HICS is updated for consistency with NIMS

The California Emergency Medical Services Authority has released an updated version of the Hospital Incident Command System (HICS), an incident management system to help hospitals improve their emergency planning and response capabilities. Formerly known as the Hospital Emergency Incident Command System (HEICS), HICS consists of a guidebook and planning and training tools developed by a national panel of experts with support from the American Hospital Association (AHA) and its American Society for Healthcare Engineering.

The update is designed to be consistent with the new implementation activities for hospitals and health care systems released on Sept. 12, 2006, by the National Incident Management System (NIMS) Integration Center of the Federal Emergency Management Agency (FEMA), notes Roslyne Schulman, AHA senior associate director of policy development. There are 17 elements in the new activities that hospitals should integrate into their current emergency management planning, according to NIMS. (See list.) These elements will assist hospitals in ensuring they are NIMS compliant.

"If you look at what was formerly the organizational chart, we now have an ICS [Incident Command System] team chart to be consistent under NIMS," notes Schulman. "It shows how the team should be organized." Also, some of the titles are somewhat different, she says. (A side-by-side comparison is offered in an appendix to the HICS system. It can be found at www.emsa.ca.gov/hics/hics.asp.)

The other improvement in HICS, says Schulman, is that it is intended to be "flexible and scalable" by organizations. "One of the things we heard from small rural facilities when HICS III came out is that it was huge; and if you are a small hospital, it was hard to put into place," she says. "Now, it is intended for different sized organizations and different types of events."

In fact, Schulman adds, the HICs web site also contains a number of scenario-based planning guidances. "Scenarios have been developed for anything from a hurricane to a nuclear detonation," she explains. "HICs has taken each scenario and designed a set of planning and response guidances around them." For hospitals, HICS also has developed guidance and scenarios for internal disasters such as hostage situations or floods, Schulman adds.

These updates, she continues, should be of major importance to ED managers, as "they would be part of the operational arm of any type of response." The external scenarios, for events such as biological disease outbreaks and pandemic influenza, should be of particular interest, she adds.

There also may be a financial impact for noncompliance, Schulman adds. "In the last couple of years, NIMS has issued some guidance for state and local agencies, which are required to be in compliance. Hospitals that receive federal preparedness funds are also required to comply, and we strongly urge others to do likewise," she says. For example, she points out, the Health Resources and Services Administration (HRSA) grants guidance include the NIMS health elements, and over the next two years facilities receiving those grants are expected to come into compliance.

[Editor's note: For more information on the Hospital Incident Command System, contact Schulman at (202) 638-1100. To download a copy of the Hospital Incident Command System free of charge, go to www.emsa.ca.gov/dms2/dms2.asp. Scroll down to the heading "Hospital Emergency Management Topics" and click on "HICS: Hospital Incident Command System."]