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Topic Collection: Incident Management (e.g., Hospital Incident Command System, EOC operations, Multi-agency coordination, demobilization)

In the aftermath of a disaster, emergency medical professionals must work collaboratively with other responders, on the scene and at healthcare facilities. An incident command structure—and hospital incident command in particular—can help healthcare personnel communicate and respond in the most effective, efficient way possible, and learning about these models before a crisis occurs is imperative. The following resources highlight incident management resources that can help healthcare emergency planners mitigate, prepare for, respond to, and recover from incidents. (It is incumbent upon the reader to ensure they are using the most recent versions of any forms or templates.)

Each resource in this Topic Collection is placed into one or more of the following categories (click on the category name to be taken directly to that set of resources). Resources marked with an asterisk (*) appear in more than one category.

Topic Collection (PDF - 166.2 KB)

Must Reads
Education and Training
General Resources
Guidance
Lessons Learned
Nursing Home Incident Command System
Plans, Tools, and Templates
Agencies and Organizations

Must Reads

Backer, H., Smiley, D., Schoenthal, L. et al. (2014). Hospital Incident Command System (HICS) Guidebook: Fifth Edition, May 2014. California Emergency Medical Services Authority.

This latest version of the HICS guidebook meets the needs of all types of hospitals, regardless of location, size, or patient care capabilities and provides event-based templates and resources in addition to the system framework and job action sheet templates.
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California Emergency Medical Services Authority (EMSA). (n.d.). Hospital Incident Command System. (Accessed 12/30/2015).

This website provides access to the Hospital Incident Command System (HICS) 2014 Guidebook, HICS forms and Job Aids.
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DeAtley, C., Potter, A., Massey, M., et al. (2011). NHICS: Nursing Home Incident Command System. American Health Care Association.

This document was developed to provide nursing homes and other long-term care facilities with planning and response guidance to strengthen their emergency management programs.
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Federal Emergency Management Agency. (2008). National Incident Management System (NIMS).

The National Incident Management System is a comprehensive, nationwide systematic approach to incident management and is composed of a core set of doctrine, concepts, principles, terminology and organizational processes. The Hospital Incident Command System (HICS) builds upon National Incident Management concepts.
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Federal Emergency Management Agency. (2010). IS-701.A: NIMS Multiagency Coordination System (MACS) Course.

These course materials introduce the MAC system and consist of a combination of elements: personnel, procedures, protocols, business practices, and communications integrated into a common system.
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Federal Emergency Management Agency. (2013). Applying ICS (Incident Command System) to Healthcare Organizations (IS-200.HCa).

This course builds on the IS-100.HC (Introduction to the Incident Command System for Healthcare/Hospitals) course. It should be completed by hospital personnel that would have a direct role in emergency preparedness, incident management, and/or emergency response during an incident.
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Federal Emergency Management Agency. (2013). Introduction to the Incident Command System (ICS 100) for Healthcare/Hospitals.

After completing this ICS 100.HCb course, students will be familiar with Incident Command System applications for healthcare/hospitals, including organizational elements, positions and responsibilities, facilities and functions, and planning.
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Hick, J. (2010). CO-S-TR Guide for Initial Incident Actions.

This poster/reference card provides the key components of the CO-S-TR model which may be a helpful visual reference for hospital incident command personnel as they prioritize and address key components of surge capacity. "CO" stands for command, control, communications, and coordination; "S" refers to staff, stuff, space, and special (event-specific) considerations; and "TR" comprises tracking, triage, treatment, and transportation.
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Hick, J.L., Koenig, K.L., Barbisch, D., and Bey, T.A. (2008). Surge Capacity Concepts for Health Care Facilities: The CO-S-TR Model for Initial Incident Assessment. (Abstract only.) Disaster Medical Public Health Preparedness. 2(Suppl 1): S51-S57.

The CO-S-TR model is designed to be implemented in the immediate aftermath of an incident, and complements the Incident Command System by aiding effective incident assessment and surge capacity responses at the healthcare facility level. "CO" stands for command, control, communications, and coordination; "S" considers the logistical requirements for staff, stuff, space, and special (event-specific) considerations; "TR" comprises tracking, triage, treatment, and transportation.
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Newsome, L. (n.d.). What's New with HICS? (Accessed 3/22/2017.)

In this presentation, the author describes modifications and revisions to the Hospital Incident Command System and shares steps for incorporating the changes into a hospital emergency management program.
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The Institute for Crisis, Disaster, and Risk Management (ICDRM) at the George Washington University (GWU) for the Veterans Health Administration (VHA), US Department of Veterans Affairs (VA). Washington, D.C. (2010). Emergency Management Principles and Practices for Health Care Systems, 2nd Edition.

This document provides a thorough overview of the framework for emergency management of a healthcare system and can be useful to any agency or organization involved with the delivery of healthcare services. The authors explain incident management concepts and how they can be applied in the healthcare system within the broader context of a holistic approach to facility emergency management.
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The Joint Commission. (2013). New and Revised Requirements Address Emergency Management Oversight.

The Joint Commission recently approved and revised requirements addressing leadership accountability for hospital-wide emergency management in hospitals and critical access hospitals. 
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U.S. Department of Health and Human Services. (2012). Policies, Strategies & Directives.

This website provides links to foundational policy upon which healthcare system disaster preparedness and response is based.
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Education and Training

Buchman, T. (2011). Using the Hospital Incident Command Forms: Which Ones, When and Why. Creighton University and University of Nebraska, Center for Preparedness Education.

The speakers in this webinar discuss the appropriate forms to complete before and after activating hospital incident command, and why accurate and complete forms are crucial during an incident.
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California Hospital Association. (n.d.). HICS Education. (Accessed 12/29/2015.)

The California Hospital Association provides links to numerous training courses that may be of interest to healthcare emergency preparedness professionals.
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Center for Domestic Preparedness. (n.d.). Framework for Healthcare Emergency Management. (Accessed 12/29/2015.) Federal Emergency Management Agency.

Framework for Healthcare Emergency Management (FRAME) is a four-day course that provides healthcare personnel fundamental knowledge in healthcare emergency management.
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Center for Domestic Preparedness. (n.d.). Healthcare Leadership for Mass Casualty Incidents. Federal Emergency Management Agency.

Healthcare Leadership for All-Hazards Incidents (HCL) is a four-day course which exposes healthcare professionals to the dynamics involved in the decision making processes during an all-hazards disaster involving mass casualties.
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Center for Domestic Preparedness. (n.d.). Incident Command: Capabilities, Planning and Response Actions for All Hazards. Federal Emergency Management Agency.

Incident Command: Capabilities, Planning, and Response Actions for All Hazards (IC) is a three-day course that provides management-level responders with knowledge of how decisions made by responders from various disciplines can impact the handling of a chemical, biological, radiological, nuclear, or explosive (CBRNE) incident.
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Federal Emergency Management Agency. (2010). IS-701.A: NIMS Multiagency Coordination System (MACS) Course.

These course materials introduce the MAC system and consist of a combination of elements: personnel, procedures, protocols, business practices, and communications integrated into a common system.
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Federal Emergency Management Agency. (2013). Applying ICS (Incident Command System) to Healthcare Organizations (IS-200.HCa).

This course builds on the IS-100.HC (Introduction to the Incident Command System for Healthcare/Hospitals) course. It should be completed by hospital personnel that would have a direct role in emergency preparedness, incident management, and/or emergency response during an incident.
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Federal Emergency Management Agency. (2013). Introduction to the Incident Command System (ICS 100) for Healthcare/Hospitals.

After completing this ICS 100.HCb course, students will be familiar with Incident Command System applications for healthcare/hospitals, including organizational elements, positions and responsibilities, facilities and functions, and planning.
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Federal Emergency Management Agency. (2013). IS-700.A: National Incident Management System (NIMS) An Introduction.

This course introduces and overviews the National Incident Management System (NIMS). NIMS provides a consistent nationwide template to enable all government, private-sector, and nongovernmental organizations to work together during domestic incidents.
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Federal Emergency Management Agency. (2013). IS-800.B: National Response Framework, An Introduction.

The course introduces participants to the concepts and principles of the National Response Framework.
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Federal Emergency Management Agency. (2013). IS-808: Emergency Support Function (ESF) #8 Public Health and Medical Services.

As part of the National Response Framework (NRF), Emergency Support Functions (ESFs) are primary mechanisms at the operational level used to organize and provide assistance. This course provides an introduction to Emergency Support Function (ESF) #8 – Public Health and Medical Services. Support.
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Minnesota Department of Health. (2015). Public Health Incident Leadership Training.

This course can help public health incident commanders and other public health leaders manage a public health emergency response. Links to PowerPoint presentations and other course materials (e.g., role play activities, checklists, forms) are also included.
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Reeves, C. (2008). Basic Emergency Preparedness for Staff of Community Health Facilities. University at Albany, State University of New York, School of Public Health and Health Professions, Center for Public Health Preparedness.

This course provides an overview of the National Incident Management System and the Incident Command System for healthcare practitioners and other staff who work at community facilities.
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Stanford Health Care. (2011). Hospital Incident Command System: An Introduction For Physicians.

The following video provides an overview of the Hospital Incident Command System (HICS) and is intended to highlight information necessary for physicians who may assume the role of a Medical Technical Specialist.
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Stanford Health Care. (2015). The Hospital Incident Command System: A Guide for Hospital Personnel.

The following video provides an overview of the Hospital Incident Command System (HICS), highlights position descriptions and defines roles and responsibilities for each position.
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University of Rochester Medical Center. (n.d.). Hospital Command Center Course Materials. (Accessed 11/20/2015.)

This University of Rochester Medical Center website houses course materials that can help other facilities as they set up and build their emergency management infrastructure.
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General Resources

Howard, L. and Massey, M. (n.d.). Hospital Incident Command System Revision Project. (Accessed 12/1/2015.)

This PowerPoint presentation provides an overview of the Hospital Incident Command System, explains why it was revised, and highlights recent revisions.
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Newsome, L. (n.d.). What's New with HICS? (Accessed 3/22/2017.)

In this presentation, the author describes modifications and revisions to the Hospital Incident Command System and shares steps for incorporating the changes into a hospital emergency management program.
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Stambler, K., Barbera, J. (2011). Engineering the Incident Command and Multiagency Coordination Systems. (Abstract only.) Journal of Homeland Security and Emergency Management. Volume 8, Issue 1.

This paper discusses the extensive product development and consensus process used to create ICS and MACS, plus the implementation process that propagated these landmark systems that continue to expand in prominence for incident management and coordination during emergencies and disasters.
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Yarmohammadian, M., Atighechian, G., Shams, L. et al. (2011). Are Hospitals Ready to Respond to Disasters? Challenges, Opportunities and Strategies of Hospital Emergency Incident Command System (HEICS). Journal of Research in Medical Sciences. 16(8): 1070-1077.

This qualitative research study examined requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS).
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Guidance

Backer, H., Smiley, D., Schoenthal, L. et al. (2014). Hospital Incident Command System (HICS) Guidebook: Fifth Edition, May 2014. California Emergency Medical Services Authority.

This latest version of the HICS guidebook meets the needs of all types of hospitals, regardless of location, size, or patient care capabilities and provides event-based templates and resources in addition to the system framework and job action sheet templates.
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Barbera, J.A. and Macintyre, A.G. (2007). Medical Surge Capacity and Capability: A Management System for Integrating Medical and Health Resources During Large-Scale Emergencies. U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response.

This handbook describes the changes to the federal public health and medical response structure since the development of the original MSCC handbook in 2004. The MSCC Management System describes a framework of coordination of public and private entities across six tiers of response, of which tier two is the management of healthcare coalitions (see Chapter 3). This document is considered to be a foundational document for coalition development that describes the response system.
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California Emergency Medical Services Authority (EMSA). (n.d.). Hospital Incident Command System. (Accessed 12/30/2015).

This website provides access to the Hospital Incident Command System (HICS) 2014 Guidebook, HICS forms and Job Aids.
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Federal Emergency Management Agency. (2008). National Incident Management System (NIMS).

The National Incident Management System is a comprehensive, nationwide systematic approach to incident management and is composed of a core set of doctrine, concepts, principles, terminology and organizational processes. The Hospital Incident Command System (HICS) builds upon National Incident Management concepts.
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Federal Emergency Management Agency. (2013). National Response Framework (NRF).

The National Response Framework is a guide to how the Nation responds to all types of disasters and emergencies. It is built on scalable, flexible, and adaptable concepts identified in the National Incident Management System to align key roles and responsibilities across the Nation. Emergency Support Function # 8, Public Health and Medical Services, is introduced and described.
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National Fire Protection Association. (2014). NFPA 1561: Standard on Emergency Services Incident Management System and Command Safety. (Free registration required to view 2014 version.)

This standard includes requirements for emergency services that can help protect the safety of emergency responders and others on the scene of an incident.
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Pfeifer, J. and Roman, O.. (2016). Tiered Response Pyramid: A System-Wide Approach to Build Response Capability and Surge Capacity.. Homeland Security Affairs. 12(Article 5).

The authors share their view on the limitations of the traditional response triangle used for disaster planning and suggest planners use a system-wide Tiered Response Pyramid to increase response capabilities and surge capacity for large scale disasters.
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The Institute for Crisis, Disaster, and Risk Management (ICDRM) at the George Washington University (GWU) for the Veterans Health Administration (VHA), US Department of Veterans Affairs (VA). Washington, D.C. (2010). Emergency Management Principles and Practices for Health Care Systems, 2nd Edition.

This document provides a thorough overview of the framework for emergency management of a healthcare system and can be useful to any agency or organization involved with the delivery of healthcare services. The authors explain incident management concepts and how they can be applied in the healthcare system within the broader context of a holistic approach to facility emergency management.
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The Joint Commission. (2013). New and Revised Requirements Address Emergency Management Oversight.

The Joint Commission recently approved and revised requirements addressing leadership accountability for hospital-wide emergency management in hospitals and critical access hospitals. 
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U.S. Coast Guard. (2014). Incident Management Handbook. U.S. Department of Homeland Security.

This handbook was designed to help personnel use the National Incident Management System. It provides summaries and checklists for the planning cycle (e.g., planning meeting agendas, operational briefing formats), and other useful materials for commanders and section chiefs.
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U.S. Department of Health and Human Services. (2012). Policies, Strategies & Directives.

This website provides links to foundational policy upon which healthcare system disaster preparedness and response is based.
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U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. (2012). The Incident Command Process.

Chapter 1 of the Medical Surge Capacity and Capability Handbook provides an overview of the Incident Command Process.
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Lessons Learned

Djalali A, Hosseinijenab V, Peyravi M, et al. (2015). The Hospital Incident Command System: Modified Model for Hospitals in Iran. PLoS Currents. 2015;7.

This paper describes modifications to HICS 2006 to optimize disaster management in hospitals in Iran and may provide insights to other healthcare facilities as they adopt and implement HICS.
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Moynihan, D. (2009). The Network Governance of Crisis Response: Case Studies of Incident Command Systems. (Abstract only.) Journal of Public Administration Research and Theory, Volume 19, Issue 4, pp 895-915.

The author reviews practical issues when implementing the Incident Command System.
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Multiple Authors. (2014). After Action Report for the Response to the 2013 Boston Marathon Bombings.

This After Action Report (AAR) describes the events related to response to the Boston Marathon Bombings and associated incidents. The report attempts to constructively evaluate and assess public safety, public health, and medical response actions with the goal of providing agencies and organizations involved in the incident with practical recommendations to address them. Unified command, multi-agency coordination, and use of the incident command system are recurring themes in the document.
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Rimstad, R., Sollid, S. (2015). A Retrospective Observational Study of Medical Incident Command and Decision-Making in the 2011 Oslo Bombing. International Journal of Emergency Medicine. 8:4.

This retrospective study examined decisions made by ambulance and medical commanders in the aftermath of the 2011 government district terrorist bombing in Norway. The authors also discuss situational assessment and critical decision-making among first responders when faced with uncertainties and limited resources.
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Schoenthal, L. (2015). A Case Study in the Identification of Critical Factors Leading to Successful Implementation of the Hospital Incident Command System. Homeland Security Affairs.

This thesis is a case study in the identification of critical factors leading to the successful implementation of HICS by Stanford Medicine in response to the Asiana plane crash of July 6, 2013.
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Timm, N. and Gneuhs, M. (2011). The Pediatric Hospital Incident Command System: An Innovative Approach to Hospital Emergency Management. (Abstract only.) Journal of Trauma-Injury Infection & Critical Care. 71(5): S549-S554.

This article highlights lessons learned from the adaptation of the Hospital Incident Command System to a pediatric hospital.
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Nursing Home Incident Command System

DeAtley, C., Potter, A., Massey, M., et al. (2011). NHICS: Nursing Home Incident Command System. American Health Care Association.

This document was developed to provide nursing homes and other long-term care facilities with planning and response guidance to strengthen their emergency management programs.
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Florida Health Care Association. (n.d.). Emergency Preparedness.

This website provides links to nursing home and long term care incident command system information and other tools and templates staff can customize for their own facilities.
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Plans, Tools, and Templates

Association of Healthcare Emergency Preparedness Professionals. (n.d.). HICS (Hospital Incident Command System) for Small Hospitals.

This website provides links to templates and other resources that can help small hospitals prepare to activate their Hospital Incident Command System.
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Hick, J. (2010). CO-S-TR Guide for Initial Incident Actions.

This poster/reference card provides the key components of the CO-S-TR model which may be a helpful visual reference for hospital incident command personnel as they prioritize and address key components of surge capacity. "CO" stands for command, control, communications, and coordination; "S" refers to staff, stuff, space, and special (event-specific) considerations; and "TR" comprises tracking, triage, treatment, and transportation.
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Hick, J.L., Koenig, K.L., Barbisch, D., and Bey, T.A. (2008). Surge Capacity Concepts for Health Care Facilities: The CO-S-TR Model for Initial Incident Assessment. (Abstract only.) Disaster Medical Public Health Preparedness. 2(Suppl 1): S51-S57.

The CO-S-TR model is designed to be implemented in the immediate aftermath of an incident, and complements the Incident Command System by aiding effective incident assessment and surge capacity responses at the healthcare facility level. "CO" stands for command, control, communications, and coordination; "S" considers the logistical requirements for staff, stuff, space, and special (event-specific) considerations; "TR" comprises tracking, triage, treatment, and transportation.
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The Center for HICS Education and Training. (n.d.). Hospital Incident Management Team Organizational Chart. (Accessed 12/1/2015.)

This online, fillable PDF form represents the typical incident management structure under the Hospital Incident Command System. It can be completed online and printed, sent via e-mail, or saved by the users.
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Agencies and Organizations

Note: The agencies and organizations listed in this section have a page, program, or specific research dedicated to this topic area.

California Hospital Association. Hospital Incident Command System (HICS).

Department of Homeland Security, Federal Emergency Management Agency. Incident Command Resources.

Department of Homeland Security, Federal Emergency Management Agency. National Incident Management System (NIMS).



This ASPR TRACIE Topic Collection was comprehensively reviewed in December 2015 and January 2016 by: Eric Alberts, BS, FPEM, CHS-V, CDP-1, CHPP, CHEP, SEM, CFRP, FABCHS, Manager, Emergency Preparedness, Orlando Health, Inc. (Hospital System); Marc Barbiere, Fairfax County Health Department, Office of Emergency Preparedness; James Bolen, MS, Planning & Operations Manager, Butler County (Ohio) Emergency Management Agency; Aaron Gardner, MD, MS, FAAP Regional Deputy Chief Medical Officer, HHS/ASPR/OEM/ NDMS and Pediatric Intensivist, MEDNAX/Eastern Idaho Regional Medical Center; John Hick, MD, HHS ASPR and Hennepin County Medical Center; Mark Jarrett, MD, MBA, MS, Sr. Vice President & Chief Quality Officer, Associate Chief Medical Officer, North Shore-LIJ Health System, Professor of Medicine, Hofstra – North Shore LIJ School of Medicine; Brad Learn, Regional Healthcare Preparedness Coordinator, Kentucky Department for Public Health; and Mitch Saruwatari, Director, Emergency Management, Kaiser Foundation Hospitals and Health Plan, Inc.