Incident Command and Exercising Regional Emergency Mass Prophylaxis

In December 2006, the Newton Department of Health and Human Services (Newton, Massachusetts) hosted the third annual regional flu clinic / Emergency Dispensing Site (EDS), full scale exercise. As the host agency for the operation, a Newton health official served in the role of incident commander. Local health officials from four neighboring jurisdictions (i.e., Arlington, Belmont, Brookline, and Watertown), filled general command staff positions. Together, the five local health departments planned and operated a clinic that provided influenza and pneumococcal vaccine to 600+ clients in two hours while exercising and evaluating several critical tasks and capabilities.

This presentation by the Incident Commander will describe how the operation was managed under the incident command system. How command and general staff communicated across jurisdictions, and how roles and responsibilities were delegated will be a focus. Management challenges inherent to any multi-jurisdictional collaboration will be discussed. Such challenges include ensuring that all health departments are able to meet their own needs through the operation, clarifying decision making authority, and maintaining day-to-day health department operations while preparing for the operation.

In an environment where the stakes are real, yet not as high as they would be in an emergency, the potential for learning how to use the incident command system effectively is high. Inexperienced staff can experiment and learn from mistakes, as well as gain the skill and confidence necessary for commanding a response that involves a mass prophylaxis operation.