HICS is consistent with the National Incident Management System, or (NIMS). HICS is the system healthcare uses because it speaks the healthcare language, making it easier for healthcare professionals to embrace. According to Tracy Buchman, National Director, Hospital Emergency Management, HSS, HICS is a “toolbox where you pick and choose whatever tools in the box you need to use regardless of your [facility] size, or the size of your event.”
New and Improved Forms
In 2014, there were changes and updates to HICS forms based on feedback and lessons learned from real-world emergencies, data from The 2009-2010 National HICS Survey, The 2011 National HICS Stakeholders Conference in California, as well as recommendations from both primary and secondary review groups. One of the lessons learned in going through the review process, is that the forms were complicated, lengthy, and hard to use in emergencies. For this reason, the forms underwent significant change. The HICS forms and training are free and are available through the California EMSA. There are now 23 forms in all, updated to offer the following benefits:
- Consistency and standardization with community partners and other hospitals working mass disaster or casualty events
- Makes information gathering and sharing easier
- Assists with regulatory and grant compliance
- The new forms work better with FEMA forms and provide additional information for expanded use
Everything has been formatted consistently so all of the forms match and work together better as a group of tools. Some of the forms went through more significant changes. For example, in Planning Guides and Job Action Sheets (JAS) there is now a section in the guidebook where you can customize these specifically to your needs. So for example, if your facility is located somewhere unique, maybe near a special hazard, you can create your own response guide or JAS.
In addition to that special section in the guidebook for customization, changes to the forms include some new terminology, additional new and updated JAS and forms, additional incident planning guides and response guides, and new appendices for smaller, rural hospitals.
There are 3 new HICS forms available for hospital use: Incident Action Plan (IAP) Quick Start; HICS 200: IAP Cover Sheet; and HICS 221: Demobilization Check-Out.
IAP Quick Start Direction Sheet
The old IAP was a combination of 5 different forms. The Quick Start IAP is now one form front and back that combines all of those and still includes all the necessary data. Every form now has an instruction sheet that goes along with it. The instruction sheet states who should fill it out, who gets copies, and how to complete each section. Numbers on the instruction sheets correspond to specific sections on the form so it’s much easier to follow.
HICS 200: Incident Action Plan Cover Sheet
The purpose of The Incident Action Plan (IAP) Cover Sheet is to encourage people to create an incident action plan. “If you don’t have a plan,” Tracy says, “you could risk burning through critical resources on the people who need it least. For example, think about triage for a mass casualty incident. The people who typically show up to a hospital first are the greens, or walking wounded. If too much is spent caring for them, then when your red and yellow tag victims arrive, you might not have adequate staff and supplies to care for them. A plan is critical, and the IAP can help to create that plan.”
HICS 221: Demobilization Checklist It’s very long, a little hard to read, but worth the effort. Tracy Buchman says, “it’s hard to articulate the whole demobilization and recovery process. As healthcare providers, you know you go through all the steps, but it isn’t always easy to document it well. The Demobilization Checklist can help you get it all documented. It’s a nice checklist to help you get back to business as usual. It’s divided out by position as well.”
The forms that follow are those that are most important to get familiar with as you implement your incident response system.
HICS 201: Incident Briefing Form
This form is now consistent with the FEMA briefing form. This form is a general overview of an event and is used by the Incident Commander to communicate basic information about an event to the Hospital Incident Management Team (HIMT) and hospital staff. Information captured here includes an event summary, the people involved, locations affected, resources needed, dates and times.
HICS 204: Assignment List
This customizable form documents the strategies and tactics of each activated Section or Branch, the resources needed and the unit assigned. Here you will capture the names of the units activated, the names of the unit leaders and the names of the members comprising the unit.
HICS 214: Operations Log
This is a form everyone should fill out. This form allows you to document right away what you did, when and why, as well as the information you had available to you when you made that quick judgment call at 2 a.m. This is your backup. It’s a way to cover yourself after the fact, because in an emergency, it’s hard to re-create the exact scenario later. As long as this form is completed, you can figure out what was done, what wasn’t and when. In fact, Tracy recommends making this log one of your future disaster objectives. “You could determine,” she advises, “that the next time you activate your hospital command center, every person with a vest on must complete a 214 Log.” The Operations Log is very valuable for lessons learned to your organization.
Choose the Forms that Work for You
Tracy’s advice to those just getting started with HICS 2014 is to pick and choose the forms that meet your specific needs. “Don’t try to make your leaders fill out every single form because the incident commander action sheet says to do so,” she says. “If you’re doing a mass casualty incident, pick up the patient tracking form the first time around and skip the other ones. Pick the ones that are the most important for your organization and have people get good at those. Then as they get more comfortable, start to implement more.”
Another great time saver you might consider is to fill out some of the HICS forms at least in part, in advance. For example, Tracy says, “Every year, your organization does a Hazard Vulnerability Analysis or HVA. That HVA tells you which 3-5 things you’re most vulnerable for, or which types of events are most likely to impact your facility. Take the information from the HVA and go to your Response Guides. Then find those matching scenarios and fill out some Quick Start IAPs. On disaster day, you can take these out and just fill in the specifics.”
Let’s face it. Forms aren’t fun. And with a total of 23 forms in the HICS toolbox, the prospect of getting them all completed can be overwhelming. The good news is that you don’t have to start out completing every single form. The best approach is to start small, using only those forms that are most appropriate for your facility based on your size, location and the types of events most likely to affect your community. Then as you get better at using the forms, you can implement more when you activate HICS.
This article was developed from a presentation by Dr. Tracy Buchman titled “HICS—Hospital Incident Command System 2014 Revision” given at The 2014 Health Systems & Facility Summit, sponsored by Grainger.
Dr. Tracy Buchman, DHA, CHPA, CHSP is the National Director, Hospital Emergency Management, HSS.
Dr. Buchman holds a doctoral degree in Health Administration, master’s degree in Occupational/Industrial Safety Studies and a bachelor’s degree in Human Resources Management. Tracy served as the Safety Director at the University of Wisconsin Hospital and Clinics for 17 years.
Possible Pull quote, Advice from Tracy Could go with her photo as a caption: “Have one person go through it all to understand HICS very thoroughly then start small with the top eight positions, chiefs and above, and bring in a couple of the forms, then take the planning and response guides that are pertinent to your HVA and exercise those.”