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With disaster events in the news every day, the necessity of keeping hospital staff up to date with emergency preparedness training is more important than ever.
In the past year, Ebola has made headlines throughout the healthcare community, causing CDC guidelines for protecting healthcare personnel to evolve. The following pages examine key distinctions between emergency management and ICS and the roles that each is designed to fulfill during a major medical incident.
Emergency management describes the science of managing complex systems and multidisciplinary personnel to address extreme events, across all hazards, and through the phases of mitigation, preparedness, response, and recovery. The activities of the EMP address the phases of mitigation, preparedness, response, and recovery.
Mitigation encompasses all activities that reduce or eliminate the probability of a hazard occurrence, or eliminate or reduce the impact from the hazard if it should occur. It is important to note that the procedures and systems used to conduct preparedness activities (committee structure and meetings, memo writing, regular email notification of meetings, etc.) are typically not adequate for use during emergency response.
The ICS provides guidance for how to organize assets to respond to an incident (system description) and processes to manage the response through its successive stages (concept of operations). The ICS, as described in NIMS, refers to the combination of facilities, equipment, personnel, procedures, and communications operating within a common organizational structure and designed to aid in the management of resources during incident response. Common terminology - use of similar terms and definitions for resource descriptions, organizational functions, and incident facilities across disciplines. Integrated communications - ability to send and receive information within an organization, as well as externally to other disciplines. Modular organization -response resources are organized according to their responsibilities.
Unified command structure - multiple disciplines work through their designated managers to establish common objectives and strategies to prevent conflict or duplication of effort.
Manageable span of control - response organization is structured so that each supervisory level oversees an appropriate number of assets (varies based on size and complexity of the event) so it can maintain effective supervision.
Consolidated action plans - a single, formal documentation of incident goals, objectives, and strategies defined by unified incident command. Comprehensive resource management - systems in place to describe, maintain, identify, request, and track resources.
Pre-designated incident facilities - assignment of locations where expected critical incident-related functions will occur. For ICS to be effective, the incident must be formally defined so that there is clarity and consistency as to what is being managed.


The utility of ICS becomes evident when analyzing the demands encountered during an incident response. When an incident generates demands on the response system, the issues addressed first are usually demands created by the hazard itself—hazard-generated demands. Appendix A highlights several critical assumptions that were made in developing the MSCC Management System. Many of these procedures increase the efficiency of preparedness activities, while essentially training participants on the procedures to be used during response and recovery.
DQE-On-Demand eLearning for Healthcare Preparedness eliminates many obstacles to keeping a well-trained staff by providing online learning to students 24 hours a day, seven days a week. Keeping pace with the latest healthcare regulations, DQE has added a new convenient, practical PPE kit that follows the new CDC guidelines. Hospital staff and other healthcare personnel might equate emergency management activities to a hospital's Disaster Committee (hence the recommended name change to Emergency Management Committee).
They are based on a hazard vulnerability analysis (HVA), which if properly accomplished, will identify potential hazards, assess their likelihood of occurrence, their potential impact and the organization's vulnerabilities to the impact, and provide a basis for understanding how the hazard likelihood and organizational vulnerabilities can be addressed.
In Comprehensive Emergency Management, mitigation activities are undertaken during the time period prior to an imminent or actual hazard impact. It includes activities that establish, exercise, refine, and maintain systems used for emergency response and recovery.
This point is often missed by organizations as they attempt to utilize emergency preparedness committees and their associated structures and processes to manage response to an event. Specific guidance for incident response, including processes for asset deployment, is addressed in an EOP.
The initial recovery stage (which actually begins in the late stages of response) is integrated with response mechanisms, and the EOP incident management process should be extended into recovery. Assets within each functional unit may be expanded or contracted based on the requirements of the event.
It did not include objectives for managing the disruption of traffic or other countywide ramifications of the plane crash.
For example, in a highly contagious disease outbreak, hazard-generated demands include the need to evaluate and treat victims, while controlling the spread of the disease. Examples include the use of emergency notification procedures for disseminating preparedness information, the use of a management- by- objective approach when planning preparedness tasks, and using tightly managed meetings with detailed agendas.
They are grouped according to similarity of purpose but are not positions, per se, because each could entail multiple persons working to fulfill that function. DQE-On-Demand has released a new look and additional features that provide enhanced functionality to Emergency Preparedness Program Administrators and their emergency management staff.


DQE now provides two preassembled, blood and virus protection kits - the SafePaq® and the SafePaq® Plus. The sum of all emergency management activities conducted by a response organization may be collectively referred to as an Emergency Management Program (EMP) for that entity. The critical task in preparedness planning is to define the system (how assets are organized) and processes (actions and interactions that must occur) that will guide emergency response and recovery. The EOP defines effective process and procedures for the context of emergency response (emergency notification procedures, establishing an incident management team, processing of incident information, etc.). An effective EOP not only guides the initial (reactive) response actions but also promotes transition to subsequent (proactive) incident management. The management transition from response to recovery (both timing and methods) must be carefully planned and implemented to avoid problems. Arlington County emergency management officials, therefore, quickly knew they had to manage these other problems through their Emergency Operations Center (EOC), which was geographically separate from, but closely coordinated with, incident command at the Pentagon. The term program is used because it denotes activity that is continuously ongoing, whereas a plan is often considered a series of actions that occur only in response to defined circumstances. This is accomplished through the development of an effective EOP (see below for suggested EOP formats). As recovery progresses, recovery management transitions to regular agency management processes or some intermediate method defined by the responsible organizations. In the same example, these demands include the need to coordinate disparate resources, to process widely dispersed data into accurate epidemiological information, to coordinate the public message, and to protect healthcare workers.
An effective mitigation effort should begin with, and be based on, a valid HVA as this will help an organization prioritize issues during follow-on mitigation and preparedness planning.
Staff should be educated and trained on the system so they gain the knowledge and skills necessary to adequately perform their assigned roles. Too often, the response community focuses on the hazard demands and neglects response demands until the latter create a significant impediment to overall response effectiveness.
With well-developed ICS and emergency management support, the incident response proactively addresses both types of demands and, in fact, reduces many response-generated demands to routine status.



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