In February 2003, President George W. Bush issued Homeland Security Presidential Directive No. 5 (HSPD-5), which mandated the development of the National Incident Management System (NIMS), including the Incident Command System (ICS). "Compliance" would become an essential element of future life, including eligibility for homeland security grant funding and other federal largesse.
What resulted-to the point of overloading the training and certification infrastructure at the U.S. Fire Administration's online training center-was a frenzy of computer-based training and certification, as providers logged in to complete ICS 100, 200, 700 and 800. Leaders and planners convened to change the terminology of their jurisdictions' emergency-operations plans, making them, too, "NIMS-compliant."
The good news now: Many, if not most, of our agencies are now NIMS-compliant. The bad news: Many of us have the illusion that we are also NIMS-competent. But those who actually manage incidents on the street have, in many jurisdictions, observed that in practice, little has changed. Practitioners have either refused to change the way they've done business for years, or they've continued the same old practices with a different vocabulary. Our colleagues in the fire service continue to be the most proficient users of the Incident Command System, because they use it more than EMS or law enforcement agencies.
WHAT IT TAKES
To become ICS-competent, an EMS agency must make a concerted effort to develop and improve its competence in the use of the techniques, tools, practices and vocabulary of ICS. There are several components of such an effort:
- Policy and procedure-The agency will have to develop policies concerning training, implementation and evaluation of ICS.
- Time and tools-The agency will have to devote staff time to training and provide the tools necessary for on-scene ICS. This means radios, vests and incident management boards for every vehicle. Most agencies will require sessions with outside trainers to build momentum.
- Walk the talk-Chief officers will need to work hard to develop their own ICS competence. You will be unable to motivate your line staff to utilize good ICS at street level if your command officers are not observed to be ICS-competent at larger incidents.
- Interagency relations-An EMS agency that has not previously involved itself in ICS, but rather stood back and allowed fire and police to manage incidents no matter the nature will have an awkward time when it begins to "do ICS." There will be reactions ranging from surprise to resistance when, for the first time, an EMS unit arrives on a scene, provides a size-up and assumes command. Leadership needs to deal with interagency friction in advance, and be prepared to deal with whatever may result on a day-to-basis. Remember, we're all required to do ICS in the post-HSPD-5 era.
Computer-based ICS training does not translate well to implementation in the field. An agency needs to devote some training time to ICS. An orderly process will be needed to move from the awareness provided by computerized ICS courses to proficiency in implementation. We think in terms of "crawl, walk, run," but we may be more successful if we "crawl, crawl a little faster, walk with support," etc. This requires:
- Training in the practical application of the policy or procedure-Lecture/demonstration will be needed to introduce the new standard to the staff and demonstrate how it should be applied. Creative use of video, incident radio recordings, etc., may make what could be a dry session more interesting.
- Tabletop or classroom activities with hands-on use of radios, vests and command boards-Facilitators inject scenarios, provide resources, etc. For a first step, try a tabletop that involves managing a three-car crash with four patients. Keep it simple, and don't inject so many confounders that you eliminate the possibility of success.
- Live scenarios-Again, keep them small and encourage success. To add some realistic interaction, recruit police and fire officers as simulators.
- Larger scenarios and interagency exercises-These will be important, but don't move to larger problems until you've become good at solving the smaller ones.