After Action Reviews: When do you do them?

[Guest]

I was curious as to what types of incidents in your departments (or ambulance corps, I don't want to limit this to just FDs) have formal debriefs/after action reviews? Are these formal as in you'll spend the next drill talking about the incident, or more relaxed as in the officers will just mention a few things they noticed. Thanks.

[Guest]

We usually thoroughly discuss the major incidents from start to finish, and paint a whole picture from collective accounts. We then analyze, and disuss what we could have done better. This is typically done at the next drill. If there is a major incident with the potential for psychological impact we may include a Critical Incident Stress Debriefing. That's when the shrinks come and have everyone sit in a happy little circle and spill their guts. Sounds corny , but it really does help. We dont' have a set incident category for the critique, but usually for any structure fire, larger hazmat, deliberate attack or threat (chemical, explosive, etc.), and some fatal MVA's.

[firemoose827 324]

For our Ambulance:

We usually talk about each call with the Crew Chief in the ambulance on the way back from each call. If any member is taking it hard, the crew chief informs an officer and we set up a formal Stress Debriefing with our county team.

Fire Dept:

The officers have Meetings on the last monday night of every month to discuss dept business and have critiques of incidents. If there are any major points or problems we spend the following drill discussing them in a formal setting thats open to the dept also. Any Major incident is taken care of through the local County Stress Debriefing team. I have been to Two of those debriefings and find them very helpfull. If your county doesnt have it I strongly advise you to look into it. Feel free to contact me for info.

Hope this helped!

Jonesy

[ex-commish 490]

I was curious as to what types of incidents in your departments (or ambulance corps, I don't want to limit this to just FDs) have formal debriefs/after action reviews?  Are these formal as in you'll spend the next drill talking about the incident, or more relaxed as in the officers will just mention a few things they noticed.  Thanks.

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We try to discuss the incident right after we get back into the station while everything is still fresh in our minds. Problem is at times many of the members are in a rush to get back to work, home, etc so it ends up being discussed at the next meeting or drill.

Andy Mancusi

CHief

Hawthorne FD

[Guest]

I was also curious in what specific types of incidents would you consider it necessary to have a formal debrief in some deail (e.g. structure fires, HAZMAT, etc). Sorry for the lack of specificity.

[firemoose827 324]

I was also curious in what specific types of incidents would you consider it necessary to have a formal debrief in some deail (e.g. structure fires, HAZMAT, etc).  Sorry for the lack of specificity.

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Well, there could be two instances in which a debrief should be considered, at least as far as my knowledge goes. First would be any sensitive situation where the police or other agency might also be involved. Like a possible crime scene, suicide attempt, domestic disturbance with injuries, suspected child abuse, or any other sensitive situation that other agencies might need important info that only we as first responders could give them.

Second, and more obvious, would be the fatality calls. Either finding the body in a bad fire or the realy messed up EMS call. A lot of people say that that doesnt bother them, but, I think that if you are human and have feelings, it SHOULD bother you and debriefing is the best way to deal with it in a healthy manner.

Department debriefings are also good to ensure that your firefighters or EMS people are doing a good job, or following dept protocols or even NYS EMS protocols. If you debrief your people you will find out who knows what they are doing and who may need a little help at next months drill. It also allows for feedback from the members as to how your leadership is doing (or NOT doing). Used constructively and creatively debriefings could help in more ways than one. Thats why I am so happy in the dept I am in now, we debrief and discuss everything, and it helps.

Hope I didnt bore you too much!! Just trying to help. Let me know if you want info about the County STress Debriefing team, be happy to help.

[TRUCK6018 50]

In my opinion the critiquing of incidents and critical incident stress debriefing (CISD) are to similar but very different things, serve two very different purposes and should not be done together under any circumstance. I have been involved with incidents where there was both post incident critiques and a CISD meeting after the fact.

Critiques are part of training. After an incident you get everyone together and discussed what happened. The critiques I've been to were moderated by the incident commander of the incident. During the discussion you bring out not just what when wrong, but what went right! So next time we won't do what didn't work and do what did. In fact, in some preplanning text, a post incident critique is part of incident preplanning. This way written preplans can be changed if needed.

When should critiques be done? In some form, after every incident. Whether it's just an EMS crew hashing out a better way a patient could be packaged after a run or on a larger level when a formal critique is done after a large scale incident.

CISD is different than critiques because CISD meetings are not moderated by anyone that was on the incident, but by a the CISD team. The CISD meetings that I've called or have participated in resulted from a tragic (for lack of better words) loss of life. Either a MVA that involved kids (I've been to one that stemmed from a double fatality of teenagers) or some other loss of life due to extreme circumstances such as a house fire.

A CISD debriefing isn't to discuss what was done right or wrong, but to help with the psychological impact of the incident. To help anyone that was involved with the incident open up about what happened. To prevent the "What should I have done different" questions.

[Guest]

In my opinion the critiquing of incidents and critical incident stress debriefing (CISD) are to similar but very different things, serve two very different purposes and should not be done together under any circumstance. 

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Perhaps I worded that incorrectly. We do include CISD as a post incident practice if needed. However, it is not done as part of a critique. As you pointed out they are unique processes. I simply wanted to point out that if necessary post incident management may include more than a critique.

I agree that critiques are something that should be done after every incident. There is no rule that says a critique requires anything more than begging the questions...How did we do? Can we do better? and how do we accomplish that? It doesn't require an organized event for this to happen. Though for major incidents an organized discussion is helpful in keeping the team focused on development given that a large number of personnel would likely be involved.