Job Action Sheet Command
INCIDENT COMMANDER
Page 1
INCIDENT COMMANDER
Mission: Organize and direct the Hospital Command Center (HCC). Give overall
strategic direction for hospital incident management and support activities,
including emergency response and recovery. Authorize total facility evacuation
if warranted.
Date: _________ Start: ________ End: ________ Position Assigned to: ____________________________
Signature: ________________________________________________________ Initial: ______________
Hospital Command Center (HCC) Location: _____________________ Telephone: ___________________
Fax: ___________________ Other Contact Info: _________________ Radio Title: ___________________
Tim Initia
Immediate (Operational Period 0-2 Hours) e l
Assume role of Incident Commander and activate the Hospital Incident Command
System (HICS).
Read this entire Job Action Sheet and put on position identification.
Notify your usual supervisor and the hospital CEO, or designee, of the incident,
activation of HICS and your HICS assignment.
Initiate the Incident Briefing Form (HICS Form 201) and include the following
information:
Nature of the problem (incident type, victim count, injury/illness type, etc.)
Safety of staff, patients and visitors
Risks to personnel and need for protective equipment
Risks to the facility
Need for decontamination
Estimated duration of incident
Need for modifying daily operations
HICS team required to manage the incident
Need to open up the HCC
Overall community response actions being taken
Status of local, county, and state Emergency Operations Centers (EOC)
Contact hospital operator and initiate hospital’s emergency operations plan.
Determine need for and appropriately appoint Command Staff and Section
Chiefs, or Branch/Unit/Team leaders and Medical/Technical Specialists as
needed; distribute corresponding Job Action Sheets and position identification.
Assign or complete the Branch Assignment List (HICS Form 204), as
appropriate.
Brief all appointed staff of the nature of the problem, immediate critical issues and
initial plan of action. Designate time for next briefing.
Assign one of more clerical personnel from current staffing or make a request for
staff to the Labor Pool and Credentialing Unit Leader, if activated, to function as
the HCC recorder(s).
Distribute the Section Personnel Time Sheet (HICS Form 252) to Command Staff
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Job Action Sheet Command
INCIDENT COMMANDER
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Tim Initia
Immediate (Operational Period 0-2 Hours) e l
and Medical/Technical Specialist assigned to Command, and ensure time is
recorded appropriately. Submit the Section Personnel Time Sheet to the
Finance/Administration Section’s Time Unit Leader at the completion of a shift or
at the end of each operational period.
Initiate the Incident Action Plan Safety Analysis (HICS Form 261) to document
hazards and define mitigation.
Receive status reports from and develop an Incident Action Plan with Section
Chiefs and Command Staff to determine appropriate response and recovery
levels. During initial briefing/status reports, discover the following:
If applicable, receive initial facility damage survey report from Logistics
Section Chief and evaluate the need for evacuation.
If applicable, obtain patient census and status from Planning Section
Chief, and request a hospital-wide projection report for 4, 8, 12, 24 & 48
hours from time of incident onset. Adjust projections as necessary.
Identify the operational period and HCC shift change.
If additional beds are needed, authorize a patient prioritization
assessment for the purposes of designating appropriate early discharge.
Ensure that appropriate contact with outside agencies has been
established and facility status and resource information provided through
the Liaison Officer.
Seek information from Section Chiefs regarding current “on-hand”
resources of medical equipment, supplies, medications, food, and water
as indicated by the incident.
Review security and facility surge capacity and capability plans as
appropriate.
Document all key activities, actions, and decisions in an Operational Log (HICS
Form 214) on a continual basis.
Document all communications (internal and external) on an Incident Message
Form (HICS Form 213). Provide a copy of the Incident Message Form to the
Documentation Unit.
Tim Initia
Intermediate (Operational Period 2-12 Hours) e l
Authorize resources as needed or requested by Command Staff.
Designate regular briefings with Command Staff/Section Chiefs to identify and
plan for:
Update of current situation/response and status of other area hospitals,
emergency management/local emergency operation centers, and public
health officials and other community response agencies
Deploying a Liaison Officer to local EOC
Deploying a PIO to the local Joint Information Center
Critical facility and patient care issues
Hospital operational support issues
Risk communication and situation updates to staff
Implementation of hospital surge capacity and capability plans
Ensure patient tracking system established and linked with appropriate
outside agencies and/or local EOC
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Job Action Sheet Command
INCIDENT COMMANDER
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Tim Initia
Intermediate (Operational Period 2-12 Hours) e l
Family Support Center operations
Public information, risk communication and education needs
Appropriate use and activation of safety practices and procedures
Enhanced staff protection measures as appropriate
Public information and education needs
Media relations and briefings
Staff and family support
Development, review, and/or revision of the Incident Action Plan, or
elements of the Incident Action Plan
Oversee and approve revision of the Incident Action Plan developed by the
Planning Section Chief. Ensure that the approved plan is communicated to all
Command Staff and Section Chiefs.
Communicate facility and incident status and the Incident Action Plan to CEO or
designee, or to other executives and/or Board of Directors members on a need-to-
know basis.
Tim Initia
Extended (Operational Period Beyond 12 Hours) e l
Ensure staff, patient, and media briefings are being conducted regularly.
Review and revise the Incident Action Plan Safety Analysis (HICS Form 261) and
implement correction or mitigation strategies.
Evaluate/re-evaluate need for deploying a Liaison Officer to the local EOC.
Evaluate/re-evaluate need for deploying a PIO to the local Joint Information
Center.
Ensure incident action planning for each operational period and a reporting of the
Incident Action Plan at each shift change and briefing.
Evaluate overall hospital operational status, and ensure critical issues are
addressed.
Review /revise the Incident Action Plan with the Planning Section Chief for each
operational period.
Ensure continued communications with local, regional, and state response
coordination centers and other HCCs through the Liaison Officer and others.
Ensure your physical readiness, and that of the Command Staff and Section
Chiefs, through proper nutrition, water intake, rest periods and relief, and stress
management techniques.
Observe all staff and volunteers for signs of stress and inappropriate behavior.
Report concerns to the Employee Health & Well-Being Unit Leader.
Upon shift change, brief your replacement on the status of all ongoing operations,
critical issues, relevant incident information and Incident Action Plan for the next
operational period.
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Job Action Sheet Command
INCIDENT COMMANDER
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Tim Initia
Demobilization/System Recovery e l
Assess the plan developed by the Demobilization Unit Leader and approved by
the Planning Section Chief for the gradual demobilization of the HCC and
emergency operations according to the progression of the incident and
facility/hospital status. Demobilize positions in the HCC and return personnel to
their normal jobs as appropriate until the incident is resolved and there is a return
to normal operations.
Briefing staff, administration, and Board of Directors
Approve announcement of “ALL CLEAR“ when incident is no longer a
critical safety threat or can be managed using normal hospital operations
Ensure outside agencies are aware of status change
Declare hospital/facility safety
Ensure demobilization of the HCC and restocking of supplies, as appropriate
including:
Return of borrowed equipment to appropriate location
Replacement of broken or lost items
Cleaning of HCC and facility
Restock of HCC supplies and equipment;
Environmental clean-up as warranted
Ensure that after-action activities are coordinated and completed including:
Collection of all HCC documentation by the Planning Section Chief
Coordination and submission of response and recovery costs, and
reimbursement documentation by the Finance/Administration and
Planning Section Chiefs
Conduct of staff debriefings to identify accomplishments, response and
improvement issues
Identify needed revisions to the Emergency Management Plan,
Emergency Operations Plan, Job Action Sheets, operational procedures,
records, and/or other related items
Writing the facility/hospital After Action Report and Improvement Plan
Participation in external (community and governmental) meetings and
other post-incident discussion and after-action activities
Post-incident media briefings and facility/hospital status updates
Post-incident public education and information
Stress management activities and services for staff
Documents/Tools
Incident Action Plan
HICS Form 201 – Incident Briefing Form
HICS Form 204 – Branch Assignment List
HICS Form 207 – Incident Management Team Chart
HICS Form 213 – Incident Message Form
HICS Form 214 – Operational Log
HICS Form 252 – Section Personnel Time Sheet
HICS Form 261 – Incident Action Plan Safety Analysis
Hospital emergency operations plan
Hospital organization chart
Hospital telephone directory
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Job Action Sheet Command
INCIDENT COMMANDER
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Documents/Tools
Radio/satellite phone
August 2006
