Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS) (original) (raw)
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Assessment of the Incident Command System Preparedness of the Hospitals in Qom, Iran
Health in Emergencies & Disasters Quarterly
Background: Hospital and prehospital emergencies are the first lines of coping and dealing with emergencies as well as emerging crises of special status. Developing and improving the readiness of these centers is considered as the main component for success in the universities of Medical Sciences. This study aimed to assess the preparedness of the incident command system in Qom hospitals, Qom City, Iran. Materials and Methods: This descriptive-analytic study was conducted on 120 senior managers, nursing directors, administrative and financial members of the Crisis Committee of 7 hospitals in Qom. The obtained data were collected using the standard disaster preparedness questionnaire with 4 domains. The researcher collected the study data through observation, interview, and review of the committee's documents. The collected data were analyzed in SPSS V. 20 using descriptiveanalytical statistics, such as mean, standard deviation, and independent t-test. Results: The mean knowledge scores of supervisors and members of the Disaster Management Committee were 14.51 and 14.62, respectively, which was not significantly different (P = 0.486). In addition, the mean attitude scores of the supervisors and members of the Committee were 69.66 and 70.70, respectively, which was not significantly significant (P = 0.437). Regarding practice, the mean scores of the practice of the supervisors and members were 9.62 and 12.0, respectively, which was significantly different (P = 0.045). Conclusion: Proper management of crises is achievable by organizing, coordinating, and strengthening all members of the crisis team.
Background: Hospitals as the essential health service providers should manage their performance during incidents and disasters. The Hospital Incident Command System (HICS) is helpful in this regard. The establishment of this system assists the hospital disaster risk management committee to get prepared in emergency situations. This study aimed to assess the effect of HICS establishment on preparedness of Police Hospitals in Tehran, Iran during disasters, under simulated conditions. Materials and Methods: This was a quasi-experimental interventional study. The study participants were 55 managers of Imam Sajjad and Vali Asr hospitals in Tehran selected by census method (23 from Imam Sajjad Hospital as the control group, and 32 from Vali Asr Hospital as the experimental group). The preparedness of hospitals was measured before the intervention using Hospital Preparedness Scale (HPS) designed by Khankeh (2012). After establishment of HICS in Vali Asr Hospital, the hospital managers received a 3-day training through incident scenario. After one month, their preparedness was measured again by HPS instrument. The collected data were analyzed in SPSS (Version 18) using descriptive statistics, Independent t test and Chi-square test. Results: Establishment of HICS significantly increased preparedness of hospitals in communications, continuity of vital services, manpower, and procurement and logistics areas. Conclusion: Establishment of HICS can improve the hospitals' preparedness at times of disasters in many aspects. It is suggested that similar studies be conducted in private and public hospitals with longer follow-up time.
Health in Emergencies & Disasters Quarterly
Background: Hospitals as the essential health service providers should manage their performance during incidents and disasters. The Hospital Incident Command System (HICS) is helpful in this regard. The establishment of this system assists the hospital disaster risk management committee to get prepared in emergency situations. This study aimed to assess the effect of HICS establishment on preparedness of Police Hospitals in Tehran, Iran during disasters, under simulated conditions. Materials and Methods: This was a quasi-experimental interventional study. The study participants were 55 managers of Imam Sajjad and Vali Asr hospitals in Tehran selected by census method (23 from Imam Sajjad Hospital as the control group, and 32 from Vali Asr Hospital as the experimental group). The preparedness of hospitals was measured before the intervention using Hospital Preparedness Scale (HPS) designed by Khankeh (2012). After establishment of HICS in Vali Asr Hospital, the hospital managers received a 3-day training through incident scenario. After one month, their preparedness was measured again by HPS instrument. The collected data were analyzed in SPSS (Version 18) using descriptive statistics, Independent t test and Chi-square test. Results: Establishment of HICS significantly increased preparedness of hospitals in communications, continuity of vital services, manpower, and procurement and logistics areas. Conclusion: Establishment of HICS can improve the hospitals' preparedness at times of disasters in many aspects. It is suggested that similar studies be conducted in private and public hospitals with longer follow-up time.
2019
Background: The current study aimed at examining Hospital Incident Command System (HICS) on the rate of accidents and disaster preparedness committee and nursing staff of Imam Ali Hospital in Zarand, Iran. Materials and Methods: The current semi-experimental study was conducted on the members of Crisis Committee (n=9) and nursing personnel (n=38) selected by fully count model. Data collection tools were two valid and reliable questionnaires: hospital disaster preparedness and the nurses' disaster preparedness. Hospital disaster preparedness also included a two-day workshop on hospital incident command system and the nurses' disaster preparedness included a one-day workshop on disaster management. Members of the Crisis Committee and nurses were evaluated based on hospital disaster preparedness and nurses' disaster preparedness questionnaires before and one month after intervention. SPSS V. 16 was used to analyze data. Results: Findings of the current study indicated a major increase in the disaster preparedness of the Crisis Committee (from 88.33 to 130.88) and nurses (from 132.63 to 2077.56) after intervention; in addition, a significant improvement was observed in the nurses group (P=0.000) Conclusion: It was concluded that the establishment of HICS and using disaster preparedness program can improve the preparedness of hospital disaster management committee and nursing personnel against disasters.
Health in Emergencies & Disasters Quarterly
The current study aimed at examining Hospital Incident Command System (HICS) on the rate of accidents and disaster preparedness committee and nursing staff of Imam Ali Hospital in Zarand, Iran. Materials and Methods: The current semi-experimental study was conducted on the members of Crisis Committee (n=9) and nursing personnel (n=38) selected by fully count model. Data collection tools were two valid and reliable questionnaires: hospital disaster preparedness and the nurses' disaster preparedness. Hospital disaster preparedness also included a two-day workshop on hospital incident command system and the nurses' disaster preparedness included a one-day workshop on disaster management. Members of the Crisis Committee and nurses were evaluated based on hospital disaster preparedness and nurses' disaster preparedness questionnaires before and one month after intervention. SPSS V. 16 was used to analyze data. Results: Findings of the current study indicated a major increase in the disaster preparedness of the Crisis Committee (from 88.33 to 130.88) and nurses (from 132.63 to 2077.56) after intervention; in addition, a significant improvement was observed in the nurses group (P=0.000) Conclusion: It was concluded that the establishment of HICS and using disaster preparedness program can improve the preparedness of hospital disaster management committee and nursing personnel against disasters.
Journal of Research in Medical and Dental Science, 2018
Achieving the goals of organizations requires an appropriate model for performance evaluation. Applying globally accepted methods for administration of hospital incident command system (HICS) can build a new tool for improving the quality of evaluation of real disasters and incidences. The present study seeks to develop a model through the implementation of a quality management system. Methodology:This applied study was conducted in two steps in 2016. First, data collection were collected from library-printed and electronic references related to the purpose of the research According to the inclusion and exclusion criteria, 28 articles having conducted on HICS and 50 articles on the quality management system were selected. In the next step, interviews were conducted with 23 experts and the themes were obtained through qualitative study and content analysis. Then the data were extracted. Findings:According to qualitative interviews, two themes of the proposed quality improvement model...
Hospital incident command system (HICS) performance in Iran; decision making during disasters
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 2012
Background: Hospitals are cornerstones for health care in a community and must continue to function in the face of a disaster. The Hospital Incident Command System (HICS) is a method by which the hospital operates when an emergency is declared. Hospitals are often ill equipped to evaluate the strengths and vulnerabilities of their own management systems before the occurrence of an actual disaster. The main objective of this study was to measure the decision making performance according to HICS job actions sheets using tabletop exercises. Methods: This observational study was conducted between May 1st 2008 and August 31st 2009. Twenty three Iranian hospitals were included. A tabletop exercise was developed for each hospital which in turn was based on the highest probable risk. The job action sheets of the HICS were used as measurements of performance. Each indicator was considered as 1, 2 or 3 in accordance with the HICS. Fair performance was determined as < 40%; intermediate as 41-70%; high as 71-100% of the maximum score of 192. Descriptive statistics, T-test, and Univariate Analysis of Variance were used. Results: None of the participating hospitals had a hospital disaster management plan. The performance according to HICS was intermediate for 83% (n = 19) of the participating hospitals. No hospital had a high level of performance. The performance level for the individual sections was intermediate or fair, except for the logistic and finance sections which demonstrated a higher level of performance. The public hospitals had overall higher performances than university hospitals (P = 0.04). Conclusions: The decision making performance in the Iranian hospitals, as measured during table top exercises and using the indicators proposed by HICS was intermediate to poor. In addition, this study demonstrates that the HICS job action sheets can be used as a template for measuring the hospital response. Simulations can be used to assess preparedness, but the correlation with outcome remains to be studied.
Assessment of a Military Hospital’s Disaster Preparedness Using a Health Incident Command System
Trauma Monthly, 2016
Background: A hospital emergency incident command system is one of the most reliable and popular organizational methods for disaster and emergency management. Objectives: The aim of the present study was to assess the level of disaster preparedness in the emergency department and other selected units of a military hospital in Tehran. Methods: This cross-sectional study was conducted in 2013 and involved 97 medical staff members from various departments: emergency, management, discharge and transport, camp (security and staff), information and communication technology, training, reception, and human resources. Three instruments were used for data collection: a self-reported questionnaire, unit evaluation checklist, and maneuver evaluation checklist. Results: The overall mean score for the maneuver checklist was 55.5%. The mean (± standard deviation) score for the questionnaire was 42.02 ± 8.62. The unit evaluation checklist had a score of 165 from a total of 244 possible points and a mean percentage of 67.62%. After conducting the maneuver, the hospital staff was reported to have weak performance in evaluating and prioritizing patients for quick release and tracking their conditions. Conclusions: The present study shows that the selected hospital had a moderate level of preparedness, which is in line with the previous studies. It is recommended that future studies evaluate the effect of education on the disaster preparedness of hospital units.
Prehospital and disaster medicine
The Hospital Emergency Incident Command System (HEICS), now in its third edition, has emerged as a popular incident command system model for hospital emergency response in the United States and other countries. Since the inception of the HEICS in 1991, several events have transformed the requirements of hospital emergency management, including the 1995 Tokyo Subway sarin attack, the 2001 US anthrax letter attacks, and the 2003 Severe Acute Respiratory Syndrome (SARS) outbreaks in eastern Asia and Toronto, Canada. Several modifications of the HEICS are suggested to match the needs of hospital emergency management today, including: (1) an Incident Consultant in the Administrative Section of the HEICS to provide expert advice directly to the Incident Commander in chemical, biological, radiological, nuclear (CBRN) emergencies as needed, as well as consultation on mental health needs; (2) new unit leaders in the Operations Section to coordinate the management of contaminated or infectiou...
2019
Materials and Methods: The statistical population of the current descriptive, cross sectional study was all hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences in 2017. The main tool to collect information in the study was the checklist of preparedness for disasters designed by Hojjat et al. A group of 20 faculty members of the Jundishapur University of Medical Sciences evaluated the checklist and confirmed its validity. Also, the reliability of the instrument was evaluated using a test-retest method on one of the research units based on Kappa test with a value of 0.8 in acceptable range. Data were collected and coded with SPSS software version 19. Results: The highest level of disaster preparedness at Jundishapur University of medical sciences in Ahvaz belonged to human inferiority with an average score of 67.66±8; 16 of 100, and the lowest belonged to the emergency areas with an average score of 3.75±0.77 or 43 of 100. Imam Khomeini Hospital was in a better status than the other hospitals in terms of emergency, reception, discharging and transferring, traffic, and communication. In terms of education, Abuzar Hospital had the highest level of preparedness; and regarding support and management of health care practices, Salamat Hospital had the highest level for disaster preparedness.