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Hospital Incident Command System's Impact in Critical Access Hospitals

by Mary Lou Weden on Feb 25, 2016 7:28:00 PM

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Disaster situations impacting a health care facility are always a challenge. When that facility is a small critical access hospital, the impact is even greater. What is defined as a disaster for a critical access facility can be very different from the definition used in a large metro facility.

Dealing with Critical Access Facility Challenges

A multiple vehicle crash with several victims can be enough to overwhelm the available staff and move the facility into disaster mode. Critical access facilities are often located in rural, more isolated areas with few resources to call on when a situation overwhelms their ability to manage it. By their nature, critical access facilities face multiple challenges because of remote locations, limited resources and potential communication issues. To deal with these factors, critical access facilities can rely on the structured approach of the Hospital Incident Command System, or HICS, framework to in dealing with such situations.

The same factors that make HICS useful in large facilities make it useful for smaller facilities. Many small facilities may be overwhelmed when they initially see the HICS system and think that it cannot help them because of their limited resources and staff available to fill the varied roles within the Incident Management Team, or IMT.

Using HICS to Effectively Manage an Emergency

One of the hallmarks of the HICS standard is that it is designed as a guideline that is flexible and adaptable. Facilities are encouraged to customize the tools to best meet their needs. The IMT positions and associated Job Action Sheets outlining the key responsibilities for each position can be combined to most effectively manage an emergency. Facilities need to evaluate the threats most likely to impact their organization and plan for the most likely scenarios to impact the facility.

The HICS standard is flexible and allows the users to activate only the roles that are needed to effectively manage an incident. This can be done by combining essential IMT positions and eliminating IMT positions that are not deemed necessary. Staff members in a small hospital routinely wear multiple hats in performing their day to day duties, so utilizing the same concept in emergency preparedness and response situations should not be totally foreign. When managing a disaster situation, those same staff members may need to assume the responsibilities of multiple positions at least until additional resources are available.

While implementing the HICS framework may seem daunting, there are key HICS steps that critical access hospitals administrators should keep in mind.

  • Identify the essential positions that are needed to manage the emergency situation. In all situations an Incident Commander is activated to lead and coordinate the response activities. Take into consideration those threats that are most likely to impact the facility and the staff that are available to manage the situation. This can then provide a guide on how to most effectively combine the IMT positions so the key functions are addressed when an emergency occurs.
  • Utilize the HICS Job Action Sheets to create combined role job action sheets that maintain the structure and response format outlined in the HICS standard. Identify and train the staff that is most likely to be activated in the event that disaster situations were to occur.
  • Prioritize the tasks that the IMT staff should be taking so the most important tasks are completed first.
  • Activate additional positions as additional resources become available, starting with those that are deemed to be most needed.
  • Have the complete HICS Job Action Sheets available to the IMT staff, this will make the expansion of the team more effective if additional resources are added.

Utilizing the principles of HICS, and tailoring it to the unique needs of the critical access hospital can provide the structure and knowledge to effectively manage those unpredictable situations that are likely to occur.

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This post was written by Mary Lou Weden

Mary Lou Weden is a product manager, business solution - Systems at Intermedix.

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