3.1. Enhancing the capacity to adapt to both expected and unexpected events

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Emergency situations occur suddenly and without warning. Therefore, organizations must be prepared and adapt their functions to respond to emergency events as quickly as possible. Among those situations, some of the events are expected while others, could be unexpected with different nature. Roles, training, strategies, and procedures must be in place to provide such capacity, using an all-hazards approach which considers the common denominator of emergency situations in different areas, building a generic response plans that can be adapted to a specific event.


Implementation

Introduction

In order to enhance organizations' capacity to adapt to all events (both expected and unexpected), it is recommended that response plans have two main features – that they are based on everyday operations, and designed using the all-hazards approach.

  • Everyday operations

While crisis situations differ from routine operational challenges and disruptions, the capacity to adapt in crisis stems from the same general capacity used in everyday operations. In addition, familiarity of personnel with known procedures and guidelines makes it easier to implement them and operate during emergencies.

  • All-hazard Approach

It is important that organizations map and understand potential emergencies, recognizing mutual components of different threats. Thus, they can build a generic response plan for many types of unexpected events, while each threat has a specific extension to its relevant needs.

The next stage is to build a mechanism (strategies, procedures, and tools) that identify roles and responsibilities, missions and goals. Personnel must be trained to work within this mechanism, and its effectiveness assessed. For further information regarding understanding roles and responsibility, please read the CC of Understanding roles and Responsibilities.

Such mechanisms need to be rehearsed, with the understanding that actual events will likely be different from anticipated situations. Assessment means learning from both failure and success, and regularly reviewing and revising. A mechanisms that supports adaptation, means having invested resources in capturing/clarifying strategies, resources and constrains. Please see more information relating to noticing brittleness and identifying sources of resilience. The implementation of this CC requires a shift in the organization's perception of emergency management. Sometime, organizations may seek assistance from resilience management experts in applying these approaches.

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Healthcare implementation - Introduction

Risk and incident managers are experts in generic management, not in specific issues related to incident scenarios.

Before a crisis

Before crises occur, preparedness activities are critical for creating the conditions for maintaining contingency and adaptation in a crisis. During non-emergency periods, organizations should first map their potential emergency situations based on experts' experience and knowledge and relevant professional literature. Following the mapping, they must identify mutual components of preparedness, including personnel behavior and checklists for action. Checklists must include required activities, and names with contact information of internal and external actors that have to be involved during those situations. The organization must analyze carefully each scenario (based on potential emergencies) in order to understand the uniqueness of each situation and to add adjusted components beyond the initial response plan. After classifying the structure of response plans (initial and adjusted components), we recommend building the plans around daily activities and operations. In this way, the organization uses known resources, and increases the familiarity of personnel with guidelines. This approach affects also on management and monitoring different type of buffers. After mapping the emergency scenarios, it is important to have appropriate equipment that in a time of a crisis will assist to create time or room for maneuvering. For more information about managing and monitor buffers, we recommend to read the CC of managing available resources. It is important that it is clear whose role it is to in charge of crisis management. This role should be nominated during the pre-crisis period. His/her tasks include being able to monitor and assess the complete picture, and together with the organization’s managers define the roles and responsibilities of involved actors. For a deeper understanding of the subject, please read the CC Understanding roles and Responsibilities. Managers should be trained in assessing the situation against prepared-for specific situations and recognize when coordination with relevant partners outside of established channels is necessary to coordinate response. For this important issue, please read the CC of Promoting Common Ground.

Triggering questions

Classify and analyze potential emergencies
  • What variables/data are monitored to assess whether there is a crisis? What is the underlying rationale for the monitoring efforts and what limitations does this approach have? What crisis information is difficult to capture in variables/data?
  • Could we classify emergencies according to their nature?
  • Do we identify mutual component of different types of emergencies?

Build a mechanism for response plans

  • Do we have an actor who will be in charge of, coordinate or synchronize crisis management planning and response?
  • Do we design the response plans based on everyday manner? Do we use known resource to handle unexpected situations?
  • Do we have appropriate equipment to the first stage of the emergency?
  • How are such managers trained to recognize when unexpected events occur that challenge the current organisational structure and processes?
  • How do we define potential relevant partners to coordinate with in case of expected and unexpected situations?
  • Are lists of “good-to-have” contacts available in case unexpected situations occur that may require contacting actors outside of established communication channels?
  • Do we (re-)develop response plans based on new experiences?
  • Do we have response plans as well as training such as exercise and drills?
  • Do we model protocols to promote a common approach?
  • How do we create communication channels and networks between partners so that they can adaptively coordinate and cooperate when unexpected situations occur?
  • Can the adaptive re-allocation and deployment of resources within and between organisations be supported by building in slack in appropriate places in the network to meet unexpected demands?

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Healthcare implementation - Before

Plans are generic to the furthest extent. Specific scenarios might be tested. All such results are compared to find common procedures that are then formed into generic guidelines for incident response. However, limitations in these generic guidelines must be made aware in order to adapt the response when needed.

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Air Traffic Management implementation - Before

  • Actor(s) who will be in charge/facilitator of, coordinate or synchronize crisis management planning and response.

The number of actors who will be in charge/facilitate the event is derived from its size. For a small air traffic controller, it is possible to have one actor. But for larger events, Air Traffic Incident Coordination and Communication Cell (ATICCC in UK) bring people together to agree on strategies. The issue is having the right level of people that bring different knowledge available at different times (e.g. volcanic ash event require MET expertise).

  • recognizing and monitoring unexpected events

For ATM as a network, there will be a number of local manager or larger involvement might be required. People train for different strategies, then being creating for situation that are not expected (e.g. volcanic ashes, run out of APRON space, snow with not deicing people is prepared for snow but not that amount) Important in ATM is people (ATCO, engineers, pilots, assistants) and time people is available. The operational community is time limited. Thus, it is required to know how many people is available to deal with the situation. Managing resources and stability of the system, time, delays, weather. Degrees of freedom related to the capacity for manoeuvre.

  • Define potentially relevant partners to coordinate with in case of expected and unexpected situations

In ATM, there is a list for emergencies, in America they have a play book that gives a preprogrammed set of strategies. An important issue is: if the document list is kept updated on regular basis, specially strategies. Communication channels between partners are in foundation of ATC the issue is to extended to making the established the existing channels effective. Enhancing resilience response in uncertain episodes. This includes creating common approaches for certain type of events

  • Response plans- development, re-examined and training .

This is a normal practice in ATM e.g. volcanic ash (things that go wrong and exceptional events). A reflecting review, talking to people of any situation volcanic ash but other situation e.g. handling an aircraft in an adequate manner (formal and informal mechanisms to collect tacit knowledge on situation people need to adapt to). Resilience capacity comes from the availability to reconfigure. There are contingency planning and facilities embedded in ATM. In ATM training is done to a limited extent, but there is a need to broader the people and roles involved as a network training (reflecting in different situations). Orchestrate agile and resilient strategies to uncertain events. There is a constant reorganization, and it imply challenges and sacrifices to understand implication of slack. That include re-allocation and deployment of resources within and between organizations.

During a crisis

During an emergency, organizations are called upon to handle challenging situations, balancing between needs and limited resources in an unknown atmosphere. Basing activities on known manners allows actors to function in familiar way, increasing their capacity and confidence. There is a need to scarify non-essential functions. During the first stage of the crisis, while the organization acts according to the basic response plans, it must also diagnose the specific emergency, and adjust organizational plans to relevant situation and needs. It must remember to balance between various needs in accordance with different organizational levels. Contact and work in coordination with external actors who may assist and deploy extra resources.

Triggering questions

Identifying the specific nature of the emergency situation
  • Are plans available and applicable?
  • How can or should elements of plans be combined to meet situational demands?
  • How can missing or inappropriate plan elements be added or compensated for (through improvisation)?
  • Are organisational plans applicable in this situation or do other mandates?
  • What uncertainties are there in the situation?
  • For which aspects of the situation are we less than well-prepared?
  • Are facts, domain knowledge, and experiential knowledge that we need to assess and/or act on the situation available to us?


Contact and work in collaboration with relevant actors

  • Do we need to contact with relevant actors?
  • How can we communicate with other/new actors in order to understand the complete picture of the event?
  • Are the actors familiar with the actions they should take?

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Healthcare implementation - During

Generic guidelines are applied and incident managers respond according to all hazard applicability as long as possible. This approach gives incident managers the ability to quickly initiate the response and focus on where specific adaptation is needed.

After a crisis

In the aftermath of critical events, there is a need to implement review processes, and revise plans and procedures according to assessment results. From the perspective of the all-hazard approach, it is important to evaluate the structure of response plans, identifying common components for various emergencies and the uniqueness of each threat. From the perspective of links between everyday operations and actions during a crisis, the lesson learning may affect both daily activities as well as further emergencies.

Triggering questions

All-hazard approach aspects
  • How did they solve unexpected or not-planned-for situations?
  • Does the planning process generate relevant, applicable and useful plans?
  • Could the structure of response plans be improved based on core elements and specific components ?

Everyday operation and regular activities

  • Which aspects of the situation were the actors involved in the response familiar with?
  • Which were new to them?
  • Could the organization advance everyday operations according to the evaluation of activities during the emergency?

General

  • Did the organisation as a whole recognize these unexpected situations when they occurred?
  • How can organisational processes be improved to recognize and act upon the unexpected in a better way?
  • Was there a proactive action to recognize unexpected circumstances?
  • How can planning and training processes be improved?
  • Does training have the desired effect?

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Healthcare implementation - After

All incidents are reviewed with the purpose to identify limitations in generic guidelines and standardise where possible.



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Understanding the context

Detailed objectives

Emergency response plans commonly guide a specific action in a specific event. The approach takes into account the common denominator of emergency situations in different areas and treats them as the thinking process proposed in this card prepares relevant actors with a framework for action rather than a blueprint for action. Monitoring and control activities are to be implemented with the purpose to check if roles, process and training support the adaptation of organizational structure in a flexible way to the changing demands of the operational environment. A “framework for action” needs to be periodically verified against the need for assessing when organizational processes, structures, strategies need to adapt to be flexible, and how to implement these changes and adaptations effectively.

Targeted actors

Actors directly concerned by this concept card are decision and policy makers, and crisis managers. The guideline is relevant at all administrative and management levels, since adaptive capability also concerns front line operators, and roles who (re-)design response plans.

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Healthcare actors

The actors, from the HC perspective, is the decisions and policy makers on regional and local level and the Ministry of health and welfare. These are for example regional and hospital disaster preparedness managers as well as Emergency Department Head Nurses and prehospital commanders.

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Air Traffic Management actors

The roles and responsibilities of involved actors change according to the type of crisis and the related environment of operations. The "Adaptation relative to events" must encompass most of the activities of the organization, at all levels starting from senior management to front line operators.

The actors involved are those listed below:

  • Air Navigation Service Providers (both civil and military)
  • Aircraft owners and operators
  • Aircraft manufacturers
  • Aviation regulatory authorities (National and International)
  • ATFCM (Air Traffic Flow and Capacity Management)
  • International aviation organizations (i.e. EUROCONTROL, ICAO, CANSO, etc)
  • Investigative agencies
  • Flying public
  • Airport operator (if airports and/or ground operations are concerned by the crisis)
  • Firefighters (if irports and/or ground operations are concerned by the crisis)
  • Police (if irports and/or ground operations are concerned by the crisis)

Expected benefits

This card facilitates the development of response plans as well as strategies, design and implementation of training based on routine operations addressing goal conflict, sacrifice decision making to both expected and unexpected events (all-hazard approach and everyday operations). This resilience approach address network interactions and is more likely to facilitate and enable responsible actors to deal with more complex incidents and emergencies potentially involving more than one type of hazard or opportunities, and combination of expected and unexpected circumstances. The actors involved in the operational response plans and acting will recognize the responsibilities and actions that should be taken or might be applicable.

Relation to adaptive capacity

It promotes adaptive performance prior, during and after emergency situations through the adaptation of organizational processes and structures in response to situational demands. The fitness-for-purpose of plans are complemented with practices (formal and informal) and organizational processes for adapting to circumstances with respect to expected and unexpected events, enhances the adaptive capacity for dealing with unknown and unforeseen situations. This will be achieved by a) flexibility in building and applying plans and practices; b) capability to interpret the situation and to work out interventions accordingly; and c) capability to adjust procedures in progress. These capabilities can be achieved through training and reflection on action.

Relation to risk management

Emergency response plans commonly guide a specific action in a specific event. In addition, resilience management promotes the development of plans and practices that provide the opportunity to identify likely threats as well as opportunities, think through their capabilities, identify key resources, explore contingencies and what for what kinds of events the organisation is well/less-prepared, and develop alternative action practices, strategies in a network of actors that are exercised to stretch adaptive capacity.

Illustration

The need to strengthen the capacity of European Member States to coordinate the public health response to cross border threats, whether from biological, chemical, environmental events or events which have an unknown origin. (see relevant practices at the example of practices).

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Healthcare illustration

The same emergency response procedure is applied to all incidents, regardless of incident scenario. For example a regional major incident medical command is formed by the same core staff in all incidents. This enables the management to be mobilised quickly and to accumulate experienced staff that are active in a wide variety of events. Further specific expertise is added to the management staff if needed in a later stage, and have the specific role as experts in the otherwise standard management team.

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Air Traffic Management illustration

[Ref. https://www.eurocontrol.int/articles/what-has-changed-aviation-dealing-volcanic-ash-2010]

"There has been significant progress since 2010 on the volcanic ash and aviation front. Overall European approach in dealing with volcanic ash"

"While each individual state remains responsible for deciding whether or not to impose restrictions on flights in its airspace, there has been a move towards a more harmonised approach – one which recognises that decisions to perform flights in airborne contamination (such as ash or sand), should be made by airlines, based on the conclusions of their safety risk assessment."

"This approach significantly reduces the number of flights that would have to be cancelled in the event of another ash crisis."

Operational response in dealing with volcanic ash

"At the request of the European Union Transport Ministers, the European Commission and EUROCONTROL established the European Aviation Crisis Coordination Cell (EACCC) in May 2010. This cell, which will fall within the activities of the new Network Manager, is responsible for coordinating the response to any crisis affecting European Aviation, such as an ash cloud."

"The Crisis Coordination Cell will utilise existing communication tools such as EUROCONTROL’s successful web-based Network Operations Portal. A new tool, the European Crisis Visualization Interactive Tool for ATFCM (EVITA), has also been developed to help airspace users evaluate the effect that an ash cloud will have on their operations."

Detecting and observing the ash

"Increased use of PIREPS (Pilot In Flight Reports) significantly contributes to determining where the ash is located, how high and concentrated it is. This information is essential for decision making during an ash crisis."

Volcanic Ash Crisis Exercices (VOLCEX)

"One year after the eruption of the Eyjafjallajökull volcano EUROCONTROL took part in a major crisis exercise to validate changes and improvements to the volcanic ash contingency plan and procedures." "The VOLCEX exercises are organised by ICAO, the International Civil Aviation Organisation and allow a full assessment of the impact of applying updated procedures."

"As part of the exercises, the European Aviation Crisis Coordination Cell is activated, and the EVITA is tested. The exercises are simulations only; they have no impact on real flights."

"The VOLCEX exercises are organized yearly. Each time, the exercise scenarios vary and simulate eruptions on the volcanoes in Iceland, the Açores and Italy. "

Implementation considerations

Challenges

Classification of available procedures and practices, taking in account expected and unexpected events. The absence of shared or coordinated procedures among all levels and types of actors involved in the crisis management (for instance, to all actors layers involved in the management of the organs transplantation, i.e. national and regional transplantation centers, regional emergency agency, traffic corporation, etc.)

Implementation cost

Building response plans based on an all-hazard approach, reduces development costs. Since, the core part of these plans to different scenario is uniform. Establishing the response plans on everyday operations increases the employees' familiarity with the required actions in emergencies, Therefore there is less need for investing resources with the learning process.

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Healthcare implementation considerations

All-hazard approach can be applied to all levels of management (national, regional, local, operative). The fundamental ideal is that regardless if you have a surge capacity challenge at the local Emergency Department, a pandemic, or a train crash, the majority of procedures would be the same. Thus, a generic response plan can be applied.

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Air Traffic Management implementation considerations

Adaptation relative to events build flexibility and adaptation. It does not solely focus on a particular event but on the organisational capabilities to deal with events (expected and unexpected).


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Relevant material

Relevant Practices, Methods and Tools

Practices

[1] Real Time Risk Assessment (Lay, Branlat and Woods; 2015) This tool was developed in the context of industrial maintenance and aims at providing support to teams experiencing challenging (novel, complex, difficult) situations at maintenance sites. Within one hour, a geographically separated, diverse group in terms of knowledge, skills, function level, and roles, convenes via telephone conference to collaboratively analyse the problem and explore solutions. At the end of the meeting, project managers on site have various courses of actions vetted by remote experts, which can be implemented to improve the situation.

[2] Anticipating resource crunches


[3] Tactical reserves "All hands" alarm.

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Healthcare Practices, Methods and Tools

Checklists for initial major medical incident response are applied to all incident types on regional, local and prehospital level. This for example include a common situation report (METHANE) and time set key process indicators such as first report from scene, first formulation of incident strategy and first inter-agency briefing.

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Air Traffic Management Practices, Methods and Tools

The ATM sector has a long history of handling disruptions on a routine basis, or out of the ordinary. While not events are dealt with successfully, this domain has built are significant set of competences, processes and mechanisms to handle disruptions and crises. Such set can serve as inspiration for other operational domains and crisis management practices in general.

Clear goals and high-level adaptive strategies

Adaptation to disruptions relies on a shared understanding of some fundamentals:

  • ATM has the primary goal of maintaining a flow and ensuring the safety of aircrafts
  • ATM operations exist in a network of control centres and roles: solutions often involve nearby nodes (e.g., an adjacent centre offloads some traffic, a higher regional node replans traffic).
  • ATM operations exist in collaboration with other organisations involved in air transportation, especially airports and airlines: disruptions are also solved in collaboration with those actors. For instance, airlines can accept some impact on traffic in order to address unmanageable situations for ATM.
  • There is a limited number of typical strategies to maintain a capacity to adapt to disruptions:
    • Sectorisation allows to ... and, thereby, provide more capacity to handle traffic and adapt
    • Especially when sectorisation is not possible, air traffic flow and capacity management (ATFCM) aims at matching the traffic to the capacity. In order to reduce stress on an airport or air traffic center experiencing difficulties, ATM might: implement a zero rate, put aircrafts in holding pattern, divert traffic to a different airport, etc. (the specifics of ATFCM are very context-dependent).

Such goals and strategies are rehearsed in training, and are experienced during everyday operations (small disruptions occur routinely). They form the basis for the management of more challenging (e.g., unexpected) events and crises.

Roles supporting the management of adaptive capacity

Specific groups and roles exist in the ATM system to allow for the implementation of adaptive strategies:

  • The Capacity and Flow Management Unit (CFMU) / Network Manager from Eurocontrol coordinates ATFCM, clearly establishing this process as a highly collaborative one (especially between ATM and airlines).
  • Managers
  • ATC Supervisors acknowledge the importance of their operators in managing disruptions
  • ATCOs are highly engaged and competent individuals

Emergency plans and checklists

Emergency plans and checklists are constructed for all types of disruption events, and they serve different purposes. They enable adaptation by serving as action and memory support.

References

  • Dawes, Sharon S., Anthony M. Cresswell, and Bruce B. Cahan. Learning from crisis lessons in human and information infrastructure from the world trade center response. Social Science Computer Review 22.1 (2004): 52-66.‏
  • Duarte-Davidson, R., et al. Recent advances to address European Union Health Security from cross border chemical health threats. Environment international 72 (2014): 3-14.‏
  • Pollet, J., & Cummins, J. (2009, May). All hazards approach for assessing readiness of critical infrastructure. In Technologies for Homeland Security, 2009. HST'09. IEEE Conference on (pp. 366-372). IEEE.‏
  • Kaundinya, I., Nisancioglu, S., Kammerer, H., & Oliva, R. (2016). All-hazard guide for transport infrastructure. Transportation research procedia, 14, 1325-1334.‏
  • Son, C., Sasangohar, F., & Peres, S. C. (2017, September). Redefining and Measuring Resilience in Emergency Management Systems. In Proceedings of the Human Factors and Ergonomics Society Annual Meeting (Vol. 61, No. 1, pp. 1651-1652). Sage CA: Los Angeles, CA: SAGE Publications.‏
  • Rankin, A., Lundberg, J., Woltjer, R., Rollenhagen, C., & Hollnagel, E. (2014). Resilience in everyday operations: a framework for analyzing adaptations in high-risk work. Journal of Cognitive Engineering and Decision Making, 8(1), 78-97.
  • Zio, E., Piccinelli, R., & Sansavini, G. (2011, September). An all-hazard approach for the vulnerability analysis of critical infrastructures. In ESREL 2011 (pp. 2451-2458).‏


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