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Apr 25, 2019

WADEM Congress on Disaster and Emergency Medicine 2019

Incident Command Adaptations during Sustained Mega-Shelter Medical Clinic Operations during 2017 Hurricane Harvey Response in Dallas, Texas

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Disaster response

Shelter

Hurricane

Incident Command

Abstract

Abstract

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Keywords

Disaster response

Shelter

Hurricane

Incident Command

Abstract

Introduction: Because of the unprecedented flooding caused by Hurricane Harvey, the Dallas Convention Center received over 3800 evacuees. A multidisciplinary medical clinic was established onsite to address evacuee needs for medical evaluations, emergency care, chronic disease management, pharmaceuticals, durable medical equipment, and local health services integration. In order to operate efficiently, the Dallas Mega­ Shelter Emergency Operations Center (EOC) worked with and the Mega­Shelter Medical Clinic (MMC) under a fluid incident command (IC) structure that was National Incident Management System (NIMS) compliant. Iterations of MMC IC demonstrated maturations in organizational structure while supporting MMC operations that varied from rigid NIMS doctrine. Aim: To explore the use of a fluid incident command structure at a large evacuation medical shelter post Hurricane Harvey Methods: Observational, evolutions of IC organizational chart and operational impact. Results: Modifications, through just-­in­-time iterations of the IC organizational chart, were posted and reviewed with MMC IC and EOC sector chiefs. Changes in the organizational chart were noted to improve identification of logistical needs, supply delivery, coordination with other agencies, and decisions of resource typing and personnel utilization. Adaptations also improved communication leading to timely situational awareness and reporting accuracy. Discussion: MMC medical services were improved through allowing modifications and adaptions to NIMS compliant MMC IC organizational roles and duty assignments. The fluidity of IC structure with ability for just-­in-­time modifications directly impacted the provision of disaster medical services. Unique situational awareness, coordination of care pathways within the local innate health infrastructure, compliance with health service regulations, and personnel resource typing all contributed to and benefitted from these IC modifications. MMC and EOC IC collaboration facilitated effective communication, maintained appropriate span of control and efficient activity reporting.

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© Copyright 2019 Morressier GmbH.
All rights reserved.