The Incident Command System

On a day-to-day basis most organizations function independently of one another. They are able to carry on with their routine activities and operate without the assistance of other agencies, jurisdictions, and/or disciplines. When an area is affected by an emergency or a disaster, however, entities come together in a system that allows them to both continue their normal operations and support emergency operations. Representatives of these entities will also be required to coordinate with the overall command and management of the operation. The Incident Command System (ICS), which has an extensive history in fire service, is a scalable product of years of experience and lessons learned from large-scale national events to small, single-jurisdictional events. The goal of ICS is to provide accurate information, strict accountability, and planning by using a management system based on manageable scope of control, for any incident, for all parties involved, including health care and hospitals. The principles of the ICS are rooted in the command and control of personnel and equipment and the coordination of objectives during the response to an emergency or disaster. ICS does not provide agencies with the techniques needed to achieve their objectives, but rather an organizational structure to reduce duplication of efforts and provide a safe and efficient working environment.

The National Incident Management System (NIMS) is synonymous with ICS; to be NIMS compliant, the mandated entities must utilize the ICS structure. NIMS was implemented as part of Homeland Security Presidential Directive 5 (HSPD-5) in February 2003. This directive enables federal, state, local, tribal, and local governments, nongovernmental organizations, and the private sector with a nationwide template for the response to emergency and disaster situations. HSPD-5 also requires all federal departments and agencies to adopt NIMS and to utilize it and its components for incident planning, response, and recovery. Additionally, state, tribal, and local organizations must adopt NIMS as a condition for federal preparedness assistance. Hospitals and health care systems participating in the National Hospital Preparedness Program (HPP) must also adopt NIMS throughout their organizations. The Hospital Incident Command System (HICS) fulfills this requirement (see Chapter 6 ).

Historical perspective

In the fall of 1970, Southern California was devastated by a number of wild-land fires that burned more than 6 million acres. The fires burned for 13 days and resulted in the loss of 772 structures and 16 lives. Analysis of the overall emergency response indicated numerous issues regarding coordination and management. As a result of this devastating event, Congress funded a consortium of state, county, and city fire departments, led by the U.S. Forest Service, known as the Firefighting Resources of California Organized for Potential Emergencies (FIRESCOPE), to investigate and address the underlying causes from this event. FIRESCOPE identified several recurring problems involving multiagency response that included nonstandardized terminology, nonintegrated communications, a lack of a consolidated action plan, and an inability to expand and contract resources and management as required by the situation. In an effort to address these major findings, FIRESCOPE developed the original ICS model for incident management.

The National Wildfire Coordinating Group (NWCG) conducted an analysis of the FIRESCOPE ICS model for a possible national application and by the 1980s FIRESCOPE ICS was revised and adopted as the National Interagency Incident Management System (NIIMS). FIRESCOPE and NWCG coordinated to update and maintain a comprehensive Incident Command System Operational Systems Description, which served as the basis for the NIMS ICS utilized today.

Current practice

All disasters or emergencies differ. It is therefore imperative that an emergency management tool be flexible, to allow users to modify their response activities to meet the needs of different circumstances without losing compatibility with the overall response. Such flexibility allows ICS to be effective regardless of the complexity of the incident. By implementing ICS in small-scale response activities, users are able to become comfortable with the system and develop best practices and lessons learned for their organization and jurisdiction. These situations will directly apply to the application of ICS during larger incidents.

ICS is a collection of basic management tools that collectively addresses the common deficiencies that occur during a response. The system allows users to have a plan for each component that requires preplanning and training. There are 14 management characteristics taught by the Department of Homeland Security that are the focus of the Federal Emergency Management Agency’s (FEMA’s) baseline and advanced ICS training.

The 14 essential ICS features follow:

  • Common terminology: This phrase applies to the use of plain language for organizational functions, incident facilities, resource descriptions, and position titles. When incidents involve multiple agencies and jurisdictions it is imperative to use common terminology to reduce miscommunication. This concept also includes radio transmissions, which means that 10-codes, agency-specific codes, and acronyms should not be used.

  • Modular organization: The ICS structure is staffed based on the size and complexity of the incident, including specifics related to the hazardous environment created by the incident.

  • Management by objectives: The command staff members of the ICS structure are responsible for developing the overall objectives for an incident. Plans, procedures, and protocols for the incident are developed based upon these objectives. Objectives will affect the organization and span of control of the incident.

  • Reliance on an incident action plan (IAP): The IAP provides a format for communicating incident objectives and operational and support activities. IAPs are broken into different form numbers to maintain consistency.

  • Chain of command and unity of command: Chain of command refers to the organized structure within the ICS organization. Unity of command refers to an individual’s direct supervisor at the incident scene. It may occur that one’s day-to-day supervisor is not the on-scene supervisor. Chain of command and unity of command are in place to provide the structure needed to perform the incident objectives and maintain management of personnel.

  • Unified command: For incidents that involve multiple agencies and jurisdictions it is important that all function collectively while maintaining their individual authority, responsibility, and accountability—unified command allows for this coordination.

  • Manageable span of control: Span of control optimizes the effectiveness of an organization by controlling the number of individuals under a single supervisor. The recommended range is three to seven subordinates, with five being optimum.

  • Predesigned incident locations and facilities: In line with common terminology requirements, incident locations and facilities have predetermined names and functions, such as bases, camps, and staging areas.

  • Resource management: This refers to the process for categorizing, ordering, dispatching, tracking, and recovering resources. It is important to track resources from the start of the incident, for accountability and accurate tracking, for possible reimbursement.

  • Information and intelligence management: This is the process of gathering, sharing, and managing incident-related information and intelligence. Information and intelligence can come from multiple sources, and special care should be given to how and to whom that information is disseminated.

  • Integrated communications: As multiple organizations come together they may not all have the appropriate communications channels to communicate with the rest of the structure. It is important to plan integrated communications in advance, so enough resources can be obtained and a comprehensive communication plan can be developed. Communication systems should include redundancy in case a system were to fail.

  • Transfer of command: As the response operations continue, personnel will change. When this occurs it is important to brief the outgoing and incoming staff in order to continue safe and effective operations.

  • Accountability: This not only occurs at the incident site, it should also occur at all jurisdictional and departmental levels. Accountability includes five major principles, three of which are part of the original 14 ICS essentials: resource check-in or check-out, an IAP, unity of command, span of control, and resource tracking.

  • Deployment: Finally, it is crucial that personnel and equipment do not self-dispatch. Resources should only respond when they are requested.

Notice that none of the tools focuses on the tactical response to an emergency or disaster. It is assumed that responding agencies have the proper training and capability to perform their duties. For example, in a mass casualty event, a primary objective would be to perform triage; ICS provides the core management capabilities and the system depends on the skill and knowledge of the responders to perform the assigned objective(s). It is imperative that individuals continue their education on ICS to grasp the overall concept and to be able to implement it into their organization.

The 14 characteristics are organized under the umbrella of the ICS structure. The ICS structure consists of five major management functions: command, operations, planning, logistics, and finance and administration ( Fig. 38-1 ). These five components, typically referred to as the incident management team, are present at all incident responses, from a routine emergency to a major disaster. The components are staffed and managed based on the type, size, scope, and complexity of the incident. For most small-scale, single-jurisdictional responses, the components may be managed by a single incident commander (IC). As the incident scale expands it may become necessary to establish each component separately and have support positions within those functions. Regardless of the function, all positions have a common set of responsibilities, as well as position-specific responsibilities.

Fig 38-1

ICS Diagram.

Command Function

Command activities are typically administered by a single IC. The IC is responsible for overall direction and guidance to the support staff. The priority of the IC is to “analyze the overall requirements of the incident and determine the most appropriate direction for the management team to follow during the response.” Some of the major responsibilities for the IC include the following:

  • Establishing the incident priorities

  • Determining the incident objectives and general direction for managing the incident

  • Ensuring scene security

  • Approving and authorizing the implementation of an IAP

  • Coordinating with key stakeholders

  • Ensuring the proper development and release of information

Based on the complexity of the incident, the IC should delegate authority for performing command activities. The specific activities are separated into three command staff positions: public information officer (PIO), safety officer, and liaison officer.

  • The PIO is responsible for developing and releasing information to the news media, incident personnel, and other appropriate agencies and organizations.

  • The safety officer is to develop and recommend measures for ensuring personnel safety. If required the safety officer has the authority to suspend, alter, delay, or terminate operations.

  • The liaison officer functions as the point of contact to and from other agency representatives.

By delegating these functions to support staff, the IC can focus on life safety, incident stabilization, and property conservation.

As an incident becomes more complex the IC will delegate authority to the general staff: operations, planning, logistics, and finance and administration. Each of these functions includes a section chief and designated support staff.

General Staff Operations

The operations section consists of staff members whose primary responsibilities are to manage all tactical operations related to the incident. The operations section is typically the largest section of an incident response, because the tactical objectives being completed fall under this section. The operations section can be overseen by the IC or typically a designated operations section chief during large incidents. The operations section chief should not be involved in the tactical objectives themselves; rather they maintain a management level to oversee those resources. All tactical objectives are directed by the IAP. The operations section chief’s primary responsibility is to operationalize the objectives through planning and coordination with the other functions of the ICS structure.

General Staff Planning

Under the planning section individuals are responsible for the overall accountability of the incident. This includes collection of scene information and documentation, tracking of resources, and demobilization of resources. The development of the IAP is coordinated by the planning section. The planning section does not have a tactical response function at the incident. If required, a planning section chief will be designated to coordinate the planning section.

General Staff Logistics

The logistics section is responsible for the logistical support of the incident facilities, services, and materials. Logistics staff does not provide support to civilians; rather it is dedicated to obtaining the necessary resources to assist the operations section with achieving the objectives. Additionally, logistics will coordinate support resources for incident facilities such as bases and camps, including technology support, food, and medical care for responders. If required, a logistics section chief will be designated to coordinate the logistics section.

General Staff Finance and Administration

The finance section manages the overall financial aspects of the incident. The designated finance section chief, if applicable, coordinates all procurements, compensation claims, and resource costs.

In order to effectively manage a response the aforementioned groups must work collectively through a standardized planning process. This process is the “template for strategic, operational and tactical planning that includes all steps an Incident Commander (IC) and other members of the Command and General Staffs should take to develop and disseminate an Incident Action Plan.” It is important to note that once the initial response has occurred, the incident management team begins preparing for the next operational period. Therefore it is the responsibility of the operations section supervisors and leaders to continue the assigned tactical objectives while the incident management team plans for the next operational period.

A properly operating planning process should provide the following :

  • Current information that accurately describes the incident situation and resource status

  • Predictions of the probable course of events

  • Alternative strategies to attain critical incident objectives

  • A realistic IAP for the next operational period

This process is often referred to as the planning “P” ( Fig. 38-2 ). This planning cycle consists of nine meetings with specific items to be addressed and prepared for. At the end of the planning cycle the IAP is approved and then executed, beginning a new operational period. This planning cycle continues throughout the duration of an incident, even throughout the recovery phase.

Aug 25, 2019 | Posted by in EMERGENCY MEDICINE | Comments Off on The Incident Command System
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