Crew Resource Management March 2012

Objectives Learn how Crew Resource Management (CRM) and Near-Miss Reporting are related Discuss the principles of Crew Resource Management (CRM) Learn how CRM assists in the prevention of firefighter/EMT injuries and fatalities Learn how to use CRM as a tool to assist you in being a more effective firefighter/EMT or officer.

CRM and Near-Miss Reporting What are the ties between the two? Can you do one without the other? Which one is more effective? Who else is using this stuff? Use remaining slides to expand on the following: CRM promotes an environment that allows for people to speak up when they see something wrong. Near-miss reporting is a natural outgrowth of a working culture that recognizes mistakes are part of any human action and the more we talk about the mistakes we make, the fewer mistakes we will actually make. The two are most effective when implemented together. They compliment each other. Commercial aviation has a 30 year history of CRM and Near-Miss Reporting. The military, medicine (surgical teams), and the oil industry are just three of many that are using the concepts and principles.

Ties that Bind Near Miss Reporting CRM Intervenes at the "Unsafe Acts” Greater ratio of opportunity for intervention All members participating CRM Targets “Unsafe Acts” area Most eyes/ears working All member commitment 1 Fatality 10 Lost Time Injuries 100 Minor Injuries 1000 No Loss Accidents 10,000 UNSAFE ACTS!

CRM is… CRM is a tool created to optimize human performance by reducing the effect of human error through the use of all resources. CRM is when all team members actively seek to prevent adverse effects on the current situations.

CRM is NOT… CRM is NOT an attempt to undermine the ranking fire officers authority. All team members direct information flow to the officer BUT the officer-in-charge has the final decision on the course of action. CRM is NOT management by committee. CRM is not…

Benefits of CRM More effective teamwork Newly acquired communication and problem solving skills An operating philosophy that promotes team member input while preserving the officer’s authority Proactive accident prevention Respect of team members

CRM Principles Communication Task Allocation Teamwork Critical Decision Making Situational Awareness

1. Communication Communication is the key to success in any endeavor. Communication breakdowns are routinely listed as a contributing factor to firefighter fatalities. Errors that occur throughout the communication process contribute to injury and death.

Communication Process Formulate idea Select medium Transmit Receive Interpret Feedback of Understanding

Do you hear what I say? The Sender and Receiver can make mistakes that interrupt the communication chain (remember, to err is human). A response of “What do you mean” is a good indicator that the receiver has missed the senders message. Receiving a message is a conscious process and you need to listen with an open mind. Refer to pages 13 and 14

Barriers, Roadblocks & Standard Language Whose on First? Barriers & Roadblocks Hazardous Attitudes Fatigue Inattention Standard Language 500 most common words have 14,000 meanings. Say what you mean and mean what you say, but know that what you mean to say may not be taken as what you meant to say. Barriers, Roadblocks & Standard Language

Communication boils down to respectfully communicating what you mean in clear text and confirm what is being conveyed to you. Errors are reduced through clear, concise communication, injuries are avoided and performance is enhanced.

CRM Communication Tools Inquiry – speak up when a discrepancy exists. Advocacy – involves crafting an assertive statement using the persons name, problem statement, solution and request for agreement. Listen – active listening overcomes the majority of communication issues. Resolve the Conflict – Stay focused on the issue at hand. Provide Feedback – this will confirm understanding.

Near-Miss Report: Communication Report # 9-892 “Our engine company was responding to a car crash. We approached an intersection and had the red light…The driver and I both looked left to oncoming traffic and we started to make the right turn... A small car was traveling at 50+ mph in the second lane. Our line of sight was blocked by the cars and trucks in the first lane. The firefighter riding behind the driver saw the car at the last minute and yelled, “Stop! Stop! Stop!” The driver hit the brakes and missed the car by inches.

Discussion Questions Do you have the confidence to communicate to your officer if you see an “accident waiting to happen”? As an officer, are you approachable, to where your crew can openly communicate with you? Do you have debriefings after incidents so you and your crew may communicate about the actions on that call? What went right? What went wrong? How will you fix it next time?

2. Teamwork Two Components of Teamwork: Leadership Followership

Leadership Authority Mentoring Conflict Resolution Mission Analysis Fire service leadership is both formal and informal. Human behavior specialist have identified 4 leadership skills that are critical to leadership functions. Authority – CRM recognizes and reinforces the legitimate authority and the ultimate responsibility of crew safety is the Leader. But, the Leader must foster and environment of respectful communication among the crew. Set clearly defined goals and involve the crew in decision making when activities are altered or situations change – allow for crew input!! Mentoring – Foster and environment for developing your crew (rookie training) Conflict Resolution – One of the challenges for CRM is that it can give rise to conflict if members let their egos get in the way of their reasoning. If you resolve these situations quickly and positively this can promote team work and accomplish your goal. As a leader, if you recognize and acknowledge differences of opinion then you are halfway toward conflict resolution. Some conflicts can become very emotional and we as firefighters are normally very opinionated. If you listen to the other person, avoid emotional involvement (easier said then done), and stay focused, you can weed through the situation and identify the core issue. Mission Analysis – This is like the size-up process and most fire officers are well versed in this skill. Includes things like evaluating risk versus gain, identifying objectives, implementing an action plan, expecting the unexpected, evaluating the effectiveness of the action plan (critiquing) and devising alternative strategies.

Followership Self Assessment Physical Condition Mental Condition Attitude Understand Human Behavior

Teamwork Skills Respect authority Personal Safety Crew Safety Accepts authority Knows authority limits Leader success Good communication skills Learning attitude Ego in check Balance assertiveness/authority Accept orders Demand clear tasks Admit errors Provide feedback Adapt

Near-Miss Report: Teamwork Report #6-309 “I became more uncomfortable with our situation as we were fighting a losing battle. I communicated my thoughts to my usual partner and he was just doing the same thing to the others inside, having arrived at the same conclusion. As we were relaying the plan to get out, which all of us agreed to, and were making sure we would leave no one behind, the evacuation air horns sounded…”

Discussion Questions Does your crew work well together now? If not, how can you, as a firefighter, EMT, or officer, bring your crew together? You don’t have to be in charge to show good leadership! Are you doing drills with your crew so they become more familiar with one another, so as to build a foundation of teamwork? Do you have members of your team that struggle with authority and don’t practice good followership? How can you eliminate that before it becomes a safety risk?

3. Task Allocation Know your limits. Know your crews limits. Capitalize on strengths.

Proper use of automation Control distractions Follow SOPs Delegate ICS Use CRM

Near-Miss Report: Task Allocation Report 10-901 “The interior crew made entrance into the Alpha/Delta side of the structure through a narrow hallway and found active fire in a small bedroom…a flashover occurred causing confusion and disorientation within the room…Ventilation efforts were coordinated on the Alpha/Delta windows. The interior crews heard glass breaking and made their way to the window for emergency egress with the assistance of exterior crews.”

Discussion Questions Does your department have SOP’s? Does your whole crew KNOW the SOP’s? Are the SOP’s followed on every call? Does your crew train for every role they may play on an incident? From Rapid Intervention, to structural firefighting, to basic EMS skills? Is your department ready to handle a Rapid Intervention in case of a Mayday? If your RIT team is activated, who is their RIT team?

4. Decision Making Making decisions in the fire service can generally be divided into two categories…Non-Life Threatening or Life Threatening. Non-Life Threatening: Decision maker has time to evaluate options and choose best decision Life Threatening: Decisions maker is not afforded the opportunity to reflect…make a decision NOW!!!

Fireground officers often select the first decision that comes to mind, virtually eliminating any analysis. Fireground officers default to previous experiences during emergency incidents. This is known as “pattern matching” (slide trays).

Critical Decision Making Fire Service Decision Making Recognition Primed Decision Making Cue Based Decision Making Traditional Decision Making Identify problem Assess hazard Assess resources Solicit solutions Select best option Monitor results

Recognition Decision Making Rapid, intuitive process Looks for critical causes Relates to previous experiences Recalls previous conclusions & best actions taken Issues direction Experience

Cue Based Decision Making Individual is prompted to act based on “cues” from event. Cues are sensory elements (sights, sounds, smells) that recall previous actions under similar circumstances.

Ways to Improve Decision Making Experience Training Communication Preplanning

“DECIDE” model Determine the problem. Evaluate the scope of the problem. Consider available options for mitigation. Identify the most appropriate actions. Do the most appropriate actions. Evaluate the effectiveness of actions.

Near-Miss Report: Decision Making Report 08-614 “The choice was made to pull the flammable gas out of the sewer by pulling a vacuum using a smoke ejector… A gas powered ejector was definitely not a choice because of operating limitations of the fan, as well as the potential for sparks. This left us with electric ejectors… The fan was started off to the side out of the LEL, placed over the manhole with the surroundings wrapped with a salvage cover. Our rational thought was when an electrical fan is started, that’s when the spark is created and once running the chance of a spark is diminished.”

Discussion Questions Would you have considered using a different type of ventilation for the incident in Report 08-614? Do you have contact information for your local Public Works Department and utility companies for incidents such as this? Do you have preplans of target or high hazard areas of your first due, and surrounding areas? What are the three closest target or high hazard areas to your response area?

5. Situational Awareness The internal process that goes on constantly, much like size-up. Like a size-up, situational awareness must be updated constantly. Situational Awareness is dynamic and firefighters must maintain the absolute highest state of alertness and attention at all times.

“Fight the fire!” Assess problems in the time available. Gather info from all sources. Choose the best option. Monitor results – alter as necessary. Beware of SA loss factors!

Situational Awareness Loss Factors Ambiguity Distraction Fixation Overload Complacency Improper Procedure Unresolved Discrepancy Nobody Fighting the Fire

Elements of Good Situational Awareness Good crew coordination Proper task completion Understanding Smooth ride Crisp and appropriate radio calls Use of checklists

Preventing Situational Awareness Loss: Crew Mental Joggers What do we have here? What is going on here? How are we doing? Does this look right?

Preventing Situational Awareness Loss: Personal Mental Joggers What do I know that everyone needs to know? What does my crew know that I need to know? What do we all need to know?

Near-Miss Report: Situational Awareness Report 08-79 “As firefighting had been taking place for almost an hour by this time at the carpet warehouse, we thought we would be on standby until overhaul, but after a few short minutes, we were told via radio to report to Operations for an assignment… I advanced the line approximately 10 – 12 feet inside the structure, which had heavy smoke with zero visibility… After an unknown but short period of time, our 4-man crew felt a rush of heat and was knocked backwards while being consumed by smoke as the entire roof (60’x 70’) over the carpet warehouse collapsed. “

Discussion Questions Does your department require a 360° walk-around before interior operations begin? Does your department have a different policy for firefighting operations in a single family home versus a commercial warehouse? How do your roles and responsibilities vary based on the type of occupancy? Does your department have a policy on interior firefighting after announcing exterior operations?

For More Information Download the CRM manual located on the Resources Page of www.firefighternearmiss.com