1. Application of Incident Action Plan and Forms: Loss of Power
Hospital Incident Command System
Application of Incident Action Plan and Forms: Loss of Power
2014 version
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. 1

2. Objectives Demonstrate the Incident Action Planning Process
Demonstrate the use of HICS Forms
Implement the use of the Incident Response Guides 2

3. Scenario Based Implementation
Discuss and rehearse practical implementation of the Incident Action Planning process utilizing HICS forms and the Incident Response Guides
Utilize a “Table Top” learning process 3

4. Incident Action Planning
Assess the Situation
Set the Operational Period
Determine Safety Priorities & Establish Incident Objectives
Determine Branch/Section Objectives
Determine Strategies & Tactics
Determine Needed Resources
Issue Assignments
Implement Actions
Reassess & Adjust Plans
We will be using the Incident Action Planning Process to walk through our scenario
Usually multiple things are being done at once but we are going to be linear and go through one thing at a time
Reference the CHA IAP Checklist 4

5. Scenario 1 Setting: Mid-August
Weather: A heat wave with higher than average temperatures (108) for 8 days
Reported heat related illnesses
Isolated losses of power
Time: 4:00 p.m.

6. The Power is Disrupted but the Generators are Functioning
Power has been off for 30 minutes. You learn that a transformer in the area has blown out.
Time until repaired: Unknown.
Is this an incident?
What are your first actions?
Who is in charge?
Start with 201
Is this an incident?
Yes
If they didn’t know it, in the majority of facilities – Air conditioning is not on emergency power.
Patients getting hot, neonates are fragile, lab equipment gets hot, morgue warms up.
First Actions –
Person in charge takes command
Activates Response plans, HICS
Question for the class: Do your communications systems rely on electricity? How will you communicate with one another?

7. Incident Action Planning
Step 1: Assess the Situation
Use HICS form 214: Operational Log
Complete HICS form 201: Incident Briefing
Event History and Current Actions Summary
Begin form 202: Incident Objectives
Weather/environmental implications for period
Refer to forms in handouts
Have the Incident Commander give you the summary to put on the 201
Put the weather on the 202

8. Which Positions to Activate?
Refer to forms in handouts
Have the Incident Commander give you the summary to put on the 201
Put the weather on the 202

9. Immediate Time Period
Position
Immediate
Intermediate
Extended
Recovery
Incident Commander X
Public Information Officer
Liaison Officer
Safety Officer
Operations Section Chief
Medical Care Branch Director
Infrastructure Branch Director
Security Branch Director
Business Continuity Branch Director
Patient Family Assistance Branch Dir.
Planning Section Chief
Resources Unit Leader
Situation Unit Leader
Documentation Unit Leader
Demobilization Unit Leader
Logistics Section Chief
Service Branch Director
Support Branch Director
Finance /Administration Section Chief
Time Unit Leader
Procurement Unit Leader
Compensation/Claims Unit Leader
Cost Unit Leader
Look at the IRG for Utility Failure (towards the back of the handout)
This is a great cheat sheet, use the IRG to figure out what positions to activate

10. Naming the Incident The Incident Commander names the incident
If the incident is a community-based incident, the appropriate jurisdiction will name the incident (e.g., county, city, EMS)
The incident name should be documented on all forms
Have the Incident Commander name the incident

11. Incident Action Planning
Step 2: Set the Operational Period
HICS form 202: Incident Objectives
Operational Period Date/Time
Incident Commander sets the Operational Period:
Based on number of simultaneous activities
How quickly the situation is changing
An Operational Period breaks the incident down into manageable timeframes
Incident Commander should state the Operational Period
In a situation that is not stable, still changing – it should be 2 hours. Usually the 1st Op Period is 2 hours

12. Incident Action Planning
Step 3: Determine Safety Priorities & Establish Incident Objectives
Identify the Incident Objectives (these are the broad objectives that will last throughout the response or are the priorities)
HICS form 202: Incident Objectives
Incident objectives –
Maintain safety of patients, staff, visitors
Maintain life support functions
Conduct safe and rapid evacuation of the facility
After they come up with some ideas then you can show them objectives on the IRG – next slide

13. Incident Objectives Utilize the Incident Response Guide
Utility Failure:
Identify extent of outage and consider evacuation
Maintain patient care capabilities
Minimize impact on hospital operations and clinical services
Communicate the situation status to patients, staff, and the public

14. Scenario Update #1
The municipal power company states that it may be at least 6 hours before they can replace the transformer; they have to wait for a large crane
It has been 45 minutes since the outage
Patients are complaining of being hot
The lab states their equipment is getting too hot

15. Side Note: Safety Officer Tasks Assess the Safety issues
What hazards exist and what precautions need to be taken
Complete the 215A – Incident Action Plan Safety Analysis
Safety Officer to work on the 215A

16. Side Note: Public Information Officer task
Prepare a statement for the media
Prepare a statement for the staff, patients and visitors (e.g., situation, status, safety precautions, next update time)
The statements need approval from the Incident Commander
Coordinate consistent messaging with the Joint Information Center (JIC)

17. Side Note: Liaison Officer
Make contact with the Power Company directly, or through the local EOC (MHOAC) if activated
Who should be notified?
Who is the source of resources in your local plan? (e.g., local EMS Department Operations Center, PHD Department Operations Center, County/City Emergency Operations Center)
These contacts/processes should be identified prior to any incident

18. Side Note: Documenting your Actions
Utilize HICS forms
214 - Operational Log

19. Incident Action Planning
Step 4: Determine Branch/Section Objectives
Document on HICS 204 – Assignment List
They are based on the Incident Objectives
These are based on what is desired to be achieved by the Branch/Section in that operational period
Objectives need to be SMART (Simple, Measurable, Achievable, Realistic, Time Sensitive & Task Oriented)
5 – 10 min for students (Section Chiefs) to develop 3-4 objectives. PIO does PIO report. Liaison officer making calls. SO – form 215a
People get confused about Sections/Branches use. A separate 204 for each Branch, if more than one branch is activated.
Have them work on this in their sections. Actually write on a 204

20. Branch/Section Objectives
A common problem during exercises is that Branches/Sections don’t develop their objectives promptly
Report top 3 objectives
Have the groups share their top 3 objectives and write on the blow up of the 202.
See IRG “Immediate Response”

21. Incident Action Planning
Step 5: Determine Strategies & Tactics
Strategies & tactics are how your Branch/Section is going to achieve the objectives
What actions do you need to take?
Use your facility response plans and Incident Response Guides
Record strategies & tactics on form 204 – Branch Assignment List
Assure any loss of power outage related policies, plans, procedures are available from the EOP in the Hospital Command Center

22. Incident Action Planning
Step 6: Determine Needed Resources
Where can patients be moved to?
What personnel resources do you need?
What equipment and/or supplies do you need?
What resources do you need in the patient collection/holding area?
What transport resources do you need?
Document resource activities:
Resources assigned (form 204)
Resource requests (form 213)
Actions taken to utilize and obtain resources (form 214)
Drinking water, Fans, Portable Generators, Generator Fuel, Battery Powered lighting
Staging areas to prepare for transport
Evacuation devices – med sleds, stair chairs, etc.
Go kits
Staff to help with evacuation
Coordinate transportation needs

23. Incident Action Planning
Step 7: Issue Assignments
Who will be assigned to the units?
Fill in assignments on form 204 – Assignment List
Are there other branches or units that need activated?
Have them work in groups on their strategies, tactics and assignments for their branches

24. Incident Action Planning
For the first Operational Period the Incident Action Plan should be done within minutes
What makes up the Incident Action Plan?
201 - Incident Briefing
202 - Incident Objectives
203 - Incident Assignments
204 - Branch Assignments
215A - Incident Action Plan Safety Analysis
The Planning Section compiles the forms to create the Incident Action Plans
As we did this process, completed the forms – THIS made up our IAP
Put a cover on it with the date, time of the Operational Period – process it, share with others

25. IAP Quick Start New form Can be used for small incidents
Or for a rapid start to a large incident and then expand out on individual HICS forms
Great for smaller pre-planned events

26. IAP Cover Sheet
Can be used for the IAP Quick Start or full Incident Action Plan forms
Can make different colors if you want to differentiate Operational Periods

27. Incident Action Planning
Step 8: Implement Actions
Put your activities / plans into action
What are some of these activities?
Remind students about monitoring & evaluating activities being implemented

28. Scenario Update #2 It is now 1730 – 1.5 hrs into the incident
Power is still out
What are your major concerns?

29. Incident Action Planning
Step 9: Reassess & Adjust Plans
Towards the end of the operational period, you will need to evaluate status
Repeat steps 1-8
Update the forms
Evaluate and/or update your Branch/Section Objectives
This creates your Incident Action Plan (game plan) for the next operational period

30. Scenario Update #3 It is now 4 hours into the incident
Power remains off, Power Company has had set backs, not sure when repairs will be made
What are some of the issues to consider?
Continued cooling measures – how
Consider evacuations – of who

31. How are we doing? What are things we need to remember to do?
Share information
Recovery / Restoration
After Action Report
Corrective Actions Plan

32. Questions?
Clean-up, part of any event is recovery-put the vests back as they belong
Post test
Evaluation 32

33. Incident Action Plan and Forms Loss of Power
HICS Basics Part 2:
Application of
Incident Action Plan and Forms Loss of Power
developed by the
California Hospital Association’s
Hospital Preparedness Program
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.