Public Health Emergency - Leading a Nation Prepared
Tier 1 is the primary site for point-of-service (i.e., hands-on) medical evaluation and treatment. It includes hospitals, integrated healthcare systems, clinics, community health centers, alternative care facilities, private practitioner offices, nursing homes and other skilled nursing facilities, hospice, rehabilitation facilities, psychiatric and mental health facilities, and Emergency Medical Services (EMS). The Medical Reserve Corps and State and Federal healthcare assets (e.g., Veterans Affairs Hospitals) that are co-located within a jurisdiction also fall into Tier 1 because they may become local assets for emergency response.
In a mass casualty and/or mass effect incident, the vast majority of medical care is provided at the local level in hospitals, outpatient clinics, community health centers, and private physician offices. The success of an incident response, therefore, depends in part on how well these and other point-of-service healthcare organizations (HCOs) are managed and their ability to coordinate with other response agencies.
The ability of an HCO to optimally manage its resources and to integrate with the larger response community is driven by its Emergency Management Program (EMP). The EMP includes all activities undertaken by the HCO to mitigate, prepare for, respond to, and recover from potential hazards. An integral component of the EMP is the Emergency Operations Plan (EOP), which defines the management structure and methodology to be used by an HCO during emergency response. The EOP is critically important because it also describes the management processes that enable the HCO to coordinate its actions with other responders.
The two Incident Command System (ICS) functions that facilitate cooperation among HCOs and integration with the larger response community are the Command element and the Planning Section:
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