“The DARWIN Resilience Management Guidelines means I’m better prepared and allows me to always be one step ahead of the next aspect of the crisis” – Rickard Lundin
Rickard Lundin, Operational Manager at KMC – Centre for Teaching & Research in Disaster Medicine and Traumatology, in Sweden tells us how he has adopted the DARWIN Resilience Management Guidelines in his organisation.
The centre is based in Linköping, Southern Sweden and is part of the local county council. Rickard and his team are responsible for managing all types of crises involving large numbers of injured people; from bus or train accidents to floods, fires and storms. The aim of the centre is to provide excellent healthcare to all citizens, focusing on research and education in disaster medicine and traumatology. Rickard is one of over 160 experts in the DARWIN Community of Practitioners who has helped develop the DARWIN Resilience Management Guidelines.
Why did you decide to join the DARWIN Community of Practitioners?
We decided to join the DARWIN Community of Practitioners because the issue of resilience is very important to us. Resilience is an integral part of disaster medicine and how we manage crises.
The DARWIN project was of great interest to us because we are one of a few centres in Sweden dealing with emergency crisis and disaster medicine. We want to be at the forefront of all new innovations and research and play a leading role in this arena so being apart of the DARWIN Community of Practitioners helps us achieve these goals.
How did you help create the DARWIN Resilience Management Guidelines?
I was trained in how to use these new guidelines and I helped conduct the pilot tests to check their robustness and strength.
One of the pilot tests involved the simulation of a ferry accident off the coast of Sweden. In the simulation test, over 2,000 people were on board the ferry when it collided with another ferry at sea. Up to 300 passengers were injured, some critically, and our task was to use the DARWIN Resilience Management Guidelines to manage the crisis and evacuate all the passengers safely.
The pilot test felt like a real-life crisis. Things happened really quickly and moved really fast – as it would in any crisis – so our stress levels were high and we had to make lots of decisions quickly.
My team in the DARWIN Community of Practitioners not only discussed the guidelines in our focus groups before the simulation, but also afterwards, so we could assess what worked well and what areas needed to be improved. In this way, we helped shape and develop the guidelines.
Which aspects of the DARWIN Resilience Management Guidelines do you find most useful?
I now use the guidelines in my daily work here in Sweden. There are ten conditions for being resilient and we put these to the test in the simulation.
One of them is how do you manage Goal Conflicts. For example, in the healthcare sector we have one goal and during a crisis the fire brigade might have a different goal and the police service another different goal and therefore we have goal conflicts that we must resolve. This is the best way to manage the crisis effectively and be resilient and the guidelines shows you how you can resolve these goal conflicts.
For example, for me in the healthcare sector, I must put plans in place for the ambulance resources and personnel. My priority is to move the injured people to a specialist hospital where I know they can get the best treatment and care. But if it is an accident at sea, for example, the helicopters and sea rescue crews might not be able to transfer the injured to this location. It might be too difficult for them. So, we need to compromise and find a solution.
If we can anticipate the goal conflicts before a crisis occurs, we can find solutions to these problems quickly and more effectively.
Have you ever used the guidelines in a REAL crisis?
Yes. Last year a bus crash happened in central Linköping involving up to 60 primary school children.
The double decker bus collided with a bridge viaduct, ripping the roof off the bus and smashing windows. Fortunately, because the children were so small (just six years old) everyone survived. If it were adults sitting in the top deck they would have died in that collision. But many of the children were injured, some seriously, so we had to manage our staff in the hospital to take care of all the children very quickly.
In this incident, I used the ‘Success Factors’ in the DARWIN Resilience Management Guidelines to help me deal with this crisis. By studying the guidelines and being prepared, I had noted previous similar crashes and what were the ‘success factors’ in these crises. This helped us find additional staff and ambulance personnel in a short timeframe to deal with the crash and help all those onboard.
I had already mapped out from the last large-scale singular collision what went right and what went wrong and used that knowledge to deal with this crisis more effectively. For example, do we have any goal conflicts with the fire brigade or the police officers or other stakeholders? Do we have any vulnerabilities that we have to work with? Do we have any other possible problems that we need to address?
The best part for me is using Success Factors. If I use the Success Factors from other accidents or other team members’ experiences; they help us to be a step ahead all the time.
Most importantly it helped me to remain calm and in control. Using the guidelines means I’m better prepared and allows me to always be one step ahead of the next aspect of the crisis.
What advice do you have for any other organisation who would like to adopt the DARWIN Resilience Management Guidelines?
Use them and reflect on them. Sit down and think how can I use these guidelines and what will it mean to us in our organisation. Familiarise yourself with them so you feel confident using them when a real crisis occurs. Discuss the guidelines with your team.
In emergency medicine, one of the biggest problems experienced right across Europe, not just in Sweden, is we don’t have enough capacity in our hospitals to manage and deal with all crises when they occur because some involve hundreds of injured people.
We have to be resilient and search for new capacity and find ways to deal with the crisis quickly and effectively. The DARWIN Resilience Management Guidelines will help you be resilient and be better prepare to cope and deal with the crisis when it occurs.
This is turn will reduce your stress levels, allowing you to make better decisions. It will also help your team remain calm and focused. I’m just one part of the team and I’m suppose to lead my team and if I am calm and not stressed then I can help my team to remain calm and in control.