To successfully make practice changes, leaders and decision-makers need to gain multi-level buy-in. Implementation teams help to build trust across sectors.
Hospital Incident Command System (HICS)
When hospitals anticipate or experience a crisis, they activate the Hospital Incident Command System (HICS), which helps them plan next steps, leverage resources, and organize personnel. [i] The HICS structure integrates the areas in a facility with responsibility for crisis preparedness and response (e.g. infection control, supply chain management) so each can operate in its area of expertise while sharing the information and capabilities.
The hospital incident management team (HIMT), the leadership group that manages HICS, provides input from operations, logistics, planning, and resource officers.
As a component of the SHEA/CDC Outbreak Response Training Program (ORTP), in 2017 SHEA issued an expert guidance for healthcare epidemiologists to guide them in incident command and HICS, and recognizing the challenges of putting outbreak response policies into practice amid multifaceted stressors, SHEA developed a companion online implementation tool kit.
This COVID-19 tool kit is an adaptation of the 2018 ORTP tool kit, and was created to guide healthcare epidemiologists and others through implementation of new policies in practices in the context of COVID-19.
Implementation Teams
This COVID-19 tool kit primarily focuses on the purpose and role of implementation teams, groups of decision-makers who collaborate on policy or practice changes to establish multi-level understanding and build trust across sectors. Implementation teams clear the path for change, identifying pitfalls before they become actual problems, tailoring communications to the interests and concerns of those affected, reassuring and leading by example, and inviting ownership of the process and outcome.
When HICS is activated, numerous primary objectives and initial responsibilities of an implementation team are fulfilled by the HIMT. The HIMT includes officers responsible for operations, planning, logistics, occupational health and safety, resources, and external and public affairs. It is responsible for seeking and considering the hospital experts’ advice, and making sure policies and recommendations are feasible.
Implementation teams take it from there, helping establish a shared view and purpose, utilizing champions, demonstrating cohesion, and providing reassurance and clarity. The implementation team helps stakeholders commit to difficult changes, saving time and resources when they’re needed most. [iv],[v], [vi]
In other words, the HIMT marks the route, fills the tank, and starts the engine. The implementation team steers to make sure it gets to its destination.