ICOHHR Healthcare HazMat Readiness

Healthcare HazMat readiness must be demonstrated.

ICOHHR—the International Commission on Healthcare Hazmat Readiness—is D2EMC's advisory framework for examining and improving how hospitals prepare for chemical, biological, radiological, nuclear and hazardous-material incidents.

Explore the Framework Discuss Readiness
  • Plans + Policies
  • Equipment
  • Training
  • Staffing
  • Support

Preparedness is documented intent.

Readiness is demonstrated capability.

01 What ICOHHR Is

Plans are not proof.
Readiness must be observable.

ICOHHR organizes healthcare HazMat readiness into five connected domains and examines the evidence behind each one.

It gives hospital leaders a focused baseline, a written record of what was observed and a practical sequence for strengthening capability.

Documented preparedness matters, but a plan does not prove that assigned personnel can recognize the event, activate the response and use the procedure under pressure.

Question ICOHHR asks: Can the written intent guide real decisions?

A cache is not a capability by itself. Equipment must fit the hazard, remain serviceable and be available to people trained to inspect, select and use it safely.

Question ICOHHR asks: Is the equipment operationally ready?

Readiness becomes visible when plans, people, equipment and partners work together through the first operational period and the organization can learn from what occurred.

Question ICOHHR asks: What evidence demonstrates the capability?

02 Readiness Architecture

Five domains.
One operational picture.

Select a domain to see what ICOHHR examines. This overview is intentionally concise; every engagement is scoped to the facility, assigned roles and operating environment.

Domain 01 / IntentPlans + Policies

Can people use the plan to make the right decisions?

ICOHHR examines whether plans connect hazards, authority, activation, clinical operations, workforce protection, communications and continuity to assigned actions.

  • 01Current, controlled and accessible procedures
  • 02Defined triggers, authority and responsibilities
  • 03Usable tools for the first operational period
Readiness looks like: staff can locate, understand and execute their assigned procedures.
Domain 02 / ProtectionEquipment

Is the equipment ready for the people expected to use it?

ICOHHR examines selection, quantity, condition, inspection, maintenance, accessibility and the relationship between the cache and the facility's operating concept.

  • 01PPE and respiratory equipment matched to roles
  • 02Decontamination systems ready for deployment
  • 03Inspection, maintenance and replacement controls
Readiness looks like: serviceable equipment reaches trained users when the response activates.
Domain 03 / CapabilityTraining

Have assigned personnel practiced the work they must perform?

ICOHHR examines role-based education, hands-on skills, refresher practices, competency documentation and whether training reflects the facility's plans and equipment.

  • 01Hazard recognition and initial protective actions
  • 02PPE, patient flow and decontamination skills
  • 03Command, clinical and support-role preparation
Readiness looks like: personnel can demonstrate the decisions and skills assigned to their roles.
Domain 04 / CoverageStaffing

Can the response be staffed across shifts and operational demands?

ICOHHR examines team composition, coverage assumptions, activation, depth, supervision and how clinical and non-clinical personnel support a sustained response.

  • 01Named roles with realistic coverage
  • 02Activation, notification and backup depth
  • 03Supervision, safety and medical monitoring
Readiness looks like: the right roles can be filled without relying on a single person or ideal shift.
Domain 05 / CoordinationSupport

Can the wider system support safe healthcare operations?

ICOHHR examines the internal departments and external partners needed to support security, facilities, logistics, communications, clinical care and improvement.

  • 01Facilities, safety, security and logistics integration
  • 02EMS, fire, HazMat, public health and coalition interfaces
  • 03Exercise, improvement and reassessment processes
Readiness looks like: dependencies and partners are connected before the incident forces the relationship.
Assessment + Advisory CBRN + HazMat Training Exercise + Validation

03 How the Review Works

Scope. Examine.
Prioritize. Improve.

A disciplined review keeps the work focused on evidence leadership can use—not a generic checklist or a ceremonial designation.

  1. 01

    Scope

    Start with the operational question.

    Confirm facilities, roles, hazards, evidence and review boundaries.
  2. 02

    Examine

    Review what exists and what can be observed.

    Documents, equipment, records, interviews and operating conditions.
  3. 03

    Prioritize

    Turn evidence into decisions.

    Identify strengths, gaps, risk and the actions that matter first.
  4. 04

    Improve

    Connect findings to accountable action.

    Assign owners, strengthen capability and establish follow-up.

04 Current Reference Points

Current sources.
Clear boundaries.

ICOHHR uses current public requirements and operational references as context. It does not replace the official source, interpret standards for an accreditor or promise compliance.

01 / Accreditation context

Joint Commission National Performance Goal 3

Effective January 1, 2026, Joint Commission organizes key hospital emergency-readiness requirements under National Performance Goal 3.

View the official overview (opens in a new tab)

Framework overview Page content and source links last reviewed August 26, 2026

ICOHHR and D2EMC are not affiliated with, sponsored by or endorsed by The Joint Commission, CMS, OSHA or NFPA. References are informational and do not constitute standards interpretation, accreditation advice or a determination of compliance.

05 Who the Framework Serves

Built around the people
who must use it.

Select your role to see where ICOHHR can create a clearer readiness decision.

Facility readiness

Know where the healthcare HazMat system is ready—and where assumptions remain.

Use the framework to examine first-receiver operations, workforce protection, decontamination, command, clinical support and program sustainment.

Discuss a Facility Review
Regional readiness

See where facility capability depends on coalition and agency coordination.

Use shared findings to identify cross-facility needs, common training priorities, resource gaps and realistic exercise objectives.

Discuss a Regional Scope
Operational interfaces

Clarify how hospitals connect with EMS, fire, HazMat and public health.

Use the framework to examine notification, arrival, transfer, zones, information sharing and the handoffs that determine safe operations.

Discuss Partner Participation
Framework development

Bring clinical, safety, engineering and response expertise into practical review criteria.

Contributors can help identify evidence, language and operational realities the framework should reflect as it develops.

Discuss Contribution

D2EMC experience informing the ICOHHR framework

40+Hospital readiness assessments

Conducted by D2EMC and its principal across healthcare environments.

32+Years of operational leadership

Experience led by D2EMC's principal across military medical, HazMat and emergency response.

Full cycleAssess through re-evaluation

Findings can inform training, exercises and improvement.

06 Common Questions

Clear answers.
No implied authority.

These answers define what the current ICOHHR offering is—and what it is not.

01What is ICOHHR?

ICOHHR—the International Commission on Healthcare Hazmat Readiness—is a D2EMC-led advisory framework for examining and improving healthcare CBRN and hazardous-material readiness across plans and policies, equipment, training, staffing and operational support.

02Does ICOHHR certify or accredit facilities?

No. As currently offered, ICOHHR provides an advisory readiness assessment and written report. It does not confer accreditation, certification, regulatory approval or a determination of compliance with Joint Commission, CMS, OSHA, NFPA or another authority.

03What does a participating facility receive?

The primary deliverable is a written, dated assessment report that identifies the agreed review scope, evidence observed, strengths, gaps and prioritized actions. Additional training, exercise or advisory support is scoped separately when useful.

04What evidence may be reviewed?

Depending on scope, the review may consider plans, policies, equipment records, training and exercise documentation, staffing assumptions, interviews, facility conditions and observed team practices. The evidence set and its limits are identified in the report.

05How is ICOHHR different from ORI™?

ICOHHR focuses specifically on healthcare CBRN and HazMat readiness. The Operational Readiness Index™ is D2EMC's broader multi-domain advisory assessment of organizational readiness. D2EMC can help determine which starting point fits the decision leadership needs to make.

06Does ICOHHR replace official requirements?

No. Facilities remain responsible for identifying and meeting every law, regulation, accreditation requirement, code, standard and organizational obligation applicable to them. ICOHHR references public sources only as context for an advisory readiness review.

07 Start With the Decision

Know what your healthcare HazMat system
can actually demonstrate.

Bring the capability, concern or review requirement driving the conversation. D2EMC will help define the smallest useful ICOHHR scope and the evidence needed to answer it.

Request an ICOHHR Conversation Email david@d2emc.com