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    Add as FriendIncident Management for Helthcare

    by: Rogers

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    1 : Incident Management for Healthcare Based upon Emergency Management Institute ICS- HC 100-200
    2 : Minnesota Emergency Readiness Education and Training Program (MERET) MERET worked with partners in Minnesota to adapt curriculum to support the Hospital Incident Command System (HICS) training MERET is a program designed to educate and train Minnesota’s health care workers in emergency preparedness, tailoring efforts to the unique needs of specific communities as they prepare for a health emergency or bioterrorism event. MERET is funded by the Office of the Assistant Secretary for Preparedness and Response (ASPR) of the U.S. Department of Health and Human Services, and is administered by the University of Minnesota Schools of Nursing and Public Health. Carol O’Boyle, PhD, RN, at the School of Nursing, is the Principal Investigator. Minnesota Emergency Readiness Education and Training (MERET) is funded under grant #TO1HP06412 from the Office of the Assistant Secretary for Preparedness and Response (ASPR),DHHS, Bioterrorism Training and Curriculum Development Program.
    3 : Objectives Name the four (4) phases of comprehensive incident management. Recognize how objectives shift from the initial response phase to the extended response phase. Name the order in which the Hospital Incident Command System (HICS) is usually activated. Select the forms used by the Command and General Section Chief staff. Identify the role of the Incident Commander. Select the appropriate span of control for any leadership position in the HICS. Identify the purpose of the Incident Briefing.
    4 : What is the Hospital Incident Command System (HICS)? Created in the 1980’s as Hospital Emergency Incident Command System (HEICS) and Evolved to HICS as a comprehensive incident management system for both emergent and non-emergent situations . Foundation for more than 6,000 hospitals in the United States to prepare and respond to disasters Hospital are seen as essential members of community preparedness and are recognized as “first responders” in emergency response. The HICS provides a common structure and language for promoting interagency communication based on functions Evolved from an Incident Command System (ICS) used by multiple agencies to manage events
    5 : Incident Command System (ICS) History FIRESCOPE – 1970s NIIMS (National Interagency Incident Management System) NIMS (National Incident Management System) MnIMS (MN Incident Management System) OSHA (Occupational Safety and Health Administration NFPA 1600 (National Fire Protection Association) The Joint Commission (formerly JCAHO) Requires healthcare facilities to use community-congruent IMS
    6 : What is the Hospital Incident Command System (HICS)? Created in the 1980’s as Hospital Emergency Incident Command System (HEICS) and Evolved to HICS as a comprehensive incident management system for both emergent and non-emergent situations . Foundation for more than 6,000 hospitals in the United States to prepare and respond to disasters Hospital are seen as essential members of community preparedness and are recognized as “first responders” in emergency response. The HICS provides a common structure and language for promoting interagency communication based on functions Evolved from an Incident Command System (ICS) used by multiple agencies to manage events
    7 : Homeland Security Presidential Directives (HSPDs) Management of Domestic Incidents http://www.whitehouse.gov/news/releases/2003/02/20030228-9.html HSPD-5 HSPD-8 National Incident Management System (NIMS) National Response Plan (NRP) National Preparedness Goal National Preparedness http://www.ojp.usdoj.gov/odp/assessments/hspd8.htm Mandates Slide courtesy of FEMA
    8 : National Incident Management System/Components (NIMS) NIMS: Standardizes incident management processes, protocols, and procedures for all responders. Mandates ICS Command and Management ICS Multi-Agency Coordination Public Information Systems Preparedness Resource Management Communications and Information Mgt. Supporting Technologies Ongoing management and Maintenance Slide courtesy of FEMA
    9 : National Response Plan Establishes . . Incidents occur and are managed at the lowest level Provision of federal aid to support state and local efforts as requested. Unified, all-discipline, all-hazard, management approach http://www.dhs.gov/xprepresp/committees/editorial_0566.shtm
    10 : NIMS & NRP Relationship Local Support or Response National Incident Management System (NIMS) Standardized process and procedures for incident management State Support or Response Federal Support or Response NIMS aligns command & control, organization structure, terminology, communication protocols, resources and resource typing National Response Plan (NRP) Activation and proactive application of integrated Federal resources Incident NRP is activated for Incidents of National Significance Resources, knowledge, and abilities from all Federal agencies DHS integrates and applies Federal resources http://www.nrt.org/production/NRT/NRTWeb.nsf/AllAttachmentsByTitle/A-319CharlieHessNIMS-NRPBrief/$File/Charlie_Hess_NIMS-NRP_Brief.ppt?OpenElement#324,6,NIMS & NRP Relationship
    11 : Weaknesses prior to ICS Lack of accountability Poor communication Lack of planning process Overloaded commanders Interagency integration – ICS purposely does not reflect agency-specific titles, etc. to avoid confusion
    12 : Capabilities and Resources Federal Response Regional / Mutual Response Systems State Response Increasing magnitude and severity Local Response, Municipal and County Tiered Response Strategy Minimal Low Medium High Catastrophic 'Medical Surge Capacity and Capability Handbook' by J. Barbera and A. Macintyre published by CNA Corporation.
    13 : Hospital Incident Management
    14 : What is meant by an “incident” in the Incident Command System? . . . an occurrence, either caused by human or natural phenomena, that requires response actions to prevent or minimize loss of life, or damage to property and/or the environment. Photos courtesy of FEMA Photos courtesy of FEMA
    15 : What is a ‘disaster’? A disaster is when the demands of an ‘incident’ outstrip available resources Goal: Get the… Right stuff / staff to the Right place at the Right time to prevent an incident from becoming a… DISASTER Incident management is the key!
    16 : Le Sueur Tornado Photographer: D. Burgess. Photo courtesy of NOAA Photo Library
    17 : Red River Flood Photographer: David Saville, Photos courtesy of FEMA
    18 : Photographer: Mark Wolfe, Photo courtesy of FEMA
    19 : Emergencies Present In 2 Ways… Oklahoma City Bombing Tornado Hurricane Katrina Midwest Floods Pandemic Flu Northridge Earthquake The Amount of Time We’re Given To Pre-Organize People and Pre-Stage Equipment Can Drastically Change Our Response Effectiveness Anticipated and/or With Warning Unanticipated and/or Without Warning Illustration courtesy of Pete Brewster – VA Medical System
    20 : Incident progression BOOM! Reactive Phase Recognition Notifications Initial control and safety actions Establish ICP Primary Tools SOPs Job Action Sheets Primary Goal Prevent incident expansion Prevent responder injury Proactive Phase Situation assessed Objectives established Strategies / tactics Resources requested Primary Tools ICS Incident Action Planning Primary Goal Manage incident Slide courtesy of John Hick Hennepin County Medical Center
    21 : Incidents Require you to …..
    22 : School Shooting Image courtesy of FEMA, Photographed by Jocelyn Augustino
    23 : What is an Incident Command System (ICS)? Provides framework to: Identify and assess the problem Develop plan to deal with the problem Implement the plan Procure and pay for necessary resources A structured system for controlling: Personnel Facilities Equipment Communications Photographer: Jocelyn Augustino, Photo courtesy of FEMA
    24 : Why use ICS? Greater efficiency in managing internal or external crisis incidents of any kind or size Better coordination and communication within and external to facility Standardization and flexibility which allows personnel from different organizations to use a common management structure To provide logistical & administrative support to ensure that operational staff can meet tactical objectives To be effective in reducing costs by avoiding duplication of efforts Photographer: Marvin Nauman, Photo courtesy of FEMA
    25 : When should ICS be used? ANY incident that requires something OTHER than day-to-day organizational structure and function (e.g.: special event planning) Utility of ICS depends on frequent use in order to maintain familiarity with structures/function No correlation between the ICS organization & administrative agency structure; every incident requires different management functions
    26 : Incident Command System (ICS) Features… Common Terminology Modular Organization Management by Objectives Reliance on an Incident Action Plan (IAP) Chain of command & unity of command Unified Command Manageable span of control Pre-designated incident locations & facilities Resource Management Information & Intelligence Management Integrated Communications Transfer of Command Accountability Mobilization Slide courtesy of FEMA
    27 : IMS Feature: Common Terminology Common terminology must be used! Plain English (not codes) Ensures efficient, clear communication Position titles, not person (e.g.: operations chief, not ‘nursing supervisor’) – titles are a common standard for all users Resource typing – ‘tanker’ Facility terminology – ex. ‘command post’ ‘command center’ LIMIT what you say to essential info Slide courtesy of FEMA
    28 : Basic ICS Structure –Modular Organization Slide courtesy of FEMA
    29 : Incident Commander The Incident Commander performs all major ICS command and staff responsibilities unless delegated and assigned. Safety Officer Liaison Officer Public Information Officer Incident Commander Operations Section Chief Planning Section Chief Logistics Section Chief Finance/Admin Section Chief Incident Commander Slide courtesy of FEMA
    30 : Incident Commander Only position always staffed Ensures safe work practices Provides overall leadership for incident response Initial IC holds post until they delegate the post to another qualified/more qualified person Demonstrates initiative by taking action Motivates responders Communicates by providing specific instructions and asking for feedback Supervises the scene of the action Delegates authority to others Understands and accepts the need to be flexible, modify plans Approves Incident Action Plan and evaluates its effectiveness Slide courtesy of FEMA
    31 : Delegation of Authority An Incident Commander's scope of authority is derived: From existing responsibilities or agreements Through a delegation of authority from the agency administrator or elected official in writing or verbally Grants authority to carry out specific functions and provides overall objectives / guidance Allows the Incident Commander to assume command. Does NOT relieve the granting authority of the ultimate responsibility for the incident. Delegation of authority comes from the governing board of your agency Slide courtesy of FEMA
    32 : Transfer of Command-Review The process of moving the responsibility for incident command from one Incident Commander to another Occurs when More qualified person / team arrives End of operational period / extended incident handoff Always includes transfer of command briefing Current situation Response needs Available resources All personnel will be informed of the effective time and date of the transfer of command
    33 : Public Information Officer (PIO) Public Information Officer Slide courtesy of FEMA
    34 : Safety Officer Safety Officer Slide courtesy of FEMA
    35 : Liaison Officer Liaison Officer Slide courtesy of FEMA
    36 : Expanding Incidents Add to the supervisory layers as the incident expands Slide courtesy of FEMA
    37 : General Staff General Staff in the ICS organizational structure are appointed as the incident complexity expands Safety Officer Liaison Officer Public Information Officer Command Staff Incident Commander Operations Section Planning Section Logistics Section Finance/Admin Section General Staff Slide courtesy of FEMA
    38 : Incident Command System Span of Control Relates to the supervisory structure of the organization and pertains to the number of individuals or resources one incident supervisor can effectively manage 1-5 is the recommended ratio Organizing resources into Sections, Branches, Groups, Divisions, Units or Teams when the supervisory ratio will exceed 7 or demobilizing when the supervisory ratio falls below 3. Slide courtesy of FEMA
    39 : Maintaining Span of Control Divide an incident geographically. Example east and west wing of hospital Describe functional areas of operation. Example, decontamination team Used when the number of Divisions or Groups exceeds the span of control. Can be either geographical or functional. Divisions Groups Branches The following supervisory levels can be added to help manage span of control: by organizing resources into Divisions, Groups, Branches or Sections Slide courtesy of FEMA
    40 : Basic ICS Structure Organization INCIDENT COMMANDER LIAISON OFFICER SAFETY OFFICER INFORMATION OFFICER OPERATIONS SECTION PLANNING SECTION LOGISTICS SECTION FINANCE SECTION Responsible for determining the appropriate tactics for an incident, conduct of tactical operations, formulation of tactical objectives & organization, & direction of tactical resources Slide courtesy of FEMA
    41 : Operations Section: Divisions Divided geographically Labeled using alphabet characters (A, B, C, etc.). Managed by a Supervisor Division A Division B https://intranet.ahc.umn.edu/ahcimages/Buildings/FrameSet.htm
    42 : Operations Section: Groups Established based on the needs of an incident. Labeled according to the job that they are assigned. Work wherever their assigned task is needed and are not limited geographically. Decontamination Group Patient Care Group Operations Section Slide courtesy of FEMA
    43 : Operations Section: Branches Established if the number of Divisions or Groups exceeds the span of control. Have functional or geographical responsibility for major parts of incident operations. Branch Director Medical Care Branch Security Branch Business Continuity Branch Operations Section Infrastructure Branch Slide courtesy of FEMA
    44 : Staging Manager is a new area for Hospital Incident Command Operations Function Responsible for deploying resources May have several staging areas Medications Staff (Labor pool) Transportation Resources within the Staging Areas are available and ready for assignment (rest and repair areas are NOT located at staging)
    45 : Branches that are essential for maintaining hospital operations Medical Care Branch Responsible for the provision of medical care of the incident victims and patients already in the hospital Infrastructure Branch Facilitates the acquisition and access to essential recovery resources Security Branch Responsible for security for facility and staff, liaison with local agencies Business Continuity Branch Facilitates the acquisition and access to essential recovery resources
    46 : Operations Section: Specialized individual or team of individuals needed for the incident Task forces – mixed resources, common mission ( task force, search and rescue task force) Strike Teams – same resource (Code Blue,IV Team, water-mopping and mass immunization strike team) Single Resources – individuals or team of individuals
    47 : Basic ICS Structure – Modular Organization INCIDENT COMMANDER LIAISON OFFICER SAFETY OFFICER INFORMATION OFFICER OPERATIONS SECTION PLANNING SECTION LOGISTICS SECTION FINANCE SECTION Slide courtesy of FEMA
    48 : Planning Section Prepares & documents the Incident Action Plan, collects & evaluates information, maintains resource status, & maintains documentation for incident record Slide courtesy of FEMA
    49 : Planning Section: Resources Unit Planning Section Resources Unit Demobilization Unit Situation Unit Documentation Unit Conducts all check-in activities and maintains the status of all incident resources. Plays major role in preparing the written Incident Action Plan and maintaining planning cycle. Slide courtesy of FEMA
    50 : Planning Section: Situation Unit Planning Section Resources Unit Demobilization Unit Situation Unit Documentation Unit Planning Section Collects and analyzes information on the current situation. Prepares situation displays and situation summaries. Develops maps and projections. Patient and bed tracking functions Slide courtesy of FEMA
    51 : Planning Section: Documentation Unit Planning Section Resources Unit Demobilization Unit Situation Unit Documentation Unit Planning Section Provides duplication services, including the written Incident Action Plan. Maintains and archives all incident-related documentation. Slide courtesy of FEMA
    52 : Planning Section: Demobilization Unit Planning Section Resources Unit Demobilization Unit Situation Unit Documentation Unit Assists in ensuring that resources are released from the incident in an orderly, safe, and cost-effective manner. Planning Section Slide courtesy of FEMA
    53 : Planning Section: Technical Specialists Provide special expertise useful in incident management and response. May be assigned to work in the Planning Section or in other Sections. Advise the Incident Commander and/or assigned Section on issues related to emergency response in their area of expertise May be assigned as technical advisor in the HCC May be assigned to advise and oversee specific hospital operations
    54 : Basic ICS Structure – Modular Organization INCIDENT COMMANDER LIAISON OFFICER SAFETY OFFICER INFORMATION OFFICER OPERATIONS SECTION PLANNING SECTION LOGISTICS SECTION FINANCE SECTION Slide courtesy of FEMA
    55 : Logistics Section - NIMS Responsible for: Meeting the operational objectives Communications Medical support to incident personnel Food for incident personnel Supplies Facilities Ground support, Transportation Ground Unit Food Unit Facilities Unit Medical Unit Supply Unit Commun. Unit Support Branch Service Branch Logistics Section Slide courtesy of FEMA
    56 : Slide courtesy of FEMA
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