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U.S. Department of Health and Human Services

3.1 Establishing Procedures for the Progressive Stages of Response and Recovery

Many emergency response organizations have found it useful to conceptualize incident response and recovery in distinct stages that occur sequentially as an incident evolves. By grouping activities that have a common purpose, these stages provide a framework for the response organization’s “Concept of Operations” (i.e., how the components of the response system function and interact through the successive stages of emergency response and recovery). This approach helps ensure that emergency response guidance is well organized and sequenced through specific intervals in the evolution of an incident.

Although the stages used by organizations may vary, they generally entail the same broad categorization of activities. Healthcare planners developing a Healthcare Coalition are encouraged to examine the stages presented here within the context of their own situations when they are developing the Coalition’s Concept of Operations. It is also helpful to examine the planned actions of individual healthcare organizations (Tier 1) and appropriate jurisdictional entities (Tier 3) during these stages of emergency response and recovery.

3.1.1 Stages of Incident Response and Recovery

The following general stages of emergency response and recovery are presented for consideration, along with the critical actions that the Healthcare Coalition should consider in each stage. By examining response actions in this manner, a comprehensive Concept of Operations for the Healthcare Coalition’s Emergency Operations Plan (EOP) can be developed. These stages typically have significant overlap in their actual time of occurrence, especially early in emergency response (Figure 3-1).

Stage 1: Incident recognition. This is the interval when an organization determines whether emergency response actions are needed. The incident recognition process identifies an anomaly (either independently or through communication with others), develops a rapid situation assessment, and determines whether a response by the organization may be necessary. An “incident” exists for the Healthcare Coalition whenever an actual or potential need arises to provide emergency-related support to healthcare organizations.

Figure 3-1. Stages of incident response and early recovery 

Figure 3-1 depicts the Stages of incident response and early recovery.  They are, from top to bottom:  Incident Recognition; Notification and Activation; Mobilization; Incident Operations; Demobilization; Transition to Recovery and Return to Readiness. 

Figure 3-1. Stages of incident response and early recovery as described in previous paragraph

Stage 2: Initial notification/activation. Initial notification and activation occur in a relatively simultaneous fashion. “Notification” refers to the actions required to inform appropriate organizations within the response system about the onset of an incident or an important change in incident parameters. Notification conveys important details (if available) and may indicate whether the notified organizations should undertake response actions. An initial notification message accomplishes the following:

  • Provides urgent information about a hazard occurrence or threat of a hazard occurrence
  • Commonly suggests actionable guidance for the notified entity for protective and initial response actions
  • Conveys the activation decision regarding the HCRT.

“Activation” refers to determining the response level for the system. As applied to the Healthcare Coalition, activation refers to the decision to transition from baseline operations to HCRT operations with a designated staffing level as described in the Coalition’s EOP. Activation levels may be partial or full (see Section 3.3.1). It is important to note that an activation order is binding only for personnel designated to staff the HCRT and does not require (but may request) individual member organizations to activate their emergency response procedures. Each organization determines its response actions independently based on information received through the Coalition and other sources.

Stage 3: Mobilization. This refers to the transition of the HCRT from a state of inactivity or baseline operations to the designated response level.[1] Each Coalition member organization mobilizes its own response (based on its EOP) independent of the HCRT activation. Coalition members are only required to make available an Organizational Liaison to interface with the HCRT and this activity may be performed by each member organization’s Liaison Officer in their activated IMT.

Stage 4: Incident operations. This stage refers to all actions that address the Healthcare Coalition’s response objectives following activation of the Coalition’s EOP (other than mobilization and demobilization). Actions in this stage may be divided into “initial” (or “immediate”) and “on-going” categories.

Stage 5: Demobilization. This stage addresses the transition of resources, and eventually the HCRT itself, from response activities back to baseline operations. Demobilization procedures are triggered as response objectives are achieved and resources are relieved of incident responsibilities.

Stage 6: Transition to recovery and return to readiness. This stage encompasses the Healthcare Coalition’s recovery activities and actions that return the Coalition to a state of readiness for the next emergency.

3.1.2 All-Hazards Applications

If the Healthcare Coalition’s EOP is written to be “all-hazards,” then many of the processes and procedures will be applicable regardless of the type of emergency or the response assets that are used (see Exhibit 3-1). Personnel developing a Healthcare Coalition should focus first on all-hazards processes before addressing hazard-specific issues.

Exhibit 3-1. Example of an “all-hazards” response process

A critical response action in any emergency is to document the structure of the team that is managing the incident for the organization. The team’s structure should be clearly understood both internally and by external entities that must interact with the team. Documenting and disseminating the names of staff who are assigned to specific positions on the team is important, even if the organizational structure is rather simple.

The remainder of this chapter describes the actions that the Healthcare Coalition should consider in each stage of emergency response and recovery.


  1. Drabek TE, Hoetmer GJ (Eds). Emergency Management: Principles and Practice for Local Government, International City Management Association, Washington, D.C.; (1991).

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  • This page last reviewed: February 14, 2012