At this point, the majority of people who get COVID-19 only experience mild symptoms. But one in six become seriously ill, according to the World Health Organization. Throughout the entirety of the crisis, those numbers have carried serious implications for the healthcare COVID-19 response, as the resultant severe disease has caused hospitalization, even admission to an intensive care unit for weekslong stints.
Reporting has covered the burden that these disproportionate numbers of severe COVID-19 cases has put on the healthcare COVID-19 response, particularly on systems in hard-hit areas like Wuhan, Lombardy, and New York City. The question for healthcare providers, whether public health agencies, hospitals, or other organizations providing care, has been to anticipate how much capacity exists within their individual systems – more specifically, how quickly the spread of disease cases could saturate the numbers of available beds, face masks, and other resources. Because without these critical resources, the healthcare COVID-19 response will be seriously compromised, greatly impeding the ability of the healthcare organization in question to respond to the virus.
What’s then to do? Well, team-driven operational planning is central to most successful emergency interventions. The healthcare sector, where operational planning has been codified in the form of the Hospital Incident Command System (HICS), is no different.
Based on the principles of the Incident Command System (ICS), HICS is an incident management system, which assists hospitals and healthcare organizations in improving emergency management planning, response, and recovery capabilities for unplanned and planned events. More specifically, HICS provides a standardized framework and management tool to continue patient care under any circumstance.
What are the system’s particular benefits in a COVID-19 surge scenario? For one, HICS offers a flexible reporting structure to capture relevant information in a fast-moving crisis situation. HICS also lets healthcare organizations set up communication flows and documentation; and because it’s standardized across the sector, healthcare organizations will greatly improve inter-agency communication (with public safety responders, as well) by using a shared command structure with a common terminology.
The objective of HICS is to provide hospital operations with strategic direction, so that key stakeholders can funnel resource support (be it staff or equipment) where it’s needed most. To that end, the structure is composed of two groups: Command Staff and General Staff. Here’s how they function[i]:
- Command staff. The Command Staff consists of an incident commander, public information officer, liaison officer, safety officer, and medical/technical specialist. The incident commander heads up the entire operation, determining which parts of the action plan are activated and at what times. The public information officer provides important information updates to external media, staff, and patients.
Meanwhile, the liaison officer acts as a critical conduit between the hospital and outside agencies, such as public safety. The safety officer is responsible for ensuring the safety of responders, staff, and patients. The safety officer also monitors the response, anticipating hazardous operations and conditions. Finally, the medical/technical specialist assists the incident commander bring providing event-specific support.
- General staff. The General Staff, on the other hand, typically compromises four positions, operations section chief, planning section chief, logistics section chief, and finance/administration section chief.
The operations section chief develops and implements strategy and tactics, carries out objectives set out by the incident commander, including staging, medical care, infrastructure, security, hazardous materials, and business continuity.
The planning section chief oversees incident-related data gathering and analysis. The planning section chief is also responsible for developing alternatives for tactical operations and preparing the incident action plan for each operational period.
The logistics section chief obtains necessary resources requested by Operations and Planning. The logistics section chief also supervises damage, sanitation, supply, transport, and nutrition, in addition to being responsible for procuring more medical supplies, if needed.
Finally, the finance/administration section chief monitors incident-related costs, providing accounting, procurement, and analysis.
The beauty of HICS is that any role can be activated or deactivated at any point during the response, depending on need. This gives healthcare users the flexibility to use HICS in any healthcare setting, large or small.
But operationalizing HICS itself, especially HICS assets like forms, takes effort and planning. Purpose-built COVID-19 response software can help, however, by uploading all of the HICS forms you need in a central repository, accessible on mobile devices, so that key stakeholders can download, fill out them electronically, and then upload again.
[i] California Emergency Medical Services Authority. Available at https://emsa.ca.gov/disaster-medical-services-division-hospital-incident-command-system-resources/.
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