Hospital Incident Command

 Major emergency incidents occur throughout the United States every day. Hospitals are required to have the ability to deal with these incidents. Without the proper process these types of emergencies can quickly overwhelm a hospital. 

Hospital Incident Command is an incident command system designed for hospitals and intended for use in both emergency and non-emergency situations. It provides hospitals of all sizes with tools needed to advance their emergency preparedness and response capability—both individually and as members of the broader response community

Building Incident Command

Lets face the truth, Incident Command is not something your organization does every day. ICS can be confusing and cumbersome for organizations that do not understand it. Some hospitals used HICS during the COVID-19 outbreak and realized the gaps in their training. HICS is a low frequency high risk event that must be done right to keep staff, patients and the facility safe during an incident. While the FEMA mandatory required courses may provide a framework, they will not magically create a competent incident management team. We offer both basic and advanced courses level courses to fill in the gaps in a way that is easy to understand. 

Hospital Incident Command Overview

The Hospital Incident Command System (HICS) is a structured framework that provides guidance for hospital emergency management and incident response. Understanding the various components of HICS can help hospitals effectively prepare for and respond to a variety of incidents. Lets take a look at the key concepts related to hospital incident command:


1. Principles

The core principles of hospital incident command include safety, scalability, flexibility, and standardization. These principles ensure that the incident command system can expand or contract based on the severity and specifics of the incident, and that the response is consistent with national standards for incident management.

2. Planning

Effective planning involves risk assessment, resource allocation, and the development of protocols for a range of potential incidents. Hospitals should have a comprehensive emergency operations plan that includes specific procedures for activation, operations, and demobilization of the incident command system.

3. Implementation

Implementation refers to the actual activation and operation of the incident command system during an incident. This includes establishing command, maintaining communication, and coordinating resources and personnel according to the pre-established plans.

4. Team Assembly and Use

Team assembly involves mobilizing the incident command team, which typically includes roles such as Incident Commander, Public Information Officer, Safety Officer, and various section chiefs (Operations, Planning, Logistics, Finance/Administration). Each member has specific responsibilities and works together to manage the incident.

5. Incident Response

Incident response is the immediate action taken to manage an emergency. This involves the execution of the hospital’s emergency operations plan, managing patient care, site security, supplies and logistics, and information management. The response activities are coordinated through the incident command structure to ensure effective management of resources and personnel.

6. Scenarios

Scenarios are hypothetical situations used to train and prepare hospital staff for real incidents. Regular training and drills based on a variety of scenarios (e.g., natural disasters, mass casualty incidents, pandemics) help ensure staff are familiar with their roles and the procedures of the incident command system.

7. Incident Action Plans

Incident Action Plans (IAPs) are detailed plans that outline the response activities for a specific operational period. An IAP includes objectives, strategies, and tactics for managing the incident and is updated regularly to reflect the evolving situation.

8. Customization

Customization of the incident command system allows hospitals to adapt the basic framework to meet their specific needs and circumstances. This is particularly important for addressing the unique challenges and resources of each facility, including considerations for patient populations, hospital size, and available resources.

9. Small/Rural Hospitals

Small and rural hospitals often face unique challenges such as limited resources and staffing. Customization of incident command protocols to fit their specific context is crucial. These hospitals may need to establish mutual aid agreements and integrate more closely with community and regional emergency management resources.


FEMA National Incident Management System (NIMS) Requirements for Hospitals


HICS Awareness recommend taken by all staff 


HICS Operations Level (Mandatory for Command Team)


ICS-100 must be taken by staff who will occupy a command,

section chief, unit leader, supervisor or branch director position in HICS during an event (i.e. those who fill a box on the organizational HICS chart). This staff might occupy a command position (e.g. serve as Incident Commander or Section Chief) at the beginning of the “immediate” period of the event but would be relieved by designated staff with additional expertise and training as the event moves further into operations during the immediate period.


ICS-200/ICS-700 must be taken by staff who will occupy a

command or section chief position in HICS during an event (i.e. those who fill a box on the organizational HICS chart designated as section chiefs or command staff). This staff is intended to occupy the command and section chief positions during the immediate phase of the event – the phase where incident management / action planning is occurring.


ICS-800 must be taken by staff principally in charge of

emergency management planning, mitigation, response, and

recovery at the facility (NOTE: This is a very limited number of

staff (e.g. the emergency management director or chair of the

emergency preparedness committee at the facility). The IS-800 A National Response Plan (NRP), An Introduction course can be completed online at the FEMA Independent Study.



Basic Hospital Incident Command

The Basic course covers all the fundamentals necessary to begin building your command team and is built on a "real world" approach. The course is designed to educate the team on the basic requirements and introduce them to the command positions and what each position is responsible for. The course is 8 hrs. and includes a basic functional tabletop exercise where the students assume the roles and work through a scenario designed for your facility. The course is designed as a per-cursor to the Advanced level course.


The course follows the following format:



  • Command Position Overview
  • Candidates For Command Positions
  • Job Action Sheets Overview
  • Incident Response Guidelines Overview
  • Command Post Basics


  • Hospital Incident Action Planning
  • HICS Forms Overview
  • Functional Tabletop Exercise



 Advanced Hospital Incident Command

The advanced course builds on the fundamentals of the basic course by explaining each section (Command, Operations, Planning, Logistics and Finance) in greater detail, and breaks down the timeline and responsibilities throughout an incident . The course is designed to take the team to the high performance level. The course is 8 hrs. and includes an advanced functional tabletop exercise where the students assume the roles and work through a scenario designed for your facility. For each course the most current job action sheets and emergency response guides are provided in binders. Also included with the Advanced course are cheat sheets for the five Section Chiefs, and a cheat sheets for the forms. 


The course includes the following:


  • Command: Incident Commander, Safety, Liaison
  • Operations: Section Chief and Support Positions
  • Planning: Section Chief and Support Positions
  • Logistics: Section Chief and Support Positions
  • Finance: Section Chief and Support Positions
  • Anatomy of an Incident Response
  • Advanced Functional Tabletop Exercise





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