Public Health Emergency - Leading a Nation Prepared
A systems-based approach to emergency response means that the disparate elements that are required to perform response operations are viewed as interrelated components of a single system. This is relevant to Healthcare Coalitions since they may involve different organizations working together to achieve a common goal (see Chapter 5). A systems-based approach uses a standardized set of management steps that are sequential and may be applied to any major undertaking. This dictates that overarching objectives, strategies, and tactics are established to promote effective response management and consistency.
The following sections relate how this management methodology might be applied during the initial development of a Healthcare Coalition’s Emergency Operations Plan (EOP). The same methodology might be applied to other major Coalition efforts (e.g., training).
The application of a systems-based approach for the Healthcare Coalition begins with understanding an overarching goal and supporting objectives for the entire healthcare response – from individual healthcare organizations through local, State, and Federal assistance. An example goal statement and objectives for all levels of MSCC incident response and recovery are stated below.
Goal: To promote healthcare system resiliency and adequate surge capacity and capability across the affected community during a mass casualty and/or mass effect incident.
Objectives to support this goal may include the following:
Response strategies are established to facilitate achievement of the response goal and objectives. The overarching MSCC priority strategy is presented in Exhibit 1-3. Implementing a Healthcare Coalition, as described in this manual, can be an important step in accomplishing this strategy during emergencies.
Exhibit 1-3. Prioritization of MSCC actions
Using the ICS and Multiagency Coordination principles described in NIMS, the six-tier MSCC model was developed to incorporate the preceding goal, objectives, and strategies for optimal healthcare system resiliency and medical surge.
The tiered model presented in the MSCC Handbook (see Figure 1-1 below) demonstrates the relational arrangement of individual healthcare response assets within the local, State, regional, and Federal government construct. Each tier is summarized below.
Tier 1: Encompasses all individual healthcare organizations in a geographic area that deliver “point of service” medical care during emergencies or disasters.
Tier 2: Tier 1 assets that have formed a Healthcare Coalition to share incident information, exchange resource status information that supports mutual aid, coordinate response strategies and tactics, and use a common interface with local jurisdictional authorities to exchange information and request assistance.
Tier 3: Municipal, county, or similar agencies with jurisdiction over the impacted areas and responsibility for the local government response. They are referred to as “Jurisdictional Agencies” throughout this handbook.
Tier 4: State-level response that supports Tiers 1-3 by managing statewide and sub-State regional coordination of the healthcare response.
Tier 5: State-level response that manages inter-State regional coordination of response to support Tiers 1-3 healthcare response assets.
Tier 6: Federal assistance to State, Tribal, local, and non-governmental healthcare response at Tiers 1-5, as managed through a Joint Field Office and/or other Federal coordinating center.
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