By Sarah Saunders, Telecommunicator, Grays Harbor E-911, IPSA Member

Sleeping is one of the most important aspects of health and self-care. Sleep can be elusive under the best conditions, and when you add in shiftwork, stress, and life in general, it can be even harder to find.

It can be difficult to get sleep while the sun is out. These tips will help if you are new to shiftwork, new to the night shift, or need a reminder on how to thrive on shiftwork. Follow these simple tricks to help you live your best nightshift life with ease. 

1. Leave the communications center lights on. It can be difficult to leave the lights on when it is dark outside and you are surrounded by computer screens, but the lights help trick your body into thinking it is daytime and time to be awake. For best results, avoid turning your communications center into a bat cave.
2. Limit the changes to your new sleep routine. It is easier on your body if you are able to keep your sleep schedule throughout your nightshift rotation, even on your days off. The less major, frequent changes to your sleep pattern, the better your body will adapt to night shift, allowing you to get better sleep.
3. Darken your rooms at home. Invest in good blackout curtains or blinds to limit the sunshine from coming in your room and allow you to sleep in darkness. The dark room lets your body know that it is time to sleep and will allow you to wake up feeling refreshed and ready to tackle your night shift.
4. Be consistent. This is important, and unexpected overtime or call-ins can be tricky, but make the effort to go to bed and wake up at the same time every day. This is the best way to sleep well and stay healthy and happy.
5. Take what you can get. Any sleep counts. Any sleep you can get is better than no sleep at all. This means even if you are able to catch an hour when you get home from your shift, a two-hour nap in the middle of the day, and an hour before you go to work, take it. Fragmented and interrupted sleep is better than no sleep at all.
6. Turn off your electronic devices. You spend your days surrounded by multiple computer screens. Give your eyes and brain a break from electronics. For the best sleep, avoid looking at television, computer and phone screens, for at least one-hour before you go to bed.
7. Step away from the caffeine. Dispatchers and caffeine seem to go hand in hand, but if you are already struggling to sleep on nightshift, your favorite dose of energy may be hurting you. The effects of caffeine can last up to twelve hours. If you are struggling to sleep during the daylight hours, avoid or limit caffeine while your body adjusts to your new hours.
8. Shout it out. Finally, if you are working a new shift and changing your normal hours, make sure you tell your friends and family. You might even consider a sign for your door asking your delivery drivers or neighbors to not disturb you by knocking or ringing your doorbell. This will help you avoid distractions and interruptions while you should be sleeping.

Nightshift, especially in the communications center, can be tough. When you follow these simple tips, you should find sleeping will become easier and you will become better rested over time. To learn more, check out this information about nightshifts.

About the Author

Sarah Saunders first sat behind a dispatch console at thirteen years old and has been dispatching full-time since 2001. Throughout her career, she has worked in multiple roles in Arizona and Washington, including dispatcher, trainer, supervisor, training coordinator, tactical dispatch team supervisor, certified instructor, systems security officer and CISM team member. One of the recurring issues that she had to address, regardless of my role, was getting adequate sleep. If you have any tips to share or want to provide feedback, email me at improvethroughkindness@gmail.com.

By Gregory L. Walterhouse, Associate Teaching Professor, Bowling Green State University, IPSA Member

After allegedly failing to include persons with disabilities in emergency response plans, or having deficient plans for equal access to emergency services by disabled persons, a number of public entities have been sued. The basis for most of the lawsuits were alleged violations of the Americans with Disabilities Act of 1990 and section 504 of the Rehabilitation Act of 1973.

In short, under section 504 of the Rehabilitation Act, it is unlawful to deny any person, based on disability, who is otherwise qualified, access to benefits from any program or activity receiving federal financial assistance. While identifying and accounting for people with disabilities within a community can present challenges, it is not a valid reason for not including the disabled in emergency response plans. The following cases provide insight on how to develop emergency plans that are inclusive of disabled persons.

New York City

Plaintiffs brought a class action lawsuit against the City of New York for failing to address the needs of people with disabilities in the City’s planning and response to various emergencies including Hurricane Sandy.

The court found that the City violated the Americans with Disabilities Act (ADA), the Rehabilitation Act, and the New York City Human Rights Law by failing to provide people with disabilities meaningful access to the City emergency preparedness program.

Specifically, the City’s evacuation plans did not accommodate the needs of people with disabilities with respect to evacuation from high-rise buildings.

Second, the City’s plan did not provide for accessible transportation for disable persons.

Third, the City’s shelter plan did not provide for architectural or programmatic accessibility to accommodate the disabled.

Fourth, the City had no provisions in their emergency plan to ensure persons with disabilities who were unable to leave their buildings were able to access City services after occurrence of a disaster.

Fifth, the City did not provide for accessible communications at after-disaster resource distribution sites.

Finally, the City lacked sufficient plans to provide people with disabilities information on the existence and location of accessible services in an emergency.

City and County of Los Angeles

The City and County of Los Angeles were also defendants in a similar class action lawsuit that was resolved by settlement agreement without trial. The settlement agreement is 167 pages in length and without going into the minute details of the agreement, Appendix B, Workplan Elements, provides a good summary of the main areas of focus for the settlement agreement and main deliverables.

First, under the mass care heading is developing a mass care and shelter annex in the overall emergency plan and maintaining a list of shelter sites in unincorporated areas of the county. 

Second, building a network of stakeholders, establishing and maintaining contact with key stakeholders and planning and conducting workshops and conferences.

Third, under community education is the completion of a Specific Needs Awareness Planning (SNAP) strategic plan, increasing SNAP registration, increasing SNAP operability, and supporting evacuation planning using SNAP.

Fourth under communications is conducting a systems assessment and formulating recommendations and providing forums or workshops.

Fifth, is to make a reasonable effort to conduct, participate in and provide guidance on inclusive drills and exercises.

Sixth, is to develop a recovery plan annex and conduct training. Seventh is to update the current Access and Functional Needs (AFN) annex.

Beyond major cities

Named in a lawsuit among other defendants was Township of Warren New Jersey, with a 2010 U.S. Census population of 15,311 for allegedly failing to provide Mr. Smith who suffered from a disability, with equal access to emergency services that were available to non-disabled persons before, during and after Super Storm Sandy.

In Shirey v. City of Alexandria School Board, the parents of a student filed a complaint in federal court alleging defects in the school’s emergency plans with regard to evacuations of students with disabilities during bomb threats and fire drills. 

Guidance by the U.S. Department of Justice

In addition to the New York and Los Angeles cases, the publication Making Community Emergency Preparedness and Response Programs Accessible to People with Disabilities published by the U.S. Department of Justice provides guidance for local governments, which includes the following. Provide notification systems to inform persons who are deaf or hard of hearing of impending disasters.

These could include teletypewriter messages (TTY), text messages, email, and direct door-to-door contact and open captioning on local television. Provide plans for persons with mobility, vision, hearing deficits, mental illness, cognitive and other disabilities to safely self-evacuate or evacuate with the assistance of others. Evacuation planning includes identifying accessible modes of transportation including mass-transit and school buses. Develop and maintain a confidential registry of persons who need assistance with evacuation and publicize the availability of the registry.

Review community shelters for accessibility including parking lots, exterior and interior routes, entrances, toilet rooms and any other potential barriers to accessibility.  

Plan to staff shelters with persons who can attend to the special needs of disabled persons and can accommodate service animals. As many shelters as possible should be equipped with emergency standby generators and refrigerators to accommodate life-sustaining medical devices and preserving medications that require refrigeration.

In addition, shelter staff needs training on alternate forms of communication including exchanging written notes, posting written announcements, reading printed material to persons who are blind or have vision deficit, and providing staff proficient in sign language.

Summary

While the guidance provided by these lawsuits and the DOJ are not all-inclusive, they provide a solid foundation for the development of emergency response plans that include the needs of persons with disabilities. Emergency response plan development must include input from all stakeholders and be customized based on local needs of disabled persons.

About the Author

Greg Walterhouse is an Associate Teaching Professor in the Fire Administration and Masters in Public Administration programs at Bowling Green State University. He received a Bachelor of Science degree in Management from Oakland University, a Master’s degree in Legal Studies from the University of Illinois and a Master’s degree in Management from Central Michigan University, and a Specialist Degree in Educational Leadership from Bowling Green State University. Before joining BGSU, Greg had over 35 years experience in various aspects of public safety with 18 years in upper management. The author may be contacted at waltegl@bgsu.edu.

By Christopher Cruz, Cybersecurity Program Manager, Commonwealth of Virginia, IPSA Member

There is a commonly held belief among cybersecurity experts that cyber-attacks are inevitable. "Things go wrong. You can't explain it, you can't predict it." These words weren't from a seasoned cybersecurity expert though, or a veteran network administrator. Instead, this quote originates from the hit 1997 movie “Twister” starring Bill Paxton and Helen Hunt.

This sentiment is important for two reasons. First, cyber incidents are increasing in both severity and sophistication. They are also occurring with a greater emphasis on public and private sector entities that represent community lifelines or national critical functions, both of which are core to public health and safety. Second, there is immense opportunity to leverage many of the core concepts from emergency management to make cyber more accessible for emergency managers and public safety personnel and enable delivery of a Whole Community approach to cybersecurity.

Cyber as a hazard

While there are several emergency scenarios available for comparison, the best parallels are drawn when thinking about cyber as a hazard much the way one would a tornado.

Just like a tornado, cyber incidents are hard to predict and can arise suddenly with little or no warning. They can have significant impacts that are extremely localized or more widespread. And, though most tornados occur between March and August, they can strike year-round if the conditions allow.

This distinction of cyber as a hazard can help circumvent a common belief that cybersecurity is not a public safety or emergency management problem. Nearly all modern agencies have adopted the all-hazards concept for public safety practices, and cyber threats can easily fit into this approach. Similarly, most emergency managers are able to engage in response and recovery work for any number of hazards that they aren't necessarily experts on. This means cyber incidents can still be supported using the same all-hazards management efforts that work for fires, floods, and even tornados.

Framework alignment

Many emergency management agencies utilize the five phases, or missions, of emergency management. These are prevention, mitigation, preparedness, response and recovery.

Comparatively, one of the most used cybersecurity concepts is the Cybersecurity Framework (CSF) established by the National Institute for Standards and Technology (NIST). The NIST CSF utilizes 5 core functions, these are categorized as identify, protect, detect, respond, and recover. For both the emergency management cycle and the NIST CSF, the 5 parts represent the same concept, which is delivering the core components of a holistic and successful program. Both operate not just as pillars, but as cyclical processes with continuous feedback and development.

When laid side-by-side, it becomes clear that cybersecurity and emergency management are following the same key steps, essentially dancing to the same song. Recognition of this alignment makes it easy to establish a common operating picture that enhances incident management for hybrid events, those incidents that have both a cyber component and a physical downstream impact. The most recent string of cyber incidents in the U.S. media included a number of these hybrid events, including Colonial Pipeline, Massachusetts Steamship Authority and JBS. Just as a tornado can be a short and devastating event requiring long term recovery efforts, so should one expect to see more cyber incidents that create longer lasting cascading failures in the physical world.

Whole Community approach

For both cybersecurity and public safety, preparedness is critical. The Whole Community approach was developed by FEMA to address the increasing scale and severity of disasters, and the systemic threats they create. Cyber incidents are equally growing in scale and sophistication, with greater threats and vulnerabilities being discovered year after year.

The Whole Community approach recognizes that emergencies will continue to scale beyond the capabilities of a government-centric program. In response, emergency management must deliver a community-driven effort that includes shared understanding, greater empowerment, social infrastructure, mutual assistance, collective preparedness, and enhanced resilience where responsibility is distributed across residents, communities, emergency personnel, organizational leaders and government officials.

Cybersecurity experts have pushed for more awareness and ownership at the community level, but no significant frameworks have been successful. By integrating cyber into public safety and emergency management, the ability to utilize years of local and regional community engagement and mutual assistance becomes widely available in establishing and enhancing cyber incident response.

Hollywood parallel

The most memorable scene from the movie “Twister” is certainly that of the cow floating by in the funnel cloud. If you see the cow, it's likely too late to engage in planning and preparedness activities. Likewise, it may be too late to build a relationship between cybersecurity and emergency management entities when in the middle of a complex hybrid incident. Planning processes that incorporate cybersecurity considerations from the onset will enable better response efforts when a cyber incident does finally occur.

Please, don't wait for the cow.

About the Author

Christopher Cruz is the Cybersecurity Program Manager for the Virginia Department of Emergency Management, assigned to the Secretary's Office of Public Safety and Homeland Security in the Commonwealth of Virginia. In this role, Christopher is responsible for the coordination, development, and integration of cybersecurity capabilities across the public safety and homeland security landscape. Previously, Christopher worked for several Fortune 500 companies leading a variety of security projects focused on insider threat, incident response, critical data protection, and IT risk management practices.

By Sarah Guenette, Learning & Development Manager, Calgary Community Standards, IPSA Mental Health & Wellness Committee Member

Because of the pandemic, burnout is now felt on a global scale. There is no doubt that the world is facing a common burnout from coronavirus restrictions. Burnout, though, is not a new phenomenon created by this public health crisis.

This article focuses on burnout in the workplace and what agencies and individuals can do to take meaningful steps to combat its effects.

What is burnout?

Burnout has been officially recognized by the World Health Organization as an “occupational phenomenon”: “Burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:

1. Feelings of energy depletion or exhaustion;
2. Increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and
3. Reduced professional efficacy.”

Burnout occurs in several professions, including healthcare and public safety.

In addition to the other occupational hazards specific to emergency services, burnout is something that can affect a first responder’s work life and home life. It is a condition that can creep up on people unnoticed. It is something that continues to add to cumulative stress already experienced by first responders.

Burnout is caused by the long-term presence of cortisol in the body. While cortisol is beneficial to have in emergency situations, over time it can deplete the body’s energy reserves as the body and brain never can rest.

The causes of burnout are varied, but it is often created by chronic workplace stress that has not been appropriately managed. This could be related to heavy workload, lack of breaks or time off and short staffing. In the first responder environment this is exacerbated by a shift work schedule and exposure to traumatic incidents.

Measuring burnout

In a 2020 paper on the emotional effects of vicarious trauma on 9-1-1 dispatchers, the author cited a study done in the Los Angeles Police Department 9-1-1 Center. It was found that 43 percent of the participants were experiencing high levels of burnout. Interestingly, this was cited as being far higher than other frontline professions.

To complete this study and others on the occurrence of burnout, researchers use the Maslach Burnout Inventory (MBI). Through a series of questions they rate participants on a scale of emotional exhaustion, depersonalization and reduced personal accomplishment. This tool is used to measure employee perceptions of their workplace and associated stressors. Once the degree of burnout is determined there is a further measure to assess what is contributing to the burnout: Workload, Control, Reward, Community, Fairness and Values. 

In the case of 9-1-1 dispatchers an “overall feeling of being misunderstood and underappreciated” was found to be prevalent. There was also a higher perceived lack of control in that profession that contributed to both burnout and vicarious trauma.

Symptoms

According to experts, common symptoms of burnout are:

What agencies can do

There are things that agencies can do to mitigate burnout in first responders. Exposure to stress and trauma are inseparably linked to the role of first responder. However, even in this fast paced, adrenaline driven environment there are some things that can be done to reduce the impact of burnout.

Take breaks: Leaders need to promote an environment within their teams where it is acceptable to take breaks as needed. They can model this by taking breaks themselves and by letting employees see them taking this step for their own health. It quickly has a negative cascade effect on a team if the leader promotes the notion that you should work non-stop and needing a break is a sign of weakness, laziness or lack of dedication. Leaders need to promote a health work environment by encouraging breaks/breathers when operational workload allows for it.

Sick leave: Agency leaders also need to work on reducing the stigma related to taking sick leave. Taking sick leave can sometimes be perceived as laziness or weakness. Agencies should be encouraging people to take time off when they need it. One survey showed that 84 percent of respondents have gone into work when they are sick. 33 percent of the respondents said that their employer created a culture of working when you’re sick. This may be exacerbated in a first responder environment by a perception of being perpetually short staffed and teammates having to pick up the slack created by the absence.

Vacation leave: Taking vacation time should also be promoted by leadership. Employees should be encouraged to take paid time off wherever possible rather than banking it out. The lure of the extra income may be tempting, especially to junior members of an agency, but the time away from the job is much more important.

Team building, support programs: In addition to modelling healthy behavior and promoting time off as needed, agencies can also offer support to assist with some of the factors that contribute to burn out. Programs like health and fitness challenges can promote a healthy lifestyle while leading to some friendly competition and team building. A robust peer support program and employee assistance program provides employees with somewhere to go to discuss their stressors and access resources.

In the case of the 9-1-1 dispatch profession mindfulness training was recommended as a way to increase their perceived control over their work role. Even though they can’t control what calls come in, they can control the influence that those events have on them through mindfulness techniques.

What individuals can do

As individuals, first responders can take positive steps to mitigate the stress factors that may lead to burnout in their lives:

About the Author

Sarah Guenette, M.A., is the Learning & Development Manager for Calgary Community Standards. She oversees recruit training and continuing education for 9-1-1 call evaluators, bylaw and animal officers, business licensing inspectors, livery inspectors and animal shelter services employees. Sarah has a background in 9-1-1 and was a call evaluator, dispatcher and operations manager for over 10 years. She has overseen the Psychological Health and Safety portfolio and the Peer Support team for Calgary Community Standards since 2013. She is passionate about creating and maintaining a healthy workplace for employees. Sarah is also the proud wife of a Calgary Police Service Officer.

By Gregory L. Walterhouse, Associate Teaching Professor, Bowling Green State University, IPSA Board Member

Over the past year there have been calls for rethinking and reimagining policing in the United States. There have been calls for defunding thus de-staffing of law enforcement agencies, decriminalization of various offenses and completely abolishing police departments.

Unintended outcomes in law enforcement are often associated with human error, which is inevitable and is the difference between a desired or planned state and actual state. Since human error will occur countermeasures are necessary and Crew Resource Management (CRM) can provide such a countermeasure by helping to avoid errors, trapping errors when they do occur and mitigating the consequences of errors that are not trapped. 

What is CRM?

In short, CRM is a decision-making model for high-risk situations. CRM is a management system using all means available including equipment and personnel to improve safety.

• The first step is to recognize that a problem exists.
• Second, is to define the problem.
• Third, identify possible solutions to the problem.
• Fourth, take appropriate action to implement a solution.

The overarching goal of CRM is to identify human error and make necessary corrections before the error results in an accident. Some of the skills associated with CRM include coordinated two-way communication, decision-making, shared situational awareness, workload management, leadership and teamwork. The objective of CRM is to improve safety through training to optimize performance and the use of the team concept.

History

Due to increasing commercial aircraft complexity, and the rising number of accidents, most the result of human error, CRM was developed in 1980 in the airline industry. CRM was initially designed for flight crews, but eventually included flight attendants and air traffic controllers. At least one study found that joint CRM training sessions comprising both flight attendants and pilots together, increased positive teamwork behaviors, and broke down communication barriers in finding solutions to in-flight emergency scenarios. CRM has since been used in a number of industries including in maritime, railroads, health care including surgical and anesthesiology teams, the military, helicopter air ambulance operations, dentistry, pharmacy and firefighting.

Does CRM work?

As to the efficacy of CRM, one study found that in the health care industry, CRM resulted in a return on investment of between $9.1 and $24.4 million from avoidable patient safety events.

Another study found that surgical outcomes and safety culture improved after CRM was implemented in a pediatric surgical department. After CRM was implement in a hospital intensive care unit, a three year study found a significant reduction in serious complications and lower mortality in critically ill patients.

An additional study from health care found that CRM training of trauma resuscitation staff, resulted in improved behavior and communication, resulting in enhanced patient safety and by inference reduction of errors.

The United States Coast Guard reports a 74 percent reduction in injuries since implementing CRM.

From the fire service a series of workshops found that CRM was a worthy model to pursue for wildland firefighting.

Finally, a specific success story from aviation is the successful landing of U.S. Airways flight 1549 in the Hudson River which Captain Sullenberger attributed to both his experience and CRM training.

Law enforcement application

Law enforcement officers are called upon to continually make decisions. Often these decisions are high-risk, and must be made in complex high-stress situations. There are also instances where it is alleged that officers fail to intervene when a fellow officer allegedly violates a victim's Constitutional rights including the use of excessive force. It’s in these types of situations, and others, where CRM could help avoid or trap errors thereby reducing unintended consequences of law enforcement interactions with the public.

One author suggests that human error is often not a singular mistake, but a product of the environment the actor is working in. Granted, law enforcement officers at times must make split second decisions while other encounters with the public evolve over a matter of minutes lending themselves to application of CRM training. It is critical that first responders, including law enforcement officers, work as a team in these types of incidents, which is the cornerstone of CRM. Yet, CRM has not been widely implemented in public safety organizations including law enforcement.

CRM focuses on human factors being the source of errors as well as being the best source of avoiding errors. CRM can help law enforcement agencies mitigate undesired outcomes and unintended consequences by focusing on teamwork, communication and theoretical background knowledge. Team work competencies include, leadership, workload management and adaptability. Communication competencies include, professionalism, efficiency and reflection. Theoretical background knowledge includes, shared situational awareness and decision making, reducing human error and stress management.

One concern law enforcement may have with CRM is that it circumvents the traditional chain of command. However, this is not the intent of CRM. Rather CRM promotes team member input while preserving authority. This is consistent with the National Incident Management System (NIMS), under which all law enforcement agencies should currently be operating. Under NIMS, safety is the responsibility of all team members, where any team member regardless of rank, has the responsibility to clearly advocate their position if they disagree with an intended action. CRM builds and expands upon this concept. While this may require a culture change in some law enforcement agencies, it is a crucial change. A culture that supports the assertiveness of all team members regardless of rank or stature, to voice their concerns when they see something going wrong is foundational to implementation of CRM.

Summary

Abolishing, defunding, and de-staffing the police is not the answer. Reimagining and rethinking policing are vague concepts that fail to offer a solution. These are uninformed reactions by politicians and vocal special interest groups, many of whom are not supporters of law enforcement. Law enforcement administrators are best situated and informed to improve outcomes and minimize unintended consequences of interactions between law enforcement and the public. CRM offers a viable solution to avoid, capture and mitigate human error and minimize unintended outcomes of law enforcement interaction with the public. CRM needs to be implemented by all law enforcement agencies.   

About the Author

Greg Walterhouse is an Associate Teaching Professor in the Fire Administration and Masters in Public Administration programs at Bowling Green State University. He holds a Bachelor of Science degree in Management from Oakland University, a Master’s degree in Legal Studies from the University of Illinois, a Master’s degree in Management from Central Michigan University, and a Specialist Degree in Educational Leadership from Bowling Green State University. Before joining BGSU, Greg had over 35 years experience in various aspects of public safety with 18 years in upper management. The author may be contacted at waltegl@bgsu.edu.

By Dr. Anna Fitch Courie, Director, Responder Wellness, FirstNet Program at AT&T

In 2017, when AT&T won the contract to build the first nationwide communications platform for first responders, it recognized the tremendous impact that public safety has on the health and wellness of local communities. So in May 2020, as a part of its commitment to build and maintain FirstNet, it established the FirstNet Health and Wellness Program.  

AT&T established the program to coordinate and plan for how the organization would support the health and wellness of first responders – integrating academic, community, industry, and organizational capabilities. And it established strategic objectives to help achieve optimal health and wellness for America’s first responders, including:

• Identifying first responder health and wellness priorities
• Developing targeted strategies to support first responder members
• Collaborating on solutions
• And sharing best practices and lessons learned

Scientific Basis of FirstNet Health and Wellness

The FirstNet Health and Wellness Program is built on the socio-ecological model of health. This is a systems theory model that posits we can influence health at different levels of inter-related systems. These include individual, relationship (family, friends, groups, units), community (workplace, schools, cities, towns, etc.), and society (including federal, government, organizational influence).

We built the FirstNet Health and Wellness Program at the societal system level. And AT&T is positioned to use organizational resources and partnerships to influence the health of the first responders it serves.

The socio-ecological model of prevention has been found to be an effective theoretical lens to view complex problems that straddle various populations. And it shows that there is a role in which we can favorably influence health through different interventions.

The goal of public safety is to support, “a secure and resilient nation with capabilities required across the whole community to prevent, protect against, mitigate, respond to, and recover from the threats and hazards that pose the greatest risk.”

A critical component of the public safety infrastructure is the people. That’s why the FirstNet Health and Wellness program considers the health and wellness needs of first responders as a critical aspect of the health of FirstNet. Without the people, the network would not be adaptable, resilient, and able to respond to public safety needs at a moment’s notice.

Conceptual Framework

The FirstNet Health and Wellness program integrates the National Association for City and County Health Officials (NACCHO) Mobilizing Action through Planning and Partnerships (MAPP) process and the Centers for Disease Control and Prevention (CDC) Community Health Improvement Framework. These frameworks and processes provide systematic and evidence-based processes for AT&T to navigate the complex health problems that face the first responders it serves.

The FirstNet Health and Wellness Program Process

In the FirstNet Health and Wellness framework, we addressed the health of a population through a step-by-step strategic planning process that included:

1. Convening the stakeholders
2. Developing a vision
3. Developing, compiling, analyzing and assessing – identifying the problems, the scope, the perceptions, and existing resources
4. Identifying priorities
5. Developing SMART Action Plans for the priorities
6. Implementing the plans
7. Evaluating the outcome
8. Making recommendations for the future

The FirstNet Health and Wellness Coalition (FNHWC) Structure

Public safety is a unique population. It spans multiple professions, organizations, and command structures. And there is no single point of policy or command entry to facilitate change at a global or federal level.

So, the success of addressing broad first responder health needs is based on collaboration, partnerships, influence, and consensus. Thereby the stakeholders unite with a collective voice to address the needs of their members.

As a result, a critical component of the FirstNet Health and Wellness program is to bring together the stakeholders and leadership of the diverse public safety disciplines. This way, AT&T can strategically identify priorities and reach consensus on the most effective way to support first responders. This includes over 20 major public safety organizations, which now make up the FirstNet Health and Wellness Coalition. Coalitions have been found to be an effective means for creating a network of partnerships across multidisciplinary organizations to create change.

The Health and Wellness of First Responders

For AT&T, our population of concern is first responders. Evidence clearly indicates first responders face significant health threats from the work that they do. First responders experience post-traumatic stress, anxiety, depression, alcohol and drug abuse, and other comorbidities at rates greater than the general population.

We also know that across all public safety disciplines or professions, one of the main concerns is the health and safety of their people.

Health and safety are common themes despite the different roles these professions execute in the public safety field. However, “health and safety” is a broad and complex concept. To effectively demonstrate and achieve outcomes, we need to peel the onion to reveal the issues that face public safety.

An evidence-based approach to identifying priorities is conducting a needs assessment in addition to a systematic assessment of health surveillance systems and databases. Consequently, the FNHWC deployed the First Responder Needs Assessment in December 2020 to help frame its prioritization efforts. This assessment identified the top health and wellness priorities for our stakeholders, barriers to them accessing resources in the areas, and identifying how they want to get help in the identified priority areas.

Once we identified priorities, the next step is establishing working groups to focus on building action plans to address the priorities. This will formalize how the coalition addresses the priorities. Evidence has shown that well-developed action plans are more likely to lead to the health outcomes groups are trying to achieve. It also helps to formalize roles and responsibilities, establish timelines and budgets, create SMART objectives to drive evaluation, and engage expertise to create interventions and solutions that are valuable to our stakeholders.

The Way Ahead

Organizations have a duty to support the health and wellness of the communities they live in, work and serve. By collaborating with stakeholders in public safety, FirstNet, Built with AT&T, is integrating health and wellness into the mission of FirstNet infrastructure. This type of strategic engagement in the health and wellness of first responders is unparalleled. We realized that the role of AT&T in public safety is about more than delivering the broadband capability of FirstNet. It is also about being there for our customers and engaging in efforts that address the most pressing problems facing them as a result of the work they do.

About the Author

Dr. Anna Fitch Courie, Director, Responder Wellness, FirstNet Program at AT&T, is a nurse, Army wife, former university faculty, and author. Dr. Courie has worked for over 20 years in the health care profession including Bone Marrow Transplant, Intensive Care, Public Health, and Health Promotion practice.  Dr. Courie holds a Bachelor’s in Nursing from Clemson University; a Master’s in Nursing Education from the University of Wyoming; and a Doctor of Nursing Practice degree from Ohio State University. Dr. Courie’s area of expertise is integration of public health strategy across disparate organizations to achieve health improvement goals.

Related Content

Free Webinar on June 16, 2021. The FirstNet Health and Wellness Coalition: A Strategic Approach to Addressing First Responder Health and Wellness

By Kate Jamison, Marketing Manager, Operative IQ

Narcotics diversion is far too common, even in public safety agencies. Narcotics diversion is the transfer of legally prescribed controlled substances from the person for whom it was prescribed to any other person for illicit use. Diversion has been recorded in every type of medical environment at every level of service, from front line to medical directors.

Narcotics diversion statistics

There is no single enforcement agency that oversees all instances of diversion so statistics can be difficult to come by.

According to statistics from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) and the American Nurses Association, about 10 percent of health care workers are abusing drugs. Using these statistics, if you have 10 medics, one of them is possibly abusing drugs.

Fentanyl is a commonly diverted drug, and diversions, in general, are on the rise. The Department of Veterans Affairs reported a significant increase in drug diversion incidents at 1,200 facilities from 2009 to 2015, with 272 incidents in 2009 and 2,926 in 2015.

Employee drug abuse can happen at any organization, and narcotics diversion can be extremely tough to pinpoint. The statistics reveal that only a fraction of people who divert are caught.

Impacts on first responders

Diversion can have serious consequences for the individual who diverted and the agency they diverted from. The person who diverted the medication may be subject to criminal liability, termination from employment, or loss of licensure. It is possible that the agency they diverted from could be penalized.

The agency may lose their license or face administrative penalties. Additionally, the medical director of the agency could be liable because of the use of their DEA number. The medical director could face sanctions against their license or monetary penalties from the DEA.

A digital narcotics solution

One way to mitigate diversion is to use narcotics tracking software to track “cradle to grave” movements of the narcotics throughout an agency. This type of software can track when the drug was picked up, who received it, where it is located, when and how much was administered, amount wasted, noteworthy incidents and more.

Software that identifies substances received into your agency and enables regular auditing of safes will help you keep a close eye on what you have in stock. Daily or weekly audits through a user-friendly system is more effective in alerting you to discrepancies helping you identify potential diversions. By the time you get around to a quarterly or annual audit, it may be too late.

How Operative IQ helps agencies avoid narcotics diversion

Operative IQ’s narcotics module helps organizations avoid diversion incidents by tracking the distribution, chain of custody, and location of every narcotic carefully. Every single transaction can be verified with single or dual verification from a signature, password and pin or biometrics.

Operative IQ’s narcotics module with RFID enables you to keep a continuous audit. The software connects with a fixed RFID reader in your narcotics safe to send a continuous stream of data back to the system to let you know which drugs are in the safe 100 percent of the time.

As an administrator, you have the power to create records that will help you identify any anomalies like narcotics administration or waste quantities that may fall outside of the norm. Operative IQ can be configured to mirror your existing processes but track the entire lifecycle digitally.

About the Author

Kate Jamison is the marketing manager at Operative IQ, an operations management software company. She is a graphic designer and tech marketer. She can be reached at kate@operativeiq.com

By Gregory L. Walterhouse, Associate Teaching Professor, Bowling Green State University, IPSA Member

There are a number of terms used to describe the relationship between politicians and leadership including elected leaders, servants of the people, and servant leader. But are elected officials truly leaders, and if so, what leadership traits should they possess?

One author with a contrarian view, suggests that politicians are not elected leaders, and that political elections are a contest of competing interests. The author furthers suggests that leaders are recognized by character traits that draw others to them; and their ability to influence and encourage others to do certain things.

Another author also questions if elected officials truly serve as leaders, because to serve as leaders they must put the needs and goals of those they represent first. Leaders focus on the collective good and have concern about the people they represent and try to make their conditions better. The author submits that servant leaders must be ethical, do the right thing, have no hidden agendas, create value, and are focused on the common good and having a positive impact on the community at large.

A study conducted at Northcentral University surveyed voters, elected officials and business executives to determine what traits they preferred to restore their trust and confidence in elected officials. The traits viewed most important by respondents to the study were, integrity, honesty, trustworthy and ethical with integrity being the most important. What are the consequences when servant leader’s actions do not comport with these leadership traits?

A negative example involving an elected official is instructive.

Social media case study

An elected official in a U.S. city was at the center of a recent controversy that received widespread news coverage and resulted in harsh public criticism. The elected official allegedly made a post to their personal Facebook page depicting a thin blue line flag with the blue stripe partially peeled back exposing a red flag with a Nazi swastika which included a caption “Reading beneath the lines.”

This was ill-perceived by many and identified by some as hate speech. One city official opined that the post was “an ethical violation of city policy.” Another city official countered by supporting the elected official’s First Amendment right to free speech.

In response to the public outcry, the elected official removed the post claiming it was misinterpreted. The elected official further explained that they were ultimately acted carelessly with the social media post.

Analysis

It has been said, perception is nine tenths of reality. Actions of servant leaders need to focus on the common good, have a positive impact on the community at large, create value, and not be based on personal or hidden agendas.

It is unknown if the elected official’s alleged social media post involved a hidden agenda, but it undeniably had a negative effect on the city and community at large. The adverse consequences of the elected official’s alleged social media post are numerous and varied.

• It forced the City to issue a statement, disavowing the post as an expression of a private citizen, and one that City does not support.
• City administrators have been forced to devote time and effort to dealing with the negative publicity, disruption and fallout from the incident, including the City Commission confronting the matter at a commission meeting.
• The city attorney is devoting time to issuing a legal opinion on possible forms of discipline.
• The elected official’s post created division among residents on both sides of the issue. Another official commented that the post has become divisive and created much stress at city hall and the community.
• Required the police department to issue a statement reassuring the community that “no matter their beliefs, or how they view politics” the department will continue to “service our community.”

Was the elected official’s alleged Facebook post protected speech?

The Supreme Court held in Pickering v. Board of Education, that public employees enjoy First Amendment protection when speaking as a citizen on matters of public concern. From available accounts, it appears the elected official was speaking on a matter of public concern, presumably on her own time and personal computer. Yet, the elected official’s speech caused considerable disruption for the City administration.

In several cases involving social media posts by public employees, various courts have held that potential disruption to a government entity can outweigh public employee freedom of speech rights (Duke v. Hamil; Gresham v. City of Atlanta (11^th Cir. 2013); Grutzmacher v. Howard County (4^th Cir. 2017)).  

Summary

Because the elected official’s alleged Facebook post caused disruption for the City, including divisiveness, stress, distraction, negative publicity and more, the post may not be protected speech.

Government has a legitimate interest in providing efficient public service, maintaining a favorable reputation with the public, and upholding public trust. That aside, the post was not made in the interest of the common good of the community, created no value, did not make conditions better or leave a positive impact, in fact did the opposite, was not the right thing to do, and is indicative that not all elected officials are true community leaders.

About the Author

Greg Walterhouse is an IPSA Board Member, an Associate Teaching Professor in the Fire Administration and Masters in Public Administration programs at Bowling Green State University. He holds a Bachelor of Science degree in Management from Oakland University, a Master’s degree in Legal Studies from the University of Illinois and a Master’s degree in Management from Central Michigan University, and a Specialist Degree in Educational Leadership from Bowling Green State University. Before joining BGSU, Greg had over 35 years’ experience in various aspects of public safety with 18 years in upper management. The author may be contacted at waltegl@bgsu.edu.

By John Klich, Superintendent, Toronto Paramedic Services, IPSA Member

Incident management does not always result in the positive or desired outcomes we hoped for. Lots of things can go wrong during an event response; the scene can de-stabilize, people can get hurt, equipment can fail. In the aftermath of an event, the incident commander’s decisions may be questioned and challenge. Questions that may be asked include: Did you have a plan? Was it a reasonable plan? Did you follow the plan?

A well thought out incident action plan for a scheduled event can mitigate many of the issues that arise when emergencies or incidents occur. This article discusses some of the considerations for making sure your plan for a scheduled event is realistic and reasonable.

Three measures that can help ensure your incident action plan is realistic and reasonable include:

1. Referring to best practices and guidance from authoritative sources
2. Consulting with the stakeholders
3. Cross-checking with other plans

Guidance, best practices

As the incident action plan is developed, there will likely be some aspects that may be new or unconventional for your organization. Refer to established practices to determine the value and risks of any of these actions.

Even for previously used strategies and tactics, it is worthwhile to stay current by asking the following questions:

• Is there any guidance or best practice to inform the action plan?
• Is the guidance directly applicable or does the situation require exemptions or considerations?
• What is the rationale for these exemptions?

Depending on when a critical event occurs, there may be limited opportunity for research or consultation. Specialists or subject matter experts can help provide best practices for a tactic or strategy; this may be especially helpful when guidance is required for matters of health and safety, labor relations, or specialized circumstances involving technology.

However, having the right staff involved in the management of the event can close this gap.

Meet with stakeholders

For large-scale events there will be multiple stakeholders from multiple agencies and jurisdictions. In the 1 October After-Action Report, it was noted that, “The Fire Alarm Office and fire department line personnel were not aware that the festival was occurring.”

One approach is to provide appropriate engagement based on how the event would normally impact them. For those actively involved in the event (staffing, equipment, property and services), direct planning and interaction will be required and should be documented in an incident action plan. Avoid making assumptions about who can do what, where people or stuff can go, or how something will be accomplished. Seek out clarification and confirmation of their roles and responsibilities.

For stakeholders that are not directly supporting the event, some level of notification is usually sufficient. Notification provides those stakeholders with the opportunity to review their plans and if deemed necessary, to make their own preparations for the event.

Review other plans

The incident action plan may rely on other plans or standard operating procedures. Reviewing and referencing these other plans will reduce ill informed decisions and incorrect assumptions.

For example, Guidelines for Field Triage of Injured Patients provides recommendations for which patients should be transported to a trauma center. Similarly, Mutual Aid & Assistance (MAA) agreements provide the rapid sharing of resources.

Alignment with other plans will ensure that conflicts and gaps are minimized. Even within an agency, continuity plans may conflict. A classic example of this is when many groups have separately identified the same location as their back up site; when the power goes out at headquarters, all these business units show up to the same place not realizing there is not enough space or infrastructure to support all of them at once.

Review how your plans integrate with other plans like transportation, crisis communications, and resource management. Make sure that your tactics or strategies are not based on an assumption, but rather they are grounded in what is expected as outlined by policy and procedure.

It is especially relevant to review how your plan aligns with your agency’s use of social media. Social media influence can change everything from crowd behavior to agency reputation in a matter of minutes. Innovative Uses of Social Media in Emergency Management provides some context on the value of integrating a social media policy with your incident action plan.

Event considerations are continually changing based on everything from social media and designer drugs to new responder equipment (e.g. UAS) and even the weather (Lightning injures 33 at music festival in Germany, 2015).

“But that’s the way we have always done it” is no longer good enough when it comes to planning. Now more than ever, incident action plans require due diligence to ensure the decisions and objectives are reasonable.

About the Author

John Klich is a Superintendent with Toronto Paramedic Services, currently assigned to supporting the Ambulance Communications Centre. His primary focus is business continuity and emergency preparedness & planning to ensure the 9-1-1 call center is operating 24/7. His previous portfolios included Community Paramedicine and Operations. John also has experience as a paramedic Field Training Officer and a Flight Paramedic. John has a BA in Social Science and several college certificates including Emergency Management, Crisis Communications, Incident Management System and Security Intelligence Counter Terrorism.

By Kate Jamison, Marketing Manager, Operative IQ

Inventory and asset management is essential to public safety preparedness. Law enforcement, first responders and emergency response providers must have enough of every essential item to ensure they can respond to each incident properly. However, this is more difficult than it sounds.   

It is time consuming to count every single item in the supply room to inventory the quantities and expiration dates of items on each ambulance, fire apparatus, police squad car, dive team or SWAT vehicle. Without managing inventory, however, you run the risk of not having what you need when you need it. This can also cause problems with re-ordering if you do not know how much supply you have on hand. Creating an order based on a quick glance of your stockroom or an educated guess of what is on your shelves may leave you with too much of one item and not enough of another.  

RFID is here to help

We know that cycle counting your supplies is time consuming but may be a necessary evil in the spirit of response readiness. Pairing RFID technology with a digital inventory management system can make monotonous tasks much quicker and easier.  

RFID, or radio frequency identification, is a technology that uses electromagnetic fields to automatically locate and track tags attached to objects. The RFID reader sends out a signal searching for responses and can pick up a signal from a variety of tags in various locations quickly. Similar to barcoding, the RFID-identified tags are scanned into a software where stock levels are managed, but the difference with RFID functionality is tags can be captured from a distance and without scanning every individual tag.  

There are two types of RFID systems for inventory and asset tracking: (1) handheld and (2) fixed.

A handheld RFID reader is portable and mobile and can capture tagged items and update counts on demand. A fixed RFID reader continuously reads RFID tags to account for items and posts changes for missing assets. You can install fixed RFID readers in a supply room, ambulance, or other kind of vehicle for constant monitoring of items and handheld RFID readers can read tags periodically to provide a snapshot of available assets and inventory in each area.

How to use RFID   

To use an RFID tracking system, you need to apply a RFID tag to every item in the supply room (or boxes of items that you don’t want to tag individually, like gloves). Then you can use the handheld RFID reader or fixed RFID reader to pick up a signal from each of the tagged items giving you an accurate count of your supply room. Yes, it may be a hassle to tag every item at first, but after touching it once to tag it, you never have to touch it again until you go to use it.   

You may be wondering ‘what is a RFID tag?’ More than just a sticker, RFID tags contain a microchip and antenna that allows them to be located by a RFID reader. The tags do not require a line of sight to be seen by the reader, they can be captured from a few feet away, meaning inventory checks can be done quickly and without touching each of the items.  

Benefits of RFID

There is a huge opportunity for time savings with RFID. Cycle counting inventory to include expiration dates in a room where all or most of the items have RFID tags can be done in minutes. Quicker cycle counts mean you can be sure you always know how much you have of everything in the supply room. It also means that crew members don’t have to manually log their usage because you can easily see how much was used when and what needs to be reordered.

Digitized inventory management allows you to set par and reorder points to send alerts when you are running low of anything. A web-based inventory and asset management tool like one provided by Operative IQ or other systems provide access to your data at your fingertips. Moving to electronic operations management tools and away from paper checks and spreadsheets gives you the information you need to make good decisions. RFID technology is the next step to automate the labor-intensive tasks and reduce human error.  

With Operative IQ, quartermasters, operations managers, logistics staff, directors and chief officers have an organizational tool to optimize their inventories and asset tracking. You can leverage software and technology to save time, improve inventory accuracy, reduce waste due to loss and expiring supplies and streamline supply levels to improve your bottom line. 

About the Author

Kate Jamison is the marketing manager at Operative IQ, an Operations Management Software company. She is a graphic designer and tech marketer. She can be reached at kate@operativeiq.com