National Incident Management System Research Articles

The Common Ground Preparedness Framework: A Comprehensive Description of Public Health Emergency Preparedness

Currently, public health emergency preparedness (PHEP) is not well defined. Discussions about public health preparedness often make little progress, for lack of a shared understanding of the topic. We present a concise yet comprehensive framework describing PHEP activities. The framework, which was refined for 3 years by state and local health departments, uses terms easily recognized by the public health workforce within an information flow consistent with the National Incident Management System. To assess the framework's completeness, strengths, and weaknesses, we compare it to 4 other frameworks: the RAND Corporation's PREPARE Pandemic Influenza Quality Improvement Toolkit, the National Response Framework's Public Health and Medical Services Functional Areas, the National Health Security Strategy Capabilities List, and the Centers for Disease Control and Prevention's PHEP Capabilities.

Hospital-Based Coalition to Improve Regional Surge Capacity

IntroductionSurge capacity for optimization of access to hospital beds is a limiting factor in response to catastrophic events. Medical facilities, communication tools, manpower, and resource reserves exist to respond to these events. However, these factors may not be optimally functioning to generate an effective and efficient surge response. The objective was to improve the function of these factors.MethodsRegional healthcare facilities and supporting local emergency response agencies developed a coalition (the Healthcare Facilities Partnership of South Central Pennsylvania; HCFP-SCPA) to increase regional surge capacity and emergency preparedness for healthcare facilities. The coalition focused on 6 objectives: (1) increase awareness of capabilities and assets, (2) develop and pilot test advanced planning and exercising of plans in the region, (3) augment written medical mutual aid agreements, (4) develop and strengthen partnership relationships, (5) ensure National Incident Management System compliance, and (6) develop and test a plan for effective utilization of volunteer healthcare professionals.ResultsIn comparison to baseline measurements, the coalition improved existing areas covered under all 6 objectives documented during a 24-month evaluation period. Enhanced communications between the hospital coalition, and real-time exercises, were used to provide evidence of improved preparedness for putative mass casualty incidents.ConclusionThe HCFP-SCPA successfully increased preparedness and surge capacity through a partnership of regional healthcare facilities and emergency response agencies.

An adaptive governance approach to disaster‐related behavioural health services

This paper explores the provision of disaster-related behavioural and mental health (DBH) services as a problem of institutional collective action in the United States. This study reviews the challenges that providers have in surmounting multi-organizational disconnects, unstable professional legitimacy, ambiguous information, and shifting disaster needs in developing a system for delivering DBH services. Based on the adaptive governance framework, it argues that existing protocols such as the National Incident Management System (NIMS) and Incident Command System (ICS) may be helpful in advancing collective action, but that real progress will depend on a recognition of norms, expectations, and credentials across many spheres-in other words, on the ability of responders to continuously adjust their procedures and administrative boundaries for behavioural health institutions.

Engineering the Incident Command and Multiagency Coordination Systems

The initial development of the Incident Command System (ICS) and the Multiagency Coordination System (MACS) was conducted through an extensive research, development, and application program initiated by the United States Forest Service in the 1970s and 1980s. Known as FIRESCOPE (Firefighting Resources of California Organized for Potential Emergencies), the complex development process produced these two major management systems that are now central to the Department of Homeland Security’s National Incident Management System (NIMS). Despite the prominence of NIMS, very little information is widely available regarding the original research and development of ICS and MACS. This paper explores the extensive product development and consensus process used to create ICS and MACS, plus the implementation process that propagated these landmark systems that continue to expand in prominence for incident management and coordination during emergencies and disasters. Through analysis of historical documents and interviews with professionals centrally involved in FIRESCOPE, this paper chronicles the evolution of ICS and MACS, including a summary of their varied courses following the end of the original 10-year FIRESCOPE Program initiative.

(A324) Emergency Management Preparedness and Response Planning in the US: Aphis Foreign Animal Disease Preparedness and Response Plan (FAD PREP)

BackgroundPreparing for and responding to foreign animal diseases are critical missions to safeguard any nation's animal health and food supply. A specific challenge of foreign animal disease preparedness and response is the ability to rapidly incorporate and scale-up veterinary functions and countermeasures into emergency management operations during a disease outbreak. The United States Department of Agriculture, Animal and Plant Health Inspection Service, Veterinary Services has established a Foreign Animal Disease Preparedness and Response Plan (FAD PReP) which provides a framework for FAD preparedness and response. The FAD PReP goal is to integrate, synchronize, and de-conflict preparedness and response capabilities, as much as possible, before an outbreak by providing goals, guidelines, strategies, and procedures that are clear, comprehensive, easily readable, easily updated, and that comply with the National Incident Management System (NIMS). An overview of FAD PReP will be presented.BodyThe APHIS FAD PReP incorporates and synchronizes the principles of the National Response Framework (NRF), the National Incident Management System (NIMS), and the National Animal Health Emergency Management System (NAHEMS). The FAD PReP contains general plans and disease specific plans that include incident goals, guidelines, strategies, procedures and timelines for local, State, Tribal and Federal responders. The FAD PReP helps raise awareness of the required veterinary functions and countermeasures, helps identify gaps or shortcomings in current response preparedness and planning, and helps to provide a framework to the States, Tribes, and Industry sectors in developing their individual response plans for specific diseases such as HPAI and FMD. The FAD PReP will also identify resources and personnel for potential zoonotic disease outbreaks and large-scale outbreaks, define stakeholder expectations for successful and timely outcomes, identify and resolve issues that may become competing interests during an outbreak and provide a systems approach to preparedness issues that need additional time, attention and collaboration.

(P2-34) Experiential Learning in Disaster Response for Veterinary Students and Veterinarians

Training for disaster responsiveness for veterinarians includes Incident Command System (ICS) and National Incident Management System (NIMS) comprehension, euthanasia, bio-security, all-hazards emergency preparedness, business continuity training, responder training, and incident de-briefing, Public and emergency management officials at all levels agree that saving animal lives saves human lives. Despite the recognition of the importance of veterinarians and other animal caretakers in animal disaster response and incident de-briefing, there has been less than adequate targeting of these groups for training opportunities leaving many veterinarians and other animal care takers vulnerable and unsure of their role when presented with a call to action in the midst of a disaster scenario in their home communities. The Louisiana State University School of Veterinary Medicine (LSU-SVM) has taken advantage of its physical presence amidst a disaster prone region of the United States to form response teams made up of students, faculty, and staff for actual training events termed disaster response experiential learning. Through a solid partnership with the Louisiana State Animal Response Team (LSART) and other response groups, the LSU-SVM has developed a disaster response program that includes animal response planning, evacuation, sheltering, emergency triage, and technical rescue expertise. Five specific response activities that occurred between 2001 and 2010 where LSU-SVM partnered with local and regional emergency responders enabled veterinary students and veterinarians to provide the work force and engage in experiential learning in a “hand-over-hand” environment with certified emergency responders. The response activities and partnerships demonstrate a successful model for veterinary student and veterinarian training in disaster response, have provided robust training experiences for hundreds of veterinary students and veterinarians, and have resulted in the subsequent development of courses to address identified gaps in veterinary disaster response training.

(A226) Establishing a Framework for Synchronizing Critical Decision Making with Information Analysis during a Health/Medical Emergency

BackgroundThe Yale New Haven Center for Emergency Preparedness and Disaster Response (YNH-CEPDR) has worked in the United States with state and local health and medical organizations to evaluate critical decision making activities and to develop decision making tools and protocols to enhance decision making in a time sensitive environment. YNH-CEPDR has also worked with international organizations and US federal agencies to support situational awareness activities in simulated and real world events.ObjectivesDuring this session YNH-CEPDR will share the best practices from recent events such as the H1N1 response and the Haiti Earthquake. Participants will be engaged in discussions regarding overall framework for successful information collection, analysis and dissemination to support decision making based on these experiences. This session will also incorporate concepts provided by the US National Incident Management System (NIMS) and the Incident Command System (ICS), specifically through the development of Situational Reports (SitReps), Incident Action Plans (IAP) and Job Action Sheets as methods to implement the framework and concepts discussed. Participants will be led through a series of scenario-based discussions to allow application of critical decision making factors to their organization. At the conclusion of the session, participants will be able to identify next steps for enhancing the synchronization of critical decision making and information analysis within their organizations.

Volunteer Fire Department Perceptions of ICS and NIMS

A mail survey designed to explore perceptions of the Incident Command System (ICS) and the National Incident Management System (NIMS) was sent to volunteer fire fighters and department chiefs in Spring of 2008. The data demonstrated that both ICS and NIMS were not well perceived among responding volunteer fire chiefs and volunteer fire fighters in North Dakota. Rather than indicating issues with the ICS or NIMS systems themselves, respondents’ comments revealed concerns with the systems to be rooted in their status as volunteers and their residence in rural areas.

Factors in Building an Incident Command Organization for the Largest Oil Spill in U.S. History

ABSTRACT The Deepwater Horizon MC 255 Oil Spill (DWH) was the largest oil spill in U.S. history, with over 255 million gallons of oil estimated released into the environment. The response to the spill was massive involving tens of thousands of resources on the ground, on the water, under the sea and in the air. The National Incident Management System's Incident Command System (ICS) was the command and control structure used to manage these resources. In the words of a nationally recognized ICS expert, Mr. Charles Mills, President of Emergency Management Systems Incorporated, “This was the most complex incident managed with ICS in the history of its use.”1 This paper focuses on the ICS organization built for the DWH incident to provide some useful information to planners and emergency preparedness professionals to use in their pollution response contingency plans and preparedness programs. This paper will focus on the State of Louisiana Incident Command Post (ICP). Due to the size of the spill and the resp...

Branch-Level Planning during a Spill of National Significance: A Best Practice from the MC-252 Incident

ABSTRACT Following the Exxon Valdez oil spill in 1989, the Oil Pollution Act of 1990 required that the National Contingency Plan be amended to include procedures for the response to a Spill of National Significance (SONS). Although SONS exercises were conducted over the last 20 years, no actual SONS occurred until the explosion of the MC-252 well in the Gulf of Mexico caused the largest oil spill in United States history in April of 2010. The MC-252 event showed that, although the United States government and industry had planned for a SONS, the full breadth of such a large-scale event was greater than anyone could have ever predicted. Although the National Incident Management System (NIMS) Incident Command System (ICS) structure was fully implemented, the scale of the response required the creation of new, innovative procedures outside of any planning that had occurred for a spill of this size. One of these procedures was the implementation of Branch-level Planning. In the Incident Command Post (ICP) Mob...

Disaster Management and Response Strategy in Urban Public Safety of the U.S.A

This presentation is intended to provide response managers and others with an understanding of national preparedness and response system that is in place to address emergencies involving industrial accidents, natural disasters, public health and social securities. This paper describes a list of important competencies that have been identified and used for effective disaster response and the management and response procedures of a typical incident in USA, taking 2008 flood in Illinois as an instance. Using the concept of National Incident Management System (NIMS) and Incident Command System (ICS), Incident Management Teams (IMTs) were trained and established in Illinois. These organizations were deployed into various positions so as to assist the governmental organizations at different levels in planning, commanding, decision making, etc.

Sociology and the National Incident Management System (NIMS): Oil and Water?

Like many previous areas of study, disaster science is in the process of incorporating a disparate range of analytical and operational concepts into a single, relatively unified discipline. As a new science, the field is experiencing simultaneous growth as both an academic topic of study, and as an operational profession. The number of accredited degree programs and the number of professional emergency managers have each grown exponentially in recent years. This realization leads to several simple, yet important, questions: Do emergency management and sociology maintain any meaningful communication with one another? In what ways might academics and practitioners interact? What is the path to translate science theory into practice? Here, we will compare and contrast the academic and practical realms of sociology and disaster science. The methodology will include a review of the search strategies employed, a brief examination of the existing literature, and results from a recent survey of practitioners. Overviews of the National Incident Management System (NIMS) and of traditional or established sociological science will also be provided. These two vantage points will then be compared and contrasted, and the possibility of a combined model examined. This overview will conclude with a summary of the state of the disaster sciences, and the identification of a suggested path forward, which includes increased educational interaction. In essence, the core query becomes whether or not primary elements of sociology are compatible with hierarchal command structures such as NIMS. Of course, the greater conversation regarding disaster science does not exist in a bubble. It has an outcome upon which large numbers of human lives quite literally depend.

Importance of Uniformity in Local Emergency Management Agency Web Sites

This study focused on the uniformity of Web sites operated by local emergency management agencies (EMAs) as they pertain to the availability of relevant emergency preparedness and response information. Of the 3,128 counties (or county equivalents) in the United States, we found Internet homepages for 1,612 local EMAs (51.5%). We reviewed each homepage to document the presence (or absence) of nine elements deemed to be essential for effective communications during emergency or disaster situations. Local EMA Web site homepages had a mean of 4.5 (± 1.5) elements. Among the findings, this review revealed that about four out of five (82.3%) of the local EMAs included the agency phone number, more than half (52.0%) provided links to other agencies with emergency preparedness information, and about two in five (38.3%) listed an agency email address. A few more than one in five (21.1%) of the local EMA homepages reviewed allowed visitors to sign up for automatic alerts or notifications. The nine communication elements identified in our study provide a minimal standard for content. We suggest that these results be used as a starting point in developing a uniform template containing the nine homepage elements. Such a template compliments National Incident Management System (NIMS) protocols and can provide a recognizable source of consistent and reliable information for people during emergency or disaster incidents.

The Current NIMS Implementation Behavior of United States Counties

This study described and explained the current implementation behavior of counties in the United States with respect to the National Incident Management System (NIMS). Data were collected in two phases: 1) an internet survey was sent to a national random sample of county emergency managers and 2) a mail survey was sent to emergency managers in the sample that had not completed the internet survey. When data collection ceased, 355 randomly selected county emergency managers had participated in the study providing a nationally generalizable study. It was discovered that NIMS may be limited in its usefulness as the foundation for our nationwide emergency management system as well as its potential for use in large-scale disaster situations because of the wide variation in the manner in which NIMS is currently being implemented in counties across the United States.

Communications Between Local Health Departments and the Public During Emergencies

Of the 2790 local health departments (LHDs) in the United States, Internet homepages were located for 1986. We reviewed each homepage to document the presence of 9 elements deemed to be critical for effective communications during emergency or disaster situations. LHD Web site homepages had a mean of 4.1 (±1.4) elements. Among the findings, this review revealed that 4 of 5 (80.5%) of the LHDs included the agency phone number, half (49.4%) provided links to emergency information, and about 1 in 5 (19.6%) listed an agency e-mail address. Fewer than 1 in 20 (4.3%) of the LHD homepages reviewed allowed visitors to sign up for automatic alerts or notifications. We suggest that these results be used as a starting point in developing a standardized template containing the 9 homepage elements. Such a template complements National Incident Management System protocols and can provide a recognizable source of consistent and reliable information for people during a public health emergency or disaster.

Public Health-Specific National Incident Management System Trainings: Building a System for Preparedness

Local health departments (LHDs) are at the hub of the public health emergency preparedness system. Since the 2003 issuance of Homeland Security Presidential Directive-5, LHDs have faced challenges to comply with a new set of all-hazards, 24/7 organizational response expectations, as well as the National Incident Management System (NIMS). To help local public health practitioners address these challenges, the Centers for Disease Control and Prevention-funded Johns Hopkins Center for Public Health Preparedness (JH-CPHP) created and implemented a face-to-face, public health-specific NIMS training series for LHDs. This article presents the development, evolution, and delivery of the JH-CPHP NIMS training program. In this context, the article also describes a case example of practice-academic collaboration between the National Association of County and City Health Officials and JH-CPHP to develop public health-oriented NIMS course content.

Improving Home-Based Hospice Understanding and Use of the National Incident Management System for Emergency and Disaster Preparation and Response

Critical to an organized and successful emergency response is having a plan based on the framework used exclusively by community and national emergency service organizations, that is, the National Incident Management System (NIMS). Standardization is vital so that diverse types of organizations can work in harmony to respond to emergencies. NIMS provides the opportunity for this standardization. Home-based hospices are generally unaware of NIMS and its value during a multiagency response to an incident. Care should be taken to revise emergency and disaster preparation and response plans to reflect the national standard.

Water rescue management in suburban environments

Effective water rescue management requires careful assessment of historical data, prediction of future rescue locations, and proper allocation and deployment of resources to ensure effective and safe rescue operations in suburban environments. Emergency workers in suburban communities are faced with an increased probability of water rescues resulting from growing population and improved access to waterbodies. This study investigates 152 water rescues performed in suburban Chester County, Pennsylvania, between 2002 and 2008. Fifty percent of the rescues occurred during flood events and were characterized by many multiple, concurrent rescues. The remaining rescues were associated with recreational use of waterbodies and flooding of roadways due to inadequate drainage. In this study, the Water Rescue Probability Index (WRPI) is presented, which uses the spatial correlation of waterbodies, roadways, and population to predict water rescue locations. The WRPI predicted 88 percent of recorded rescues, demonstrating its use as a planning tool. Emergency managers should train and equip their first responders to national standards and must be prepared to use the National Incident Management System when large incidents occur.

THE VIEW FROM THE TRENCHES: PART 1–EMERGENCY MEDICAL RESPONSE PLANS AND THE NEED FOR EPR SCREENING

Few natural disasters or intentional acts of war or terrorism have the potential for such severe impact upon a population and infrastructure as the intentional detonation of a nuclear device within a major U.S. city. In stark contrast to other disasters or even a "dirty bomb," hundreds of thousands will be affected and potentially exposed to a clinically significant dose of ionizing radiation. This will result in immediate deaths and injuries and subsequently the development of Acute Radiation Syndrome (ARS). Additionally, millions more who are unlikely to develop ARS will seek medical evaluation and treatment, overwhelming the capacity of an already compromised medical system. In this paper, the authors propose that in vivo electron paramagnetic resonance (EPR) dosimetry be utilized to screen large numbers of potentially exposed victims, and that this screening process be incorporated into the medical-surge framework that is currently being implemented across the nation for other catastrophic public health emergencies. The National Incident Management System (NIMS), the National Response Framework (NRF), the Target Capabilities List (TCL), Homeland Security Presidential Directives (HSPD), as well as additional guidance from multiple federal agencies provide a solid framework for this response. The effective screening of potentially-exposed victims directly following a nuclear attack could decrease the number of patients seeking immediate medical care by greater than 90%.

The Elephant in the JIC: The Fundamental Flaw of Emergency Public Information within the NIMS Framework

The National Incident Management System (NIMS) framework is the nationally-accepted model for emergency public information for emergencies and disasters. NIMS mandates that all released public information are approved by the Incident Commander prior to distribution. Unfortunately, this does not accommodate the need and structure of social media outlets which have quickly become an integral component of public communication during an event with emergent information and details. These two communication mechanisms must be reconciled to ensure successful emergency public information during future emergencies or disasters.