Critical Incident Response Research Articles

Towards an Evidence-Based Critical Incidents and Suicides Response Program in Australian Construction

Fatal and non-fatal accidents and suicides at work pose a substantial threat to workers’ physical and psychological safety, particularly within the construction industry. Managing these incidents is an essential component of workplace health and safety (WHS). Additionally, a formal program to support workers and provide feedback to improve the existing WHS management system is increasingly important. However, knowledge of the factors contributing to an effective critical incident (CI) or postvention response is limited by the lack of published evidence-based interventions, especially for occupations and industries that are exposed to higher rates of fatal and non-fatal injuries due to accidents and suicides. In addition, broader concerns surrounding the effectiveness of conventional critical incident programs highlight the need to develop innovative and evidence-based critical intervention and postvention responses addressing acute stress symptoms arising from exposure. This research outlines the development of the MATES Respond Training Program, a component of the WHO-endorsed MATES in Construction program, which is a charity charged with the task of improving mental health and suicide prevention in the construction industry in Australia and New Zealand. Development of the MATES Respond Training Program was informed by the following three key sources: a rapid literature review, interviews with 11 workers trained in peer support suicide prevention interventions, and an analysis of site notes on 193 critical incident and postvention construction site attendances by MATES in Construction field officers, case managers and social workers. Insights and recommendations obtained from these sources, along with the resulting program, are discussed in this paper.

Predictors of fatal officer-involved shootings from eight municipal police agencies in the USA (2015–22)

Abstract In the USA, fatal officer-involved shootings (OIS) persist as a topic of nationwide concern. Still, due to a lack of reliable, public OIS data, research examining the predictors of these incidents is limited. The current project utilizes OIS data submitted to the Police Data Initiative (PDI) from eight large, municipal police agencies in the USA to assess trends and characteristics of OIS (fatal and nonfatal) occurring between 2015 and 2022. Using a logistic regression model, this analysis explores officer characteristics, civilian characteristics, and situational characteristics as predictors of the lethality of OIS incidents within these eight US jurisdictions. Results suggest three characteristics were significant predictors of fatal OIS, including the number of officers involved in the OIS, the officer’s years of experience, and the civilian’s age. Based on these findings, evidence-based strategies for fatal OIS prevention, critical incident response, and OIS data availability are discussed and future directions for research are explored.

Access, Engagement, and Experiences with Critical Incident Response Resources in Athletic Training

Purpose: Experiencing an event that involves actual or threatened death or serious injury is a critical incident and produces serious emotional responses. Athletic trainers (ATs) experience critical incidents in their day-to-day work. The purpose of this study was to explore how ATs experience a critical incident during the course of clinical practice. Methods: We used one-on-one, web-based, semi-structured interviewing with a criterion sample of ATs who experienced a critical incident and used any critical incident response resources in the last year (n=17; age=32±8; years of experience=9±7; years in current position=4±5). We used a 3-person team with a multi-phase process to identify the emerging domains and categories. Results: Two emergent domains were identified from the study. External support referenced multiple personnel resources available after a critical incident occurred, specifically, trained mental health professionals, untrained personnel, and trusted colleagues/coworkers. Coping with the emotional response included debriefing, spirituality, and complementary mental health strategies. Conclusion: In preparation for critical incidents, emergency action planning and after-action planning for healthcare delivery and the emotional response are both essential. Many ATs do not have the formal training, but continuing education courses, community-based mental health resources, and the promotion of professional organization resources can assist ATs in critical incident management.

Prepare all‐hazards approach for handling emergencies during athletics events

Whether you call them critical incident response or emergency action plans, your department must prepare to address all types of catastrophic injuries involving multiple casualties caused by natural and man‐made incidents, from active shooters to bombings and earthquakes to fires. An all‐hazards approach can reduce risk and liability in most situations.

Protect Our Kids: a novel program bringing hemorrhage control to schools

BackgroundFollowing the shooting at Sandy Hook Elementary School, the Hartford Consensus produced the Stop the Bleed program to train bystanders in hemorrhage control. In our region, the police bureau delivers critical incident training to public schools, offering instruction in responding to violent or dangerous situations. Until now, widespread training in hemorrhage control has been lacking. Our group developed, implemented and evaluated a novel program integrating hemorrhage control into critical incident training for school staff in order to blunt the impact of mass casualty events on children.MethodsThe staff of 25 elementary and middle schools attended a 90-minute course incorporating Stop the Bleed into the critical incident training curriculum, delivered on-site by police officers, nurses and doctors over a three-day period. The joint program was named Protect Our Kids. At the conclusion of the course, hemorrhage control kits and educational materials were provided and a four-question survey to assess the quality of training using a ten-point Likert scale was completed by participants and trainers.ResultsOne thousand eighteen educators underwent training. A majority were teachers (78.2%), followed by para-educators (5.8%), counselors (4.4%) and principals (2%). Widely covered by local and state media, the Protect Our Kids program was rated as excellent and effective by a majority of trainees and all trainers rated the program as excellent.ConclusionsThrough collaboration between trauma centers, police and school systems, a large-scale training program for hemorrhage control and critical incident response can be effectively delivered to schools.

Prepare all‐hazards approach for handling emergencies

Whether you call them critical incident response or emergency action plans, your athletics department must prepare to address all types of catastrophic injuries involving multiple casualties caused by natural and man‐made incidents, from active shooters to bombings and earthquakes to fires. An all‐hazards approach can reduce risk and liability in most situations. To help your department prepare, follow these eight steps recommended by Ray Castle, Ph.D., LAT, ATC, NREMT, Program Director for Athletic Training at Louisiana State University, during a recent virtual presentation hosted by the National Athletic Trainers’ Association:

Towards a co-ordinated framework for critical incident response in school communities: A review of current evidence

Aims:This paper synthesises current evidence from trauma studies with a model emerging from a recent large-scale study of the responses of educational psychologists to critical incidents (CIs). It explores how evidence in providing psychological support in the immediate period after a traumatic event can be applied within a framework for consultation to organise and co-ordinate multi-agency support for individuals and school communities.Rationale:Recent large-scale traumatic events affecting schools and wider communities such as the Grenfell Tower fire in 2017 have highlighted the need for co-ordinated support for schools from various agencies following traumatic events. This paper distils evidence-based principles from relevant studies relating to immediate post-trauma support in helping the school system to remain functioning and maximising the wellbeing of members of the school community following a CI.Findings:A consultation model (COPE) is proposed as a framework for professionals supporting school communities in the immediate period after a CI that employs the five evidence-based principles. Suggestions are also made about longer-term support for schools following traumatic events.Limitations:The heterogeneity of traumatic events, school contexts, definitions of CIs and the available wider support for schools is acknowledged as a feature of CI work, limiting the applicability of any framework. Opportunities and constraints that arise from synthesising different theoretical approaches to trauma are also discussed, including tensions between mental health and wellbeing perspectives.Conclusions:The paper highlights the need for a co-ordinated professional response in supporting schools after traumatic events that makes use of evidence-based principles within a consultation framework. In the context of increased mental health support in schools, the need to ensure that a range of professionals with different perspectives work together to support the mental health and well-being of school communities in the immediate period after a CI is highlighted.

I’ve got an idea! Exploring the antecedents of suggestion sharing in consumer services

PurposeCustomer suggestions offer valuable insights to companies, and suggestion sharing is a form of engagement that strengthens customers’ relationships with firms. Yet research to date has neglected to explicitly study the antecedents of direct-to-firm consumer suggestion sharing or to adequately characterize the behavior. This paper aims to address this deficiency.Design/methodology/approachThe research draws on two surveys using three different elicitation techniques – critical incident, direct reporting and scenario response. Inductive content analysis of consumer responses is used to derive exploratory insights regarding the range of factors that motivate and inhibit consumer suggestion sharing, with an emphasis on consumer service-related contexts.FindingsPotential self, other and firm benefits motivate suggestion sharing, whereas a host of factors, including the effort involved, a lack of perceived firm efficacy and unpleasant sharing contexts inhibit it. The findings reveal a rich portrait of antecedents that illustrates how direct-to-firm suggestion-sharing behavior combines elements of customer citizenship behavior, customer complaint behavior and online community idea sharing.Research limitations/implicationsThe research relies upon reporting by US students and consumers.Practical implicationsService firms hoping to avail themselves of customers’ desire to contribute to their and their customers’ betterment must understand and manage the tripartite nature of consumer suggestion sharing evinced by the antecedents revealed.Originality/valueTo the best of the author’s knowledge, this research offers the first description of the range of factors that motivate and inhibit direct-to-firm consumer suggestion sharing. As such, it provides a theoretical foundation upon which future consumer suggestion-sharing research can build.

Suicide Prevention in U.S. Law Enforcement Agencies: a National Survey of Current Practices

Increasing attention is being paid to suicide among law enforcement officers, and how the agencies that employ these officers could prevent such deaths. This study presents the results of a national survey of U.S. law enforcement agencies’ strategies for preventing officer suicide. We invited 177 agencies from across the United States to be interviewed, and 110 agreed to participate in qualitative interviews. Agencies were grouped into one of four categories based on the services they offered. Agencies offered minimal (a municipal employee assistance program), basic (mental health, critical incident response procedures, and training), proactive (in-house mental health care, embedded chaplains, substance misuse programs, peer support, screening, or health and wellness programs), and integrated services (integration of services into day-to-day operations). The results indicate that many U.S. law enforcement agencies are engaged in efforts to promote officer wellness and prevent suicide. Officers’ perceptions of confidentiality may inhibit the use of in-house or contracted mental health services, while a weak or inconclusive evidence-base raises questions about common approaches like peer support or critical incident stress debriefing.

Telehealth Intensive Care Unit Nurse Surveillance of Sepsis.

The purpose of this article is to describe the usability and human factors engineering standards used in development of a sepsis alert known as the sepsis prompt. Sensory processing, cognitive processing, signal detection, criterion response, and user satisfaction were evaluated with controlled user testing and critical incident response techniques. Nurses reported that the sepsis prompt was visible and distinct, making it easily detectable. The prompt provided a clear response mechanism and adequately balanced the number of false alerts with the likelihood of misses. Designers were able to use a mental model approach as they designed the prompt because the nurses were already using a manual sepsis detection process. This may have predisposed the nurses to response bias, and as such, they were willing to accommodate more false alarms than nurses who are not familiar with sepsis screening (surveillance). Nurses not currently screening for sepsis may not place the same value on this alert and find it an annoyance. The sepsis prompt met usability standards, and the nurses reported that it improved efficiency over the manual screening method.

Exploring the development of critical incident response teams

Critical incidents, such as human or natural disasters, can have profound effects upon children and young people, and upon the adults who work with and care for them. Educational psychologists have contributed to and led the development of critical incident response teams to support those affected. This study sought to develop understanding of the inception, development, and maintenance of such teams. Sixteen team members, 14 of whom were educational psychologists, across seven critical incident response teams were interviewed. Findings revealed instrumental factors relating to the context of the team development and operations, to the personnel, and to the developed processes.

Organizational Outcomes Following Traumatic Workplace Incidents: A Practice-Based Exploration of Impact of Incident Severity Level

Traumatic workplace events (critical incidents) occur with unfortunate regularity and with significant repercussions for affected organizations. Critical incident stress management (CISM) units, often a specialty component of employee assistance programs, provide consultation and support for workplace incidents. While CISM seeks to support both individual and organizational outcomes, trauma research oriented toward individual traumatic stress dominates the literature, mirroring practitioner training that tends to emphasize clinical over organizational practice. This research contributes to less-prevalent studies that explore organizational-level outcomes. Despite the facts that social workers play a central role in critical incident response and CISM units collect massive amounts of practice data, there are no published social work studies capitalizing on the potential of existing critical incident data. Employing the methodology of clinical data mining, this practice-based, exploratory research examines the propositions that incident severity level associates with several post-incident organizational outcomes. Several findings translate into considerations for evidence-informed CISM practice in the areas of intake assessment, organizational consultation, and incident response planning.

Skin bank development and critical incident response

The Donor Tissue Bank of Victoria (DTBV), situated in Melbourne, Australia developed a skin banking program in 1994. It remains Australia's only operational skin bank, processing cryopreserved human cadaveric skin for the treatment of burns. The demand for allograft skin in Australia has steadily increased since the development of the program. The bank has been involved in the provision of skin for a number of critical incidences or disasters both in Australia and overseas. Demand always exceeds supply, and in the absence of other local skin banks, the DTBV has needed to develop strategies to enable increased provision of allograft skin nationally.

The Business Case for Workplace Critical Incident Response: A Literature Review and Some Employer Examples

This article reviews the research literature on the business value that can be achieved when employers and organizations offer critical incident response (CIR) services. CIR services are frequently provided as requested by corporations, insurers, and as a specialty service from Employee Assistance Programs (EAPs). There is a significant body of applied research conducted over the past 20 years worldwide that offers considerable empirical evidence to support the clinical effectiveness of CIR and related “psychological first aid” kinds of workplace services. In contrast, there are far fewer research studies available to examine the business case for CIR. A search of the literature obtained a small number of employer case studies conducted in the 1990s and several newer investigations of CIR services that are integrated with other behavioral health and benefit management programs. The research available indicates that CIR services can offer financial savings and business value, primarily from reducing disability and workers' compensation claims and improving the rate and success of employee return to work after a critical event. Six employers' case studies are presented. Although the available evidence is promising, the rare event nature of the conditions that create the need for CIR services and their delivery in applied settings combine to offer significant challenges to conducting scientific investigations of the business impact of these services. More high-quality research is needed before firm conclusions can be drawn about the nature of business outcomes in this area.

Critical incident preparedness and response on post-secondary campuses

Campus-based critical incidents received renewed focus in the aftermath of the Virginia Tech and Northern Illinois University shootings. Legislative bodies, task forces, and professional associations sought to provide campus public safety departments with a range of recommended strategies to prevent and mitigate accidental and intentional critical events. Using data from a national sample of colleges and universities, this study examined the status of critical incident preparedness and response in the spring of 2008. Results indicated a solid base of prevention and response capacity; at the same time, respondents highlighted areas lagging behind recommended practices and barriers limiting achieved changes.

Australian Legal Guidelines for Forensic Engineering Experts

SummaryThis article will guide the forensic engineering expert through all aspects of an engineering dispute in Australia. This includes investigations into the failure or non-operation of materials, products, structures or components; assisting the client and their legal teams in identifying the root cause of the failure or non-operation; and issues to consider when giving evidence to a tribunal as to the cause and potential repair or replacement options. The first part of this article provides guidance to an expert engaged as an independent expert or a “clean expert”, and the second part provides guidance to an expert engaged as an expert consultant or a “dirty expert” in relation to their role in the critical incident response through to the hearing of the dispute.

Developing Workplace Resilience

Critical Incident Stress Management (CISM) is offered by many EAP companies to assist employees deal with their emotional response to a critical event. Some organizations utilize employees in this process while others focus on the work of the mental health professional. A current model (Justice Institute of British Columbia) for CISM utilizes both mental health professionals and peers in CISM response and this is the model utilized by Family Services EAP within Canada Post Corporation Pacific Region. The use of employees (peer diffusers) in critical incident response has its locus within the fire, police, and ambulance services (Mitchell, 1988) and is well established within these groups as a requirement of the CISM process. The focus of this study was to develop a system of intervention utilizing peer diffusers to assist the employees of Canada Post Corporation Pacific Region who experience emotional trauma due to a significant or traumatic event. The results of this applied research exhibited the value of peer diffuser intervention in the quick emotional recovery of employees. It also met our primary purpose of demonstrating validity for the involvement of peer diffusers in this workplace. An unexpected result was how the peer diffusers reduced lost employee time, were able to transfer skills to other employee workplace issues enhancing employee resilience and how their involvement in the workplace improved organizational culture and workplace health.

Design principles for critical incident response systems

The national incident management system (NIMS) was developed so that responders from different jurisdictions and disciplines could work together to respond to natural and manmade disasters and emergencies, including acts of terrorism. The NIMS document provides a set of guidelines about practices but it does not make explicit the design requirements for information systems to support the management of critical incidents. Though there are academic and practitioner papers in the general area of emergency management, there is a lacuna of literature discussing how to design information systems to support critical incident response. In this paper we develop a set of design principles that are grounded in emergency management concepts and also in the insights from the real response managers in the Western New York area. The set of design principles provide a foundation for the development of critical incident response systems.

University of Arizona Life and Work Connections

SUMMARY The concept of integration has emerged in recent years as a strategy considered by providers of employee assistance, wellness and work-life services to meet the changing needs of the organizations they serve. There continues to be much discussion, however, about what exactly integration is, and how to do it. Beginning with a definition of integration, this article seeks to contribute to the discussion by describing the University of Arizona (UA) Life and Work Connections, a program that was conceived from its development to be an integrated service model. The theoretical and philosophical backgrounds of the program are presented and translated into the UA Life and Work Connections model. Advantages of the model and challenges to integration are discussed, and a detailed case study of a critical incident response is presented.

Responding in Times of Crisis— An Exploratory Study of Employer Requests for Critical Incident Response Services

Summary Increasingly, employers play an active role in assisting their employees in dealing with crisis. This exploratory study conducted analyses using a large national database to examine how companies representing various industry types differed in the frequency of requests for critical incident response services, the types of incidents that evoked the requests, the types of interventions utilized, and the delay time between the request and provision of services. Results demonstrated substantial variability in the types of incidents and frequency of service utilization. However, some consistent patterns were noted. For example, over half of all critical incident response services across industry types were delivered in response to a death impacting the workforce. A different pattern was evident for the Finance/Insurance/Real Estate industry, where robberies were most prevalent and the delay time between the incident and the critical incident response delivery date was shortest. There appeared to be an inverse relationship between the size of the company and the use of critical incident response services. This study has implications for further research regarding the training of practitioners administering critical incident response services and determining themost effective crisis interventions for the situation and recipient population.