1. Hospital Emergency Incident Command System Presented by:
Jersey City Medical Center
Emergency Medical Services

2. 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

3. 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.

4. 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.

5. Establishing the Need
A Virginia hospital treated victims from the Pentagon on September 11 and postal workers that contracted Anthrax in October 2001.

6. 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)

7. 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

8. 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
Jersey City, alone, has a surge population of over 1 million people during the day
Brennan Court House- A Hudson County Landmark

9. 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 Hudson-Bergen Light Rail system all run through the County

10. A Local Perspective
Hudson County is home to 4 colleges and seven parks, including Liberty State Park and the Ellis Island National Historic Landmark.

11. 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

12. HELP! HELP! Our Disaster Recovery Plan goes something like this…
Current State of Preparedness
Our Disaster Recovery Plan goes something like this…
HELP!
HELP!

13. 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

14. All initial response is local!!
Current State of Preparedness
Must improve state of readiness
All initial response is local!!
Training and equipment lacking

15. 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”

16. 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!

17. What is HEICS?

18. 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

19. What is HEICS?
COSTS C H O I E S
ISSUES
TIME

20. Because the Regulatory Agencies are here to “help” us.
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

21. Hospitals must develop written plans and exercise them twice a year
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)

22. What is HEICS? Based on ICS Hospital Council of Northern California
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)

23. FLEXIBLE 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
FLEXIBLE

24. What is HEICS?
The end goal of HEICS is to provide comprehensive emergency management in four areas
Preparedness
Response
Mitigation
Recovery

25. The Basic Structure

26. The Basic Structure
The organizational chart structure helps to promote meaningful communication among those managing an incident.

27. Incident Command Finance Operations Logistics Planning Color Scheme
The Five Main Functions
Incident Command
Finance
Operations
Logistics
Planning
Color Scheme
Note the

28. To define and plan the mission and ensure its completion
The Command Staff
Function:
To define and plan the mission and ensure its completion

29. The Logistics Section
Function:
To provide an environment and materials for the overall medical objective or incident needs

30. 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

31. The Finance Section
Function:
Provide funding for present objectives, and stress facility- wide documentation for later financial recovery

32. The Operations Section

33. The Operations Section
close up
Function:
Conducts Medical Operations to carry out action plan. Directs all direct patient care resources.

34. In-Patient Medical Branch
The Operations Section
close up
In-Patient Medical Branch

35. Out-Patient Medical Branch
The Operations Section
close up
Out-Patient Medical Branch

36. The Operations Section
close up
Human Services Branch

37. Ancillary Services Branch
The Operations Section
close up
Ancillary Services Branch

38. The BIG Picture

39. One JAS for Each Position
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)

40. Job Action Sheets (JAS)

41. Activity Log Action Plan Personnel time sheet
Supporting Forms
Forms Help Drive Positions
Aid in Documentation
Activity Log
Action Plan
Personnel time sheet

42. Valuable for Identification
Position Vests
Valuable for Identification
Valuable for Organization

43. Emergency Ops Center (EOC)
The Emergency Operations Center (EOC) serves as the “nerve center” of all HEICS activities

44. Location Supplies Operating Protocols Communications
Emergency Ops Center (EOC)
There are many factors to consider in setting up an EOC
Location
Supplies
Operating Protocols
Communications

45. 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 decision-making.

46. This is a Process Implementation
Implementing HEICS means taking the time to do it right!
Administrative “buy-in”/support
Staff education
Adequate resources and funding

47. Questions?