Command Control And Coordination

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Command,Control, and CoordinationJeffrey Michael Franc-Law, MD, CCFP.EM, D Sport Med, EMDMAssistant Clinical Professor of Emergency Medicine, University of AlbertaEdmonton AB CanadaVisiting Professor in Disaster Medicine, Dept. of Anesthesia and Intensive Carel'Universit degli Studi del Piemonte Orientale Novara, ItalyObjectivesDescribe ICS for PrehospitalDescribe HEICS for HospitalRecognize link between Pre-Hospital and HospitalPractical ExampleHow does disaster management differ from the usual day-to-day activities of the Emergency Medical System?CoordinationOften in day-to-day activity individual agencies work in isolationEMS HospitalsDepartmentsPhysiciansNeed for a Coordinated ResponseCoordinationBetween physiciansBetween departmentsBetween hospitalsBetween EMS / HospitalCannot be solved simply by adding more resourcesDecisions take place at a lower levelNew non-routine tasks with no clear responsibilityIncident Command SystemICS: DefinitionModel for command structureCoordination of emergency responseWARNING: Not a simple structure: Designed to manage CHAOSICS: HistoryDeveloped in Southern California (wildfires in 1970's)?Firefighting Resources of California Organized for Potential EmergenciesICS: HistoryIn response to a number of problems:Lack of standardized terminologyLack of ability for response to expand and contractLack of standardized / integrated communicationLack of consolidated action planLack of designated facilities.ICS: ApplicationsMultiple types of incidents:FireHAZMATLarge Public EventsAir / Water / Rail DisastersSearch and RescuePrivate sector emergency ManagementOil spills????ICS: SuccessWhy is ICS SuccessfulCommon organizational structureKey management principles presented in a standardized wayAllows communication between EMS and Medical StaffFailure to Use ICS:World Trade CenterThroughout the crisis, the two largest departments, Police and Fire, barely spoke to coordinate strategy or to share intelligence (Operations Issue)?The Police and Fire Department did not work together that day, and they rarely did before(Command Issue)?Failure to Use ICS: World Trade Center...other Firefighters appear to have been using one radio channel while evacuation orders went out over anotherThe fire department has no formal system to evaluate problems or develop plans for multiple complex eventsFDNY Suffered 343 DeathsICS: JFL Five Second SummaryFirst person on scene is the incident commander (IC)?The IC is initially responsible for all dutiesIC recruits staff as neededAdd positions to the Org Structure ONLY WHEN NEEDEDIC develops middle managers as neededIC can transfer responsibility to a new IC when neededICS: Twelve Principles Five Primary Management FunctionsEstablishing and Transferring of CommandSingle or Unified Command StructureManagement of ObjectivesConsolidated Incident Action PlansComprehensive Resource ManagementUnity and Chain of CommandManageable Span of ControlModular OrganizationPersonnel AccountabilityCommon TerminologyIntegrated CommunicationsICS Principles1. Five Primary Management FunctionsFive Primary Management FunctionsCommandPlanningOperationsLogisticsFinance / AdministrationCommandEvery incident has an Incident Commander (IC)?Accepts and maintains overall responsibility at the incidentCommand StaffThree possible positionsliaison OfficerSafety OfficerInformation OfficerDirectly responsible to ICAdded when IC unable to fill dutiesOnly one staff for each position, but may have assistantsGeneral StaffIn small incidents, IC may supervise resources directlyAs incident grows, general staff positions are activatedOperations Section ChiefPlanning Section ChiefLogistics Section ChiefFinance Section ChiefOperations SectionOperations section responsible for carrying out all tactical operationsDuties of the Operations Section ChiefDirect and coordinate all tactical operationsSet up and maintain organizational structureDetermine resources neededRequest resources through ICKeep IC informed of resource statusPlanningIn smaller incidents, Command is responsible for planning.As incident grows, a planning section is added.May contain 5 unitsResources UnitSituation UnitDocumentation UnitDemobilization UnitTechnical SpecialistLogisticsResponsible for all service and support needs of the incidentNeed for logistics section determined by ICCan be divided into two branchesService BranchSupport BranchFinance SectionFor larger incidents requiring off site managementFour unitsTime UnitProcurement UnitCompensation / Claims UnitCost UnitICS Principles2. Establishing and Transferring CommandEstablish / Transfer CommandFirst Trained person on scene is ICWhen to transfer commandMore qualified individual is availableLong operat