Operational Art and the Incident Command System: Public Health's Bridge in Bioterrorism Preparedness and Response   [open pdf - 2MB]

Homeland Security Presidential Directive 5 issued 28 February, 2003 calls for a National Incident Management System (NIMS) to provide a consistent nationwide approach for federal, state, and local governments in preparedness for, response to, and recovery from domestic incidents. The Incident Command System (ICS) is nationally recognized as the platform of choice for unification of operations in emergency response. Public health has a lack of understanding of ICS beyond familiarization, an established leadership style involving consensus building and group decision-making, and an unproven track record in leading mass casualty response teams. This research project recommends the development of a nationwide system of ICS training and application for public health personnel, to include exercise scenarios and simulations built on ICS unified command. The national ICS model would incorporate the existing FEMA model, but would allow for unique health care issues such as epidemiologic surveillance and investigation, patient cohorting for isolation, and lab operations. Selected personnel would be trained in military concepts of command and control (C2) and operational art to include campaign planning and principles of war. The ICS platform can enable the public health system to respond to public health emergencies in a timely and successful manner, whether the crises are manmade or natural biological outbreaks. Public health personnel must be able to take command and control the situation, preventing additional cases of infectious disease and saving lives during a mass casualty incident. In addition, cross-cultural training in military concepts to accomplish ICS functions could provide a bridge between the military and civilian sectors for future response partnerships.

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