Activation Level Definition/ Parameters Authority to Activate Anticipated HICS Activation Notifications 2 Minor Impact An actual situation or event that is having a minor unusual impact on facility operations. Incident Commander Assigned as needed Incident Commander Operations Section Chief Command Staff as needed Liaison Officer Safety Officer Public Information Officer Branches / divisions / groups / units / individual resources as needed Administrator on Call Emergency Department Charge Nurse Emergency Management Coordinator Environmental Services Supervisor Facilities Engineering Supervisor Health System or Network EOC Nursing Office Safety Officer Security Supervisor Telecommunications Other departments/ units/managers as conditions warrant Local government/ public safety/ public health / EOC (if services, support, or information needed) Emergency Department and Clinical Factors Patients from single event 10 actual patients, or 3 patients requiring immediate ICU or OR services ED waiting time Greater than 4 hours Increase in ED patient census Greater than 50 percent above normal over 8 hours Increase in census (surge) 1-10 patients admitted above licensed bed count Logistical Factors Facilities Physical plant or utility disruption that is limited, contained, and/or has a minor impact on operations (e.g., a partial system failure; failure of a system) Staff 15 percent of staff not available for duty Supplies/Materiel Actual or projected supply shortage of non-critical items, or 48 hours supply remaining of critical items Internal occupancy Need for horizontal evacuation of patients/visitors/staff from an area of a building Recommended Resources Hospital Beds Additional Clinical Staff Bed Management staff to provide tracking and movement of patients Mobilize non-medical support staff (Activate Labor Pool) Actions Activate medical surge plans, procedures and protocols Consider early discharge of in-patients
Activation Level Definition/ Parameters Authority to Activate Anticipated HICS Activation Notifications 3 Moderate Impact An actual situation or event that is having a moderate unusual impact on facility operations. Incident Commander Incident Commander Operations Section Chief Logistics Section Chief Command Staff Liaison Officer Safety Officer Public Information Officer Medical / Technical Specialists as needed Planning Section Chief as needed Finance/ Administration Section Chief as needed Branches / divisions / groups / units / individual resources as needed Administrator on Call Emergency Department Charge Nurse Emergency Management Coordinator Environmental Services Supervisor Facilities Engineering Supervisor Health System or Network EOC Nursing Office Safety Officer Security Supervisor Telecommunications Other departments/ units/managers as conditions warrant Local government/ public safety/ public health / EOC (if services, support, or information needed) Emergency Department and Clinical Factors Patients from single event 20 actual patients, or 5 patients requiring immediate ICU or OR services ED waiting time Greater than 8 hours Increase in ED patient census Greater than 100 percent above normal over 8 hours Increase in census (surge) 11-30 patients admitted above licensed bed count Logistical Factors Facilities Physical plant or utility disruption affecting a major or mission-critical area or system, or affecting general operations Staff 25 percent of staff not available for duty Supplies/ Materiel Actual or projected supply shortage of critical items, or 24 hours supply remaining of critical items Internal occupancy Need for vertical evacuation of patients/visitors/staff from one floor of a building Event duration Level 2 event lasting greater than 8 hours Recommended Resources IN ADDITION TO LEVEL 2 RESOURCES Assess initial and ongoing need for medical specialists and use as needed Actions Activate alternate care sites within the facility and overflow
Ensure adequacy of medical equipment and supplies for restocking supplies and equipment requested emergency care facilities to manage hospital surge capacity Complete early discharges Consider transfer of some patients to other facilities. Activation Level Definition/ Parameters Authority to Activate Anticipated HICS Activation Notifications 4 Major Impact An actual situation or event that is having a major unusual impact on facility operations. Incident Commander, in consultation with hospital CEO Incident Commander Operations Section Chief Logistics Section Chief Planning Section Chief Finance/ Administration Section Chief Command Staff Liaison Officer Safety Officer Public Information Officer Medical / Technical Specialists as needed Branches / divisions / groups / units / individual resources as needed Administrator on Call Emergency Department Charge Nurse Emergency Management Coordinator Environmental Services Supervisor Facilities Engineering Supervisor Health System or Network EOC Nursing Office Safety Officer Security Supervisor Telecommunications Other departments/ units/managers as conditions warrant Local government/ public safety/ public health / EOC (if services, support, or information needed) Emergency Department and Clinical Factors Patients from single event 50 actual patients ED waiting time Greater than 12 hours Increase in ED patient census Greater than 200 percent above normal over 8 hours Increase in census (surge) 31-50 patients admitted above licensed bed count Logistical Factors Facilities Physical plant or utility disruption affecting multiple areas or systems Staff 40 percent of staff not available for duty Supplies/ Materiel Critical shortage of essential items Internal occupancy Complete evacuation of a patient care building Event duration Level 3 event lasting greater than 24 hours