Category Archives: Emergency Management

Academia, Culture, Health Care

Human Resource Management

Mrs. Jackson’s Dilemma

In the dilemma of Mrs. Clara Jackson, as presented by Fallon and McConnell (2007), the emergence of health care professions created a vacuum of administrative roles that, until this time, were haphazardly fulfilled by senior clinical staff. Mrs. Jackson, professionally torn between clinical and adminstrative roles, understood that one would suffer for the attention spent on the other. As this realization set in, Mrs. Jackson allowed non-clinical supervisors to hire employees; however, this tended to decentralize the function of personnel management. This ad hoc methodology would eventually prove detrimental as regulations and legal requirements become standard. Mrs. Jackson could enlist an assistant to help with these administartive roles, but an unprepared assistant would prove as detrimental as the decentralized process previously discussed.

Caldwell, Troung, Linh, and Tuan (2011) show that “reframing an organization’s internal environment [by implementing strategic human resource functions] results in significantly higher organizational outcomes and financial performance that is superior to what firms can attain by implementing individual human resource program elements piecemeal” (p. 172); therefore, reorganizing and restructuring the processes used to handle these administrative personnel issues would benefit the hospital better than the ad hoc use of senior clinical personnel, such as Mrs. Jackson (Fallon & McConnell, 2007), especially with workforce legislation circa 1930 (e.g. workmen’s compensation, Social Security, collective bargaining).

These issues, requiring a sense of increasing specialization and knowledge, helped to form the field of human resource management (HRM) as we understand it today. HRM strives to use a form of “ethical stewardship[,] … a philosophy of leadership and governance that optimizes long-term wealth creation and that honors duties owed to all stakeholders” (Caldwell, Troung, Linh, & Tuan, 2011, 178), to “help their organizations add value to the lives of individuals and organizations” (Caldwell, Troung, Linh, & Tuan, 2011, p. 177). This philosophy helps to gain “commitment from employees which is the key to long-term wealth creation” (Caldwell, Troung, Linh, & Tuan, 2011, 178). Using this philosophy of ethical stewardship, HRM managers would have enlisted the help of Mrs. Jackson to formulate a list of requisite knowledge, skills, and abilities (KSAs) needed to perform each clinical job and hire nurses based on these, while meeting the requirements of employment law and regulation, so as to free Mrs. Jackson to perform her senior clinical role unimpeded.

References

Caldwell, C., Truong, D. X., Linh, P. T., & Tuan, A. (2011). Strategic human resource management as ethical stewardship. Journal of Business Ethics, 98(1), 171–182. doi:10.1007/s10551-010-0541-y

Fallon, L. F. & McConnell, C. R. (2007). Human resource management in health care: principles and practice. Sudbury, MA: Jones and Bartlett.

Academia, Clinical, Culture, Emergency Medical Services, Health Care

Measuring EMS: Patient Satisfaction

As a paramedic, I become discouraged when so-called academic literature, like that of McLean, Maio, Spaite, and Garrison (2002), Spaite (1993), and Stiell et al. (2008), turns up describing what little impact the emergency medical services, especially advanced life support procedures, have on patients. Instead of dismissing these writings, I tend to focus within the view of my own practice and experience on how I feel that I impact the patients that I see. This exercise allows me to confront the literature in a specific and meaningful manner that might be used in the future to publish a dissenting view. This discussion gives me a lens through which to dissect the import I feel that the emergency medical services has as a public safety entity.

Public safety is typically viewed as the amalgamation of police, fire, and emergency medical services. In all three, the public seems to have the idea that we stop threats before they take hold; however, we typically respond to the aftermath, the police to investigate crimes that have already occurred, the fire department to conflagrations that have already caused damage, and emergency medical services to traumatic incidents or medical conditions that have already caused distress. There are exceptions. The police have learned to integrate crime prevention techniques, the fire department has learned to adopt a fire prevention model of service, and the emergency medical services in many areas support preventative health clinics, such as community immunization, blood pressure checks, and CPR and first aid classes. The public, I feel, has a skewed perception of each one of these departments (e.g. the police should stop crime in progress, the fire department should save their house, and emergency medical systems should save their loved one whenever called upon to do so). Any deviation from the public perception is, in their minds, a failure of the system.

I ask myself, “What is that we, as the emergency medical services, do that really matters?” For the public, it seems that the answer can be given two-fold: “save me” and “make me feel better.” El Sayed (2012) describes the manner in which both aspects, outcomes and patient satisfaction, can be measured, as both are essential. Unfortunately, El Sayed does not go into much detail regarding patient satisfaction scores, except as a means of measure. In contrast, I feel that the most benefit that we offer patients is that we alleviate suffering. From a confident, yet compassionate, bed-side manner to effective and efficient treatment modalities, emergency medical personnel can prove to be the mediator between illness or injury and definitive hospital-based care. Emergency medical providers should be knowledgeable enough about the hospital to calm and educate patients as to what to expect. Further, medical knowledge allows the provider to restore a choking person’s breathing, to stop an epileptic seizure, and to minimize a crash victim’s pain. In my opinion, these measures are just as important, if not more, to quality management as mortality and morbidity. Again, El Sayed mentions the generality of patient satisfaction; however, with the abundance of competing literature questioning the effectiveness of the emergency medical services, patient satisfaction should be expounded upon as a legitimate and important aspect of quality patient care.

References

El Sayed, M. J. (2012). Measuring quality in emergency medical services: a review of clinical performance indicators. Emergency Medicine International, 2012, 1-7, doi:10.1155/2012/161630

McLean, S. A., Maio, R. F., Spaite, D. W., & Garrison, H. G. (2002). Emergency medical services outcomes research: evaluating the effectiveness of prehospital care. Prehospital Emergency Care, 6(2), S52–S56. doi:10.3109/10903120209102683

Spaite, D. W. (1993). Outcome analysis in EMS systems. Annals of Emergency Medicine, 22(8), 1310–1311. doi:10.1016/S0196-0644(05)80113-1

Stiell, I. G., Nesbitt, L. P., Pickett, W., Munkley, D., Spaite, D. W., Banek, J., Field, B., … Wells, G. A., for the OPALS Study Group. (2008). The OPALS Major Trauma Study: impact of advanced life-support on survival and morbidity. Canadian Medical Association Journal, 178(9), 1141-1152. doi:10.1503/cmaj.071154

Academia, Emergency Management, Politics, Society, Technology

Messaging as an Ongoing Process

Just after midnight on March 24, 1989, the Exxon Valdez ran aground in the Prince William Sound off of the Alaskan coast causing the 36th largest oil spill in history (Baker, n.d.; Fearn-Banks, 2011; Holusha, 1989; Moss, 2010). Though the initial ecological insult was severe, Exxon’s poor response to the emergency is noted as having the most significance (Baker, n.d.; Holusha, 1989). According to Fearn-Banks (2011), the initial public relations response was swift, but the public perception, especially with the obvious absence of CEO Lawrence G. Rawl from the public spotlight, was that the company did not view the incident with the importance that it deserved (Holusha, 1989). “The biggest mistake was that Exxon’s chairman … sent a succession of lower-ranking executives to Alaska to deal with the spill instead of going there himself and taking control of the situation in a forceful, highly visible way” (Holusha, 1989, para. 6). Rawl made comments about being technologically obsolete as a reason for not responding to the incident personally, and in a later television interview, Rawl explained that it was not the responsibility of the CEO to read specific response plans, then he went on to blame the media for the crisis (Baker, n.d.; Fearn-Banks, 2011).

According to Fearn-Banks (2011), Don Cornet, Exxon’s Alaska public relations coordinator, rushed to the scene and instituted a plan focused on the clean-up upon hearing of the incident; however, resources were scarce and the plan was slow to implement. Alaskan oil industry regulations held that the Alyeska Pipeline Service Company, an oil company consortium, was ultimately responsible for the initial response, which was soon taken over by Exxon. It was Alyeska’s involvement in the incident that introduced George Mason, an experienced crisis communications public relations expert for the company that represented Alyeska, into the spotlight. Mason worked with Cornet to streamline the media response and did much to limit the impact of Exxon’s poor media relations, even in light of Rawl’s disastrous commentary. Without the efforts of Mason, Cornet, and a few others, it appears that Exxon’s reputation would have suffered much more.

The primary issues identified in Exxon’s response to the Valdez incident, according to Baker (n.d.), are 1) a lack of resources and preparedness for a crisis of this magnitude, 2) failing to commit to prevention efforts in the future, and 3) the perceived indifference to the ecological shock.

According to Holusha (1989), Exxon’s response to the Alaskan spill was immediately identified as highlighting what not to do in responding to a crisis. Holusha compared Rawl’s messaging and response with that of the Ashland Oil spill and the Union Carbide incident in Bhopal, India, in which both CEOs responded immediately, availing themselves to the media to answer questions and respond to scrutiny.

The Exxon Valdez spill was significant, large, costly, and affected many industries and lifestyles in Alaska. Rawl’s response should have been immediate, and he should have taken responsibility to be apprised of all efforts being undertaken to rectify the situation. Legitimizing Rawl’s concerns of being a distraction to local efforts, he could have held frequent press conferences in the mainland United States, which would have limited the media’s need to send so many representatives directly to Alaska. This would have helped to show cooperation with the media as well as allow Rawl to address any concerns that the public might have. The messaging should have been that Exxon will do everything needed to return Alaska back to pre-spill status no matter the cost or manpower required.

Today, social media presents a unique opportunity for companies to address their public. Recently, Connecticut Light and Power utilized Facebook and Twitter, two popular social media programs, to provide real-time updates to their affected customers during a freak early snowstorm that put most of Connecticut without power for weeks (Singer, 2011; State of Connecticut, Department of Emergency Services and Public Protection, 2011). Though there are still concerns that Connecticut Light and Power were unprepared for such a crisis, without the deliberate effort to maintain communication with customers, the corporate image would have been much worse, as Exxon experienced.

It is a common precept in crisis communications that crises will occur and hopes can only be made to minimize their effect (Fearn-Banks, 2011). While preparing for such a crisis, a focus on communication and messaging should be paramount. The more the public trusts that the company will respond to the emergency effectively, the more apt they will be to acknowledge the difficulties involved in such a response. Messaging should be open, honest, and realistic. Every effort to use a multitude of media (e.g. radio, television, print, internet, telephone, et al.) to maintain a sense of transparency should be used to promote messages that accept responsibility and sets realistic goals. These communications, however, should not be unidirectional. A conversation needs to take place where the public can have their concerns and curiosity addressed in a fair and open environment.

By addressing the concerns of all stakeholders in a timely, open manner, corporate images will fare much better even in light of the worst crisis imaginable.

References

Baker, M. (n.d.). Companies in crisis – What not to do when it all goes wrong: Exxon Mobil and the Exxon Valdez. Retrieved from http://www.mallenbaker.net/csr/crisis03.html

Coombs, W. T. (2012). Ongoing crisis communication: Planning managing, and responding (3rd ed.). Thousand Oaks, CA: Sage.

Fearn-Banks, K. (2011). “Textbook” crises. Crisis communications: a casebook approach (4th ed; pp. 90-109). New York, NY: Routledge.

Holusha, J. (1989, April 21). Exxon’s public-relations problem. New York Times. Retrieved from http://www.nytimes.com/1989/04/21/business/exxon-s-public-relations-problem.html

Moss, L. (2010, July 16). The 13 largest oil spills in history. Mother Nature Network. Retrieved from http://www.mnn.com/earth-matters/wilderness-resources/stories/the-13-largest-oil-spills-in-history

Singer, S. (2011, November 4). CT utility takes heat over winter storm response. News 8 WTNH. Retrieved from http://www.wtnh.com/dpp/weather/winter_weather/ct-utility-takes-heat-over-winter-storm-response-

State of Connecticut, Department of Emergency Services and Public Protection. (2011, November 8). Winter storm October 29, 2011 (Situation Report #49). Retrieved from http://advocacy.ccm-ct.org/Resources.ashx?id=802e4723-2e4a-4a61-896e-f51eafbbd4c0

Criminal Justice, Politics, Public Health, Society, Technology

Impact of Technology: Social Media and Cyberbullying

The advent of the internet and social media allows like minded people to easily seek each other out and share their ideas. As I see a growing trend towards anti-sematism not unlike that of the 1930’s, I begin to draw parallels to that time and imagine sociopolitical paths of the likes we never want to tread. It was for this reason and others that I made a simple post on Facebook and Twitter reading “I support Israel.” This proclamation was made to let my Jewish friends know in no uncertain terms that I would never sway towards anti-Jewish sentiment, and it also made my other friends aware that I would not support them if they should harbor such feelings. There is inherent freedom in the idea of free-flowing information; however, this freedom also comes with responsibility. The same technology that promotes freedom also simplifies efforts to conspire against ideas, governments, and sometimes individuals. It is this conspiracy against individuals that has piqued my interest. The use of the internet (and, other technology, such as cell phones) to conspire against individuals can be seen in the act of cyberbullying.

Cyberbullying, according to Bill Belsey, the award winning author of the bullying.org website “involves the use of information and communication technologies such as email, cell phone and pager text messages, instant messaging, defamatory personal Web sites, and defamatory online personal polling Web sites, to support deliberate, repeated, and hostile behavior by an individual or group, that is intended to harm others” (as cited in Li, 2007, p. 1779). Li (2010) goes further to include “exclusion” to this list. Exclusion is the specific and intentional exclusion of an individual from an online group. Further, Li (2007) hypothesizes that internet users are socially isolated and inept. This is certainly not the case. Li also discusses demographic differences in both victims and bullies, but the evidence from other studies prove confounding to any hypothesis regarding specific demographics (Schneider et al., 2011; Slonje & Smith, 2008; Smith et al., 2008; Smith, Mahdavi, Carvalho, & Tippett, 2006). Children do not seem either savvy enough or willing enough to block these communications as they happen (Smith et al., 2008). Further, children and adolescents are not emotionally stable enough to make this type of rational decision when confronted with cyberbullying; however, they also do not seem prepared to become emotionally stable enough to deal with typical adolescent musings when they become persistent, such as rumors posted to a website.

There is a real problem with social media and cyberbullying, but we need to call it as it is: bullying. By attaching the prefix cyber- to the act, we acknowledge the sophistication needed to perpetrate this type of bullying, which might egotize the bully. Most communities respond to cyberbullying by focusing on the technology used to perpetrate the bullying; however, it is more important to focus on the motivations and the social intolerances involved in bullying in general. By losing sight of the cause and focusing on the vehicle, no one will be able to overcome this problem, which is inherent, though sometimes magnified, in normal social adjustment and development of children and adolescents. Communities that wish to address cyberbullying would do well to educate the students about social responsibility, the rights and responsibilities of civic duty, and the different levels of appropriateness of various forms of communication.

References

Li, Q. (2007). New bottle but old wine: A research of cyberbullying in schools. Computers in Human Behavior, 23(4), 1777-1791. doi:10.1016/j.chb.2005.10.005

Li, Q. (2010). Cyberbullying in high schools: A study of students’ behaviors and beliefs about this new phenomenon. Journal of Aggression, Maltreatment, and Trauma, 19(4), 372-392. doi:10.1080/10926771003788979

Schneider, S. K., O’Donnell, L., Stueve, A., & Coulter, R. W. S. (2011). Cyberbullying, school bullying, and psychological distress: A regional census of high school students. American Journal of Public Health. Advance online publication. doi:10.2105/AJPH.2011.300308

Slonje, R. & Smith, P. K. (2008). Cyberbullying: Another main type of bullying? Scandinavian Journal of Psychology, 49(2), 147–154. doi:10.1111/j.1467-9450.2007.00611.x

Smith, P. K., Mahdavi, J., Carvalho, M., Fisher, S., Russell, S., & Tippett, N. (2008). Cyberbullying: its nature and impact in secondary school pupils. Journal of Child Psychology and Psychiatry, 49(4), 376–385. doi:10.1111/j.1469-7610.2007.01846.x

Smith, P. K., Mahdavi, J., Carvalho, M., & Tippett, N. (2006, July). An investigation into cyberbullying, its forms, awareness and impact, and the relationship between age and gender in cyberbullying (Report to the Anti-Bullying Alliance, Brief No. RBX03-06). Retrieved from https://www.education.gov.uk/publications/eOrderingDownload/RBX03-06.pdf

Academia, Criminal Justice, Emergency Management, Public Health, Society

Coordinated Community Response to Special Populations

Being a victim of crime, especially a crime of a violent nature, one suddenly finds his or her self in a state of personal emergency that requires finely developed coping mechanisms in order to rationalize the situation. In addition to the need of a sound mind, a sound body is required in order to defend one’s self from harm in all but the most benign cases (Roberts & Yeager, 2009). The elderly population is characterized as having the predisposition of declining mental acuity as well as declining health and increasing frailty, as many of the elderly have disabilities related to their advanced development (Heisler, 2007). It could be stated that the elderly make for the perfect victim. However valid this statement may or may not be, it stands to reason that the elderly are at risk for being taken advantage of, at risk of injury from others, and at risk for both emotional and physical decline due to unwarranted stress (Heisler, 2007).

Elder abuse, which includes physical abuse, sexual abuse, emotional/psychological abuse, financial and material exploitation, neglect, and abandonment, “is being recognized as a … complex societal problem” (Heisler, 2007, p. 161). Heisler (2007) states that “in physical abuse cases, men are usually the abusers” (p. 169), yet it stated that men only account for 53% of the abuse, which is much closer to ‘half’ than ‘usually’, so it seems that both men and women are just as likely to abuse. The National Center on Elder Abuse (as cited in Heisler, 2007) also describes “self-neglect” as a type of abuse; however, this appears to fall under neglect and abandonment. Elder self-neglect should not be treated as a crime but should be addressed with the elder’s emotional and psychological well-being in mind.

The elderly are a vulnerable population due to their complex and specific needs and tend not to report abuse for fear of losing their support structure and further undermining their independence. According to Acierno et al. (2010), Podnieks (as cited in Heisler, 2007) and Wolf (as cited in Heisler, 2007), the one-year prevalence of elder abuse appears to fall between 4-5.6%, though the exact numbers have been difficult to quantify. It is this difficulty in identifying the abuse accurately that creates difficulty in responding to the crime. It is for this reason that every state and Washington, D.C., has enacted legislation that mandates the reporting of suspected elderly abuse by certain authorities (e.g. doctors, nurses, police, EMS, social workers, et al.).

In order to further develop coordinated community responses to elderly abuse, we must further understand the prevalence and intricacies of the abuse and its particular effects on the victims. It is imperative to bolster social support with prevention initiatives in order to address the prevalence of elder abuse in all of its forms.

References
Acierno, R., Hernandez, M. A., Amstadter, A. B., Resnick, H. S., Steve, K., Muzzy, W., & Kilpatrick, D. G. (2010). Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: The national elder mistreatment study. American Journal of Public Health, 100(2), 292-297. doi:10.2105/AJPH.2009.163089

Heisler, C. J. (2007). Elder abuse. In R. C. Davis, A. J. Lurigio, & S. Herman (Eds.), Victims of crime (3rd ed.; pp. 161-188). Thousand Oaks, CA: Sage.

Roberts, A. R. & Yeager, K. R. (2009). Pocket guide to crisis intervention. New York, NY: Oxford University Press.

Criminal Justice, Emergency Management, Politics, Society

Wall Street Bombing of 1920: Terrorism and its Victims

In my search of a terrorist act, I hoped to find an example that was both pertinent in history and applicable today. With the growing “Occupy Wall Street” movement of anarchists, communists, socialists, and other anti-capitalists focusing their attention on the “evils” of Wall Street bankers, I am reminded of a similar set of circumstances that occurred in 1920 as the same groups of anti-capitalists focused themselves on Wall Street and for much the same reason. Unfortunately, the 1920’s protest resulted in the most fatal act of terrorism on U.S. soil at the time. According to Gage (2001), Kengor (2011), and the New York Times (“Explosives,” 1920; “Havoc,” 1920), on September 16, 1920, a horse-drawn carriage was driven down Wall Street and parked in front of the offices of J. P. Morgan bank. A few minutes later, a large explosion occurred killing 38 people and injuring 400 others. The scars of this attack, attributed to Italian Galleanist anarchists, can still be seen today as pockmarks in some of the local buildings.

“It would seem at times as if the whole world is one madhouse” (as cited in Gage, 2001, para. 12). This quote from the New York Call seems to summarize terrorism as it occurs on U.S. soil. However, those who are directly affected might have a more acute perception of the ordeal. By definition, terrorism instills terror, an acute fear reaction associated with daily living, and provides for more intense and prolonged psychological effects, such as insecurity, social disruption, anger, uncertainty, and loss of control, compared to disasters of other etiologies (Roberts & Yeager, 2009). However, according to DiMaggio and Galea (2007), most of the population appears to cope appropriately after such an event. When focusing on at-risk groups that might fail to cope, the literature describes females, those with previous psychiatry, and those directly involved, whether victim or rescuer, to be more apt to progress from a lesser acute stress phase to a more significant post-traumatic stress disorder. Though DiMaggio and Galea promote these as potentially useful triage markers, they admit that “many questions remain to be answered about how best to utilize health care resources in response to terrorism” (p. 157).

As much as I wish not to consider the possibility of another bombing on Wall Street this year or next, I know that it remains a real possibility. I am encouraged in the growth of victim awareness and crisis intervention that has occurred over the last few decades that might blunt the psychological effects of another terrorist event.

References

DiMaggio, C. & Galea, S. (2007). The mental health and behavioral consequences of terrorism. In R. C. Davis, A. J. Lurigio, & S. Herman (Eds.), Victims of crime (3rd ed.; pp. 147-160). Thousand Oaks, CA: Sage.

Explosive stores all accounted for. (1920, September 17). The New York Times, pp. 1, 3. Retrieved from http://query.nytimes.com/mem/archive-free/pdf?res=9A05E5D61E31E433A25754C1A96F9C946195D6CF

Gage, B. (2001, September 17). The first Wall Street bomb. History News Service. Retrieved from http://www.hsmichigan.org/~hns/articles/2001/091701a.html

Havoc wrought in Morgan offices. (1920, September 17). The New York Times, pp. 1, 4. Retrieved from http://query.nytimes.com/mem/archive-free/pdf?res=9C05E5D61E31E433A25754C1A96F9C946195D6CF

Kengor, P. G. (2011, November 8). In 1920, U.S. saw the carnage of class warfare. USAToday. Retrieved from http://www.usatoday.com/news/opinion/forum/story/2011-11-08/occupy-wall-street-bombing/51125358/1

Roberts, A. R. & Yeager, K. R. (2009). Pocket guide to crisis intervention. New York, NY: Oxford University.

Academia, Criminal Justice, Emergency Management, Public Health, Society

Coordinated Community Response – Terrorism, Hate Crimes

In a previous paper, I describe a coordinated community response to individual crime; however, when considering terrorism and, to some degree, hate crimes, we need to understand the more comprehensive needs of effected communities more so than the individual, yet, we still need to address individual needs (Schadone, 2011). According to a U.S. Department of Justice (2000) report on responding to victim needs after a terror event, comprehensive victim assistance centers should be centralized for ease of identification and resource management. This report acknowledges victims, family, and responders as potential users of victim assistance resources.

Coordinated community response programs should also be comprehensive and modular in order to provide services during normal day-to-day operations and to be able to coordinate for larger undertakings, such as those in the wake of large-scale emergencies. The U.S. Department of Justice (2000) report recommends being mindful of victim rights and including victim services representatives in planning, ensuring timely death notifications to family of the deceased, creating centralized centers to provide information, crisis counseling, and privacy, planning for transitioning short-term mental health counseling to long-term mental health care, streamlining victim compensation programs, organizing committees to ensure that unmet needs are identified with provisions of responding to these needs are created, creating an emergency fund for immediate payment for resources or victim compensation when other directed funds are inadequate or delayed, and creating processes for recruiting and preparing volunteers to assist in response efforts.

According to Roberts and Yeager (2009), crisis intervention counselors should take some specific steps in counseling individual victims of large-scale events. Initially, triage and remove victims from the scene as soon as possible to limit exposure to the aftermath of the event, considering the breadth of possible injuries and always taking into account the potential for responders’ needs following their exposure. Next, victims should be assessed medically to ensure that all physical health needs are identified and addressed, including their level of responsiveness, both in general and in light of the recent trauma. At this phase of the response, crisis counselors could assist other responders by obtaining demographic information (i.e. name, address, phone numbers, next of kin, medical history, current medications, and allergies) of victims being prepared for treatment and transport. Talking to and reassuring victims in a general sense would also be helpful by connecting to the victim on a personal level and establishing a rapport, acknowledging the victim’s concerns, and grounding the individual while ensuring that he or she knows that he or she is now safe. Further into the response, provide directed support to victims while allowing them to express their ordeals while providing them opportunities to acknowledge the reality of the situation. Some may benefit by providing assistance to other victims while others may require lengthy counseling sessions in order to move forward.

Any coordinated community response for large-scale incidents need to focus on health and safety, mental health, financial health, and the preservation of rights during the response. These coordinated community response programs should be comprehensive and modular while both giving and receiving assistance to and from state and federal victim assistance programs that might also be effective during the immediate aftermath of the event.

References
Roberts, A. R. & Yeager, K. R. (2009). Pocket guide to crisis intervention. New York, NY: Oxford University Press.

Schadone, M. (2011, November 6). Coordinated community response to crime. Unpublished Manuscript. Walden University, Minneapolis, MN.

U.S. Department of Justice, Office of Justice Programs. (2010, October). Responding to terrorism victims: Oklahoma City and beyond. Retrieved from http://www.ojp.usdoj.gov/ ovc/publications/infores/respterrorism/welcome.html

Criminal Justice, Emergency Medical Services, Society

Coordinated Community Response to Crime

Victims, especially those that find difficulty in coping, have similar needs and concerns independent of the type of crime committed against them. Victims in need share the same litany of psychological responses to crisis, such as fright, helplessness, nervousness, insecurity, anger, et al. (Roberts & Yeager, 2009). All victims of crime could potentially benefit from community support in the form of coordinated community response teams (CCRTs; Guo, Biegel, Johnsen, & Dyches, 2001; Roberts & Yeager, 2009).

A Google Scholar search of the terms coordinated community response -domestic -violence revealed a dearth of information regarding CCRTs, aside from those dedicated to domestic violence (which yielded a large portion of the result when the Google Scholar search term was limited to coordinated community response). As I consider the possibilities of an effective CCRT dedicated to a crime other than domestic violence, which enjoys an apparent steady and potent growth in activism, I envision a CCRT that is prepared to intervene for victims of crime in general.

In many communities, today, an effort is ongoing to develop Community Emergency Response Team (CERT) programs. The aim of this effort, headed by the Federal Emergency Management Agency (FEMA), is to prepare and train a broad citizen base to help respond to and aid victims of disasters when emergency services are overwhelmed, either by a multiple-seated disaster (a disaster involving a large geographical area where emergency resources are spread thinly throughout) or a small but involved emergency such as a search and rescue mission or a building collapse. This infrastructure of trained disaster responders is prime to include training in crisis intervention for victims of crime.

As respected members of the community, the CERT would be familiar with the community as a whole and would be trustworthy. Many CERT members are local fire officials or family members of fire officials.

In order to augment disaster response services with coordinated community response in crisis intervention of crime, the team, again, would require training in crisis intervention and must establish a cadre that is ready and willing to respond more often than official CERT requirements. The cadre must prepare a list of community resources available to assist victims of crime, such as psychological and psychiatric counseling if lethality is present or indeterminable or if a general need for counseling exists (Lewis & Roberts, 2001; Roberts & Ottens, 2005; Roberts & Yeager, 2009). Other important resources to include are state victim services organizations, safe housing, legal advocacy, judicial avenues of protection, such as instructions on obtaining no contact orders from the court, press contacts to prepare organized press releases when the crime is of such a magnitude that community outreach is desired. This program with additional assistance from licensed social workers, psychologists, and psychiatrists could also benefit the community by providing traditional mobile crisis intervention services, crime notwithstanding.

Guo et al. (2001) examines the usefulness of mobile crisis intervention teams. Redundancy being a limitation in a small community, CERT provides an existing framework of trustworthy and available community members that might be willing to augment their training in order to further service their community in a time of need.

References

Guo, S., Biegel, D. E., Johnsen, J. A., & Dyches, H. (2001). Assessing the impact of community-based mobile crisis services on preventing hospitalization. Psychiatric Services, 52(2), 223-228. doi:10.1176/appi.ps.52.2.223

Lewis, S. & Roberts, A. R. (2001). Crisis assessment tools: the good, the bad, and the available. Brief Treatment and Crisis Intervention, 1(1), 17-28. doi:10.1093/brief-treatment/1.1.17

Roberts, A. R. & Ottens, A. J. (2005). The seven-stage crisis intervention model: a road map to goal attainment, problem solving, and crisis resolution. Brief Treatment and Crisis Intervention, 5(4), 329-339. doi:10.1093/brief-treatment/mhi030

Roberts, A. R. & Yeager, K. R. (2009). Pocket guide to crisis intervention. New York, NY: Oxford University Press.

Third Judicial District Conference. (1999). Characteristics of an effective coordinated community response. Retrieved from http://www.ncdsv.org/images/ CharacteristicsCCR.pdf

Academia, Emergency Management, Society

The Importance of Planning

To borrow from the motto of the Boy Scouts of America (2011), “Be prepared!” There is no possible way to fully predict with perfect accuracy when and where a crisis will develop. However, with some foresight, the adoption of a comprehensive crisis communication plan will allow an immediate response to any emergency, disaster, or other crisis that might arise. Gray (2008) discusses how JetBlue might have benefited from such a plan. JetBlue, if they had focused on developing a crisis communication plan, might have uncovered the not unlikely possibility of a major storm grounding many of its passengers. In this case, JetBlue would have been in a more proactive position to mitigate the effects such a storm might produce on passengers and their east coast operations. According to Fearn-Banks (2011), the impending storm prediction would have been a warning sign, or prodrome, that JetBlue could have responded to in order to prevent the crisis. Had JetBlue contacted the passengers prior to their arrival at the airports, they might have been able to secure better and more comfortable accommodations than the airports had to offer. Additionally, the company would have presented themselves proactively instead of taking the defensive posture noted by Gray.

In December 1984, Union Carbide, a pesticide production company, was the subject of the worst industrial accident in history. At their plant in Bhopal, India, an employee purposefully allowed water into large tanks of a chemical called methyl isocyanate (MICN) which caused a chemical reaction (according to Union Carbide management), bursting the tanks and releasing MICN gas into the environment killing more than 3,000 people (some estimates exceed 25,000 dead) and injuring 100 times that amount (Venkatasubramanian, 2011). According to Muller (2001), MICN was stored in large above ground tanks, a water valve was connected to the tanks, and employees had largely unrestricted access to these tanks and valves. When liquid MICN and water are mixed, MICN rapidly expands to a gaseous state and can quickly overwhelm holding tanks. Had Union Carbide conducted an investigation of potential crises while constructing a crisis communication plan, these circumstances might have been uncovered and considered prior to the accident, allowing company officials the opportunity to mitigate the potentially deadly situation and avoid the catastrophe in 1984. Additionally, had this crisis occurred regardless of mitigation, the company would have been poised to provide helpful instructions and recommendations to public safety officials and the public to minimize the loss of life. Union Carbide was eventually sued for billions of dollars, which it has never paid.

Another incident that might have benefited from a crisis communication plan is the Massey Energy Upper Big Branch mine explosion that occurred in West Virginia on April 5, 2010. Venkatasubramanian (2011) describes this explosion as the worst mining accident in four decades, killing 29 people. Like the Union Carbide example above, Massey Energy initially tried passing the blame to employees and single system failures, but eventually the company closed its Kentucky Freedom Energy Mine #1, and the CEO, Don Blankenship, stepped down. This after being confronted with the over 600 safety violations in 2009 and 2010. Again, the implementation of a crisis communication plan would have focused on potential accidents and allowed a window for mitigation and prevention. Upon completion of the effort, when the accident occurred, there would have been clear directives on how to proceed, which might have helped to save the company’s reputation; although, in this case, that is unclear.

Only when a company’s management realizes that safety is important and that crises do occur can they set forth means of mitigating their risk. One important way to mitigate risk is to consider that no matter the attempts at prevention, errors and failures can always occur and it is best to be prepared for the worst-case scenarios in hopes that they never do occur. By being prepared for the worst case scenarios, mainly by having drafted crisis communication plans along with incident action plans, the company representative has focus and direction on how to proceed with response efforts both publicly and internally. The benefits are appearing with a unified message of adequately responding and recovering from the crisis, and bringing a sense of strength and direction to that effort that the public, employees, and shareholders alike can appreciate and find faith. It is always best to be prepared.

References

Boy Scouts of America. (2011, March). Overview of Boy Scouts of America. Retrieved from http://www.scouting.org/About/FactSheets/OverviewofBSA.aspx

Fearn-Banks, K. (2011). Crisis communications: a casebook approach (4th ed.). New York, NY: Routledge.

Gray, S. (2008). Without crisis plan, your reputation could be at risk. Las Vegas Business Press, 25(8), 22. Retrieved from http://www.ebscohost.com/academic/regional-business-news

Muller, R. (2001). A significant toxic event: The Union Carbide pesticide plant disaster in Bhopal, India, 1984. Rural and Remote Environmental Health, 1(10). Retrieved from http://www.tropmed.org/rreh/vol1_10.htm

Venkatasubramanian, V. (2011). Systemic failures: Challenges and opportunities in risk management in complex systems. AIChE Journal, 57(1), 2-9. doi:10.1002/aic.12495

Academia, Emergency Management, Society

Defining Crisis

A crisis is any problem that has a significant impact. Most simply, a crisis is a decision-point of change, for better or worse. For example, a new father seeing his child for the first time might have a crisis of faith. A beautiful and healthy child may trigger thoughts of awe and trigger a divine revelation; whereas, a seriously ill child may bring feelings of doubt and religious contempt. In the field of crisis management, Coombs (2012) defines crisis as “the perception of an unpredictable event that threatens important expectancies of stakeholders and can seriously impact an organization’s performance and generate negative outcomes” (p. 2). In this definition, Coombs suggests that crises are both negative and unpredictable events that effect others. While I agree with the scope of the definition, as I stated above, crises do not necessarily have to be negative events, and frequently, they can be predicted. Predictable negative crises are usually caused by negligent management, such as economic crises (Berg & Pattillo, 1998; Compagnon, 2011; Feldstein, 2010; Roubini, 2010).

A crisis usually develops from a less significant issue and, if understood and contemplated, can be mitigated early (Coombs, 2012). A crisis stemming from an issue finds a causal relationship with risk. Risk can be categorized by human, systematic, and process or random (Youndt, Snell, Dean, & Lepak, 1996). Human and systematic risk can be mitigated easily; however, process risk is inherent and requires substantial process change to minimize.

The British Petroleum Deepwater Horizon event, which occurred on April 20, 2010, was said to have been fraught with risk of all three types. A New York Times article by Barstow, Rohde, and Saul (2010) describes the event and attempts to elucidate what went wrong. Initially, according to the article, there was a blowout of the Macondo Prospect well, a risk that is inherent to drilling, especially in deep water. Next, every single “formidable and redundant defenses against even the worst blowout” (para. 10) failed. This was certainly a failure of process errors (geological “bursts” causing the well blowout), systematic errors (“One emergency system alone was controlled by 30 buttons” [para. 18]), and human errors (“members of the crew hesitated and did not take the decisive steps needed. Communications fell apart, warning signs were missed and crew members in critical areas failed to coordinate a response” [para. 15]).

On a micro-organizational level (the rig), these failures are evident and allowed risk to develop into an issue, which developed into a crisis. On a macro-organizational level, however, the response seemed to be swift, but the focal response to the incident and the public relations response appeared very disjointed, which was compounded by both the media and the federal government, that is, until the U.S. Coast Guard took control. It was apparent very early that both British Petroleum and the federal government were concerned with reputation over response and recovery from the focal incident. This translated to poor support for both by the public. I believe the U.S. Coast Guard is the only managing entity involved in the response to have managed to maintain dignity throughout the effort.

Crisis management is promoted as a multifaceted approach to mitigate, alleviate, respond to, and recover from crises of different types and scope. Although there are many aspects to organizations that require attention during these efforts, it needs to be understood that some have higher priorities than others, and reputation is a culmination of all of these.

References

Barstow, D., Rohde, D., & Saul, S. (2010, December 25). Deepwater Horizon’s final hours. New York Times. Retrieved from http://www.nytimes.com/2010/12/26/us/26spill.html

Berg, A. & Pattillo, C. (1998). Are currency crises predictable: a test (Working paper #98/154). International Monetary Fund. Retrieved from http://books.google.com/

Compagnon, D. (2011). A predictable tragedy: Robert Mugabe and the collapse of Zimbabwe. Philadelphia, PA: University of Pennsylvania Press.

Coombs, W. T. (2012). Ongoing crisis communications: planning, managing, and responding (3rd ed.). Thousand Oaks, CA: Sage.

Feldstein, M. (2010, June 14). A predictable crisis: Europe’s single currency was bound to break down. The Weekly Standard, 15(37), 1-3. Retrieved from http://www.weeklystandard.com/articles/predictable-crisis

Roubini, N. (2010, May 17). All crises are predictable: Contrary to beliefs, history shows there’s nothing new in debt or inflation. Gulf News. Retrieved from http://gulfnews.com/business/features/all-crises-are-predictable-1.627708

Youndt, M. A., Snell, S. A., Dean, J. W., & Lepak, D. P. (1996). Human resources management, manufacturing strategy, and firm performance. The Academy of Management Journal, 39(4), 836-866. doi:10.2307/256714