Whole-of-Government Crisis Management: From Research to Practice

2021 ◽  
Author(s):  
Kathryn H. Floyd
Keyword(s):  
Best Practices ◽  
Crisis Management ◽  
Terrorist Attack ◽  
Lessons Learned ◽  
Surge Capacity ◽  
Roles And Responsibilities ◽  
Pivotal Moments ◽  
National Power ◽  
Government Crisis Management ◽  
Mix And Match

When a crisis manifests, the problem or situation is often at a terrible point where sage and timely decisions are of critical importance. Ideally, the particular emergency has been known previously and various challenges, roadblocks, and solutions workshopped in a tabletop or other exercise. Whether in advance or at a sudden precipice, a whole-of-government approach can navigate, mitigate, and alleviate the disaster in a holistic and comprehensive manner that is tailored to the task at hand. Whole-of-government crisis management—at the local, state, national, or international level—involves several elements. First, those in command need to know the myriad of players who may have roles and responsibilities to play at pivotal moments. Every organization will not be required in every crisis, and a strategic mix and match is often valuable. Second, each agency needs to understand how it fits into the larger puzzle and adjust their internal culture accordingly to support interagency operations, regardless of who is providing a lead function and who is supporting. Then, the agencies must have the staff available to fulfill their tasks and surge capacity, making provisions for alternative personnel or a “backbench” to execute everyday operations while the frontlines are busy. Elements of whole-of-government approaches appear throughout all aspects of crisis management. A relatively recent term, whole of government is an expansive framework for coordinating interagency responses that is often invoked in policy documents, as well as examined in academic studies. As it is adopted by various administrations and organizations during times of calm and emergency, the whole-of-government approach has aspects that are enduring, countervailing, and aspirational. The instruments of national power—diplomatic, information, military, and economic (DIME)—provide one lens through which to examine whole-of-government crisis management. Past interagency responses demonstrate best practices and difficult lessons learned for future whole-of-government operations. A broad analysis of whole-of-government crisis management enables government leaders, practitioners, scholars, researchers, and others to create comprehensive and flexible strategies with delineated roles for dedicated interagency partners in advance of the next hurricane or terrorist attack.

Medical Surge Capacity in Atlanta-Area Hospitals in Response to Tanker Truck Chemical Releases

2015 ◽  
Vol 9 (6) ◽  
pp. 681-689 ◽  
Author(s):  
Curtis Harris ◽  
William Bell ◽  
Edward Rollor ◽  
Tawny Waltz ◽  
Pam Blackwell ◽  
...  
Keyword(s):  
Health Care ◽  
Terrorist Attack ◽  
Community Response ◽  
Health Care Facilities ◽  
Lessons Learned ◽  
Toluene Diisocyanate ◽  
Surge Capacity ◽  
Incident Command ◽  
Care Facilities ◽  
Tanker Truck

ABSTRACTObjectiveWe designed and conducted a regional full-scale exercise in 2007 to test the ability of Atlanta-area hospitals and community partners to respond to a terrorist attack involving the coordinated release of 2 dangerous chemicals (toluene diisocyanate and parathion) that were being transported through the area by tanker truck.MethodsThe exercise was designed to facilitate the activation of hospital emergency response plans and to test applicable triage, decontamination, and communications protocols. Plume modeling was conducted by using the Defense Threat Reduction Agency’s (DTRA) Hazard Prediction and Assessment Capability (HPAC) V4 program. The scenario went through multiple iterations as exercise planners sought to reduce total injuries to a manageable, but stressful, level for Atlanta’s health care infrastructure.ResultsAtlanta-area hospitals rapidly performed multiple casualty triage and were able to take in a surge of victims from the simulated attack. However, health care facilities were reticent to push the perceived manageable numbers of victims, and scenarios were modified significantly to lower the magnitude of the simulated attack. Additional coordination with community response partners and incident command training is recommended. Security at health care facilities and decontamination of arriving victims are two areas that will require continued review.ConclusionAtlanta-area hospitals participated in an innovative regional exercise that pushed facilities beyond traditional scopes of practice and brought together numerous health care community response partners. Using lessons learned from this exercise coupled with subsequent real-world events and training exercises, participants have significantly enhanced preparedness levels and increased the metropolitan region’s medical surge capacity in the case of a multiple casualty disaster. (Disaster Med Public Health Preparedness. 2015;9:681–689)

scholarly journals Design of MARQUIS2: study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Amanda S. Mixon ◽  
◽  
G. Randy Smith ◽  
Meghan Mallouk ◽  
Harry Reyes Nieva ◽  
...  
Keyword(s):  
Best Practices ◽  
Medication Reconciliation ◽  
Improve Patient Safety ◽  
Lessons Learned ◽  
Medication History ◽  
Medication Discrepancies ◽  
Roles And Responsibilities ◽  
Medical Centers ◽  
Phone Calls ◽  
Barriers To Implementation

Abstract Background The first Multi-center Medication Reconciliation Quality Improvement Study (MARQUIS1) demonstrated that implementation of a medication reconciliation best practices toolkit decreased total unintentional medication discrepancies in five hospitals. We sought to implement the MARQUIS toolkit in more diverse hospitals, incorporating lessons learned from MARQUIS1. Methods MARQUIS2 is a pragmatic, mentored implementation QI study which collected clinical and implementation outcomes. Sites implemented a revised toolkit, which included interventions from these domains: 1) best possible medication history (BPMH)-taking; 2) discharge medication reconciliation and patient/caregiver counseling; 3) identifying and defining clinician roles and responsibilities; 4) risk stratification; 5) health information technology improvements; 6) improved access to medication sources; 7) identification and correction of real-time discrepancies; and, 8) stakeholder engagement. Eight hospitalists mentored the sites via one site visit and monthly phone calls over the 18-month intervention period. Each site’s local QI team assessed opportunities to improve, implemented at least one of the 17 toolkit components, and accessed a variety of resources (e.g. implementation manual, webinars, and workshops). Outcomes to be assessed will include unintentional medication discrepancies per patient. Discussion A mentored multi-center medication reconciliation QI initiative using a best practices toolkit was successfully implemented across 18 medical centers. The 18 participating sites varied in size, teaching status, location, and electronic health record (EHR) platform. We introduce barriers to implementation and lessons learned from MARQUIS1, such as the importance of utilizing dedicated, trained medication history takers, simple EHR solutions, clarifying roles and responsibilities, and the input of patients and families when improving medication reconciliation.

scholarly journals Insights Into French Emergency Planning, Response, and Resilience Procedures From a Hospital Managerial Perspective Following the Paris Terrorist Attacks of Friday, November 13, 2015

2016 ◽  
Vol 10 (5) ◽  
pp. 789-794 ◽  
Author(s):  
Ali Ghanchi
Keyword(s):  
Crisis Management ◽  
Terrorist Attack ◽  
Lessons Learned ◽  
Emergency Planning ◽  
University Teaching ◽  
Local Context ◽  
Major Incident ◽  
Staff Performance ◽  
Medical Response ◽  
Plan Blanc

AbstractOn Friday, November 13, 2015, Paris was subjected to a multiple terrorist attack that caused widespread carnage. Although French emergency planning, response, and resilience procedures (Plan Blanc) anticipated crisis management of a major incident, these had to be adapted to the local context of Pitié-Salpêtrière University Teaching Hospital. Health care workers had undergone Plan Blanc training and exercises and it was fortunate that such a drill had occurred on the morning of the attack. The procedures were observed to work well because this type of eventuality had been fully anticipated, and staff performance exceeded expectations owing to prior in-depth training and preparations. Staff performance was also facilitated by overwhelming staff solidarity and professionalism, ensuring the smooth running of crisis management and improving victim survival rates. Although lessons learned are ongoing, an initial debriefing of managers found organizational improvements to be made. These included improvements to the activation of Plan Blanc and how staff were alerted, bed management, emergency morgue facilities, and public relations. In conclusion, our preparations for an eventual terrorist attack on this unprecedented scale ensured a successful medical response. Even though anticipating the unthinkable is difficult, contingency plans are being made to face other possible terrorist threats including chemical or biological agents. (Disaster Med Public Health Preparedness. 2016;page 1 of 6)

Adapting Tactical Military Structures to the Current and Future Operational Environments

2020 ◽  
Vol 26 (1) ◽  
pp. 157-162
Author(s):  
Paul Tudorache ◽  
Lucian Ispas
Keyword(s):  
Best Practices ◽  
Lessons Learned ◽  
Organizational Adaptation ◽  
Common Denominator ◽  
Military Operations ◽  
The Future ◽  
Military Units

AbstractUsing the lessons learned from recent military operations such as Operation Inherent Resolve (OIR) from Syria and Iraq, we proposed to investigate the need for tactical military units to adapt operationally to grapple with the most common requirements specific to current operational environments, but also for those that can be foreseen in the future. In this regard, by identifying the best practices in the field that can be met at the level of some important armies, such as USA and UK, we will try to determine a common denominator of most important principles whose application may facilitate both operational and organizational adaptation necessary for tactical military units to perform missions and tasks in the most unknown future operational environments.

The ethics of pandemic preparedness revisited - autonomy, quarantine, transferability and trust

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Schröder-Bäck ◽  
T Schloemer ◽  
K Martakis ◽  
C Brall
Keyword(s):  
Crisis Management ◽  
Ethical Issues ◽  
Lessons Learned ◽  
Point Of View ◽  
Ethical Challenges ◽  
Pandemic Preparedness ◽  
Ethical Aspects ◽  
Outbreak Management ◽  
Ethics Framework ◽  
Ethical Point

Abstract Background The outbreak of SARS in 2002 lead to a public health ethics discourse. The crisis management of that time was ethically analysed and lessons to be learned discussed. Scholarship and WHO, among others, developed an ethics of pandemic preparedness. The current “corona crisis” also faces us with ethical challenges. This presentation is comparing the two crises from an ethical point of view and a focus on Europe. Methods An ethics framework for pandemic preparedness (Schröder et al. 2006 and Schröder-Bäck 2014) is used to make a synopsis of ethical issues. Ethical aspects of 2002 and 2020 that were discussed in the literature and in the media are compared. For 2020, the focus is on interventions in Italy, Germany, Switzerland, and the Netherlands. Results Topics that emerged from the 2002 crisis were, among others, revolving around aspects of stigmatisation and fair distribution of scarce resources (esp. vaccines, antivirals). Currently, most urgent and ethically challenging aspects relate to social distancing vs. autonomy: Isolation and quarantine are handled differently across Europe and the EU. Questions of transferability of such interventions prevail. Contexts vary vertically over time (2002 vs. 2020) and horizontally (e.g. between Italy and Germany at the same time). Furthermore, trust in authorities, media and health information is a key issue. Conclusions Ethical aspects are key for good pandemic preparedness and management. The context of the crises between 2002 and 2020 has slightly changed, also based on “lessons learned” from 2002. This has implications on ethical issues that are being discussed. New lessons will have to be learned from the 2020 crisis. Key messages Pandemic preparedness and outbreak management entail many ethical tensions that need to be addressed. Currently, questions of trust and transferability are key to the crisis management, further ethical issues could still emerge.

scholarly journals Patient and public involvement of young people with a chronic condition: lessons learned and practical tips from a large participatory program

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Femke van Schelven ◽  
Eline van der Meulen ◽  
Noortje Kroeze ◽  
Marjolijn Ketelaar ◽  
Hennie Boeije
Keyword(s):  
Young People ◽  
Chronic Condition ◽  
Public Involvement ◽  
Patient And Public Involvement ◽  
English Summary ◽  
Lessons Learned ◽  
Project Teams ◽  
Data Sources ◽  
Future Prospects ◽  
Roles And Responsibilities

Plain English summary Background Young people with a chronic condition are increasingly involved in doing research and developing tools and interventions that concern them. Working together with patients is called Patient and Public Involvement (PPI). We know from the literature that PPI with young people with a chronic condition can be challenging. Therefore, it is important that everyone shares their lessons learned from doing PPI. Aim We want to share our lessons learned from a large program, called Care and Future Prospects. This program helps young people with a chronic condition to, for example, go to school or to find a job. It funded numerous projects that could contribute to this. In all projects, project teams collaborated with young people with a chronic condition. What did we do We asked young people with a chronic condition and project teams about their experiences with PPI. Project teams wrote reports, were interviewed, and filled out a tool called the Involvement Matrix. Young people filled out a questionnaire. Findings In the article, we present our lessons learned. Examples are: it is important to involve young people with a chronic condition from the start of a project and everyone involved in a project should continuously discuss their responsibilities. We provide practical tips on how young people with a chronic condition and project teams can do this. A tip for young people is, for example: ‘discuss with the project team what you can and want to do and what you need’. An example of a tip for project teams is: ‘Take time to listen attentively to the ideas of young people’. Abstract Background The Patient and Public Involvement (PPI) of young people with a chronic condition receives increasing attention in policy and practice. This is, however, not without its challenges. Consequently, calls have been made to share lessons learned during PPI practice. Methods We share our lessons learned from a large participatory program, called Care and Future Prospects. This program aims to improve the social position of young people aged 0–25 with a physical or mental chronic condition by funding participatory projects. We have drawn our lessons from 33 of these projects, using four data sources. One data source provided information from the perspective of young people with a chronic condition, i.e. questionnaires. Three data sources contained information from the perspectives of project teams, i.e. project reports, case studies of projects and Involvement Matrices. For most of the projects, we have information from multiple data sources. Results We have combined the findings derived from all four data sources. This resulted in multiple lessons learned about PPI with young people with a chronic condition. Those lessons are divided into six themes, including practicalities to take into account at the start, involvement from the start, roles and responsibilities, support, flexibility and an open mind, and evaluation of process and outcomes. Conclusions The lessons learned have taught us that meaningful PPI requires effort, time and resources from both young people and project teams, from the beginning to the end. It is important to continuously discuss roles and responsibilities, and whether these still meet everyone’s needs and wishes. Our study adds to previous research by providing practical examples of encountered challenges and how to deal with them. Moreover, the practical tips can be a valuable aid by showing young people and project teams what concrete actions can support a successful PPI process.

Sustainability Certification and Green Public Procurement: Ideals and Outcomes in a New Jersey School District

2021 ◽  
pp. 097340822110125
Author(s):  
Cluny Mendez ◽  
Christopher L. Atkinson
Keyword(s):  
New Jersey ◽  
School District ◽  
School Districts ◽  
Best Practices ◽  
Public Procurement ◽  
Lessons Learned ◽  
Future Research ◽  
Review Of The Literature ◽  
Green Public Procurement ◽  
The Subject

The implementation of sustainability and green public procurement (GPP) initiatives in school districts has been the subject of some debate; questions over definitions and programme goals have led to inconsistency and concerns about programme achievements. The legitimacy of programmes rests not only with the announcement of policy by officials, but with adherence to policy and staff buy-in. This study examines barriers districts face, and makes recommendations based upon district experience on ways to successfully implement sustainability and GPP initiatives. A review of the literature on GPP and legitimacy in the execution of public functions within the education domain begins the study. Major components relative to best practices for GPP programmes are studied through the review of GPP-related documents from a school district in New Jersey considered as an exemplar of such programmes. Analysis of an interview with the district’s representatives suggests that, despite the normative approval such programmes receive, and widespread understanding of the rationale for pursuing such initiatives, there remain critical failings in implementation of these programmes, stemming from education, resourcing of initiatives and prioritization of green procurement in relation to other district priorities. The study concludes with lessons learned from this case, which is important given its positioning within New Jersey as an exemplar and recommendations for future research where work in this area is needed.

Encouraging millennials to collaborate and learn on the job

2015 ◽  
Vol 14 (4) ◽  
pp. 118-123 ◽  
Author(s):  
Lauren Trees
Keyword(s):  
Knowledge Management ◽  
Best Practices ◽  
Social Networking ◽  
Age Groups ◽  
Lessons Learned ◽  
Retention Rates ◽  
Direct Access ◽  
Content Type ◽  
Business Outcomes ◽  
Wide Range

Purpose – The purpose of this paper is to present enterprise social networking and gamification as two potential tools to help organizations engage Millennial employees in collaboration and learning. Design/methodology/approach – The research provides general descriptions of enterprise social networking and gamification approaches, shares data on adoption of these approaches from APQC’s “2015 Knowledge Management Priorities Data Report” (based on a January 2015 survey of 524 knowledge management professionals) and includes four company examples adapted from APQC’s Connecting People to Content and Transferring and Applying Critical Knowledge best practices studies. The methodology for APQC’s best practices studies involves screening 50 or more organizations with potential best practices in a given research scope area and identifying five or six with proven best practices. APQC then conducts detailed site visits with the selected organizations and publishes case studies based on those site visits. Findings – Enterprise social networking platforms are in place at 50 per cent of organizations, with another 25 per cent planning to implement them by the end of 2015. By providing near-immediate access to information and answers, enterprise social networking helps Millennials learn the ropes at their new workplaces, gives them direct access to more knowledgeable colleagues who can assist and mentor them, and helps them improve their business outcomes by reusing knowledge and lessons learned across projects. Younger workers can also harness the power of social networking to create a sense of belonging and build their reputations in large, dispersed firms, where it is particularly difficult for them to gain visibility. A recent APQC survey indicates that 54 per cent of organizations either currently employ gamification to encourage collaboration or expect to implement it within the next three years. The rush to gamify the enterprise is, at least in part, a reflection of employers’ desire to satisfy Millennials and make them feel connected to a community of co-workers. Although games appeal to a wide range of age groups, Millennials grew up with digital interaction and tend to prefer environments that emphasize teamwork, social learning and frequent feedback – all of which can be delivered through gamification. Originality/value – The value of this paper is to introduce the value of and relationship between enterprise social networking and gamification platforms to human resource (HR) professionals looking to increase engagement and retention rates for Millennial employees.

Milestones, Lessons Learned and Best Practices in the Designing, Deployment and Installation of ICDs in Saudi Arabia

2015 ◽  
Author(s):  
Mohammed A Madan ◽  
Kousha Gohari ◽  
Roberto Vicario ◽  
Heikki A Jutila ◽  
Hesham A Mohammed
Keyword(s):  
Saudi Arabia ◽  
Best Practices ◽  
Lessons Learned
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