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IV. EMERGENCY OPERATIONS/HICS ACTIVATION
Emergency Event Criteria
An emergency event is identified by one or more of the following conditions: 

Danger or  threat to  patients, visitors or employee

Failure of one or more mission critical systems.

Disruption of normal delivery of patient care.

Reliance on multiple city agencies for incident management.

Recall and/or reassignment of staff to support critical functions.

Community-wide impact

Incident Response Protocol
The following response protocol shall be followed if an incident poses a potential threat to the Center's staff, patients or visitors or mission critical systems:

1. The first employee who discovers the incident will call x6000 to notify the emergency operator. If the incident has caused injuries be sure to advise the operator of injuries.

In the event of injuries the operator will request the Medical Code Team be deployed to the incident location.

2. The operator will dispatch the appropriate Department (i.e. Safety, Security, Plant Operations, or Fire Response Team) to respond to incident location to assess:

Life safety concerns
Damages 
Potential impact to the environment of care and hospital operations
The need for emergency response agencies; FDNY, NYPD, EMS, DEP, etc
Estimated time to service restoration

3. Response personnel will take the immediate appropriate action to preserve life and mitigate the impact of the incident.  

4. Response personnel will report findings to their respective Department Head(s). Department Head will inform the Center's Administrator if there will be prolonged disruptions and/or if the incident requires external support and resources.  The Center's Administrator will make a determination to either:

Immediately activate the Center's Incident Command System (HICS) at the appropriate level, or 

Convene a Situation Assessment Team (SAT) to continually monitor the incident for potential impacts to hospital operations, and recommend the appropriate intervention and mitigation strategies, including activation of the Center's Incident Command System (HICS).

5. For incidents that occur after-hours and weekends the on-duty/after hours Departmental supervisor will confer with the Nursing Supervisor and AOC who will make the determination to either convene a Situation Assessment Team (SAT) or immediately activate the Center's Incident Command System (HICS) at the appropriate level.  During weekend and evening hours the Nursing Supervisor, Administrator on Call, Security Supervisor, and Plant Operations Supervisor are designated as the Situation Assessment Team.

Authority to Activate HICS
Only the Senior Vice President/Hospital Administrator, Administrator-on-Call, or Nursing Supervisor has the authority to activate the HICS and the Hospital Command Center.  

The Senior Vice President/Hospital Administrator or designee will assess the incident to determine the level of HICS activation, personnel required, and the need, if any,  for Hospital Command Center (HCC) activation.    Based on the direction of the I/C or designee, the operator will be contacted at 212-639-6000 or ext. 6000 to page/activate select HICS positions or the entire HICS team.  HICS personnel may be requested to:

Monitor email for an incident briefing and further instructions.
Attend a conference call.
Attend a meeting in-person at a specified location.
Report to the Command Center.

Those HICS members not activated for the incident will be advised of the limited HICS activation and will remain prepared to assist with incident management from their regular work locations or as directed.

HICS Incident Levels
HICS will be activated at one of three following levels.  Note that activation can occur at any level and does not require a stepwise sequence of activation.  For example, the plan can be activated at Level III for a situation having a major impact on the facility, and all
activities and notifications consistent with Levels I and II shall be implemented concurrently.  

HICS Level

Level 1: Description 
Situation assessment/monitoring and/or 
Pre-incident action planning (IAP)

Level 1: Incident Examples
Minor incident that can be managed with on duty staff.
Minimal impact to hosp. operations
Potential incident ex. severe weather, pending transit strike, pre-pandemic, etc.

Level 1: Considerations
Activate Situation  Assessment Team  (SAT) or select HICS for pre-planning
Assess/Monitor
Develop Pre-Incident Action Plan.
Establishment of 12-24 hour operational periods)


HICS Level

Level 2: Description
Moderate impact on hospital operations and/ multiple offsite & Regional & operations 

Level 2: Incident Examples
Limited disruption of Operations
Confirmed fire w/unit(s) evacuation
Staffing shortage – some curtailment of services required.
Utility systems failure – short-term (back-up systems operational).
Surge – UCC expansion required.
Supply chain disruptions 

Level 2: Considerations
Activation of HICS Command Staff, Chiefs, and positions as needed.
Establishment of 8-12 hour operational periods.
Limited activation of  M107 Command Center or Virtual Command Center
Implementation of Incident Action Plan (IAP) /update as needed


HICS Level

Level 3: Description
Major or significant impact on hospital operations and/or multiple offsite & Regional & operations

Level 3: Incident Examples
Prolonged disruption of Operations
Prolonged Supply Chain disruption
Utility systems failure  - extended 
Utility back-up systems failure or potential to fail
Partial or full evacuation (external)
Staffing shortages requiring altered care standards or cancellations
Surge requiring  establishment of alternate critical care areas 
Evacuation of Memorial Hospital
Evacuation of NYPH – Mutual Aid Request

Level 3: Considerations
Full activation of Command Center (M107 or back-up site)
Establishment of 2-8 hour operational periods
Implementation of Incident Action Plan (IAP) /update as needed

Hospital Command Center Activation Protocol
1.The HCC will be activated by the Incident Commander or designee.   

2.The HCC will be activated for all Level III emergencies and at the discretion of the Incident Commander may be activated for Level II incidents.  If M-107 is not available, the alternate HCC site will be established at RRL-116.

3.Activation of HICS personnel will be based on the scope of the incident and at the discretion of the Incident Commander.  NOTE: The Medical/Technical Specialist would respond only if needed in a specific disaster that fits their specialty.

Hospital Command Center Phone Numbers:

M-107 Command Center - 212-639-2222
Red Phone - 646-422-2165
Red Phone - 646-422-2160
Red Phone - 646-422-2158
Red Phone - 646-422-2157

RRL-116 – Backup Command Center - 212-639-3229
Red Phone - 646-422-2220
Red Phone - 646-422-2221
Red Phone - 646-422-2222
Red Phone - 646-422-2223

Establishment of Operational Centers
Operational Centers will be activated as needed, based on the scope of the emergency.  Areas designated as Operational Centers have been surveyed to determine the availability of critical resources and utilities to serve specific HICS functions.  A detailed list of Operational Centers and the accompanying resource matrix may be found in Appendix A of this plan.