HICS 201 - INCIDENT BRIEFING HICS

PURPOSE: The HICS 201 – Incident Briefing provides the Incident Commander and the Hospital Incident Management Team (HIMT) with basic information regarding the incident, current situation, and the resources allocated to the response.

ORIGINATION: Prepared by the Incident Commander for presentation to the staff or later to the incoming Incident Commander along with a detailed oral briefing.

COPIES TO: Duplicate and distribute before the initial briefing of the Command and General Staff or other responders as appropriate. All completed original forms must be given to the Documentation Unit Leader.

NOTES: If additional pages are needed for any form page, use a blank HICS 201 and repaginate as needed. Additions may be made to the form to meet the organization’s needs.

NUMBER TITLE
INSTRUCTIONS

1 Incident Name
Enter the name assigned to the incident.

2 Operational Period
Enter the start date (m/d/y) and time (24-hour clock) and end date and time for the operational period to which the form applies.

3 Situation Summary
Concise statement of the status and information regarding the current situation.

4 Health and Safety Briefing Enter the summary of health and safety issues and instructions.

5 Map / Sketch Attach as necessary: floor plans, maps, sketches of impacted area, or response diagrams. North should be at the top of the page unless noted otherwise.

6 Current Hospital Incident Management Team
Enter the names of the individuals assigned to each position directly onto the Hospital Incident Management Team (HIMT) chart. If Unified Command is being used, split the Incident Commander box and indicate agency for each of the Incident Commanders listed.

7 Incident Objectives
Enter the objectives used for the incident.

8 Summary of Current and Planned Actions
Enter the current and planned actions and time (24-hour clock) they may or did occur. If additional pages are needed, use a blank sheet or another HICS 201 (page 3), and adjust page numbers accordingly.
The Winlink form allows for pasting tab delimited data from a spreadsheet in these fields.

9 Summary of Resources Requested and Assigned
Enter information about the resources allocated to the incident. If additional pages are needed, use a blank sheet or another HICS 201 (page 4), and adjust page numbers accordingly.
Resource
Enter the number and category, kind, or type of resource ordered.
Date / Time Ordered
Enter the date (m/d/y) and time (24-hour clock) the resource was ordered. ETA
Enter the estimated time of arrival (ETA) to the incident (24-hour clock).
Date / Time Arrived
Enter the date (m/d/y) and time (24-hour clock) the resource arrived.
Notes
Enter notes such as the assigned location of the resource and/or the actual assignment and status.
The Winlink form allows for pasting tab delimited data from a spreadsheet in these fields.

10 Prepared by Incident Commander
Enter the name and signature of the person preparing the form. Enter date (m/d/y), time prepared (24-hour clock), and facility.

Back to links

Copy and Paste Data From Spreadsheet

Copy the data from the spreadsheet and paste (2 columns X 20 lines) in box below, then click "Parse Data"
TAB delineation only. Ensure fields match and data does not exceed field lengths, or HTML will miss some data.


        

Close this window
Close this window

Copy and Paste Data From Spreadsheet

Copy the data from the spreadsheet and paste (5 Columns X 15 lines) in box below, then click "Parse Data"
TAB delineation only. Ensure fields match and data does not exceed field lengths, or HTML will miss some data.


        

Close this window
Close this window

                   HICS 201 INCIDENT BRIEFING
                 HICS - Hospital Incident Command System

                                               

   1. Incident Name

     

     
   2. Operational Period     (#):  

         Date From      To  

         Time From         To  

   3.Situation Summary (for briefings or transfer of command)
  


   4.Health and Safety Briefing
Identify potential incident health and safety hazards and implement necessary measures (remove hazard, provide personal protective equipment, warn people of the hazard) to protect responders from those hazards. (Summary of HICS 215A)

  


   5. Map/Sketch (include sketch, showing the total area of operations, the incident site/area, impacted and threatened areas, overflight results, trajectories, impacted shorelines, or other graphics depicting situational status and resource assignment as needed):

JPEG map/sketch attached


      HICS 201 Page 1 of 4  

 

                   HICS 201 INCIDENT BRIEFING
        


    6. Current Hospital Management Team (fill in additional positions as appropiate)

PIO
 
Incident Commander
 
Medical Technical Specialist
     
Liasion Office
     
Medical Technical Specialist
     
Safety Officer
-    
Medical Technical Specialist

 
 
Operations
Section Chief

 
Planning
Section Chief

 
Logistics
Planning Chief

 
Finance / Administration
Section Chief

Staging Manager
 Resources Unit Leader
Service Branch Director
Time Unit Leader

 
Medical Care Branch Director
 
Situation Unit Leader
 
Support Branch Director

 
Procurement Unit Leader
 
Infrastructure Branch Director
 
Documentation Unit Leader
     
Compensation/Claims Unit Leader
 
Security Branch Director

 
Demobilization Unit Leader
     
Cost Unit Leader

 
HazMat Branch Director

           
 
Business Continuity Branch Director
           
 
Patient Family Assistance Director

           
 
Other (if needed)
           



      HICS 201 Page 2 of 4  


     7. Incident Objectives
  
  

  8. Summary of Current and Planned Actions                   Paste Data from a Spreadsheet     

 TIME  ACTIVITY
HICS 201 Page 3 of 4  


    9. Summary of Resources Requested and Assigned                 Paste Data from a Spreadsheet     

RESOURCE DATE / TIME
ORDERED
ETA DATE / TIME
ARRIVED
NOTES
(LOCATION / ASSIGNMENT / STATUS)


    10. Prepared by:
Name    Position/Title:    Signature:

    Date/Time:

 


                        

HICS 201 v 0.1.2 Page 4 of 4