Pre-Planning fr a Crisis TOPICS COVERED INCLUDE: ACCIDENT NOTIFICATION PROCESS FAMILY CARE DEVELOPMENT OF A FUNERAL PLAN PERSONNEL/HUMAN RESOURCES DEPARTMENT RESPONSIBILITIES CRITICAL INCIDENT STRESS MANAGMENT (CISM) MEDIA COMMUNICATIONS PLAN Primary Authr: Tammy L. Chatman, CMTE Flight Fr Life Milwaukee Reginal Medical Center Milwaukee, WI 2008
Ntificatin This dcument begins at the pint where the ccurrence f an incident/accident has been verified and yur Pst Accident/Incident Plan (PAIP) has been pulled, yu will be racing against time t ntify all f the apprpriate individuals n yur ntificatin list. It is critical t determine ahead f time wh will be ntified, in what rder, hw it will ccur, and wh will be respnsible fr the ntificatin. Yur ntificatin dcument shuld list all individuals/agencies wh shuld be ntified and in what timeframe. Sme ntificatins will bviusly ccur immediately r within the first few hurs while thers can be dne later in the prcess. Each Prgram must make their wn determinatin as t wh is t be ntified and when based upn their individual situatin. Once the determinatin f wh shuld be placed n the call list, in what rder the ntificatin shuld ccur and by whm, then the next step will be t divide them int grups and determine if they are an internal r external custmer. Understanding wh yur internal and external custmers are will be valuable nt nly fr PAIP purpses but als in strategic planning, marketing, and custmer service. The fllwing list is just a sampling f the agencies/individuals that yu may cnsider including in yur ntificatin fr the first 24-48 hurs after the accident. They are nt in any particular rder. a. Management Team b. Medical Directr c. Dispatch Supervisr d. Families e. Crew f. Ride-Alng Family (if ne n bard) g. Media Relatins/Public Infrmatin Officer h. Backup individuals fr each persn n the list in the Prgram i. Other area Prgrams j. Vendr/Manufacturer k. Hspital/Spnsring institutins l. Bard Members/Investrs/Trustees m. Specialty Transprt Team supervisr n. Hspital/Airprt Security. Operatr/Secretary/Receptinist p. Referring/Receiving Agencies q. Dispatch Centers r. Cncern Netwrk s. Specialty Team Families (if n bard) The PAIP is a living dcument and must be treated as such. All data, frm addresses t phne numbers t names must be kept current and up-t-date. A system may have t be develped t keep track f the ever-changing persnal cntact data f individuals (such as cell phne r pager numbers) n yur list. Different frms such as bigraphical and persnal infrmatin will have t be utilized t capture and rganize the infrmatin needed fr the ntificatin prcess fr yur wn persnnel and their families. 2
Family care The mst imprtant ntificatins will ccur after there is psitive cnfirmatin f the crew members invlved. The next f kin/emergency ntificatin frms fr each f the team shuld be pulled and the apprpriate cntacts must be ntified. Wh shuld be invlved in the ntificatin f crew family (ies) shuld be cntained with this frm. Due t vacatins, gegraphic prximity, illness etc it may be necessary fr any f the members f the management team t be invlved in the injury/death ntificatin alng with the emplyee designated individuals (listed in the next f kin/emergency cntact frm). Sme things t cnsider invlving family ntificatin: Always use mre than ne individual i.e. Prgram Directr, chaplain, ther team members alng with the emplyee designated individual which is fund n the next f kin/emergency ntificatin frm. The emplyee designated individual may r may nt be the same chice as their Family Liaisn. Determine wh yur ntificatin team is ging t be prir t an accident but have back-ups. Wh shuld be ntified? Spuse? Parents? Siblings? In-laws? Children? This shuld be n the next f kin ntificatin frm Keep in mind the diversity f family dynamics that may ccur in this situatin. Where will the ntificatin ccur? Hme, wrk, ut f state Be prepared fr delays In the case f serius injuries, the mst imprtant cncern is getting the family t the emplyee. This can be dne via law enfrcement, family liaisn, prgram staff member r cab. A Family Liaisn shuld be assigned t each injured/deceased crewmember family based upn the emplyee s designatin n the next f kin/emergency ntificatin frm. The family shuld learn f the injury/death befre the media Smetimes this is just nt pssible due t real time news reprting A phne call is nt preferable but may be the nly pssible way t reach the family members befre the situatin is reprted by the media. Whenever pssible, tell the family in persn If dne via the phne, the ntificatin team shuld meet with the family as sn as pssible. Use lcal law enfrcement persnnel t physically g t the hme t be present fr the ntificatin if yur agency is unable due t gegraphical distance r urgency due t media invlvement. Assist with ther ntificatins if desired Cntract emplyees such as mechanic r pilt Extended family 3
Be prepared fr anger directed at yu Dn t release names until family agrees Multiple victims: Assign a liaisn t each family Assemble in a neutral area that yu have pre- determined and specified in yur plan. Ntificatin can be traumatic t the ntificatin team Be prepared t defuse and/r debrief thse invlved, particularly if there is mre than ne death ntificatin r the respnse frm the family is verwhelming. The family(ies) will have nging needs fr infrmatin and supprt that will funnel thrugh the Family Liaisn. It is imprtant that the family f each affected crew member knw that they are being kept infrmed and that there is genuine cncern fr them by the Prgram and its staff. Cmmunicatin is the key in this situatin in maintaining psitive relatins with the family(ies). Ignring the family and their questins will nly result in negative feelings at a time when they are suffering is nt nly inapprpriate but it can increase the pprtunity fr litigatin. Be prepared t deal with the pssibility that legal cunsel may recmmend a shut dwn in cmmunicatins between the prgram and the affected families shuld a lawsuit be filed. It is extremely imprtant that the family des nt feel they have been frgtten by the Prgram. Whether crew members are injured and require hspitalizatin r are deceased, a Family Liaisn shuld be assigned t each f the crew member families. This persn is determined based n the emplyee s wishes expressed in the next f kin/emergency ntificatin frm. The Family Liaisn shuld be assigned a cell phne and/r pager s that the family can cntact them at any time. They will functin as the liaisn between the family and the prgram and will be with the family n a daily basis. In the case f serius injury, the Liaisn will supprt the family during hspitalizatin f their lved ne and will assist with daily tasks during this time. In the advent f a fatal accident, the Liaisn will als supprt and assist the family, helping them t deal with funeral, family and benefit issues. In either situatin the Family Liaisn acts as a "gatekeeper" t assist the family in screening r respnding t the media, incming telephne calls and well-wishers stpping by. The Family Liaisn will als ntify the family when the NTSB reprt f findings is t be released and will assist, alng with the Prgram Directr, in answering any questins that may arise frm the reprt. Develpment f a funeral plan It is imperative that each agency develp a step-by-step funeral plan that all members f the rganizatin are familiar with, agree t, and understand. Emplyees shuld discuss the funeral plan and share their wishes with their families. This is als the time that persnnel shuld make sure they have selected an individual r individuals t fulfill the rle f liaisn t their families in the event f serius injury r death. It is entirely pssible and shuld be anticipated that the family may chse t disregard the wishes f their lved ne when it cmes t the funeral ptins they have chsen. 4
The plan shuld include wake, funeral, and memrial ptins. Different levels may be utilized based upn the fire department mdel if s desired: Level 1-line f duty death f persnnel, Level 2-death f a full-time member f yur agency, and Level 3-death f retired member. Resurces shuld be identified ahead f time and a cmmitment fr assistance shuld then be slidified based n a pre-determined checklist that the Prgram develps that is specific t their rganizatin and needs. Every crewmember and their family have respnsibility fr learning and understanding the Prgram benefits and services available t them prir t a tragedy. Understanding yur wn disability and death benefits is imprtant in estate planning. As part f yur pre-planning prcess, it wuld be advantageus t bring a Human Resurces r insurance representative t a staff meeting t discuss disability and death benefits. Decisins regarding death wishes and desire fr a full hnrs funeral shuld be decided upn and made knwn by the emplyee t their family and the Prgram t prevent pssible cnfusin shuld an accident ccur. Once the emplyee Air Medical Funeral Optin Checklist is cmpleted it shuld be kept with the Next f Kin/Persnal Infrmatin and Bigraphical Frms. T ensure emplyee privacy, the frm can be put int a sealed envelpe, nly t be pened in the case f a line f duty death. This will help t alleviate any difficulties surrunding death wishes. Prgram management shuld be ever-mindful f the cmplex family relatins and multi-cultural differences that exist in tday s culture. Divrce, re-marriage, estrangements, cultural diversity, and ther factrs cntribute t a minefield that has t be carefully managed in the emtinal aftermath f serius injury r death f an emplyee. Being cgnizant f the dynamics that may ccur during interactins with families can g a lng way in reducing misunderstandings and misperceptins. The Family Liaisn Officer(s) (FLO) will be critical t the family and the Prgram as they navigate thrugh the days and weeks that fllw the incident/accident. This persn is predetermined by the emplyee and their name can be fund in the next f kin/emergency cntact frm. The FLO(s) will be the pint persn between the family(ies) and the flight prgram. It is therefre key that the FLO(s) be ntified immediately and an initial briefing by the Prgram Directr shuld fllw. As stated befre, a cell phne and/r pager shuld be assigned t each FLO t allw the affected family(ies) t cntact them when necessary. After the initial meeting(s) with the family(ies) f fallen crewmembers t ffer supprt and assistance alng with determining their funeral/memrial wishes, yur next step shuld be t assign a Prgram Liaisn that will meet with the individual(s)/cmmittee wh will be respnsible fr assisting in the planning and crdinatin f the wake(s)/funeral(s) and/r memrial. It will be imprtant during this prcess t remain diligent in yur effrts t maintain cnstant cmmunicatin with the family(ies) regarding the funeral/memrial planning prcess via the family liaisn(s). Yur air medical funeral ptins checklist, if it has been filled ut and the family(ies) chse t hnr it, shuld be used t guide the funeral prcess. Shuld there be n invlvement by the rganizatin in the funeral(s) f the deceased crew (based upn family wishes) then the individual(s)/cmmittee will be invlved strictly in the memrial service. The memrial is typically cmbined fr all deceased crewmembers. 5
A decisin will have t be made as t whether t utilize Fire and EMS agencies in the memrial and a date and time can then be established. The respnsibilities f the FLO can be fund belw thugh ther respnsibilities can be assigned based n the prgram r family s needs. Single pint persn between the family and the Prgram. Cntact family and set up appintment t meet with them t explain the assistance the Prgram can prvide and any immediate supprt they can ffer. Meet with Prgram Management and Funeral Cmmittee t brief them regarding the wishes and needs f the family as they relate t the wake and funeral f the individual. Inquire if the family needs the supprt f the agency chaplain/mental health prfessinal and set up. Determine if the family/prgram is planning a receptin fllwing the final services. Acts as a gatekeeper fr the family t assist in screening and respnding t the media, well wishers, and phne calls whether at hme r at the hspital. Obtain cunt f family (immediate/extended) attending memrial t accmmdate seating needs. Assist family in determining and prcuring ntarized cpies f dcuments needed fr benefit frm submissins. Assists with lgistics such as ut f twn family transprtatin and ldging, childcare, husehld chres etc. Prvides n-ging cmmunicatin and assistance t the family befre, during, and after the funeral. Crdinate family visits and assistance frm Prgram persnnel. Cmmunicates with the Funeral Cmmittee t cnfirm that law enfrcement has been ntified t patrl the family s neighbrhd prir t, during, and after the funeral. Cllect the deceased crew member s belngings t give t the family at a later time. Items shuld be inventried and dcumented in frnt f a witness. Persnnel/Human Resurces Department Respnsibilities Every agency shuld have an individual r department that is respnsible fr persnnel benefits. They shuld have a check list f items that need t be dealt with in the event f a serius injury r death. Sme f the items are: 6
a. Emergency check t family f predetermined amunt (if part f Prgram plicy) Check is t be deducted frm emplyee benefits at time f settlement b. Final paycheck c. Disability benefits d. Pensin e. Memrial funds f. Prgram insurance plicies Term life Wrkers cmpensatin g. Scial Security survivr benefits h. Special benefits fr settlement Vacatin Time due Sick time Other items i. Cntinued survivr benefits j. Referral list fr survivrs Cunseling agencies Supprt grups The Family Liaisn r Human Resurces persnnel shuld be available t sit dwn and assist the family in dealing with all f the paperwrk that will fllw a serius injury r line f duty death. Expect that the family will be emtinally and physically challenged during this time and will welcme assistance in understanding and filling ut the required frms and making the multitude f phne calls that are ften necessary in the prcess. As f the writing f this article, air medical persnnel are nt eligible fr the Public Safety Officer s Benefit (PSOB) unless they are serving a public agency in an fficial capacity with r withut cmpensatin. Please see the Bureau f Justice Assistance website fr definitin f a public safety fficer at http://www.jp.usdj.gv/bja/grant/psb/psb_def.html#pub. CISM An acute (immediate respnse) as well as lng term CISM plan shuld be develped by the prgram. A plan fr dealing with the anniversary f the accident and the respnses it will trigger shuld als be incrprated int the lng term plan. Each f the team members shuld have a full understanding f the plan in the event f an accident. Cunseling resurces shuld als be ffered t the affected crew member families and ride alng (if invlved) family(ies) and is just a part f the care these individuals shuld receive frm yur rganizatin. Suggestins fr a CISM plan are prvided belw: Initial debriefing Within 24 hurs whether it invlves a minr injury r fatal accident the respnse is based n the magnitude f the incident/accident Make sure yu allw time fr crew members wh are ut f twn t return Determinatin f briefing rm lcatin and number f rms necessary Have a mental health prfessinal as part f the team Utilize reginal air medical CISM team members 7
cllabrate with ther prgrams (if there are ther prgrams in yur regin)t have several crew members frm each prgram trained in CISM. this wuld be useful in prviding immediate respnse with persnnel wh have creditability with yur crew. requires upfrnt planning and crdinatin Cnsider activatin and utilizatin f the natinal START team 1-866-879-0555 www.start4cism.rg Have a pre-determined individual assigned strictly t assess the cnditin f the management team, particularly the Prgram Directr. The Prgram Directr/thers primarily invlved will nt have time t grieve. Their cntinued perfrmance will hinge upn taking the time t grieve and take care f themselves Availability f mandatry timeut if deemed necessary Mnitr the cnditin f and debrief the Family Liaisn(s) as they are als grieving and under stress as well. Debriefing with lcal agencies wh were invlved Within first 3 days Open t all flight crew, administrative staff, dispatchers, and invlved agencies Hst at a neutral site Number f sessins fr staff Average f 3-6 based n grup Additinal ne-n-ne individual cunseling shuld be prvided t thse team members as needed via the Emplyee Assistance Plan (EAP) If yu d nt have an EAP then emplyees shuld be allwed t make their wn chice f certified/accredited cunselrs There shuld be n ut-f-pcket csts fr the emplyee Shuld be available fr as lng as is necessary It is als helpful t develp a list ahead f time f pssible individuals and grups that yu wuld include in yur debriefings. The decisin as t hw t break up the grups int different debriefing sessins is smething that shuld be decided based n the prgram and its wn circumstances. Mst mental health prfessinals suggest that the family(ies) be debriefed separately frm the staff and crew. Belw yu will find individuals/grups that are suggested t be debriefed: Flight crew Management/Admin. Staff Dispatchers Families Specialty transprt teams Invlved agencies Own hspital Referring/Receiving hspitals Others Patient(actual patient flwn r intended fr transprt) Frmer crew 8
Keep in mind that team members will display a variety f different emtins ver time. These emtins may be directed internally and/r externally i.e. twards friends, family, r ther team members. The management team may be faced with tremendus anger frm flight crews. It is imprtant during this time t keep in mind that the anger is nt persnal; it is a respnse t the stress and grief that ccurs after a serius incident r accident. Respnse t stress and grief is individual but is influenced by gender, culture, and spirituality and it can be magnified by ther issues in a persn s life at the time. Remember that each persn will respnd differently t the incident/accident. The anniversary date f the incident/accident and release f reprt f findings frm the NTSB is a particularly difficult time fr many prgrams, families, and crew members. Prepare fr and plan debriefings immediately fllwing the release f the NTSB reprt and just prir t r after the anniversary f the event. Make sure the Family Liaisns cntact the family(ies) t ntify them that the NTSB reprt f findings will be released and assist them in understanding the reprt if they s desire. Als cnsider prviding access t cnfidential individual cunseling fr all f yur persnnel. Prepare yur management team fr a renewed wave f emtins similar t thse exhibited by prgram persnnel when the incident/accident ccurred. Media Cmmunicatins Plan One f the mst challenging and emtinally draining respnsibilities prgram management will face is management f the media immediately/lng term fllwing a crash. It is advisable that a media cmmunicatins plan is develped and put int place as part f the PAIP pre-planning. Prir t the develpment f a media plan, a Prgram/Agency shuld make a determinatin as t wh will make statements t the media fllwing an incident r accident. This can be handled in a variety f different ways: a. Prgram/Agency Public Infrmatin Officer (PIO) b. Prgram Directr c. Hspital Media Relatins Crdinatr d. Cntracted utside agency Once this has been decided, a cmmunicatins plan shuld be develped based upn wh will be the spkespersn(s) fr the Prgram and hw the flw f infrmatin will ccur. The extent and degree t which an agency trains its management persnnel in Media Relatins will be dependent upn wh will fill the psitin f PIO and what the rganizatin s verall perceived risk is. If this is a designated psitin, then a psitin descriptin shuld be develped with agreed upn expectatins. This individual will be respnsible fr and shuld be trained in daily and crisis media relatins. A Prgram Media Plicy will need t be develped and implemented, designating the PIO s respnsibility fr handling all media interactin. The plicy shuld then be cmmunicated t Prgram/Agency persnnel. The utilizatin f a media plicy and predetermined spkespersn(s), (PIO), can reduce any cntrl and/r assumptin issues that may arise when dealing with the media. It is recmmended that the Prgram/Agency have a minimum f tw trained individuals wh can functin as PIOs. This will allw fr the availability f tw cmmand psts initially, especially in situatins f excessive media demands and will cver the psitin in case f vacatin r illness. It will als be useful t have smene functin as the Media Crdinatr t assist the PIOs in 9
the first week after the accident, particularly if there are fatalities r serius injuries. The Media Crdinatr can be a secretary r administrative assistant within the rganizatin wh will assume this rle during a crisis. This individual will als be respnsible fr prviding apprved infrmatin t the webmaster fr psting n the Prgram s website. It is prudent t prvide all management persnnel with basic training in media relatins fr everyday peratins. This training can be btained in a variety f ways nce the needs and resurces f the rganizatin have been determined. This training shuld include mck interviews with videtaping. Belw yu will find a list f resurces f available training, much f it cming at minimal r n cst: a. Each state has an Emergency Management Agency that prvides curses n basic and advanced PIO training. Usually these curses are free r prvided at a minimal cst. A Prgram can qualify fr these classes as lng as it is a part f a lcal disaster plan (city, cunty, state). Many als prvide training classes in tabletp, functinal, and full scale disaster training that can aid in cnducting a dwned aircraft drill. b. The Emergency Management Institute lcated in Emmitsburg, Maryland ffers an advanced PIO curse that persnnel can apply fr admissin t nce the state basic and advanced curses have been cmpleted. These are ffered a number f times per year but must be signed up fr in advance (registratin fr the year is allwed at the beginning f the calendar year). Additinal infrmatin can be fund n www.fema.gv website. c. If hspital based, r yu have a clse relatinship with a lcal hspital, talk with them regarding their in-huse media training (if they have this available) that they prvide t their staff. Yur management team may be able t attend. If they d nt have this type f training available, cnsider cmbining effrts t prvide the training fr bth agencies. d. Organize with ther air medical agencies in yur area r thrugh yur state AAMS chapter t bring an educatr in t train persnnel n media relatins. This is an excellent way t cmbine resurces and spread csts ver several rganizatins. e. Jin the Natinal Infrmatin Officers Assciatin. This rganizatin is an excellent resurce fr public infrmatin fficers frm arund the cuntry. They hst a natinal cnference that prvides excellent training pprtunities relating t media relatins. Their website is www.nia.rg f. Attend area/natinal seminars/cnferences n media relatins, i.e. at Fire Department Instructrs Cnference, EMS Tday Cnference, JEMS Cnference etc. g. Cntract with a lcal agency t assess yur rganizatin s needs and custmize a training prgram t suit yur specific requirements. These agencies are usually public relatins firms. Check yur lcal phne bk. h. Talk with ne f yur fire department PIO s regarding the PIO classes that are ffered in yur state fr fire department persnnel. It may be pssible t attend these classes fr the cst f a registratin fee. 10
Cnclusin This article is by n means an all-inclusive dcument t utilize when dealing with a fatal crash and its aftermath. It merely ffers ideas and suggestins fr pre-planning and PAIP develpment. Hpefully the infrmatin within this dcument will prvide a starting pint fr thse wh are lking t enhance and update their current PAIP. The pre-planning prcess and develpment/updating f yur PAIP is nt easy r quick t d but it is a necessary and useful dcument in its finalized frm. Preparing yur rganizatin t deal with a serius incident r accident is nt nly beneficial but it is als yur respnsibility. That respnsibility nt nly extends t the flight prgram, its persnnel and their families; it ges far beynd that t include the referring and receiving agencies yu serve, the cmmunities they are in, and the patients yu care fr and transprt. Hw yur prgram deals with this type f critical event will determine if it will survive and flurish in the years t cme. If yu have dne yur hmewrk and are prepared, the PAIP will be the radmap t yur successfully navigating thrugh the crisis. 11