Incident Action Planning for Hospitals By Ann Potter, Washington Hospital Center and Mitch Saruwatari, LiveProcess LiveProcess 271 Grove Ave, Bldg D Verona, NJ 07044 www.liveprocess.com LiveProcess and the LiveProcess logo are trademarks of LiveProcess, Inc. All other trademarks listed in this document are the property of their respective owners. This product and its functionality may be covered by one or more of the following patents: U.S. Patent No. 7,596,608. Other patents pending. 2010 LiveProcess. All rights reserved. March 2010
CONTENTS Overview... 1 Importance of Incident Action Planning... 2 Setting up an IAP... 3 How to Document Your Plan... 5 About LiveProcess... 7 Conclusion... 8 About the Authors... 9
OVERVIEW When a hospital responds to an emergency or disaster, an incident action plan (IAP) empowers the facility s command center and Incident Management Team (IMT) with the ability to make better and timelier decisions. In addition to facilitating patient and employee safety and enhancing organizational decision making, the IAP ensures a consistent and reliable process for both short and long term recovery activities. This white paper will discuss the importance of incident action planning in healthcare emergency response. We will also suggest steps for developing an incident action plan including tools hospitals can use in the planning and response process. Incident Action Planning for Hospitals 1
IMPORTANCE OF INCIDENT ACTION PLANNING A well-prepared IAP can help your facility: Maximize available resources. Clearly assign resource-related tasks and responsibilities, as well as track, estimate and project when more resources will be needed and when they will arrive. Reduce and prevent duplication of efforts. Account for and track actions taken, and assign response tasks to the appropriate IMT position or person. Reduce or control costs. Track ongoing expenditures and project the cost for extended operations. Improve and enhance communication. Delineate communication chains, provide consistent messages and identify anything that could impede an effective response. Increase the effectiveness of response and recovery actions. Identify the tasks, roles and resources needed, and document items for follow-up. Ensure understanding of the strategic direction. Identify command objectives, as well as the strategies and tactics needed to meet them. Incident Action Planning for Hospitals 2
SETTING UP AN IAP Here are six essential steps to setting up an IAP: 1. Understand the hospital s policy and direction. You need a clear picture of what your facility can and can t do when responding to an event. A great place to start is a review of your emergency operations plan (EOP), hazard-specific response guides and hospital s administrative policy. 2. Assess the situation. In many disasters, most of us receive our first information from the media, but how can we validate that? Before an event occurs, preparedness actions should include establishing links with your external partners to ensure you are in the loop. These may be relationships that you use daily as well as those you may tap into only when a significant event threatens or occurs. This critical step will ensure that information received by the hospital is valid and timely. 3. Establish incident objectives. Determining your overall priorities for a response based on hospital policy and situational assessment is a critical step. This requires you to establish an operational period, which is the length of time you are going to take to meet those command strategic objectives and tactics. The Incident Commander sets the overall command objectives while each section of the IMT will identify the strategies and tactics specific to their functional role. You will also need to give each event a name; if the event is specific only to the hospital, the Incident Commander will name the event. If the disaster or emergency begins in the community, the on-scene Incident Commander or Emergency Operations Center will name the event. It is important that all paperwork generated in the response and recovery consistently use the event name. 4. Determine appropriate strategies to achieve the objectives. This involves creating a plan, in consultation with your IMT as well as community partners, for getting things done, such as making sure your hospital is safe and capable of providing care. 5. Provide tactical direction and ensure that it is followed. This entails selecting effective strategies and tactics to meet the overall command and control objectives, issuing assignments with no overlap, developing realistic timeframes for completion, establishing metrics for continuous measuring of response, and Incident Action Planning for Hospitals 3
a means to revise your tactics based on these successes or any identified roadblocks. 6. Provide necessary support. It s important that you project your requirements based on situational and ongoing assessments, and ensure command-level awareness of your support needs and projections. Incident Action Planning for Hospitals 4
HOW TO DOCUMENT YOUR PLAN Documentation of your plan will provide a standardized, common framework for everyone involved in the response. For hospitals, 20 incident command system (ICS) forms have been adapted from the original FEMA versions that allow more appropriate use within healthcare but remain consistent with community response agencies. While every hospital emergency manager won t need every form, there are several key tools with which you should be familiar: Incident Briefing Form #201. Documents what has occurred, how the incident was responded to, and identifies incident management team positions. This provides the framework for the development of objectives and organizational messages. Incident Objectives Form #202. This form is a kind of mission statement, defining command objectives as well as any issues for the operational period. It serves as an overall response roadmap. Organizational Assignment List Form #203. Documents the positions that have been activated and assigned. Branch Assignment List #204: When the event requires the activation of branches or units within the IMT, this form documents these persons as well as the strategies and tactics they will follow during that operational period. Operational Log Form 214. Documents each member s role in an incident, and facilitates cost recovery as well as any critical actions taken. Incident Action Plan Safety Analysis Form #261. Documents hazards and defines the mitigation strategies. These are only a few of the twenty forms that were developed for healthcare. Hospital Emergency Manager should review the forms, working with their community response partner to ensure consistency in forms that will be used to develop the IAP and enhance sharing of response assets. You don t have to use every ICS form for every event. Use only what you need and customize it if necessary. Work with your community partners to see what they re using. Be consistent, so what you re documenting is and the information you are sharing can be easily accessed. Incident Action Planning for Hospitals 5
Tips to Implementing and Completing Incident Action Plans One consideration if utilizing the IAP forms and concepts is ensuring consistency and familiarization with the documents. Consider using the forms in meetings; operational logs can document the meeting interactions. Message forms can be used to communicate among participants. IAP forms can be used in a variety of exercises, small and large events and will ensure a level of comfort when an actual event necessitates their use. Each IAP is completed at the end of the Operational Period. Typically, it includes all ICS forms and any relevant and appropriate other documents such as media releases, response plans or policies. The IAP is communicated to the arriving IMT for the ensuing Operational Period and provides clear guidance for driving response strategies and tactics. Incident Action Planning for Hospitals 6
ABOUT LIVEPROCESS LiveProcess provides a secure SaaS platform for emergency management professionals at hospitals, healthcare organizations and regional coordinating entities. The LiveProcess platform enables users to prepare for disasters and emergencies, comply with Joint Commission and NIMS, and effectively respond to events. Many capabilities in LiveProcess can help hospitals develop and maintain their Incident Action Plan. For example: LiveProcess provides tools to help hospitals assess and identify the top hazards and maintain response plans, including detailed Incident Command Structure and Job Action Sheets for personnel to use during a response if that hazard occurred. To connect with community partners during an incident, LiveProcess offers a variety of tools for communicating via the Internet or by email, phone or fax. LiveProcess also provides a contacts database that can be populated with an unlimited number of contacts. Any necessary incident command forms or other documentation can be centrally stored and easily accessed through LiveProcess, making it easier to ensure that all users have access to the same, latest versions of documents. The patented LiveProcess platform has the exclusive endorsement from the American Hospital Association as their preferred solution for disaster readiness and incident command. For more information on using LiveProcess for Incident Action Planning, visit www.liveprocess.com/iaptoolkit. Incident Action Planning for Hospitals 7
CONCLUSION An IAP helps hospitals maximize resources, reduce duplicate efforts, reduce costs, improve communications, and provide more effective response and recovery. For additional resources and information, please visit the Center for HICS Education and Training at www.hicscenter.org Incident Action Planning for Hospitals 8
ABOUT THE AUTHORS Ann Potter is a project specialist for the ER1 Institute at the Washington Hospital Center in Washington, DC. She is a member of the Advisory Board for the Center for HICS Education and Training, and has lectured extensively on emergency planning for hospitals. She has a background in healthcare and government emergency management. Mitch Saruwatari is vice president of Quality and Compliance at LiveProcess, Verona, NJ. Mr. Saruwatari is a recognized national healthcare emergency management expert who co-chaired the development of the National Incident Management System (NIMS) compliant Hospital Incident Command System (HICS). Incident Action Planning for Hospitals 9