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HOSPITAL INCIDENT COMMAND SYSTEM (HICS)

The hospital has implemented the Hospital Incident Command Structure IV (HICS) developed by the Emergency Medical Services Authority (EMSA) of California as a revision from the previous Hospital Emergency Incident Command System III (HEICS).

HICS is an incident management system based on the Incident Command System (ICS) that assists hospitals in improving their emergency management planning, response, and recovery capabilities for unplanned and planned events. HICS is consistent with ICS and the National Incident Management System (NIMS) principles. The new HICS has been restructured to be consistent with ICS and NIMS principles and will provide greater flexibility/adaptability for the hospital setting (NIMS Element 2).

Operations Section
The Operations Section conducts the tactical operations (e.g., patient care, clean up) to carry out the plan using defined objectives and directing all needed resources. Many incidents that are likely to occur involve injured or ill patients. The Operations Section will be responsible for managing the tactical objectives outlined by the Incident Commander. A subject level expert in the health care emergency service will be required for this position. A potential individual for this role may be the CNO (or someone familiar with the hospital disaster policy).

The Operations section is typically the largest in terms of resources to marshal and coordinate. To maintain a manageable span of control and streamline the organizational management, Branches, Divisions and Units are implemented as needed. The degree to which command positions are activated depends on the situational needs and the availability of qualified command officers. The NIMS span of Control ratio of 5-7 individuals will be observed.

Planning Section
The Planning Section collects and evaluates information for decision support, maintains resource status information, prepares documents, and maintains documentation for incident reports. It will also be responsible for preparing status reports, displaying various types of information, and developing the Incident Action Plan (IAP). The effectiveness of the Planning Section has a direct impact on the availability of information needed for the critical, strategic decision-making done by the Incident Commander and the other General Staff positions.
The Incident Commander will assign the position of Planning Section Chief, which can be filled by the Emergency Management Coordinator, Chief Quality Officer, Administrator On-Call, etc. A senior representative from the Medical Staff, Information Systems, and Admitting Departments should support the Planning Sector Chief.

Logistics Section
The Logistics Section provides support, resources, and other essential services to meet the operational objectives set by Incident Command. The Director of Facilities or an individual with knowledge of the building structure, utilities, material resources, etc. would be appropriate for this role.

For the hospital to respond effectively to the demands associated with a disaster, support requirements will be coordinated by the Logistics Section. These responsibilities include acquiring resources from internal and external sources using standard and emergency acquisition procedures and requests to the Pima County EOC or the Regional HCC. Each resource request from an area in the hospital should be reported to the Logistics Section using pre-identified ordering procedures outlined in the EOP. When requesting resources from outside sources, it will be important that the hospital specify exactly what its need are and not try to identify how that need can be met: that will be done at the local EOC or RHCC. In addition, it is important for the hospital to know how the requests are to be made (electronically, fax, phone).

Finance Section
The Finance/Administration Section monitors costs related to the incident while providing accounting, procurement, time recording, and cost analyses. The Incident Commander will assign the position of Finance Sector Chief. It is recommended that the position be filled by the CFO, Controller, or another individual experienced in fiscal operations.

The costs associated with the response must be accounted for from the outset of the incident. These costs can come from multiple sources such as overtime; loss of revenue-generating activities; and repair, replacement, and/or rebuild expenses. Daily financial reporting requirements are likely to be modified, and, in select situations, new requirements outlined by state and federal officials.
Preplanning efforts should identify what state and federal financial aid documents must be completed for receiving reimbursement. In addition to patient costs being tracked, vendor expenses, mutual aid financial remuneration, and personnel claims must also be accounted for and processed. The Finance/Administration Section coordinates personnel time (Time Unit), orders items and initiates contracts (Procurement Unit), arranges personnel-related payments and Workers' Compensation (Compensation/Claims Unit), and tracks response and recovery costs and payment of invoices (Cost Unit).

US Patent Numbers 7,720,998 B2, 7,836,207