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Recommended Modifications and Applications of the Hospital Emergency Incident Command System for Hospital Emergency Management

Published online by Cambridge University Press:  28 June 2012

Jeffrey L. Arnold ,
Louise-Marie Dembry ,
Ming-Che Tsai ,
Nicholas Dainiak ,
Ülküen Rodoplu ,
David J. Schonfeld ,
Vivek Parwani ,
James Paturas ,
Christopher Cannon  and
Scott Selig
Jeffrey L. Arnold*
Affiliation:
Yale University School of Medicine, New Haven, Connecticut, USA
Louise-Marie Dembry
Affiliation:
Yale University School of Medicine, New Haven, Connecticut, USA
Ming-Che Tsai
Affiliation:
Department of Emergency Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, ROC
Nicholas Dainiak
Affiliation:
Yale University School of Medicine, New Haven, Connecticut, USA
Ülküen Rodoplu
Affiliation:
Department of Emergency Medicine, Alsancak State Hospital, Izmir, Turkey
David J. Schonfeld
Affiliation:
Yale University School of Medicine, New Haven, Connecticut, USA
Vivek Parwani
Affiliation:
Yale University School of Medicine, New Haven, Connecticut, USA
James Paturas
Affiliation:
Yale-New Haven Center for Emergency Preparedness and Disaster Response, Yale New Haven Health System, New Haven, Connecticut, USA
Christopher Cannon
Affiliation:
Yale-New Haven Center for Emergency Preparedness and Disaster Response, Yale New Haven Health System, New Haven, Connecticut, USA
Scott Selig
Affiliation:
Yale-New Haven Center for Emergency Preparedness and Disaster Response, Yale New Haven Health System, New Haven, Connecticut, USA
*
Yale-New Haven Center for Emergency Preparedness and Disaster Response, 1 Church Street, 5th Floor New Haven, CT 06510USA E-mail: Jeffrey.arnold@ynhh.org
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Abstract

The Hospital Emergency Incident Command System (Hospital Emergency Incident Command System), nowin its third edition, has emerged asa popular incident command system model for hospital emergency response in the United States and other countries. Since the inception of the Hospital Emergency Incident Command System in 1991, several events have transformed the requirements of hospital emergency management, including the 1995 Tokyo Subway sarin attack, the 2001 US anthrax letter attacks, and the 2003 Severe Acute Respiratory Syndrome (Severe Acute Respiratory Syndrome) outbreaks in eastern Asia and Toronto, Canada.

Several modifications of the Hospital Emergency Incident Command System are suggested to match the needs of hospital emergency management today, including: (1) an Incident Consultant in the Administrative Section of the Hospital Emergency Incident Command System to provide expert advice directly to the Incident Commander in chemical, biological, radiological, nuclear (CBRN) emergencies as needed, as well as consultation on mental health needs; (2) new unit leaders in the Operations Section to coordinate the management of contaminated or infectious patients in chemical, biological, radiological, nuclear emergencies; (3) new unit leaders in theOperations Section to coordinate mental health support for patients, guests, healthcare workers, volunteers, anddependents in terrorismrelated emergencies or events that produce significant mental health needs; (4) a new Decedent/Expectant Unit Leader in the Operations Section to coordinate the management of both types ofpatients together; and (5) a new Information Technology Unit Leader in the Logistics Section to coordinate the management of information technology and systems.

New uses of the Hospital Emergency Incident Command System in hospital emergency management also are recommended, including: (1) the adoption of the Hospital Emergency Incident Command System as the conceptual framework for organizing all phases of hospital emergency management, including mitigation, preparedness, response, and recovery; and (2) the application of the Hospital Emergency Incident Command System not only to healthcare facilities, but also to healthcare systems.

Finally, three levels of healthcare worker competencies in the Hospital Emergency Incident Command Systemare suggested: (1) basic understanding of the Hospital Emergency Incident Command System for all hospital healthcare workers; (2) advanced understanding and proficiency in the Hospital Emergency Incident Command Systemfor hospital healthcare workers likely to assume leadership roles in hospital emergency response; and (3) special proficiency in constituting the Hospital Emergency Incident Command System ad hoc from existing healthcare workers in resource-deficient settings. The Hospital Emergency Incident Command System should be viewed asa work in progress that will mature as additional challenges arise and ashospitals gain further experience with its use.

Keywords

biologicalchemicalconsultanthospitalhospital emergency incident command system (HEICS)informationmanagementmental healthmitigationnuclearpreparednessradiologicalrecoveryresponseterrorism
Type
Theoretical Discussion
Information
Prehospital and Disaster Medicine , Volume 20 , Issue 5 , October 2005 , pp. 290 - 300
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2005

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