Hospital incident command: First responders or receiving centers?

Objectives: (1) Propose a conceptual model of an alternative hospital incident management system (HIMS) that integrates concepts used by emergency operations centers (EOCs). (2) Compare HIMS to the standard hospital incident command system (HICS) model.

Design: A quasi-experimental study was performed. Two identical tabletop incident scenarios were presented, one utilizing HICS and one using HIMS. Participants completed postexercise surveys for each tabletop. Surveys contained both knowledge and satisfaction questions. The Likert Scale (1 strongly disagree and 5 strongly agree) was utilized for satisfaction questions.

Setting: The Medical University of South Carolina (MUSC), a level I trauma and academic center.

Participants: N = 16; participants were members of MUSC's Emergency Management Committee. Participation was voluntary.

Main Outcome Measures: (1) Knowledge of reporting structure within each model and (2) end-user satisfaction with model implementation.

Results: Using the HIMS model, participants correctly answered reporting structure questions 63.75 percent of the time in comparison to the HICS model of 35 percent (p value 0.001). Statistical analysis of qualitative satisfaction data between the two models revealed that HIMS was preferred over the HICS, 87.5 and 33.5 percent, respectively.

Conclusions: The HIMs model is a new application for hospital incident management. This article serves to introduce the concept. Using the established EOC framework, continued research in this area is needed to validate the proposed HIMS model and standardize its design.