Learning Objective #1: Describe HEICS as it relates to the National Incident Command System

Learning Objective #2: Apply key elements for the implementation of HEICS through situation awareness and the formation of high reliability teams

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The term disaster, or mass casualty incident, has taken on new meaning since September 11, 2001. Pre 9/11, hospitals, for the most part, were capable of handling the surge from natural disasters, single site plant explosions, or multiple motor vehicle accidents. Post 9/11, however, it is not clear that hospitals are capable of managing the tremendous influx of patients, families, and community members who may seek refuge after a disaster event. Additionally, JCAHO has stipulated that hospitals participate in multidisciplinary community disaster drills twice a year, mandating interaction with local law enforcement and emergency first responders who are part of the National Incident Management System. It is not evident how the hospital teams will collaborate with outside agencies including fire, law enforcement, and emergency medical systems either locally or at a national level. Firefighters and law enforcement have utilized formalized incident management systems since the 1970s. Hospitals are now beginning to follow the lead by instituting the Hospital Emergency Incident Command System (HEICS) in order to respond to all hazards-all risks. HEICS provides a template for critical incident management and can assist an organization in the assessment of whether it is ready for a disaster event, specifying in terms of structure, management, and resources what the hospital should do to be prepared as possible. However, HEICS does not necessarily enhance situation awareness, an essential cognitive process for high reliability teams. Aviation has extensive research, including measurement and interventions, related to situation awareness yet more research is needed in health care critical incident management. It is important for nurse leaders to understand how situation awareness enhances the decision-making processes of high reliability teams and the emphasis on joint problem solving among unified teams for the successful resolution and error free response to a mass casualty incident.