Hospital Emergency Incident Command System (HEICS): Not Just for Emergencies Anymore!

摘要

During the past 15 years, the author has seen emergency preparedness for healthcare evolve significantly, based on increased regulatory requirements and the changing environment. The requirements for basic emergency preparedness are still necessary but terrorism and emerging illness have heightened the requirements for more extensive and sophisticated responses to these new threats. One component of emergency preparedness that has become more formalized in an effort to meet the requirements of these new threats includes the hospital incident command structure. In the past, the typical attempt to coordinate disasters was an adhoc "command center," established around the emergency room's nurse's station. Administration and other hospital staff would respond to the emergency room to assist as directed by the highest ranking member of administration or the most assertive emergency room nurse or physician. Having been involved in that type of emergency response, it was quickly evident that it was marginally effective at best in reference to functional roles and effective management of the emergency incident. In spite of the chaos, we typically would manage the incident, treat the patients and wait for the next disaster to strike. In an attempt to bring some structure to the organized chaos of hospital emergency response, we developed a dedicated room for a command center, equipped with dedicated telephones, a computer and response cart with necessary vests to identify the emergency room staff and a variety of tracking forms and checklists to formalize our response. The command center was still located in our emergency room but had been moved to a small staff lounge and attempts to consider setting up the command center anywhere outside of the safe confines of the emergency room were met with resistance from both staff and Administration.