Implementing the Hospital Emergency Incident Command System: An Integrated Delivery System's Experience

Abstract

Introduction:Hospital disaster manuals and response plans often lack formal command structure; instead, they rely on the presence of key individuals who are familiar with hospital operations, or who are in leadership positions during routine, day-to-day operations. Although this structure occasionally may prove to be successful, it is unreliable, as this leadership may be unavailable at the time of the crisis, and may not be sustainable during a prolonged event. The Hospital Emergency Incident Command System (HEICS) provides a command structure that does not rely on specific individuals, is flexible and expandable, and is ubiquitous in the fire service, emergency medical services, military, and police agencies, thus allowing for ease of communication during event management.Methods:A descriptive report of the implementation of the HEICS throughout a large healthcare network is reviewed. Results and Conclusions: Implementation of the HEICS provides a consistent command structure for hospitals that enables consistency and commonality with other hospitals and disaster response entities.

Principles and Practice of Disaster Relief: Lessons From Haiti

“…The earliest emergency management system, reportedly, was the Vienna Voluntary Rescue Society, formed in the aftermath of the Vienna Ring Theater fire in 1881. The Incident Command System concept uses a common organizational structure and language and allows disparate agencies (fire, police, emergency medical services) and/or multiple branches of the same agencies to work together effectively in response to a disaster 12,13…”

Hurricane Evacuations of the University of Texas Medical Branch at Galveston

“…To become ready for catastrophic cases, it is relevant to develop localized structures, disaster plans and to establish drills. The following functional sections should be established: incident commander, incident planning, logistics, administration, communication (internal, with committees and media), and security (Born et al, 2007a(Born et al, , 2007bZane & Prestipino, 2004). At UTMB in Galveston, valuable lessons have been learned from the sequential evacuation of the university hospital.…”

“…The sooner an evacuation may be started, the higher the likelihood that the evacuation will proceed accordingly to the emergency plans. The Incident Command center has to keep track of evacuated patients and on-site personnel, to utilize expert clinical staff (MDs and RNs) to coordinate loading of ambulances and helicopters for patient transfer, or to reassign staff as necessary to care for transferred patients (Zane & Prestipino, 2004). 3.…”

Hurrikan Ike

“…Eine Schlüsselrolle spielte hierbei die Installation eines Leitenden Notarztes, der durch den Universitätspräsidenten bestimmt wurde und die alleinige Entscheidungsgewalt während der gesamten Evakuierungsphase trug. Dem Leitenden Notarzt wurde ein "incident response team" zur Seite gestellt, das aus Vertretern verschiedener medizinischer Fachbereiche sowie aus Sicherheitsbeamten der UTMB-Polizei und Kommunikationsspezialisten bestand [11,12].…”