Hospital Command Post/ Section Command Posts
Exercise Evaluation Form
Incident Name/TypeLocation Evaluated
Evaluator / Date:
Major Concerns /
- Performance of command tasks.
- Control of resources, including personnel, supplies and equipment.
- Ensuring personnel accountability for safety and task accomplishment.
- Effective coordination with TDH and other facilities/agencies.
Look For: /
- Establishment of strategic priorities.
- Initial determination, and continued assessment of goals, objectives and current capabilities.
- Development of an Incident Action Plan.
- Management of resources.
- Overall coordination of hospital response.
Instructions for Evaluator
- Interpret the criteria only as it applies to the function that you are evaluating.
- For each item, check the appropriate box. “Not Seen” does not mean that the action never occurred; only that the assigned Evaluator didn’t actually see it occur.
- For each “No” response, make an attempt to identify a reason why the applicable criteria were not met. Prepare a short statement on the last page of the packet recommending a corrective action. Base your findings on a “root cause” analysis.
- If you know that your assessment will require additional information on either of the last two pages, check the “Notes” box to remind you of this.
- Your recommendations may or may not be implemented, but may provide guidance for others who will be involved in making decisions. Your input is vital!
- Record positives too, especially if others may benefit from knowledge of “best practices.”
- Any criteria that ask for additional information, such as “Describe the process…” or “How was this done?” should be recorded in paragraph form if it cannot be quickly noted in the provided space.
- Do not let the process of recording detailed information distract you from observing your assigned function. Make quick notes. Elaborate later.
Incident Command
1. Facility personnel were notified in a timely manner / Yes No Not Seen
2. The facility’s Emergency Response/Operations Plan was activated and followed. / Yes No Not Seen
3. Hospital Command System (HICS) was established within 30 minutes / Yes No Not Seen
4. Incident Commander took control of the facility in accordance with established procedures. / Yes No Not Seen
5. What HICS positions were initially activated?
Time: ______Incident Commander
Time: ______Operations Section Chief
Time: ______Planning Section Chief
Time: ______Logistics Section Chief
Time: ______Finance/Admin. Section Chief / Other:
Time: ______
Time: ______
Time: ______
Time: ______ ______
Time:______
6. Call-down or other notification procedures were effective. / Yes No Not Seen
Briefly describe system used
7. The IC effectively coordinated and disseminated information among key personnel. / Yes No Not Seen
8. An initial Incident Action Plan and Operational briefing was developed and shared with command staff outlining objectives / Yes No Not Seen
9. External communication between the IC and outside entities was effective / Yes No Not Seen
10. Job Action Sheets and HICS forms were distributed and utilized effectively / Yes No Not Seen
11. Hospital staff exhibited coordination and teamwork / Yes No Not Seen
12. Progress/status reports were relayed to appropriate agencies. / Yes No Not Seen
13. The IC conducted operations from a designated location or in accordance with the facility’s plan. / Yes No Not Seen
14. The facility maintained personnel accountability throughout the incident. / Yes No Not Seen
15. Emergency credentialing and privileging procedures were implemented / Yes No Not Seen
16. The IC was properly trained and equipped to perform this function. / Yes No Not Seen
Describe any issues and evaluate overall function within the Command Center:
Communication within the Command Center
1. Communication was established with the RMCC Time______ / Yes No Not Seen
2. THAN was activated? Time ______ / Yes No Not Seen
3. A Public Information Officer (PIO) was designated Time______ / Yes No Not Seen
4. Activation of the exercise announced overhead Time______ / Yes No Not Seen
5. HRTS was functional, updated and monitored by hospital staff / Yes No Not Seen
6. “End of Exercise” was communicated appropriately Time______ / Yes No Not Seen
7. Disaster Hotline (if available) was activated / Yes No Not Seen
8. Communication tools were effective and worked as expected:
HAM Radio / Yes No Not Seen
HRTS / Yes No Not Seen
Radios / Yes No Not Seen
Other ______/ Yes No
Describe any issues and evaluate overall communication within the Command Center:
Safety within the Command Center
1. Internal security and safety operations were initiated / Yes No Not Seen
2. Adequate security was provided to the Command Center / Yes No Not Seen
3. Access and movement within the facility was controlled / Yes No Not Seen
Describe any issues and evaluate overall safety within the Command Center:
Resources and Assets within the Command Center
1. Were resource control and tracking implemented? / Yes No Not Seen
2. Were resources purchased due to event documentation on HICS 256? / Yes No Not Seen
3. Were resources received documented on HICS 257? / Yes No Not Seen
4. Was staffing adequate? / Yes No Not Seen
5. Was labor pool established? / Yes No Not Seen
6. Was the management of staff support (transportation, stress debriefs, housing) adequate? / Yes No Not Seen
Describe any issues and evaluate overall resource and assets within the Command Center:
Utilities/Infrastructure within the Command Center
1. Did the primary utility systems meet the needs of the incident? / Yes No Not Seen
2. Were redundant utility systems instituted? / Yes No Not Seen
3. Were Facility Systems Status Reports (HICS 251) completed as required? / Yes No Not Seen
4. Were utilities disconnected because of unsafe conditions? / Yes No Not Seen
5. Was necessary fuel available to manage the incident (emergency generators, transportation)? / Yes No Not Seen
6. Was facility evacuation conducted in accordance with procedures if required? / Yes No Not Seen
Describe any issues and evaluate overall Utilities/Infrastructure within the Command Center:
Staff Roles and Responsibilities within the Command Center
1. Did staff members understand their roles and responsibilities? / Yes No Not Seen
2. Did staff understand the difference between normal operations and HICS? / Yes No Not Seen
3. Were Incident Command staff appropriately identified (HICS vests)? / Yes No Not Seen
Describe any issues and evaluate overall Utilities/Infrastructure within the Command Center:
Did you observe any noteworthy practices or strengths? Yes No
If yes, please describe:
Did you observe any noteworthy areas for improvement?. Yes No
If yes, please describe: