Hospital Incident

Command System

Application of Incident
Action Plan and Forms:
Loss of Power

This material has been developed for training purposes; do not share, distribute, transmit or reproduce without prior written consent of California Hospital Association This course was
developed by the CHA Hospital Preparedness Program with grant funds provided by the U.S. Department of Health & Human Services Assistant Secretary for Preparedness &
Response Hospital Preparedness Program and awarded by the California Department of Public Health. No part of this course or its materials shall be copied or utilized for monetary
gain.

Objectives
Demonstrate the Incident Action Planning
Process
Demonstrate the use of HICS Forms
Implement the use of the Incident Response
Guides

Scenario Based Implementation

Discuss and rehearse practical
implementation of the Incident Action
Planning process utilizing HICS forms and
the Incident Response Guides
Utilize a Table Top learning process

Incident Action Planning

1. Assess the Situation
2. Set the Operational Period
3. Determine Safety Priorities & Establish Incident Objectives
4. Determine Branch/Section Objectives
5. Determine Strategies & Tactics
6. Determine Needed Resources
7. Issue Assignments
8. Implement Actions
9. Reassess & Adjust Plans

Scenario 1
Setting: Mid-August
Weather: A heat wave with higher than
average temperatures (108) for 8 days
Reported heat related illnesses
Isolated losses of power
Time: 4:00 p.m.

The Power is Disrupted but the

Generators are Functioning
Power has been off for 30 minutes. You learn
that a transformer in the area has blown out.
Time until repaired: Unknown.
Is this an incident?
What are your first actions?
Who is in charge?

Incident Action Planning

Step 1: Assess the Situation
Use HICS form 214: Operational Log
Complete HICS form 201: Incident Briefing
Event History and Current Actions Summary

Begin form 202: Incident Objectives

Weather/environmental implications for period

Which Positions to Activate?

Immediate Time Period

Position

Immediat
e
X
X
X
X

Intermedia
te
X
X
X
X

Extend
ed
X
X
X
X

Recovery

Operations Section Chief

Medical Care Branch Director
Infrastructure Branch Director
Security Branch Director
Business Continuity Branch
Director
Patient Family Assistance Branch
Dir.

X
X
X
X

X
X
X
X

X
X
X
X

X
X
X
X
X

Planning Section Chief

Resources Unit Leader
Situation Unit Leader
Documentation Unit Leader
Demobilization Unit Leader

X
X
X

X
X
X
X

X
X
X
X
X

X
X
X
X
X

Logistics Section Chief

Service Branch Director
Support Branch Director

X
X
X

X
X
X

X
X
X

X
X
X

Finance /Administration
Section Chief
Time Unit Leader
Procurement Unit Leader
Compensation/Claims Unit Leader
Cost Unit Leader

X
X

X
X

X
X
X
X

Incident Commander
Public Information Officer
Liaison Officer
Safety Officer

X
X
X
X

Naming the Incident

The Incident Commander names the
incident
If the incident is a community-based
incident, the appropriate jurisdiction will
name the incident (e.g., county, city, EMS)
The incident name should be documented
on all forms

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Incident Action Planning

Step 2: Set the Operational Period
HICS form 202: Incident Objectives
Operational Period Date/Time

Incident Commander sets the Operational

Period:
Based on number of simultaneous activities
How quickly the situation is changing

An Operational Period breaks the incident

down into manageable timeframes
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Incident Action Planning

Step 3: Determine Safety Priorities &
Establish Incident Objectives
Identify the Incident Objectives (these are
the broad objectives that will last throughout
the response or are the priorities)
HICS form 202: Incident Objectives

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Incident Objectives
Utilize the Incident Response Guide
Utility Failure:
Identify extent of outage and consider
evacuation
Maintain patient care capabilities
Minimize impact on hospital operations and
clinical services
Communicate the situation status to patients,
staff, and the public
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Scenario Update #1
The municipal power company states that
it may be at least 6 hours before they can
replace the transformer; they have to wait
for a large crane
It has been 45 minutes since the outage
Patients are complaining of being hot
The lab states their equipment is getting
too hot
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Side Note:
Safety Officer Tasks
Assess the Safety issues
What hazards exist and what precautions
need to be taken
Complete the 215A Incident Action Plan
Safety Analysis

15

Side Note:
Public Information Officer task
Prepare a statement for the media
Prepare a statement for the staff, patients
and visitors (e.g., situation, status, safety
precautions, next update time)
The statements need approval from the
Incident Commander
Coordinate consistent messaging with the
Joint Information Center (JIC)
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Side Note:
Liaison Officer
Make contact with the Power Company
directly, or through the local EOC (MHOAC) if
activated
Who should be notified?
Who is the source of resources in your local
plan? (e.g., local EMS Department
Operations Center, PHD Department
Operations Center, County/City Emergency
Operations Center)
These contacts/processes should be
identified prior to any incident
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Side Note:
Documenting your Actions
Utilize HICS forms
214 - Operational Log

18

Incident Action Planning

Step 4: Determine Branch/Section
Objectives

Document on HICS 204 Assignment List

They are based on the Incident Objectives

These are based on what is desired to be
achieved by the Branch/Section in that
operational period
Objectives need to be SMART (Simple,
Measurable, Achievable, Realistic, Time
Sensitive & Task Oriented)
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Branch/Section Objectives
A common problem during exercises is
that Branches/Sections dont develop
their objectives promptly
Report top 3 objectives

20

Incident Action Planning

Step 5: Determine Strategies & Tactics

21

Incident Action Planning

Step 6: Determine Needed Resources
Where can patients be moved to?
What personnel resources do you need?
What equipment and/or supplies do you need?
What resources do you need in the patient
collection/holding area?
What transport resources do you need?
Document resource activities:

Resources assigned (form 204)

Resource requests (form 213)
Actions taken to utilize and obtain resources (form 214)
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Incident Action Planning

Step 7: Issue Assignments
Who will be assigned to the units?
Fill in assignments on form 204
Assignment List
Are there other branches or units that need
activated?

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Incident Action Planning

For the first Operational Period the Incident
Action Plan should be done within 30-45
minutes
What makes up the Incident Action Plan?

201 - Incident Briefing

202 - Incident Objectives
203 - Incident Assignments
204 - Branch Assignments
215A - Incident Action Plan Safety Analysis

The Planning Section compiles the forms to

create the Incident Action Plans
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IAP Quick Start

New form
Can be used for small incidents
Or for a rapid start to a large incident and
then expand out on individual HICS forms
Great for smaller pre-planned events

25

IAP Cover Sheet

Can be used for the IAP Quick Start or full
Incident Action Plan forms
Can make different colors if you want to
differentiate Operational Periods

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Incident Action Planning

Step 8: Implement Actions
Put your activities / plans into action
What are some of these activities?

27

Scenario Update #2
It is now 1730 1.5 hrs into the incident
Power is still out
What are your major concerns?

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Incident Action Planning

Step 9: Reassess & Adjust Plans
Towards the end of the operational period,
you will need to evaluate status
Repeat steps 1-8
Update the forms
Evaluate and/or update your Branch/Section
Objectives
This creates your Incident Action Plan
(game plan) for the next operational period
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Scenario Update #3
It is now 4 hours into the incident
Power remains off, Power Company has
had set backs, not sure when repairs will
be made
What are some of the issues to consider?

30

How are we doing?

What are things we need to remember to do?
Share information
Recovery / Restoration
After Action Report
Corrective Actions Plan

31

Questions?

32

HICS Basics Part 2:

Application of
Incident Action Plan and Forms
Loss of Power
developed by the
California Hospital Associations
Hospital Preparedness Program
www.calhospitalprepare.org

This material has been developed for training purposes; do not share, distribute, transmit or reproduce without prior written consent of California Hospital Association
This course was developed by the CHA Hospital Preparedness Program with grant funds provided by the U.S. Department of Health & Human Services Assistant Secretary
for Preparedness & Response Hospital Preparedness Program and awarded by the California Department of Public Health. No part of this course or its materials shall be
copied or utilized for monetary gain.

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