(HICS) method as a standard. Since 2006, the Ontario Hospital Association (2006) created a hospital emergency management toolkit, which included the call for implementation of the Hospital Incident Command System (HICS). From information found in research, it appears that this has become a voluntary standard across Canada, although it does appear as if there was some government urging.
3.9 China
Prior to May 2018, China had no nationwide emergency management agency or a nationwide IMS method in place. Until the formation of the new Chinese emergency management agency in 2018, the process of managing emergencies, planning for emergencies, and managing response and recovery efforts were handled by a hodgepodge of national, regional, and local governmental agencies. These agencies usually responded with no specific or defined way of handling incidents, and they usually did not integrate well when they were forced to work together. In a 2018 press release, it was stated that the new formation of the emergency management agency would improve the speed and efficiency of the Chinese response to disasters (Liqiang, 2018). No information was found on the use of a hospital IMS method in China, so it is assumed that there is none in place.
3.10 Germany
In Germany, their IMS method is known as Dienstvorschrift 100 (DV 100), Leadership and Command in Emergency Operations. The regulation of DV 100 was approved by the Board of Firefighting Affairs in Germany around the year of 2007. It is a regulation that was designed in a way that it was in harmony with the German Federal Constitution and allowed the states to be autonomous. DV 100 is a regulation that explains the command and control system for Germany, and it places the responsibility for emergency response to the 16 states within the boundaries of Germany. DV 100 was implemented in 1999 among the fire service, then later implemented by other national organizations. Since 1999, it appears to have become the single system utilized in Germany for the purposes of incident management (Dienstvorschrift, 2007).
Much like the ICS method developed in the United States, the roots of this method of IMS came from the fire service: it was later transformed to an all‐hazards IMS method, for use in all types of incident. Also similar to the NIMS and its companion ICS, the DV 100 system is flexible and allows operational leaders to make basic decisions based on the circumstances evolving around them. The DV 100 system relies on motivated staff as a key to success, and much like NIMS, it does not micromanage operations. It allows operational flexibility to tactical crews so that they can achieve the mission's goals without being micromanaged. This IMS method is different because it identifies the disposition that the Incident Commander (IC) should possess, and the leadership styles that should be used. In most instances, it calls for the Cooperative Leadership, with an Authoritarian Leadership Style as needed. This regulation calls on the Incident Commander (IC) to be both confident and competent (Dienstvorschrift, 2007).
Confidence and competency are based on the protocols for an Incident Commander (IC). Requirements to serve as an Incident Commander (IC) include specific training and qualifications. To serve as an Incident Commander (IC) usually requires 24 months of training that helps ensure that they are competent in operational leadership. In most instances, it is also required that the candidate who wishes to become an Incident Commander (IC) must possess the minimum of a bachelor's degree, thereby putting an importance on higher education. Individuals are groomed and developed over a period of time to become specialists within their defined roles (Dienstvorschrift, 2007).
DV 100 has several mandates that require a noticeable involvement of elected officials. In this IMS method, elected officials are required to have a more hands‐on role than the method used in the United States. In extended response and/or in major incidents, the overall command is held by the local or regional elected official (or authority). This might be a governor, a mayor, or some other political figure. To guarantee that the regulation is obeyed, they must oversee administrative‐organization‐component and the operative‐tactical component. An administrative council is required by DV 100 so that quick decisions can be made to help manage major incidents. This council is tasked with focusing on political conditions, financial responsibilities, and other administrative tasks. This allows operation‐tactical‐component to focus on operations (Dienstvorschrift, 2007).
The Incident Commander (IC) is charged with managing the operational‐tactical‐component. They will use a continuous process of analyzing the situation, assessing the situation and deciding a plan of action, and implementing directives or orders. This is the German method for planning the response to an incident, where the United States uses the Planning P (Chapter 15). In assessing the situation phase, reconnaissance is heavily emphasized as an important factor to mitigating or ending the incident (Dienstvorschrift, 2007)
It should be noted that the arrangement of personnel commanded by the Incident Commander is similar to that of the ICS method. They have varying levels of responsibility and specific jobs. Technical and tactical considerations are handled by these individuals, based on their assigned position (Dienstvorschrift, 2007)
The synopsis of the DV 100 is a quick review; it is not a detailed analysis. While many portions of DV 100 are similar to NIMS and its companion IMS method, ICS, however, they are not exactly alike. An entire book could be written on the differences between the two, so it is strongly suggested that the reader do a more in‐depth study on the German system to gain a better understanding.
While not very much information could be found, it appears that hospitals in Germany use the Hospital Incident Command System (HICS) to manage disasters and in‐house emergencies. The lack of information could be related to security protocols, or it could be due to just a lack of information sharing. It appears that Germany began researching and preparing to use Hospital Incident Command System (HICS) since approximately 2005.
3.11 Haiti
Due to the geographical location, and the situation that Haiti is an economically depressed country, large disasters tend to affect this country considerably more negatively than most countries. Historically, the socioeconomic status in Haiti usually creates compounding and cascading effects when disasters strike. In this Caribbean country, even the most basic of disasters often leads to increased death tolls and severe devastation. These issues have amplified human suffering during many major incidents, and the country of Haiti is quite often reliant upon other countries for assistance when a disaster occurs. Because Haiti often relies on integrating outside resources, it is extremely important to have an IMS method. When the country decided to enact an IMS method as a basis for incident management, it was decided that the method used should be a system that was familiar to the countries, especially those most likely to respond to their request for assistance. Unfortunately, it would take a major disaster to move toward the standard use of an IMS method.
In January 2010, a 7.1 earthquake struck Haiti. While in the initial stages of the disaster, there was no estimate of deaths and injuries, but the country knew they needed outside assistance. It would later be realized that more than 222 500 killed, and the earthquake displaced over 300 000 people (United States Geological Survey, 2011). Haiti did not have an IMS method in place when the earthquake struck, which created additional challenges for those countries and agencies that came to assist them in their time of need. In the initial stages of the response, chaos, confusion, and uncertainty appeared to be the common theme, and it was ongoing for many days, even after outside resources arrived. The international response to this disaster was swift, and large contingencies of rescue workers began to arrive from a multitude of other nations within 24 hours.
With Haiti being a member of the Caribbean Disaster Emergency Management Agency (CDEMA), the first outside help to arrive was from neighboring Caribbean countries. In 2010, some of these countries were using an adapted form of the ICS method, but not all of them were on the same page. According to Fordyce, Sadiq, and Chikoto (2012), the country of Haiti had a new and inexperienced emergency management agency in place at the time that the earthquake struck. The fledgling agency was so
