This spring, Martin Health System has been transitioning its Hospital Incident Command System (HICS) from a single command structure to an area command structure.
The need for this change became clear after opening a third hospital, Tradition Medical Center in Port St. Lucie, in December 2013, and upon evaluating issues that came up during a recent downtime period in the system’s IT network.
The transition is being led by Steven Wolfberg, Director of Safety, Security and Transportation for Martin Health System, and the former director of emergency services for Martin County.The area command structure places a hospital incident structure at each of the system’s three hospitals. “We knew we needed ‘boots on the ground’ for each facility,” Wolfberg said. “The incident command team is dedicated solely to a particular hospital to determine the specific needs at that location and address them.”
While the corporate commander takes responsibility for setting strategic goals and objectives, the three incident commanders at Martin Health will maintain tactical control and carry out the goals in their facility.
Martin Health worked with a consultant to develop the new area command structure and revise the system’s comprehensive emergency plan.
During this process, it became apparent that physician engagement was lacking in the organization’s emergency planning.
“We had failed to include physicians in our hospital incident command structure,” Wolfberg said. “They were primarily our subject matter experts and called on an ‘as needed’ basis.”
A team was created that included physicians to review options. “Based on past experience and future needs, it became obvious we needed a medical officer working under the incident commander,” Wolfberg explained.
As a result, Martin Health developed an Incident Medical Officer role; four physicians were selected to serve in this capacity for emergencies.
“These physicians offer a broader breadth of oversight and input into the command center decision-making,” Wolfberg said. “With their clinical expertise, we will have a better understanding of what is happening, whether involving patient care needs, physician concerns or the safety of our associates.”
In addition to being part of the HICS leadership structure, physicians are assigned to the Incident Command Operations Medical Branch. Medical Branch physicians are the ‘boots on the ground’ and work under the direction of the Incident Command Operations Chief. However, with the Incident Medical Officer in a command position, direct concerns of the physicians may be proactively addressed.
“We believe these changes to our hospital incident command system will make our response strategy smoother for all involved,” Wolfberg said. “We will have better communication and a more timely response to issues. Most importantly, it will improve patient safety. That is our number one priority.”
