Topic Collection Cover Page

Incident Management
Topic Collection
January 18, 2019

Topic Collection: Incident Management

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.

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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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 and its integration into the community response structure..
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California Department of Public Health (CDPH) and the California Association of Health Facilities (CAHF). (2017). NHICS: Nursing Home Incident Command System.
This webpage includes information on the nursing home incident command system (NHICS), which can be used by facilities regardless of size or resident care capabilities, and is intended to assist with their emergency planning and response efforts for all hazards. Links to the NHICS guidebook, forms, response guides, Job Action Sheets (JAS), and training are included.
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California Department of Public Health (CDPH) and the California Association of Health Facilities (CAHF). (2017). NHICS: Nursing Home Incident Command System. American Health Care Association.
This webpage includes information on the nursing home incident command system (NHICS), which can be used by facilities regardless of size or resident care capabilities, and is intended to assist with their emergency planning and response efforts for all hazards. Links to the NHICS guidebook, forms, response guides, Job Action Sheets (JAS), and training are included.
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Federal Emergency Management Agency. (2017). 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. (2018). IS-100.C: Introduction to the Incident Command System, ICS 100.
After completing this online course, students will be familiar with the principles and features of the Incident Command System, including organizational elements, positions and responsibilities, facilities and functions, and planning.
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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. Access the related poster/reference card here: https://files.asprtracie.hhs.gov/documents/co-st-r-guide.pdf
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Hospital Incident Command System. (n.d.). Hospital Incident Command System. (Accessed 2/18/2019).
This website provides access to the Hospital Incident Command System (HICS) 2014 Guidebook, HICS forms and Job Aids.
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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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U.S. Department of Health and Human Services. (2019). 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 7/23/2019.)
The California Hospital Association provides links to 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 7/23/2019.) Federal Emergency Management Agency.
This four-day (32-hour) course is geared towards people responsible for emergency management in healthcare facilities. It covers standards AND regulations; the Incident Command System; resource acquisition; plans/the planning process; facility and personnel preparedness; exercises and training; mass casualty and surge issues; recovery; and finances.
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Center for Domestic Preparedness. (n.d.). Healthcare Leadership for Mass Casualty Incidents. (Accessed 7/23/2019.) Federal Emergency Management Agency.
This four-day course for healthcare leaders focuses on critical disaster emergency preparedness decision making, management of different facets of the hospital response, and considerations for the community. The course applies to any incident with multiple casualties requiring surge capacity implementation and emphasizes the importance of incident command.
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Center for Domestic Preparedness. (n.d.). Incident Command: Capabilities, Planning and Response Actions for All Hazards. (Accessed 7/23/2019.) 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. (2018). IS-100.C: Introduction to the Incident Command System, ICS 100.
After completing this online course, students will be familiar with the principles and features of the Incident Command System, including organizational elements, positions and responsibilities, facilities and functions, and planning.
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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. (2018). IS-800.C: National Response Framework, an Introduction.
The course introduces participants to the concepts and principles of the National Response Framework.
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Reeves, C. (2015). 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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This 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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This 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 7/23/2019.)
These course materials review planning and operations considerations for the hospital command center and may help other facilities as they set up and build their emergency management infrastructure.
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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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Federal Emergency Management Agency. (2016). 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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Federal Emergency Management Agency. (2017). 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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Hospital Incident Command System. (n.d.). Hospital Incident Command System. (Accessed 2/18/2019).
This website provides access to the Hospital Incident Command System (HICS) 2014 Guidebook, HICS forms and Job Aids.
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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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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 including an illustration of the planning "P."
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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. Journal of Public Administration Research and Theory. 19(4):895-91.
The author discusses why the Incident Command System should be viewed as a network, rather than as a strict hierarchy, and how this impacts its implementation.
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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, decentralized decision-making, 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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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. (Free registration required; 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


California Department of Public Health (CDPH) and the California Association of Health Facilities (CAHF). (2017). NHICS: Nursing Home Incident Command System. American Health Care Association.
This webpage includes information on the nursing home incident command system (NHICS), which can be used by facilities regardless of size or resident care capabilities, and is intended to assist with their emergency planning and response efforts for all hazards. Links to the NHICS guidebook, forms, response guides, Job Action Sheets (JAS), and training are included.
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California Department of Public Health (CDPH) and the California Association of Health Facilities (CAHF). (2017). NHICS: Nursing Home Incident Command System.
This webpage includes information on the nursing home incident command system (NHICS), which can be used by facilities regardless of size or resident care capabilities, and is intended to assist with their emergency planning and response efforts for all hazards. Links to the NHICS guidebook, forms, response guides, Job Action Sheets (JAS), and training are included.
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Florida Health Care Association. (n.d.). Emergency Preparedness. (Accessed 7/23/2019.)
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 resource provides links to guidance and templates that can help smaller hospitals implement the Hospital Incident Command System, which should be defined in healthcare organization emergency operations plans.
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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. Access the related poster/reference card here: https://files.asprtracie.hhs.gov/documents/co-st-r-guide.pdf
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The Center for HICS Education and Training. (2014). Hospital Incident Management Team Organizational Chart.
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


California Hospital Association. Hospital Incident Command System (HICS).
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Department of Homeland Security, Federal Emergency Management Agency. Incident Command Resources.
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Department of Homeland Security, Federal Emergency Management Agency. National Incident Management System (NIMS).
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