Incident Command System Structure Research Articles

Disaster preparedness: An interprofessional student incident command system simulation

Disasters are complex and require teams to navigate uncertain situations, communicate effectively across teams, craft unified messages, and address inputs from multiple stakeholders in real time. It is vital that students learn to work in interprofessional teams while they are in school so that when they become practicing professionals they have the teamwork and communication skills necessary to collaborate during a disaster. The aim of this interprofessional tabletop simulation was to engage first semester graduate health administration students and upper level undergraduate public health students in an incident command center response to an F5 tornado. Best practices in simulation design, including creating mutual objectives, promoting a safe learning environment, and utilizing a structured debriefing, were used to craft the incident command simulation. Evaluation of the simulation was conducted through direct observation, as well as surveys assessing knowledge gain and satisfaction. Evaluation of quantitative data indicated knowledge gain in incident command system sections and roles, job action sheets to perform necessary actions, and coordination of services to respond to a disaster. Students also reported high levels of satisfaction with the experience and improvements in teamwork and communication skills. Qualitative themes described characteristics of interprofessional education (role clarity, communication, collaboration, teamwork) and simulation (value of practice, complexity of response). Applying evidence-based practices to the design and implementation of this interprofessional simulation helped ensure students gained knowledge with incident command system structure and function and improved their ability to communicate.

How Will You Respond to the Next Emergency?

Features| April 2022 How Will You Respond to the Next Emergency? Stacey Watt, MD, MBA, MHPE, FASA; Stacey Watt, MD, MBA, MHPE, FASA Search for other works by this author on: This Site PubMed Google Scholar Terrence R. Burns, MD, D.ABA; Terrence R. Burns, MD, D.ABA Search for other works by this author on: This Site PubMed Google Scholar Zachary Fetter, DO; Zachary Fetter, DO Search for other works by this author on: This Site PubMed Google Scholar Kenneth Todd, DO; Kenneth Todd, DO Search for other works by this author on: This Site PubMed Google Scholar Vincent Bargnes Vincent Bargnes Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor April 2022, Vol. 86, 26–30. https://doi.org/10.1097/01.ASM.0000826976.66246.ae Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share MailTo Twitter LinkedIn Cite Icon Cite Get Permissions Search Site Citation Stacey Watt, Terrence R. Burns, Zachary Fetter, Kenneth Todd, Vincent Bargnes; How Will You Respond to the Next Emergency?. ASA Monitor 2022; 86:26–30 doi: https://doi.org/10.1097/01.ASM.0000826976.66246.ae Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsASA Monitor Search Advanced Search Topics: internship and residency, mass casualty setting, surgical procedures, operative Any hospital can be impacted by a mass casualty event regardless of the size, location, or capabilities of the facility. A coordinated response cannot be developed between the first warning of a mass casualty event and the arrival of the first patient. This two-part series of articles explains the fundamentals of developing an Incident Command System (ICS). In this second part, we analyze key components of the ICS as well as provide an example of an ICS structure for the perioperative setting of a mass casualty event. Our plan has been tailored to meet the needs of our health care system (Buffalo General Hospital) based upon the core principles of ICS. As we discussed in part 1, the ICS is a standardized approach to the command, control, and coordination of on-scene crisis management (asamonitor.pub/3HRxkD2). This approach provides a common hierarchy where personnel can be integrated across health care... You do not currently have access to this content.

Incident Command in the Time of COVID-19.

The SARS-CoV-2 virus was initially contained in China but rapidly spread across the globe. The grave threat was not apparent until it was already in our midst. Our organization implemented an Incident Command System (ICS), based on previous experience, to respond to the COVID-19 pandemic in a comprehensive and effective manner. This well-known management and response framework is used by many specialties and organizations in disasters of different complexity and size. Our ICS was able to assemble the appropriate people, assess the situation, and develop and implement plans to deal with the COVID-19 crisis. The effectiveness of the ICS structure and its execution was instrumental in getting in front of the virus and managing regional activities. The ICS is an effective tool to improve safety and mitigate risk when dealing with large-scale disasters and should be implemented and practiced before the need arises.Our organization implemented a formal Incident Command System (ICS) very early as a response to the COVID-19 pandemic. Although it recently disbanded, we are maintaining its core functionality and communication as we continue to deal with COVID-19 into the future. The author has observed the ICS being used at hospitals through hurricanes, blizzards, and riots but never saw it work as well as it did during the initial weeks of the pandemic. This group deftly navigated through uncharted waters by leveraging the spirit and structure of Incident Command.

Aligning student-led initiatives and Incident Command System resources in a pandemic.

Removed from classrooms and clinics amid the coronavirus disease 2019 (COVID-19) pandemic, health professions students have answered the call to fulfil alternative roles by rapidly mobilising to address health system and community-identified needs in innovative ways.1 Many institutions, including the University of Nebraska Medical Center (UNMC), have formally recognised student roles by adding service learning requirements to adapted curricula. Although the crisis has spurred an explosion of student-led volunteer initiatives, many risk operating beyond the protection of their academic institution and could bolster their efficacy by harnessing institutional resources. The UNMC formally integrated student-led service initiatives into the institution’s Incident Command System (ICS) operations section. The ICS, a component of the United States Federal Emergency Management Agency (FEMA) guidelines, is designed to effectively manage resources, procedures and communications in emergency scenarios. Our initiative, UNMC COVID Relief (UNMC CoRe; www.unmccore.org/), catalysed this integration as we developed our tripartite mission: the provision of child and pet care for frontline health care workers; the collection and distribution of personal protective equipment (PPE), and the coordination of community mask sewing. At 10 weeks after its conceptualisation and 5 weeks after ICS integration, UNMC CoRe had organised an interprofessional group of 263 student volunteers, distributed 41 000 units of various PPE items to 131 under-resourced clinics and hospitals, and galvanised 400 community members to sew 40 000 masks for intensive care unit patients, visitors and non-clinical staff. By directly linking UNMC CoRe to the university’s crisis mitigation efforts, we established a defined means of utilising institutional resources. Applications of this integration included a media relations collaboration to produce instructional videos on mask sewing, a finance department partnership to create a portal for tax-deductible donations, and access to information technology licenses for volunteer management and communication. These institutional links facilitated our support of systems-level needs and granted administrators a streamlined connection to a previously decentralised volunteer network. Although many student organisations operate independently of their universities, members of these grassroots initiatives can often be identified by their common academic institution and may inadvertently create legal vulnerabilities for themselves and their institutions. Integrating UNMC CoRe into the ICS chain of command provided greater legal protection to our volunteers. For example, student leaders gained insight into critical language for volunteer release forms by working with university risk management services. This coordination also ensured that volunteers employed proper precautions when providing child care for health care workers. Finally, the ICS framework facilitated multidisciplinary collaboration. Academic health centres often consist of multiple independent professional schools, which contributes to siloed volunteer structures designed by and for specific health professions. Consolidating within the ICS framework helped our organisation to galvanise a campus-wide, interprofessional effort with a diverse volunteer pool. Our fundamental reflection is that the formal pairing of learner-led initiatives with institutional resources fosters innovation from students and academic health centre leaders alike. In the coming months, we intend to formally assess qualitative outcomes derived by student volunteers. The integration of UNMC CoRe into the UNMC ICS structure sets an important precedent for the formal consideration of student-led initiatives within institutional emergency preparedness and response efforts.

Use of Incident Command System in Health Emergency Management for FDMN’s in Bangladesh: a Qualitative Study

Background: Bangladesh bears the double burden of extreme exposure and high vulnerability to both natural and man-made disasters. In 2017, an enormous influx of Forcibly Displaced Myanmar Nationals from Myanmar to Bangladesh created massive humanitarian crisis due to geopolitical conflicts.
 Objective: The objective of this study was to assess the FDMN’s health situation and to work with the district health office facing the emergency. Another objective was to introduce a proper Incident Command System (ICS) approach in order to achieve system efficiencies and improve management capabilities of the district health office.
 Materials and Methods: This qualitative, exploratory study was conducted at three Upazilas and two disaster prone coastal civil surgeon offices in Bangladesh over a period of one year from May, 2017 to April, 2018. The target population of the study was FDMN’s, local inhabitants, health care providers, public health managers and administrators at different level. Using non-probability purposive sampling method as data collection procedure, 50 semi-structured interviews were carried out.
 Results: A rapid field assessment was done followed by detailed field assessment. In rapid field assessment it was observed that gaps in proper leadership created confusion and for that some participants were overlooked, while others were underutilized. There was gap in coordination between different actors in the field. It was observed that in crisis situation, challenges associated with coordination and delegations were almost similar. Interview was taken based on concepts from political and social science approaches. Under each approach emergency health management issues, gaps and constrain were discussed along with proposed solutions. In order to conduct a detailed field assessment incident command system approach were broken down to five major categories. Two ICS orientation workshop were done in Cox’s Bazar and Chittagong civil surgeon office. It was evident that CS offices would not have the entire workforce as ICS structure demand but identifying existing stuffs that could fill in all those roles in ICS structure with how to work and go in operation was done.
 Conclusion: The study advocates that with limited resources utmost priority should be given to train the existing workforce for emergency preparedness, planning and response. Evidence-based incident command system deployment would be beneficial for health emergency management for vulnerable people in Bangladesh.
 JOPSOM 2019; 38(2): 53-62

Response Functions in Disasters: Iran Flash Flood 2016

Heavy rain and flash flooding left behind a trail of disaster in the western and south-western provinces of Iran in April 2016. The purpose of this study is to highlight the response functions that should be undertaken when such disasters strike. Secondary data, such as documents, organizational reports, and forms completed during response to the flood visits, were the methods of data collection in this study. Then, collected data were analyzed according to the response functions to disasters. The study found that a strong disaster response function was the early warning system, by the Iran Meteorological Organization, announced 1 week before the flood. Weaker functions were the lack of coordination among response organizations and the lack of a safety officer in the Incident Command System structure during the flash flood. The list of the disaster response functions identified by this study should aid the decision makers and first responders in facing natural or man-made disasters and enable them to better prepare for response functions in the future disasters.

Chevron Position Qualification System for Development of Emergency Response Leadership

ABSTRACT The 2010 Deepwater Horizon incident raised the awareness of the potential scale, complexity and duration of oil spill events, highlighting the need for emergency response organizations to develop and maintain advanced levels of capability and readiness. Such capability and readiness requires teams of experienced and trained personnel who ideally can be cascaded throughout an enterprise to fill Incident Command System (ICS) positions in coordination with outside organizations. Experience gained through either responses to real- world events or carefully crafted simulation exercises is critical to the development and maintenance of response team capability, and providing such can present a significant challenge for team coordinators. Chevron Corporate Emergency Response developed and tested a qualification program aimed at providing consistency and structure to the training and experiential development of Chevron's corporate emergency response personnel. The Chevron Position Qualification System (CPQS) program establishes a minimum level of training and observed demonstrated competencies for leadership positions within the ICS structure. Twenty-one position-specific workbooks detail training, readiness and competency metrics for internal certification through the program. CPQS draws from different established agency programs and is consistent with ICS training curriculum. The program is tailored to fit the roles filled by Chevron Corporate Emergency Response Team members. Members of Chevron's Corporate Emergency Response Teams have a baseline of professional training that supports and sustains a corporate culture of safety, operational discipline and environmental, safety risk and hazard awareness. The CPQS program was built upon the premise that participants have this foundational training, capability and professionalism. The CPQS program builds upon this foundation, expanding the professional competency of response personnel through a standardized program. The CPQS program establishes minimum ICS and function-specific courses along with recommended training and the demonstration of specified skills and abilities in either real-world or exercise environments. Qualified and vetted approvers, known within the program a Qualified Approvers, provide consistent verification of the demonstration of skills and capabilities identified for each position. Additionally, these expert observers provide commentary on areas where skills or professional expertise can be improved. The goal of CPQS is to enable a mobile and versatile workforce that can respond worldwide and integrate into response organizations around the globe. Skills gained through the completion of CPQS requirements enable business units to transfer personnel into key response positions across the enterprise to carry out responses to more complex events. Common training and exercising goals allow organizations to gain efficiencies and build progressive experience and expertise-building opportunities through shared professional development resources. Periodic refresher training and ongoing participation in response exercises or actual incidents are also required to maintain the certification. The CPQS program is currently used by Chevron's Corporate Emergency Response Teams and was field tested at a three-day response exercise in Trieste, Italy where responders from relevant functional groups completed training and demonstrated response capabilities and ICS skills. CPQS is also being utilized with the Chevron regional response team in the Gulf of Mexico with an initial implementation at a training and exercise event in Covington, Louisiana, USA.

Regional Interoperability: Making Systems Connect in Complex Disasters

Effective use of the Incident Command System (ICS) is the key to regional interoperability. Many different organizations with different command structures and missions respond to a disaster. The ICS allows different kinds of agencies (fire, police, and medical) to work together effectively in response to a disaster. Functional requirements, not titles, determine the organizational hierarchy of the ICS structure. The ICS is a modular/adaptable system for all disasters regardless of etiology and for all organizations regardless of size.

Standardized Emergency Management System and Response to a Smallpox Emergency

AbstractThe smallpox virus is a high-priority, Category-A agent that poses a global, terrorism security risk because it: (1) easily can be disseminated and transmitted from person to person; (2) results in high mortality rates and has the potential for a major public health impact; (3) might cause public panic and social disruption; and (4) requires special action for public health preparedness. In recognition of this risk, the Los Angeles County Department of Health Services (LAC-DHS) developed the Smallpox Preparedness, Response, and Recovery Plan for LAC to prepare for the possibility of an outbreak of smallpox.A unique feature of the LAC-DHS plan is its explicit use of the Standardized Emergency Management System (SEMS) framework for detailing the functions needed to respond to a smallpox emergency. The SEMS includes the Incident Command System (ICS) structure (management, operations, planning/intelligence, logistics, and finance/administration), the mutual-aid system, and the multi/interagency coordination required during a smallpox emergency. Management for incident command includes setting objectives and priorities, information (risk communications), safety, and liaison. Operations includes control and containment of a smallpox outbreak including ring vaccination, mass vaccination, adverse events monitoring and assessment, management of confirmed and suspected smallpox cases, contact tracing, active surveillance teams and enhanced hospital-based surveillance, and decontamination. Planning/intelligence functions include developing the incident action plan, epidemiological investigation and analysis of smallpox cases, and epidemiological assessment of the vaccination coverage status of populations at risk. Logistics functions include receiving, handling, inventorying, and distributing smallpox vaccine and vaccination clinic supplies; personnel; transportation; communications; and health care of personnel. Finally, finance/administration functions include monitoring costs related to the smallpox emergency, procurement, and administrative aspects that are not handled by other functional divisions of incident command systems.The plan was developed and is under frequent review by the LAC-DHS Smallpox Planning Working Group, and is reviewed periodically by the LAC Bioterrorism Advisory Committee, and draws upon the Smallpox Response Plan and Guidelines of the Centers for Disease Control and Prevention (CDC) and recommendations of the Advisory Committee on Immunization Practices (ACIP). The Smallpox Preparedness, Response, and Recovery Plan, with its SEMS framework and ICS structure, now is serving as a model for the development of LAC-DHS plans for responses to other terrorist or natural-outbreak responses.

Comprehensive Oil Spill Response Planning: Going Beyond “What” your Going to do

ABSTRACT A review of the law and responsibilities for oil spill response reveals a need for taking oil spill response incident management planning beyond just describing what will be done, to a new level that describes specifically who will do it. Facilitating the development of an effective management team in the first 24–48 hours of a spill is critical to setting the response operations in a positive motion, and ultimate success. The development of a draft Incident Command System (ICS) structure to meet the expectations of a Type II incident and pre-identification of personnel for specific assignments will enable a more cohesive personnel qualification process, training and exercises focused on general incident management, and ultimately a better prepared cadre of response personnel. The vision for Coast Guard District Thirteen is a District Response Group that is organized into a defined and pre-approved ICS structure, with these expectations set. The National Oil and Hazardous Substances Pollution Contingency Plan requires the Coast Guard to form District Response Groups. By definition, this is all personnel and every asset the Coast Guard has within each District. However, this does not speak to the qualifications of these personnel, or address the tasking some units may receive, both of which are known. In the early hours of a major spill, confusion reigns and calls for help are made. This can be a call for help that is specific, such as the number of beach monitors, OPS Section Chiefs, or Check-in Recorders that are needed, or the more likely request is to send whoever is available. The latter is not likely to enable success if well intentioned but inexperienced management personnel show up. If we know who is available within the Coast Guard district, then we know our strengths. Therefore, we also know our weaknesses, and can identify gaps. By identifying our ICS structure, we can examine our resources, needs, and expectations; and have a plan that works while remaining flexible. There is no need to assemble a management team on the fly in the first 24 hours of a spill.

Adaptation of the Incident Command System to Oil Spill Response During the American Trader Spill

ABSTRACT While developing its new crisis management plan in 1989, BP America (BPA) modified the incident command system (ICS) for use as the organizational structure of its oil spill response team. This was done to be compatible with the post-Exxon Valdez organization of the Alyeska response team and for certain advantages it would provide for responses in other locations and in other types of crisis situations. The ICS was originally developed for fighting wildfires in California and has since been widely adopted by other fire and emergency services in the U. S. While retaining most of the ICS structure, ?PA developed modifications necessary to fit the unique requirements of oil spill response. The modified ICS was used during a full scale test of ?PA's draft crisis management plan in December 1989, and thus was familiar to ?PA's top executives and other participating response team members. When the American Trader spill occurred in February 1990, BPA's management used the modified ICS organization even though the crisis management plan had not been finalized or widely distributed within the company. Details of the organizational structure evolved as the spill response progressed, in part due to the changing requirements of the response over time and in part because of previously unrecognized issues. This paper describes that evolution and the resulting final structure. Essential differences between the original ICS and BPA's oil spill version of it are highlighted. Despite the unrecognized issues and the unfamiliarity of some team members with the ICS, the organization worked well and can be credited with a share of the success of the American Trader response.