Use job action sheets for your disaster plan
When ED managers at Brandon (FL) Regional Hospital set about revamping their hospital’s disaster plan, one major change was made: The ED is now using the "Hospital Emergency Incident Command System" (HEICS) during any mass-casualty incident, disaster, or bioterrorism event. "The events of 9/11 pushed us to update our disaster plan sooner rather than later," reports Katherine Haddix-Hill, RN, MSN, the hospital’s director of emergency services.
HEICS is an emergency management system based on the public safety field’s Incident Command System. This disaster readiness tool employs logical management structure, defined responsibilities, clear reporting channels, and a common nomenclature to unify hospitals with other local emergency responders. HEICS is a project of the San Mateo County (CA) Department of Health Services’ Emergency Services Agency with the California Emergency Medical Services Authority. (For ordering information, see "Sources and resource" at the end of this article.)
Here are benefits of the HEICS system:
• Every staff member has a checklist to use. An individual checklist to use during a disaster promotes responsibility and accountability for each position, says Tracy G. Sanson, MD, FACEP, assistant medical director for the hospital’s department of emergency medicine. (To see Job Action Sheet for Triage Unit Leader, click here.) The checklist prompts the individual to perform the necessary tasks, says Sanson. "It also helps the individual move along in an orderly and thorough fashion, when multitasking or caught up in the midst of a real disaster," she adds.
Listing specific tasks prevents important items from being missed and helps to maintain some organization during chaos, says Haddix-Hill. "Previously, hospital staff reported to the ED when they heard the disaster page without knowing their job assignment," she says. HEICS provides instant information on defined job duties and tasks, reporting structure, communication channels, and accountability, says Haddix-Hill. "It provides the tools necessary to survive a difficult situation," she adds.
• The plan allows certain sections to be activated. The HEICS plan is flexible and allows for activation of only those sections or positions specific to the individual disaster, says Haddix-Hill. "This offers an efficient, cost-productive response," she explains. For example, the incident commander, patient information officer, liaison officer, safety and security officer, and operations section chief are the only job titles activated for a small-scale disaster, she says.
"We would only activate the job titles that are pertinent to the specific disaster," says Haddix-Hill. "We would not activate the financial, planning, and logistics sections for a small-scale disaster; whereas for a major hurricane, we would definitely need to activate the financial section."
• Other staff members can take over specific roles as needed. The checklists allow another individual to step in and take over a given position if the usual individual is not available, incapacitated, or unable to reach the hospital, Sanson says.
The job action sheets make it possible for anyone in the hospital to function in roles that are not in their normal job description, says Haddix-Hill. "Each job action sheet is custom tailored to the individual role," she explains. All of the responsibilities are outlined on the form, so any individual can pick it up and perform the duties, which ensures all tasks are completed, she adds. Education and training are easier because of the consistency of roles provided by the job action sheets, says Haddix-Hill. Staff are trained in the HEICS plan through orientation, scheduled classes, and mock drills, she notes.
• It interfaces with the community’s response plan. The HEICS format interfaces with the community’s response plan and provides a coordinated effort among agencies responding to any disaster, says Haddix-Hill. The hospital’s disaster plan is approved by the Hillsborough County Emergency Planning agency, says Haddix-Hill. "We do joint disaster drills with the county to ascertain we have a coordinated effort," she says. When the hospital uses the same job titles as other first responders, it makes communication easier, she explains. "All agencies are singing from the same sheet of music, so to speak," she says.
For example, if the Fire /Rescue Incident Commander has a question about logistics, he knows to call the Logistics Chief at the hospital, says Haddix-Hill. "He does not need the individual’s name," she says. Haddix-Hill notes that mock disaster drills are held with the county emergency medical services. "Using the new format makes the drills easier because we are all speaking the same language," she says.
Sources and resource
For more information on the Hospital Emergency Incident Command System, contact:
• Katherine Haddix-Hill, RN, MSN, Emergency Services, Brandon Regional Hospital, 119 Oakfield Drive, Brandon, FL 33511. Telephone: (813) 571-5156. Fax: (813) 681-4986. E-mail: [email protected].
• Tracy G. Sanson, MD, FACEP, Department of Emergency Medicine, Brandon Regional Medical Center, 119 Oakfield Drive, Brandon, FL 33511. Telephone: (813) 571-5150. Fax: (813) 948-8477. E-mail: [email protected].
A free copy of the Hospital Emergency Incident Command System (HEICS) plan is available on the American Hospital Association’s web site (www.aha.org). (Click on "Disaster Readiness," "Member Advisory: Hospital Emergency Incident Command System: A Hospital Readiness Template.") Or access the plan directly at www.emsa.cahwnet.gov/dms2/heics3.htm. A video introduction to HEICS is also available free by sending an e-mail to [email protected].
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