title: The hospital incident command system: modified model for hospitals in iran.
abstract: BACKGROUND
  Effectiveness of hospital management of disasters requires a well-defined and rehearsed system. The Hospital Incident Command System (HICS), as a standardized method for command and control, was established in Iranian hospitals, but it has performed fairly during disaster exercises. This paper describes the process for, and modifications to HICS undertaken to optimize disaster management in hospitals in Iran.
  
  
  METHODS
  In 2013, a group of 11 subject matter experts participated in an expert consensus modified Delphi to develop modifications to the 2006 version of HICS.
  
  
  RESULTS
  The following changes were recommended by the expert panel and subsequently implemented: 1) A Quality Control Officer was added to the Command group; 2) Security was defined as a new section; 3) Infrastructure and Business Continuity Branches were moved from the Operations Section to the Logistics and the Administration Sections, respectively; and 4) the Planning Section was merged within the Finance/Administration Section.
  
  
  CONCLUSIONS
  An expert consensus group developed a modified HICS that is more feasible to implement given the managerial organization of hospitals in Iran. This new model may enhance hospital performance in managing disasters. Additional studies are needed to test the feasibility and efficacy of the modified HICS in Iran, both during simulations and actual disasters. This process may be a useful model for other countries desiring to improve disaster incident management systems for their hospitals.
authors.affiliation: Research Center in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice (CRIMEDIM), Università del Piemonte Orientale, Novara, Italy.
authors.forename: Ahmadreza
authors.initials: A
authors.lastname: Djalali
authors.affiliation: Department of Health, Safety and Environment, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Vahid
authors.initials: V
authors.lastname: Hosseinijenab
authors.affiliation: Prehospital and Disaster Medicine Centre, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Department of Medical Informatic Management, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mahmoudreza
authors.initials: M
authors.lastname: Peyravi
authors.affiliation: Research Center of Health Services Management and Institute for Futurology in Health, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Nekoei-Moghadam
authors.affiliation: Disaster Management, Natural Disaster Research Institute, Tehran, Iran.
authors.forename: Bashir
authors.initials: B
authors.lastname: Hosseini
authors.affiliation: Disaster Medical Services Division, California Emergency Medical Services Authority, Rancho Cordova, California, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Schoenthal
authors.affiliation: Center for Disaster Medical Sciences, University of California, Irvine, California, USA; World Association for Disaster and Emergency Medicine (WADEM).
authors.forename: Kristi L
authors.initials: KL
authors.lastname: Koenig