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Question About Earthquake Facility Response


Hi all, nursing student here. I had a question for my BSN Leadership and Management class that I am hoping you might be able to help me answer. In the scenario provided an earthquake has damaged a nearby hospital prompting evacuation and your hospital is the only one available to take in the patients. Who would normally be the incident commander in this scenario? My thoughts so far is that it should be the Chief Nursing Officer or Chief Medical Officer.  Am I on the right track here? Who would make up the critical team that reports to the incident commander? 

I found a lot of information about hospital evacuation,  but little to no information about the process of receiving the patients from an evacuated hospital. Would the process be similar to evacuating since some patients would have to be discharged and moved around to make room for the more critical patients? Anything helps. 

Thank you in advance for your responses 🙂

Rebecca Reed

MunoRN, RN

Specializes in Critical Care. Has 10 years experience.

In my experience the overall incident commander is actually the County emergency response commander, particularly in a situation like this where the hospital's response has to be part of a larger response effort.  At the hospital level, working under the county's emergency response command, either the CNO or CMO could be designated leader at the hospital level. 

The hospital would be notified by emergency response command of how many patients and at what level of care they would need to receive, both from the other damaged hospital and from the community, and what if any availability to transfer more stable patients to other facilities (ie SNFs) might be available.  The hospital would then oversee the triage process as well as things like enacting crisis standards of care.  


I agree with Muno that the county or state emergency management would most likely manage the incident through their incident command system (ICS).  However, both the sending and receiving facilities should activate their own hospotal incident command system (HICS) as soon as possible.  The hospital's chief operating officer would most likely assume the role if incident commander.  The chief medical and/or chief nursing officer would most likely assume management roles under the operations section chief.

If you are interested in learning more about the ICS and HICS you might find FEMA’s IS-100.C: Introduction to the Incident Command System, ICS 100 and IS-200.C: Basic Incident Command System for Initial Response helpful.

Best wishes.