Use of Incident Command System for Disaster Preparedness: A Model for an Emergency Department COVID-19 Response

Andra Farcas*, Justine Ko, Jennifer Chan, Sanjeev Malik, Lisa Nono, George Chiampas

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


The COVID-19 pandemic has placed unprecedented demands on health systems, where hospitals have become overwhelmed with patients amidst limited resources. Disaster response and resource allocation during such crises present multiple challenges. A breakdown in communication and organization can lead to unnecessary disruptions and adverse events. The Federal Emergency Management Agency (FEMA) promotes the use of an incident command system (ICS) model during large-scale disasters, and we hope that an institutional disaster plan and ICS will help to mitigate these lapses. In this article, we describe the alignment of an emergency department (ED) specific Forward Command structure with the hospital ICS and address the challenges specific to the ED. Key components of this ICS include a hospital-wide incident command or Joint Operations Center (JOC) and an ED Forward Command. This type of structure leads to a shared mental model with division of responsibilities that allows institutional adaptations to changing environments and maintenance of specific roles for optimal coordination and communication. We present this as a model that can be applied to other hospital EDs around the country to help structure the response to the COVID-19 pandemic while remaining generalizable to other disaster situations.

Original languageEnglish (US)
Pages (from-to)e31-e36
JournalDisaster Medicine and Public Health Preparedness
Issue number3
StatePublished - Jun 2021


  • COVID-19
  • communication
  • coordination
  • disaster preparedness and response
  • incident command system

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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