Both the Hospital Incident Command System (HICS) and a Myocardial Infarction (MI) are managed by addressing key objectives. In fact I think they use the same prioritize activities identically. Read on and see if you agree.
Hospitals are often challenged when it comes to understanding the value of using of the HICS to manage events since they already have hierarchies with reporting chains. I’ll use the example of an MI patient presenting to their Emergency Department (ED) to show the concepts of the HICS are firmly in use in the hospital setting when it comes to managing critical events. The ICS uses one set of objectives and they are consistently addressed in order of:
Return to Normalcy
Now follow my example of a middle aged man patient presenting to your busy ED complaining of crushing sub-sternal chest pain. He’s pale, diaphoretic and says he “feels like he’s going to die. At this point, someone steps up to take charge (the Incident Commander) and they conduct a more focused assessment to determine the extent of the problem. In the ICS we call this assessing the scene to help determine the immediate issues and formulate our initial action plan.
With our MI patient we must ask ourselves do we have a life safety issue? The answer in this case is we obviously do therefore we need to immediately assign resources to manage this patent or risk the patient’s condition deteriorating further. We don’t ignore patients already in the ED and we don’t assign more resources than necessary. One of the key benefits of using the ICS is our ability to assign and manage resources.
Next we need to stabilize the patient by placing them on oxygen, starting a line, taking vitals, hooking up the EKG and managing pain. This sounds an awful lot like “incident stabilization in ICS terms.
We’re very concerned about trying to conserve heart muscle in this case. The more heart muscle we can conserve at this point and re-oxygenate, the better our patient’s prognosis to survive the immediate event. I’d say this is identical to the ICS task of property conservation.
Lastly the patient is managed and a care plan initiated so upon discharge the patient returns to as near as possible their pre-existing health condition, if not better. In ICS terms, we ensure a return to normalcy as soon as possible. Not just for the victims in the event but also the resources we had assigned to manage the event. When the ED personnel hand off the patient’s care to the unit, they return to their work in the ED. It’s all about resource management.
In summary when you think about it, ICS concepts are used every day to prioritize resources based upon a set of standardized objectives. Adopting the HICS makes sense for a major teaching hospital or a critical access facility. If you’d like to explore institutionalizing a customized HICS within your organization contact me at firstname.lastname@example.org, it just may be easier than you thought.