1. 1 Hospital Incident Command System Updated with May 2014 HICS Revisions 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. HICS Basics Part 1 Management System and Tools for Events

2. 2 Objectives Learn the principal concepts and features of the Hospital Incident Command System Understand the roles and relationships of the Hospital Incident Management Team Understand the principles of Incident Action Planning

3. 3 HICS Overview Assists in emergency management planning, response, and recovery capabilities for unplanned and planned events Consistent with ICS and the National Incident Management System (NIMS) principles Logical management structure Defined responsibilities Clear reporting channels Common nomenclature

4. 4 What HICS is Not HICS is not: HICS does not replace or supplant daily hospital operations The HICS Guidebook does not replace the hospital’s Emergency Operations Plan

5. 5 HICS Features Hospital Incident Management Team Chart All hazard approach Incident Action Planning Job Action Sheet Incident Planning Guides Incident Response Guides HICS Forms Promotes Recovery

6. 6 Where do I find HICS information? www.emsa.ca.gov/disaster_medical_ser vices_division_hospital_incident_comma nd_systemwww.emsa.ca.gov/disaster_medical_ser vices_division_hospital_incident_comma nd_system www.calhospitalprepare.org www.hicscenter.org HICS Resources

7. 7 Basic Incident Command Structure Modular Organization: Functional Sections Activated as Needed Incident Commander Planning Section Chief Logistics Section Chief Operations Section Chief Finance/ Administration Section Chief Public Information Officer Liaison Officer Medical/ Technical Specialist(s) Safety Officer

8. 8 Hospital Incident Command System The system is scalable so that more or fewer positions-- depending on the emergency--may be implemented

9. 9 Command Command functions Maintain overall management of the incident Sets incident objectives and priorities Devise and approve strategies Ensure mission completion Command consists of: Incident Commander Command Staff

10. 10 Command Incident Commander Public Information Officer Liaison Officer Medical/ Technical Specialist(s) Safety Officer Chemical Clinic Administration Biological/Infectious Disease Hospital Administration Legal Affairs Medical Ethicist Medical Staff Pediatric Care Radiological Risk Management

11. 11 Incident Commander Description/Duties: Determine scope and magnitude of event and facility impact Activate and direct the Hospital Command Center Give overall strategic direction for the hospital Initiate and approve the Incident Action Plan Authorize total facility evacuation if warranted Only position always activated

12. 12 Public Information Officer Description/Duties: Communicate with internal and external stakeholders including: Staff Visitors and family Media Determine information to be released Collaborate with local community officials (Joint Information Center) for consistent content Obtains Incident Commander approval on all messages Reports to: Incident Commander

13. 13 Safety Officer Description/Duties: Ensure safety of staff, patients and visitors Monitor and have authority over the safety of rescue operations and hazardous conditions Determine safety risks Initiate corrective/protective actions Completes the HICS form 215A, Incident Action Plan Safety Analysis Has authority to halt any operation that poses immediate threat to life and health Reports to : Incident Commander

14. 14 Liaison Officer Description/Duties: Hospital Command Center contact for supporting agencies and organizations Make facility needs and requests for assistance and resources Reports to : Incident Commander

15. 15 Description/Duties: Medical/Technical Specialist Subject matter experts that advise the Incident Commander and/or assigned section. May be assigned as technical advisor in the Hospital Command Center May be assigned to advise and oversee specific hospital operations Example: Decontamination operations during a chemical exposure situation Reports to: Incident Commander

16. 16 Biological Infectious Disease Chemical Radiological Legal Affairs Risk Management Reports to : Incident Commander Examples Include: Medical/Technical Specialist Medical Staff Pediatric Care Medical Ethicist Clinical Administration Hospital Administration

17. 17 Command Review The Incident Commander is responsible for: Management of the Incident Activities within the Hospital Command Center Continuing as Incident Commander until authority is delegated to another The Command Staff consists of: Public Information Officer (PIO) Liaison Officer Safety Officer Medical/Technical Specialist(s)

18. 18 Sections Operations Section Chief Planning Section Chief Finance / Administration Section Chief Incident Commander Public Information Officer Liaison Officer Medical/ Technical Specialist(s) Safety Officer Logistics Section Chief

19. 19 Sections include: Operations Planning Logistics Finance/Administration Sections are led by a Chief Section Chiefs are called General Staff Sections

20. 20 Operations

21. 21 Operations Section Mission: Manage tactical operations Direct all tactical resources Carry out the mission and Incident Action Plan Directs all tactical resources Led by a Section Chief Operations Section

22. 22 The Section includes: Staging Area Medical Care Branch Patient Family Assistance Branch Infrastructure Branch HazMat Branch Security Branch Business Continuity Branch Operations Section

23. 23 Staging Manager Organize and manage the deployment of supplementary resources, including personnel, vehicles, equipment, supplies, and medications Mission:

24. 24 Mission: Organize and manage the delivery of emergency, inpatient, outpatient, and casualty care, and clinical support services Duties: Address provision of acute and continuous care Work with Logistics for resource acquisition Work with Staging Manager for delivery of resources to areas Medical Care Branch Director

25. 25 Supervises: Inpatient Unit Leader (all inpatient units) Outpatient Unit Leader (all outpatient services) Casualty Care Unit Leader (Emergency Department) Behavioral Health Unit Leader Clinical Support Unit Leader (i.e., Lab, Diagnostic Imaging, Pharmacy, Morgue, Blood Donor) Patient Registration Unit Leader Medical Care Branch Director

26. 26 Mission: Organize and manage the services required to sustain and repair the hospital ’ s infrastructure operations Duties: Maintain overall facility operations and operating capacity Identify and fixes utility service-delivery failures Assign personnel to address damage Infrastructure Branch Director

27. 27 Supervises: Power/Lighting Unit Leader Water/Sewer Unit Leader HVAC Unit Leader Building/Grounds Unit Leader Medical Gases Unit Leader Infrastructure Branch Director

28. 28 Mission: Coordinate activities related to internal and external personnel and facility security Duties: Implement facility security measures Ensure security and access control of the Hospital Command Center Liaison with responding law enforcement Oversee search and rescue operations Security Branch Director

29. 29 Supervises: Access Control Unit Leader Crowd Control Unit Leader Traffic Control Unit Leader Search Unit Leader Law Enforcement Interface Unit Leader Security Branch Director

30. 30 Mission: Organize and direct hazardous material incident response activities Technical, and emergency decontamination; and facility and equipment decontamination Duties: Oversee hazmat event Decontamination of victims, staff, facility Safe and appropriate use of PPE Clean up operations Collaborates with Medical Care Branch Director HazMat Branch Director

31. 31 Supervises: Detection and Monitoring Unit Leader Spill Response Team Unit Leader Victim Decontamination Unit Leader Facility/Equipment Decontamination Unit Leader HazMat Branch Director

32. 32 Mission: Ensure business functions are maintained, restored or augmented Duties: Facilitate acquisition and access to essential recovery resources, including business records Coordinate IT services with Logistics Section Assist Branches and impacted areas to restore normal operations Business Continuity Branch Director

33. 33 Supervises: IT Systems and Applications Unit Leader Service Continuity Unit Leader Records Management Unit Leader Business Continuity Branch Director

34. 34 Patient Family Assistance Branch Director Mission: Organize and manage assistance for patient family care needs, including communication, lodging, food, health care, spiritual, and emotional needs that arise during the incident. Duties: Ensure patient family assistance resources Coordinate external community resource requests Ensure Family reunification, Social Service, Cultural and Spiritual needs Communication with law, government and non- governmental agencies, and media through the Liaison Officer and Public Information Officer

35. 35 Supervises: Social Services Unit Leader Family Reunification Unit Leader Patient Family Assistance Branch Director

36. 36 Operations Section Review The Operations Section is responsible for: The tactical objectives and organization All tactical operations Directing all tactical resources Operations is led by a Chief Operations positions are activated as needed by the incident

37. 37 Logistics

38. 38 Section Mission: Organize and direct maintenance of the physical environment – providing human resources, material, and services to support the incident. Provides support (stuff) to other sections Acquires resources from internal and external sources Through Liaison, links to local Emergency Operations Center for resource requests Led by a Section Chief Logistics Section

39. 39 Scope and Responsibilities overlap Logistics Supply Unit and Operations’ Infrastructure Branch Labor Pool and Credentialing Unit and Staging Manager– Personnel Tracking Manager Logistics and Operations are closely linked and must work collaboratively Logistics Section are the “getters” Operations Section are the “doers” Logistics and Operations

40. 40 Logistics Section The Section includes: Service Branch Support Branch

41. 41 Mission: Organize and manage services to maintain hospital communication, food and water supply and information technology and systems Service Branch Director Communications Unit Leader IT/IS and Equipment Unit Leader Food Services Unit Leader Oversees :

42. 42 Mission: Manage supplies, facilities, transportation, and labor pool. Provide logistical, psychological, and medical support to hospital staff and their dependents Oversees: Employee Health and Well-Being Unit Leader Employee Family Care Unit Leader Supply Unit Leader Transportation Unit Leader Labor Pool and Credentialing Unit Leader Support Branch Director

43. 43 The Logistics Section is responsible for: Organizing and directing internal and external resources to support the incident Providing support to other sections Logistics supports the incident resource requirements Logistics has two branches: Support Service Logistics is led by a Chief who works closely with the Operations Section Logistics Section Review

44. 44 Planning Section

45. 45 Mission: Collect, evaluate, and disseminate incident action information and intelligence to Incident Commander Prepare status report Develop the Incident Action Plan Led by a Section Chief Planning Section

46. 46 Supervises: Resources Unit Leader Personnel Tracking Materiel Tracking Situation Unit Leader Patient Tracking Bed Tracking Documentation Unit Leader Demobilization Unit Leader Planning Section Chief

47. 47 The Planning Section is responsible for: Collecting, evaluating and disseminating incident situation information to the Hospital Command Center Maintaining resource status Developing the Incident Action Plan (IAP) and obtaining Incident Commander approval on IAP Archiving response and recovery documentation Assisting with After-Action Report development Planning Section Chief

48. 48 Finance Section

49. 49 Finance/Administration Section Chief Mission: Monitor the utilization of financial assets and the accounting for financial expenditures. Supervise the documentation of expenditures and cost reimbursement.

50. 50 Supervises: Time Unit Leader Procurement Unit Leader Compensation/Claims Unit Leader Cost Unit Leader Finance/Administration Section Chief

51. 51 Putting it all together: Choosing the Hospital Incident Management Team: Incident Commander is the only position that must be included The Incident Commander chooses down to the Chief Level Each Chief appoints positions in their section needed to complete the mission based on available personnel The Hospital Incident Management Team

52. 52 Questions?

53. 53 Job Action Sheets Series of action steps to “prompt” team members to take needed actions related to their roles and responsibilities One for each position Includes title, mission/function and duties Adjusted to meet hospital needs Refers to supporting forms

54. 54 Operations Section Chief Mission: Develop and implement strategies and tactics to carry out the objectives established by the Incident Commander. Organize, assign, and supervise the resources of the Staging Area, the Medical Care, Infrastructure, Security, Hazardous Materials (HazMat), Business Continuity, and Patient Family Assistance Branches. Job Action Sheet Format

55. 55 Action Steps and Considerations Job Action Sheet provides position action steps and considerations Actions listed by Response Time Periods Immediate 0 – 2 hours Intermediate 2 – 12 hours Extended Beyond 12 hours Demobilization/ System Recovery Job Action Sheet Format

56. 56 Immediate Response (0-2 Hours) TimeInitial Receive appointment Obtain a briefing from the Incident Commander on: o Size and complexity of the incident o Expectations of the Incident Commander o Incident objectives o Involvement of outside agencies, stakeholders, and organizations o The situation, incident activities, and any special concerns Assume the role of Operations Section Chief Review this Job Action Sheet Put on position identification (e.g., position vest) Notify your usual supervisor of your assignment Assess the operational situation Obtain information and status from the Staging Manager, and the Medical Care, Infrastructure, Security, Hazardous Materials (HazMat), Business Continuity, and Patient Family Assistance Branch Directors Provide information to the Incident Commander on the operational situation including capabilities and limitations Determine the incident objectives, tactics, and assignments Determine which Operations Section functions need to be activated

57. 57 Documents/Tools: A listing of pertinent HICS forms this position is responsible for using Forms noted in Job Action Sheet action steps Other tools that will help them fulfill their role and responsibilities Hospital plans, policies and procedures Technology tools Other adjuncts Job Action Sheet Format

58. 58 Documents/Tools: Operations Chief Documents/Tools  HICS 203 - Organization Assignment List  HICS 204 - Assignment List  HICS 205A - Communications List  HICS 213 - General Message Form  HICS 214 - Activity Log  HICS 215A - Incident Action Plan (IAP) Safety Analysis  HICS 221 - Demobilization Check-Out  HICS 251 - Facility System Status Report  HICS 252 - Section Personnel Time Sheet  HICS 254 - Disaster Victim/Patient Tracking  HICS 255 - Master Patient Evacuation Tracking  HICS 257 - Resource Accounting Record  HICS 259 - Hospital Casualty/Fatality Report  HICS 260 - Patient Evacuation Tracking  Hospital Emergency Operations Plan  Incident Specific Plans or Annexes  Hospital organization chart  Hospital telephone directory  Telephone/cell phone/satellite phone/internet/amateur radio/2-way radio

59. 59 Job Action Sheet Use Job Action Sheets are used continuously Actions in all operational periods should be continued and monitored Job Action Sheets should transfer to your replacement and actions continued Upon shift change or position change

60. 60 Job Action Sheet Section Review The Job Action Sheets are: An incident management tool A series of actions to meet the incident response Are divided in response time periods: Immediate: 0 – 2 hours Intermediate: 2 – 12 hours Extended : Greater than 12 hours Demobilization/System Recovery Standardized to facilitate interagency response Customizable for the unique facility needs/roles

61. 61 Questions?

62. 62 Hospital Incident Action Planning Key to Effective Response and Recovery

63. 63 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 Hospital Incident Action Planning

64. 64 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

65. 65 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

66. 66 “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 & Establish Incident Objectives

67. 67 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

68. 68 #5 Determine Strategies and 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”

69. 69 Tactical resources may include: Personnel Equipment Supplies Pharmaceuticals Vehicles Available and needed resources to meet the objectives must be identified # 6 Determine Needed Resources

70. 70 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

71. 71 The Planning Meeting The Planning Meeting is: Led by the Planning Section Chief Defines and finalizes operational period objectives, strategies, tactics, and resources as determined by each section for the next operational period

72. 72 The Planning Meeting 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

73. 73 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

74. 74 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

75. 75 # 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

76. 76 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

77. 77 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

78. 78 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

79. 79 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

80. 80 The Logistics Section Chief Determine tactics and resource requirement (HICS 204) 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

81. 81 The Finance/Administration Section Chief Determine tactics and resource requirement (HICS 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

82. 82 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

83. 83 Questions?

84. 84 Demobilization and Recovery

85. 85 Preparation for Demobilization Demobilization The Demobilization Plan is created by the Demobilization Unit Leader and approved by the Planning Section Chief and Incident Commander Demobilization begins As incident objectives are met Follow-on objectives are more focused upon recovery and returning to “normal” The demobilization of resources no longer Needed should occur rapidly and efficiently

86. 86 Demobilization Considerations Demobilizing must be a part of the Incident Action Plan Managing public perception Equipment rehab and restocking Financial restoration Addressing hospital personnel concerns Preparation for Demobilization

87. 87 Recovery follows response and focuses upon returning the hospital to baseline level of functioning The starting point for recovery begins early in the response Transition from response to recovery is rarely obvious Recovery may extend over a long time, from weeks to years Recovery

88. 88 The recovery plan includes principles of organizational learning and improvement: After Action Report and Improvement Plan Evaluate hospital response/recovery operations Identify strengths, weaknesses, and strategies to: Lessen future vulnerability Improve ability to respond to future incidents Revise the Emergency Operations Plan Organizational Learning

89. 89 Section Review Demobilization and Recovery should be planned early Demobilization and Recovery is the return to “normal,” or “new-normal” Demobilization is managed by the Planning Section The development of a Demobilization Plan by the Demobilization Unit Leader

90. 90 Questions?

91. 91 Scenarios, Incident Planning Guides and Incident Response Guides Active Shooter Chemical Incident Earthquake Evacuation, Shelter-in-Place, & Hospital Abandonment Explosive Incident Hostage or Barricade Incident Infectious Disease There are 16 Scenario/Incident Planning and Response Guides to assist in planning and training:

92. 92 Scenarios Information Technology (IT) Failure Mass Casualty Incident Missing Person Radiation Incident Severe Weather with Warning Staff Shortage Tornado Utility Failure Wildland Fire

93. 93 Incident Planning Guides Incident Planning Guides assist hospitals with evaluating existing plans or writing needed plans They address 16 scenarios They are intended to identify actions or strategies to prepare for identified hazards Assess current plans and identify gaps Develop event-specific response guides

94. 94 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

95. 95 Section Review Incident Planning Guides and 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

96. 96 Questions?

97. 97 HICS Forms

98. 98 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

99. 99 No.NameResponsible 200Incident Action Plan Cover SheetPlanning Section Chief 201Incident BriefingIncident Commander 202Incident ObjectivesSection Chiefs 203Organizational Assignment ListResource Unit Leader 204Assignment ListBranch Directors 205Communications LogCommunications Unit Leader 206Staff Medical PlanSupport Branch Director 207Organization ChartIncident Commander 213Incident Message FormAll Positions 214Operational LogAll HIMT Staff 215aIncident Action Plan Safety AnalysisSafety Officer IAP QS IAP QuickStartIncident Commander and Planning HICS Forms

100. 100 No.NameResponsible 221Demobilization Check-OutDemobilization Unit Leader 251Facility System Status ReportInfrastructure Branch Director 252Section Personnel Time SheetSection Chiefs 253Volunteer Staff RegistrationLabor Pool and Credentailiting Unit Leader 254Disaster Victim / Patient TrackingPatient Tracking Manager 255Master Patient Evacuation TrackingPatient Tracking Manager 256Procurement Summary ReportProcurement Unit Leader 257Resource Accounting RecordSection Chiefs 258Hospital Resource DirectoryResource Unit Leader 259Hospital Casualty / Fatality ReportPatient Tracking Manager 260Patient Evacuation Tracking FormInpatient Unit Leader Outpatient Unit Leader, Casualty Care Unit Leader HICS Forms

101. 101 HICS Forms 200: Incident Action Plan 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

102. 102 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

103. 103 HICS Form 201: Incident Briefing

104. 104 Purpose: Defines incident objectives Instructions: Include Weather/Environmental Implications General Safety/Safety Messages Attachments Prepared by Planning Section Chief Approved by: Incident Commander HICS Form 202: Incident Objectives

105. 105 HICS Form 202 : Incident Objectives

106. 106 Purpose: To document Hospital Command Center staffing Origination: Planning Section Chief or designee (Resources Unit Leader) Copies to: Command Staff and General Staff Branch Directors and Agency Staff Documentation Unit Leader HICS Form 203: Organization Assignment List

107. 107 HICS Form 203: Organization Assignment List

108. 108 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 When to complete: At the start of each operational period HICS Form 204: Assignment List

109. 109 HICS Form 204: Assignment List (page 1)

110. 110 HICS Form 204: Assignment List (page 2)

111. 111 HICS Form 215A: Incident Action Plan Safety 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 roles

112. 112 HICS Form 215A: Incident Action Plan Safety Analysis

113. 113 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: General Message Form

114. 114 HICS FORM 213: General Message Form

115. 115 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

116. 116 HICS FORM 214: Activity Log

117. 117 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:

118. 118 HICS Form IAP Quick Start: (page 1)

119. 119 HICS Form IAP Quick Start: (page 2)

120. 120 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

121. 121 HICS During Off Hours and Small and Rural Hospitals The same principles for large hospitals is used at smaller hospitals or off hours, holidays and weekends at all size hospitals Activate needed Hospital Incident Management Team members When not enough staff, it may be necessary to blend job roles into a single Job Action Sheet For example, the Incident Commander may assume the role of the Public Information Officer and even the Liaison Officer.

122. 122 Operationalizing HICS Assign an individual in charge of implementation Obtain support from the CEO/senior leadership Make it high priority for administrators and staff Provide budgets support Establish training requirements/competencies Promote integration into the community response Provide training of HICS and the Emergency Operations Plan Exercise the plan and use of HICS

123. 123 Questions?

124. 124 HICS Basics Part 1 Management System and Tools for Events developed by the California Hospital Association’s Hospital Preparedness Program www.calhospitalprepare.org 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