident Action Plan components

• Exercise the development of an Incident Action Plan

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Hospital Incident Management Team Review

Operations Section Chief

Planning Section Chief

Logistics Section Chief

Finance / Administration Section Chief

Incident Commander

PublicInformation

Officer

LiaisonOfficer

Medical/Technical

Specialist(s)

SafetyOfficer

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Hospital Incident Action Planning

Key to Effective

Response and Recovery

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1. Assess the Situation

2. Set the Operational Period

3. Determine Safety Priorities and Establish Incident Objectives

4. Determine Branch/Section Objectives

5. Determine Strategies and Tactics

6. Determine Needed Resources

7. Issue Assignments

8. Implement Actions

9. Reassess & Adjust Plans

Incident Action Planning

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• Type, location, magnitude, possible duration• On-going hazards and safety concerns• Determine initial priorities based on:

1 - Life saving 2 - Incident stabilization 3 - Property preservation

• Establishes the Hospital Command Center• Sets the initial “Operational Period”

The Incident Commander conducts the initial incident assessment:

#1 Assess the Situation

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An Operational Period is: • The time period scheduled for execution of

tactical actions in the Incident Action Plan

• Set by the Incident Commander

The Operational Period is usually set in hours

• Does not have to conform to shift times

• Can be long or short, depending on the intensity of the incident

#2 Set the Operational Period

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“Incident Objectives”• Broad organizational objectives that are

foundational and do not change during response and recovery; not limited to an operational period

Examples:• Provide adequate care to all patients who

present as a result of the incident

• Provide for the safety of hospital personnel

#3 Determine Safety Priorities and Establish Incident Objectives

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Individual Section/Branch Objectives• More specific Branch/Section objectives to

achieve overall Incident Objectives

• Steps during the defined Operational Period

• Should be tangible and measurable

Example:

• Provide prophylaxis to 75% of direct patient care staff within 2 hours

• Decontaminate 50 victims within 1 hour

#4 Determine Individual Section/Branch Objectives

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#5 Determine Strategies and Tactics

Strategy defined:• The general direction selected to accomplish

incident objectives

• The approach to achieving the objectives

Tactics defined:• Specific actions, sequence of actions,

procedures, tasks, assignments to meet strategies and objectives

• The “boots on the ground” or “doers”

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• Tactical resources may include:

Personnel Equipment Supplies Pharmaceuticals Vehicles

• Available and needed resources to meet the objectives must be identified

#6 Determine Needed Resources

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• Hospital Command Center positions are activated according to incident needs

• Staff are assigned to conduct incident specific operations:

Evacuation Decontamination Triage and treatment Safety measures

Once the objectives and needed resources are identified, assignments are issued:

#7 Issue Assignments

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The Planning Meeting

The Planning Meeting is:

• Led by the Planning Chief

• Defines and finalizes operational period objectives, strategies, tactics, and resources as determined by each section for the next operational period

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The Planning Meeting is conducted after:

Incident Commander has provided an incident briefing and determined the Incident Objectives and identified the Operational Period

Sections have met to discuss their response priorities and identified Section/Branch objectives

The Planning Meeting

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The Planning Meeting is:

Based on a fixed agenda and includes a report out of section-specific objectives for the Operational Period, resources assigned, resource needs

Attended by Incident Commander, Command and General Staff

The Planning Meeting

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At the end of the Planning Meeting: The Section Chiefs submit completed

HICS Form 204 Assignment List

The Safety Officer submits completed HICS Form 215A Incident Action Plan Safety Analysis

The Planning Meeting

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Direct, monitor and evaluate response:• Constant monitoring of strategies and tactics

for effectiveness

• Assess the Branch/Section Objectives

Are the objectives being achieved?

Is the strategy/tactics safe?

Is the strategy/tactics effective?

Evaluation is an ongoing process throughout response and recovery

#8 Implement Actions

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#9 Evaluate and Revise Plans

Conduct a current situation assessment Update situation/incident information

Assess the impact on the hospital

Length and duration of incident

Resource availability

• Assess the Incident Objectives

• Assure objectives are achieved in a safe and timely manner

• Revise objectives, strategies, tactics and resource needs for the upcoming operational period

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Incident Action Plan Responsibilities

The Incident Commander

• Provides overall Incident Objectives (HICS 202)

• Sets the Operational Period

• Develops major strategies (priorities)

• Activates Hospital Incident Management Team

• Establishes policy for resource orders

• Approves initial actions and the completed Incident Action Plan

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The Safety Officer

• Advises the Incident Commander and Section Chiefs on safety issues and measures

• Develops the Safety Plan (HICS 215A)

• Oversees the safety of operations and tactics

Incident Action Plan Responsibilities

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The Operations Section Chief

• Determines/assesses areas of operation

• Advises Incident Commander of activated Operations positions and work assignments

• Determines tactics (HICS 204)

• Determines resource requirements (HICS 204) and communicates needs with Logistics

Incident Action Plan Responsibilities

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The Planning Section Chief• Prepares for the Planning Meetings

Gathers information for the Incident Action Plan (HICS 201, 202, 203, 204s and 215A)

Develops demobilization plans

• Conducts the Planning Meeting

• Coordinates and submits the Incident Action Plan to the Incident Commander for approval

• Disseminates the Incident Action Plan

Incident Action Plan Responsibilities

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The Logistics Section Chief

• Determine tactics and resource requirements (204)

• Ensures resource ordering meets the needs

• Advises activated Logistics positions

• Ensures resources to support Incident Action Plan

• Develops plans that support the Incident Action Plan Communications Plans

Transportation Plans

Incident Action Plan Responsibilities

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The Finance/Administration Section Chief

• Determine tactics and resource requirements (204)

• Provides cost implications of the Incident Objectives

• Ensures the Incident Action Plan is within cost limitations

• Advises the Incident Commander on Finance/Admin activated positions

Incident Action Plan Responsibilities

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The Incident Action Plan

• Provides Hospital Incident Management Team with direction for the Operational Period

• Uses the elements of Management by Objectives

• Developed by Command, General Staff provide input

• Essential for effective response and recovery

Incident Action Plan Responsibilities

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Questions?

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Incident Planning Guides

• Active Shooter 

• Chemical Incident

• Earthquake 

• Evacuation, Shelter-in-Place, & Hospital Abandonment

• Explosive Incident

• Hostage or Barricade Incident

• Infectious Disease 

There are 16 Scenario-based Incident Response Guides :

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Incident Planning Guides (continued)

• Information Technology (IT) Failure 

• Mass Casualty Incident

• Missing Person 

• Radiation Incident 

• Severe Weather with Warning

• Staff Shortage 

• Tornado 

• Utility Failure 

• Wildland Fire 

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Provides Incident-specific:• Directions

• Incident Objectives

• Management tasks by function and timeframes

• Sample Hospital Incident Management Teams

Should compliment:

• Emergency Operations Plan and Job Action Sheets

Can be used as documentation

Incident Response Guides

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Section Review

Incident Response Guides• Are incident-specific tools to assist with

planning, training and response/recovery

• Assist in meeting regulatory requirements

• Guide Command and General Staff with decision-making and actions

• Should be consistent with the Emergency Operations Plan

• Do not replace the Job Action Sheets

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Questions?

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HICS Forms

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• Serves as a road map in response: everyone acting from the same plan

• Serves as foundation for corrective action

• Ensures consistency and compliance with regulatory guidelines

• Complies with documentation for FEMA reimbursement

The Value of Using HICS Forms

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HICS Form 200Incident Action Plan Cover Sheet

• Purpose: Provides a cover sheet and a checklist for HICS Forms and other documents included in the operational period Incident Action Plan

• Origination: Incident Commander or Planning Section Chief

• Copies to: Command and General Staff and Documentation Unit Leader

• Helpful Tips: Additions may be made to the form to meet the organization’s needs

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HICS Form 201 Incident Briefing

• Purpose: Documents initial response information & actions at start-up

• Origination: Incident Commander

• Copies to: Command Staff, Section Chiefs, and Documentation Unit Leader

• When to Complete: Prior to briefing the current operational period

• Helpful Tips: Distribute to all staff before initial briefing

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HICS Form 201Incident Briefing

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• Purpose: Defines incident objectives

• Instructions: Include -Weather/Environmental Implications General Safety/Safety MessagesAttachmentsPrepared by Planning Section Chief

Approved by: Incident Commander

HICS Form 202Incident Objectives

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HICS Form 202Incident Objectives

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• Purpose: To document Hospital Command Center staffing

• Origination: The Planning Section Chief or designee (Resources Unit Leader)

• Copies to:

Command Staff and General StaffBranch Directors and Agency StaffDocumentation Unit Leader

HICS Form 203:Organizational Assignment List

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HICS Form 203:Organization Assignment List

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• Purpose: Document branch assignments, objectives, strategies/tactics and resource needs

• Origination: Section Chief or Branch Director

• Copies to: Command, General Staff and Documentation Unit Leader

• Prepared by: Branch Director

• When to complete: At the start of each operational period

HICS Form 204: Assignment List

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HICS Form 204: Assignment List

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HICS Form 215A: Incident Action Plan Safety Plan Analysis

• Purpose: Document hazards and mitigation

• Origination: Safety Officer

• Copies to: Command and General Staff, Sections, and Branches

• Prepared by: Safety Officer

• Approved by: Incident Commander

• When to complete: Prior to safety briefing during the Operations Briefing and at transfer of role

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HICS Form 215A: Incident Action Plan Safety Plan Analysis

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Purpose: Provide standardized message recording Instructions:

• Response Required: Indicate a reply was requested and to whom reply addressed

• Priority: Indicate level of urgency

• Message:

Keep all messages/requests brief, to the point, and very specific

Transcribe complete, concise, and specific content of message

• Action Taken (if any)

HICS Form 213: Incident Message Form

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HICS Form 213: Incident Message Form

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• Purpose: Document

Incident issues encountered Decisions made Notifications conveyed

• Origination: Command and General Staff

• When to complete:

Continuously, from activation through demobilization

HICS Form 214:Activity Log

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HICS Form 214:Operational Log

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Purpose: A short form combining forms 201, 202, 203, 204 and 215A. May be used in place of full forms to document initial actions or short incidents, and can expand to the full forms as needed.

Origination: Incident Commander or Planning Section Chief

HICS Form IAP Quick Start

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HICS Form IAP Quick Start

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Section Review

The HICS Forms:• Provide the Hospital Incident Management Team

with documents needed to manage a response

• Assist in communication with external agencies

• Assist in communication with hospital staff

• Documents response and recovery

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Questions?

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This material has been developed for training purposes; do not share, distribute, transmit or reproduce without prior written consent of California Hospital Association This course was developed by the CHA Hospital Preparedness Program with grant funds provided by the U.S. Department of Health & Human Services Assistant Secretary for Preparedness & Response Hospital Preparedness Program and awarded by the California Department of Public Health. No part of this course or its materials shall be copied or utilized for monetary gain.

developed by theCalifornia Hospital Association’sHospital Preparedness Program

www.calhospitalprepare.org

Incident Action Planning

Updated with May 2014 HICS Revisions