Organizational Structures for Emergency Response − Rakyat Biologi

Organizational structures for emergency response must be based on two basic principles. First, the organizational structure used to respond to everyday emergencies will form the basis of an expanded structure to deal with disasters. Second, the local response structure must be flexible enough to readily expand as additional external resources are added to match the increasing agent generated and response generated demands of the disaster. The prevailing organizational structures for emergency response are ICS and IMS. These two organizational structures differ, but relatively slightly.

Incident Command System/Incident Management System

For many years, the federal government provided state and local governments with criteria for evaluating their EOPs (US Nuclear Regulatory Commission/Federal Emergency Management Agency, 1980; National Response Team, 1987, 1988; Federal Emergency Management Agency, 1988, 1990, 1996b). However, it avoided requiring—or even recommending—a specific structure for emergency response organizations to meet those criteria. In part, that reluctance seems to have been based on the principle that a federal system should allow state and local governments to meet the federal planning criteria in any way that they deemed appropriate. Moreover, as a practical matter, state governments across the country differ from each other in their normal organizational structures and resources, as do local governments. Consequently, the imposition of a single structure for emergency response organizations might have seemed doomed to failure. The consequence of the federal government’s performance oriented (rather than prescriptive) approach was a proliferation of organizational structures, positional titles, resource names, and operational procedures that sometimes impeded interjurisdictional cooperation—even among identical emergency response agencies (e.g., fire departments) from neighboring jurisdictions.

Following a major series of wildfires in Southern California in 1970, fire departments joined to address the lack of a common organizational structure, inadequate emergency assessments, poorly coordinated planning, uncoordinated resource allocation, and inadequate interagency communications at the incident scene. This led to the development of the ICS, which can be summarized in terms of seven basic principles (cf. Irwin, 1989, see also National Wildfire Coordinating Group, 1994; National Response Team, no date). First, all jurisdictions use a common organizational structure that encompasses standardized names and functions for subunits (standardization). This includes standardized names and duties for individual positions to make personnel from different jurisdictions interchangeable. Second, there is a division of labor, so each unit is assigned a specific function to perform (functional specificity). Third, subunits are established to limit the number of personnel directly supervised by each unit manager (manageable span of control). This is usually five subordinates, but the number can range from three to seven. Fourth, personnel from a given professional discipline (e.g., police or fire) are assigned to the same unit in the emergency response organization to facilitate teamwork and also to simplify recordkeeping (unit integrity). Fifth, most incidents are managed by a single Incident Commander (IC), but a Unified Command team manages the emergency response when multiple agencies have statutory authority and responsibility for a specific type of incident (unified command). Sixth, senior incident managers develop action plans that include specific, measurable objectives and evaluate their effectiveness by monitoring the achievement of these objectives (management by objectives). Seventh, the IC or Unified Command team direct the allocation of all resources—including personnel, facilities, vehicles, and equipment—to emergency response tasks (comprehensive resource management).

Over the next decade, ICS received increasing support as a collection of organizing rules designed to serve the needs of fire and police departments (Kramer & Bahme, 1992). Unfortunately, the way in which ICS was implemented tended to be region specific and, in some cases, idiosyncratic to a single jurisdiction. By the 1980s, the fire services in particular became concerned that responding departments needed a common ICS to increase the effectiveness of response to larger incidents. With funding from FEMA, FIRESCOPE (Firefighting Resources of Southern California Organized for Potential Emergencies) developed a version of ICS that was ultimately adopted and promoted by the FEMA (Federal Emergency Management Agency, 1987). FIRESCOPE ICS is a planning based emergency response system that combines planning functions with the functions of an EOC. Planning and coordination is achieved by a multiagency coordination system (MAC) that is operated by a team of agency directors and divided into two functional tasks. The first is a computer-based Fire Information Management System that stores fire relevant data. The second is an operations coordination system that implements policy devised by the MAC. The EOC component of FIRESCOPE comprises sections that deal with issues of field operations, logistics, planning and finance.

Although this version of ICS was tailored specifically to large scale incidents and to the jurisdictional structure of Southern California fire services, it was a major improvement over previous systems (Coleman & Granito, 1988; Lesak, 1989). The basic system was very popular and promising, but was used for several years only on major multijurisdictional emergencies, rather than for minor fire department incidents. With support from the National Fire Protection Association, Brunacini (1985, 2002) adapted and enhanced the FIRESCOPE system so it could be used as readily in small events as large ones. Brunacini changed the command function to include specialized advisors, expanded the operations function to include routine departmental response demands (hazardous materials response, technical rescue, evacuation, etc.), and included explicit connections to a municipal EOC and police incident commanders. The advantage of this revised structure, called the Incident Management System (IMS), was that daily use on all incidents—minor and major—would enhance the effectiveness of the system when it needed to be used in the rarely experienced major incidents. IMS is now widely used in the American, Canadian, British, and Australian fire services. For more than a decade, the Oklahoma State University Fire Services Program and the National Fire Protection Association have provided IMS instruction in the US and internationally. DHS is in the process of requiring all jurisdictions to adopt the NIMS version of ICS as a condition for reimbursement of disaster expenses. Despite this requirement, this chapter will discuss IMS as it has been implemented by Phoenix Fire because the differences from NIMS/IMS are not substantial. In addition, Chapter 10 will show that both of these systems lack adequate structures for managing large scale population protection tasks effectively.

A principal consequence of IMS is to make all resources of the jurisdiction available for every incident, whether it is a routine emergency or a communitywide disaster. The resources are provided automatically, as the IC escalates the response to meet the emerging incident demands. The IMS itself is a field structure that can manage resources at multiple impact scenes from an Incident Command Post. In such cases, the IMS might not necessarily be supported by activation of an EOC, especially in minor incidents. In disasters that are diffuse and present no real geographic location for scene operations, the jurisdictional EOC can assume the role of the onscene Incident Command Post in using IMS to manage the emergency response. This would be particularly likely in response to a terrorist attack involving a biological agent where impacts might not be detected until long after the attack, at which point the source might be unclear and remain the subject of investigation.

The advantage of using the local IMS (supplemented by a jurisdictional EOC) as the basis for emergency and disaster response lies in its enhancement of the ability to quickly and effectively initiate emergency operations. Thus, every incident is initially addressed by trained and equipped emergency responders guided by an IC. These personnel are always on duty, responding to all calls. Especially in CBR terrorist threats, this approach reduces the chance that untrained, unprotected responders will enter an incident scene and become casualties themselves. Whether the incident is known to be a disaster (such as a major flood, hurricane, or chemical plant incident) or initially appears to be a routine incident that becomes a disaster (e.g., an emergency call for “people down” is the first indication that terrorists have launched a chemical attack), IMS is an organizational structure for emergency response that is already established and can be expanded to fit situational demands.

Basic IMS Principles

The IMS as a system is built around responsibilities vested in standardized roles rather than the idiosyncratic abilities of individuals. The fundamental principle of IMS is that there must always be one (and only one) IC at every incident scene. In principle, any emergency responder may assume the role of IC. In practice, however, the IC is usually the first arriving company officer (usually of an engine company or ladder company) or Battalion Chief (supervisor). Thus, it is the duty of the most senior officer who is first to arrive at the incident scene to assume command. Once established, command may be transferred to other more senior officers as they arrive. Figure 9-1 shows a fully implemented IMS structure that would be appropriate for a major disaster, but IMS size and composition expand as the IC seeks to meet incident demands. Thus, the structure begins with the assumption of command and the designation of specialized functional units to address the hazard at the scene. This includes responding to agent generated demands that involve addressing the threat itself (e.g., a fire; structural damage; victim rescue, treatment, and transportation). It also includes dealing with response generated demands that involve supporting the emergency responders (e.g., logistics of acquiring needed equipment and supplies; rescue for endangered responders) and coordinating with other agencies (e.g., communicating information about the incident to the EOC and the public).

IMS uses the terms sections, branches, and sectors to describe different sized functional groupings of personnel, equipment, and apparatus. In Figure 9-1, Command is shown with five sections directly attached to it. The five sections—Planning, Operations, Administration, Safety, and Logistics—are staffed as appropriate to the incident size and conditions. Section chiefs in the Incident Command Post work with the Command staff to formulate an overall emergency response strategy. The section chiefs then direct and monitor tactical operations, whereas branch and sector officers implement tactical operations. In a fully implemented IMS, branches are established under sections and are functional tactical areas relevant to each section. For example, Figure 9-1 shows five branches under the operations section—transport, rescue, hazardous materials, fire, and medical.

The naming of branches follows the specific activity they perform; the number of branches depends upon the intensity of the demand for each of the functions needed in the incident response. Thus, an IMS for an urban earthquake would include a heavy rescue branch. Sectors are defined beneath branches and execute specific tasks. Typically, sectors contain fire companies or special teams. Branches and sectors are activated in response to (or, better still, in anticipation of) incident demands. Hence, in small hazardous materials incidents where few victims are present, the medical branch would be only a single unit and is called a medical sector. In events where there is no fire, the fire branch would not be activated. Although basic principles of IMS are easy to grasp, more advanced concepts provide a complex method of allocating responsibility for response strategy, tactics, and tasks (Brunacini, 2002; Carlson, 1983).

As indicated earlier, there are some differences between IMS and ICS structures. Under ICS, there is neither a Senior Adviser nor a Support Officer. Instead, there is a Scientific Officer in the Command Section and the Safety function is staffed by a single officer in the Command Section rather than by a separate section. Moreover, ICS has only a single Liaison Officer rather than separate police and EOC liaisons. Finally, ICS defines Finance and Administration as two separate sections rather than combining them as in IMS.

IMS Implementation

In larger incidents, the IC may be supported by a Support Officer and Senior Advisor. Senior officers typically fill these two additional roles within the IMS Command section as they arrive at the scene. After assuming command, the IC establishes a command post and, throughout the incident, performs seven activities.

Conduct initial situation evaluation and continual reassessments
Initiate, maintain, and control communications
Identify the incident management strategy, develop an action plan, and assign resources
Call for supplemental resources, including EOC activation
Develop an organizational command structure
Continually review, evaluate, and revise incident action plan
Provide for continuing, transferring, and terminating command

Through these duties, the IC develops and maintains the strategy and resources that will be needed to terminate the incident. The Senior Advisor and Support Officer perform duties assigned by the IC—including reviewing, evaluating, and recommending changes to the incident action plan. In particular, the Senior Advisor focuses on the overall incident management or “big picture” issues. This officer monitors the overall incident, evaluating possible responses to current and future incident demands in order to determine the need for activating additional branches or sections. The Senior Advisor also evaluates the need for liaison with other jurisdictional departments, outside agencies, public officials, property owners, tenants, and other parties impacted by the incident. In addition, the Support Officer provides direction related to tactical priorities, critical factors, and safety. Thus, this officer assists with creation of tactical worksheets (written plans) for control and accountability and evaluates the viability of the response organization and span of control. The Support Officer also evaluates the need for additional resources at the scene and assigns logistics responsibilities.

When there is a major emergency or a community-wide disaster, most jurisdictions provide for the Command staff to be supported by an onscene Public Information Officer (PIO) and a Police Liaison to the law enforcement command posts In addition, there is an EOC Liaison who is responsible for coordination between the incident scene and the EOC. The goal of an Articulated Command is to spread the functions to specialists where possible, permit effective communication with responders on scene and emergency authorities off scene, and allow the IC to focus on the incident demands.

As soon as it is practical, Command establishes a Public Information Sector to deal with the mass media and provide the information the media will need to accurately report the status of the incident and the response to it. The staff PIO directs the sector, establishes a media area that does not impede operations (as necessary), and gathers information about the incident. In a major incident, the onscene PIO coordinates with the EOC PIO and PIOs of other responding agencies to insure consistent, accurate information dissemination and to avoid release of potentially sensitive information.

In complex incidents, particularly suspected or identified terrorist attacks, Command assigns a Police Liaison Sector. A police supervisor’s presence may be requested in the Fire Command Post or communications may be directly established with the Police Command Post. The Police Liaison Sector deals with all activities requiring coordination between the two departments, including (but not limited to) traffic control, crowd control, incident scene security, evacuations, crime scene management, and persons interfering with Fire Department operations.

Within the IMS structure, Command delegates responsibility for implementing its emergency response strategy to the five section chiefs. The Planning Section is charged primarily with technical liaison, forecasting incident demands, and other planning functions. The Planning Section serves as the Incident Commander’s “clearinghouse” for information. In CBR incidents, this function is particularly critical because specialized information from a variety of specialists (e.g., toxicologists and physicians) will flow to the scene, and the Planning Section relays information from these sources to Command.

The Operations Section deals directly with all hazard source control activities at the incident site. In addition, this section is responsible for the safety and welfare of personnel working within the section. A critical administrative duty of the Operations Section is to establish branches that accomplish specific tasks to meet incident demands. The Operations Section creates and oversees as many branches as needed depending on the demands of the specific incident. Branches typically include primary operational functions: transport, rescue, hazmat, fire, and medical. Transport Branch is responsible for transporting injured persons from the incident scene to hospitals for definitive care. Rescue Branch is charged with search and rescue and extrication of firefighters who become lost, trapped, or endangered. This branch may oversee a potentially large number of units serving as Rapid Intervention Crews (RIC units) commensurate with the size of the incident. RIC units stage, at full ready, with the exclusive responsibility of first responder rescue. In addition, an Evacuation Branch or Sector can be created to deal with endangered citizens.

The Hazardous Materials Branch typically houses four sectors representing the four principal functions of research, monitoring, decontamination, and site entry. In a hazmat incident, the Hazardous Materials Branch addresses critical response priorities; identifies the hazard agent; designates hot, warm, and cold zones; and coordinates with law enforcement resources for site access control and special services (e.g. Bomb Squad or Special Weapons and Tactics). To assist in agent identification, this branch is supported by the Planning Section, onscene toxicology specialists (if appropriate), and other specialized personnel operating in the EOC. An Entry Team Sector is responsible for hot zone entry and is supported by a Backup Team Sector. The latter is present for relief or rescue of the entry team. Although emergency decontamination of victims can begin with the first units on scene, the Hazardous Materials Branch assembles specialized decontamination lines and equipment and performs technical decontamination.

Fire Branch is charged with the management and suppression of fires and, as appropriate, operates sectors (a tactical or task level function). Fire Branch is charged with the suppression of fire in the incident. When fire occurs in context of other hazard agents such as explosives or hazardous materials, Fire Branch confers with the Incident Commander to identify priorities. In some cases, Fire Branch will operate in a defensive posture until other hazards have been addressed and then shift to offensive operations to extinguish fire. In the operational phase, Fire Branch operates a safety sector that includes one company in reserve for rapid rescue of trapped firefighters. Building related (e.g., inside, lobby, outside) sectors are used in high rise incidents to control access and conduct inside firefighting. Directional sectors (e.g., north, south, roof) are established for both defensive and offensive attacks. After the fire has been declared to be controlled and flames are knocked down, the Overhaul Sector is established to search for and extinguish any remaining active fire. Depending upon the materials burning, the Overhaul Sector will remain at the site for long periods to extinguish spontaneous combustions.

The Medical Branch coordinates the activity of sectors and/or units to address extrication, triage, and treatment of patients. The Extrication Sector is responsible for locating, extricating, and removing patients to treatment areas. Triage Sector performs the initial assessment of patient conditions and treatment needs. In hamat incidents, this function may be performed before, simultaneously with, or after decontamination. The toxicity of the agent determines victim assessment and, in the case of nerve agents, the timing of antidote administration. Triage and initial treatment may also be performed within the Extrication Sector, depending upon the stability of the area where patients are located. Similarly, contingent upon the agent, antidote administration may be appropriate at the earliest moment. In such cases treatment and extrication personnel with appropriate personal protective equipment (PPE) would begin administration prior to or during mass decontamination. When time is not critical to survival, antidote administration may take place at treatment areas, which can also serve as patient collection areas. Triage tags are used to categorize patient injuries and record treatments administered in the field. The triage tag number also becomes the tracking mechanism for patients.

Particularly in a hazmat incident, Behavioral Health will operate as a sector within the Medical Branch. These personnel and units may be assigned in a variety of activities at the scene. The onscene Behavioral Health Coordinator works through the Medical Branch Officer while maintaining liaison with the Planning Section and the EOC (if the latter has been activated). Behavioral Health units, with appropriate PPE, may oversee and assist patients awaiting decontamination, during decontamination, in treatment, and during transportation.

The Transportation Branch can expand as incident demands escalate, typically to four sectors. Transport north and south represent different directional movement points for ground transportation to local hospitals or mass care facilities (usually established through the Red Cross contact in the EOC). This movement may involve different vehicles as appropriate to patient needs, including buses for uncontaminated or decontaminated “walking wounded”, as well as ambulances or other vehicles obtained through the National Guard, public transit, or other organizations. The jurisdictional fire department might operate its own ambulance system, and formal agreements (as well as mutual and automatic aid agreements) should be established for transport vehicles from local EMS providers and ambulance services. The Air Sector moves patients by rotary wing aircraft if this is safe, given the hazard agent involved and the requirements of the patients’ conditions. Finally, the NDMS Sector prepares patients in accordance with the local NDMS plan and moves them to the designated collection point for transport to other locations.

The Safety Section is staffed by a Safety Officer who is responsible for mobilizing this unit and maintaining safe operations at the incident scene. This officer’s primary task is to develop and implement plans for rescue, incident scene safety practice, and environmental remediation after emergency response operations have been terminated. In large incidents, the Safety Officer is supported by additional personnel who monitor reports from all incident scenes and report progress to the Command Section. If safety observers discover a pattern of unsafe practices, the Safety Officer is authorized to stop operations at an incident scene.

The Administration Section focuses on procurement, cost recovery, liability, and risk management. These activities involve contracting with vendors to deliver services that cannot be provided by the responding agencies and recording the time of use for rental equipment. They also include establishing resource sharing agreements among responding agencies as well as documenting casualties and property damage to settle later claims.

The Logistics Section is the support mechanism for the emergency response organization. This section oversees a variety of functions and establishes sectors (which operate at a tactical and task level) to execute its functions. Figure 9-1 shows four principal sectors under Logistics: Staging, Accountability, Rehabilitation, and Resources. Staging oversees the initial arrivals of unassigned companies (units). Accountability tracks the units and individual crews responding to an incident to insure their safety. The Rehabilitation Sector is responsible for the monitoring and care of deployed personnel, addressing both physical and psychological ability to function effectively. This sector uses specialized equipment and also provides food, fluids, and debriefing for personnel. Finally, the Resource Sector oversees all equipment and apparatus, provides any needed communications equipment, and handles repairs and resupply. In a hazmat incident, this sector will be responsible for supervising the movement of antidotes, other pharmaceuticals and medical supplies, and equipment from local jurisdictional caches to the scene.

In summary, the IMS is a flexible structure for organizing emergency response. Its value lies in the close linkage between emergency plans and emergency response operations. To adequately plan for a threat, it is imperative that the emergency response organization adapt to the specific demands of each incident. The IMS both reflects and directs the capabilities of the organizations that respond to the incident, so planning processes that account for the local IMS have greater flexibility and a greater likelihood of being successfully implemented in the field. The principal advantage of IMS over the earlier ICS is that it provides for a better accounting of the activities that must be performed away from the incident scene. For example, IMS explicitly addresses activities such as warning, evacuation, and mass care of victims that are not addressed within ICS. Unfortunately, these activities must all be addressed by the Operations Section. For example, an Evacuation Branch (staffed by either police or fire personnel, or both) would be established to coordinate the movement of people from risk areas adjacent to the scene and coordinate information releases to the public through the onscene PIO. However, this arrangement requires the Operations Chief at an incident scene to be responsible for branches or sectors that s/he cannot supervise directly (because they are in other locations). Moreover, assignment of these activities to the Operations Chief has the potential for violating the principle of manageable span of control if s/he must supervise warning, evacuation, and mass care branches in addition to transport, rescue, hazmat, fire, and medical branches. Unfortunately, there has been no empirical research on the effectiveness of IMS or ICS as an organizing mechanism for incident command. In part, this situation exists because there is no formally structured alternative command system to which it might be compared. There have been attempts to adapt the IMS more directly to EOCs, but these efforts have been descriptive rather than data based (Perry, 1995). Ultimately, the use of IMS rests upon the intuitive strength of the assumption that implementing the seven basic principles will yield more effective incident management.