Typical Roles within a Hospital Emergency Management Team

The roles within a hospital emergency management team can be much more extensive than the roles in a non-medical organization. This is due to hospitals often having to respond to the needs of the community after an emergency in addition to managing its own environment.

According to the Federal Emergency Management Agency (FEMA), most non-governmental organizations base their emergency management team structure on ICS-100 – an Incident Command System in which an Incident Commander is supported by Section Leaders from Operations, Planning, Logistics, and Finance/Admin, who each have support teams beneath them.

Larger organizations and government agencies are more likely to adopt the military-style ICS-300 model for expanding incidents. In this model the Incident Commander has a small team reporting directly to him or her in addition to the Section Leaders. The roles beneath the Section Leader level are clearly defined and each role can be the responsibility of an individual or a department.

A hospital emergency management team is often far more extensive beneath the Section Leader level due to events that can occur in a medical environment that would be unlikely elsewhere. In addition, a hospital emergency management team may include two further Section Leaders depending on the nature of the event – one in charge of a Medical Section, the other in charge of an Infrastructure Section.

Looking Deeper into a Hospital Emergency Management Team

In September 2016, the Centers for Medicare and Medicaid Services (CMS) published the Emergency Preparedness Rule requiring participants in the Medicare and Medicaid programs to develop an Emergency Preparedness Plan. In order to comply with the Rule, hospitals have to conduct a risk assessment and, from the results of the risk assessment, develop policies and procedures to initiate and execute the plan.

Part of the development procedure includes determining the roles that need to be fulfilled before, during, and after each type of emergency, and where the roles should be located within the Incident Command System. As the image below demonstrates, the number of roles within the Operations Section can be far more extensive than in the ICS-300 model; and, in this case, includes a Medical Director and an Infrastructure Director, each with their own support teams.

As with the ICS-300 model, the roles within a hospital emergency management team can be the responsibility of an individual or a department. Whether all the roles are activated in an emergency will depend on the nature of the emergency, the type of care the hospital provides, and the likely demand for healthcare from the community. It might also be the case roles are distributed across a health system, rather than being located in a single medical facility.

Other Downflows from the Section Leader Level

Other downflows from the Section Leader level do not expand as much as the downflow from the Operations Section, but there can be unique roles you would not find in a non-medical emergency management team. In the example below, unique roles exist in the Planning Section of the hospital emergency management team for personnel, materials, patient, and bed tracking.

Personnel in these roles are not only responsible for planning how resources will be tracked, but also for collecting and evaluating information during an emergency. The information is communicated upwards through the Planning Section Leader, but may also be shared with the Logistics Section, whose role it is to coordinate support requirements before, during, and after an emergency.

Although the downflow from the Finance/Admin Section Leader in a hospital emergency management team is identical to that of the ICS-300 model, the individuals or departments fulfilling the roles will have addition responsibilities than in a non-medical environment. These additional responsibilities include recovering the cost of patient care and collecting financial aid from state and local governments.

Communications within and from a Hospital Emergency Management Team

Under CMS´ Emergency Preparedness Rule, participants in the Medicare and Medicaid programs are required to have a primary and secondary means of communicating with staff and with federal, state, tribal, regional, and local emergency management agencies. Therefore, the communication solutions selected by the hospital emergency management team should be compatible with the systems of those they need to contact. The communication solutions also need to be resilient against outages.

Consequently hospital emergency management teams should adopt multi-modal communication solutions (i.e. those that enable two-way communication via SMS, email, voice broadcasts, etc.) that can be operated remotely, and that integrate with FEMA´s Multi-Agency Coordination System “WebEOC”. These types of solutions ensure emergency preparedness plans can be executed efficiently, support business continuity, and help hospitals recover faster from an emergency.

Indeed, an effective communications system is the backbone of an effective hospital emergency management team – whatever the model. A system that cannot support group messaging at scale via multiple channels of communication, or that is unable to monitor requests for resources, will hamper the efficient execution of an emergency preparedness plan – potentially placing the lives of the people the plan is supposed to protect in greater danger.