Integrated Crisis Management

Dominic Morgan, Director of Operations for the UK Charity Inspiral Health talks about Integrated Crisis Management and how to apply it.

Integrated Crisis Management (ICM) is designed to apply a clear and simple response to all crisis situations

2: Integrated Crisis Management: What is it?

A crisis can be defined as a critical event or sequence of unstable, dangerous critical events capable of overwhelming current organisational structures, capacity, and response, or to cause, by its very nature a loss of structures, capacity, and response, directly leading to suffering or organisational loss.

When faced with crisis, which by its very definition has the potential to either overwhelm us and our organisations, or to adversely impact on us or organisational resources, such as a pandemic or Sudden Impact Disaster (SID), causing both impacts to occur at the same time. Therefore, in crisis, we are required to think and act differently. So how do we do this. 

The answer is amazingly simple, as a crisis affecting a complex environment, cannot be resolve with a complicated solution. Consider this equation, if you have a complex environment, such as health care, any solution that is complicated will normally result in unachievable. Therefore, if something is unachievable, in any circumstances, it often means you have complication and complexity working against each other. Crisis cannot be solved this way.

Complicated + Complexity = Unachievable.

Equally, Unachievable = Complicated + Complexity.

Integrated Crisis management (ICM) is designed to apply a clear and simple response to all crisis situations and while ICM preparation will reduce the scale and nature of the adverse impact created by crisis, it can also be applied during any crisis.

So how do we respond to crisis and what is Integrated Crisis Management or ICM, as it’s known? ICM has been developed in response to address significant crisis, that could be affecting you, your family, your team, your organisation, your healthcare system, county or a global need or threat. It can address all crisis situations, affecting any type of organisation, at any time.

3: Integrated Crisis Management: Where does it come from?

ICM has been developed from two well understood major incident response structures. The first is Integrated Emergency Management (IEM), developed in the UK for major incident management, in the 1980’s. Developed to address shortcomings identified after numerous Major Incident response failures.

It was recognised that organisations responding to significant major incidents was being adversely affected by each responding organisation having its own organisational priority, such as police, fire, ambulance and others such the military, coast guard, Royal National Lifeboat Institution (RNLI) or any responding agency depending on the type of major incident. While each organisational priority was valid, it was recognised time and time again in major incident debriefs that this did not create the right environment to create an integrated major incident response.

Most recent examples of this failure would include the Manchester bombing, where one agency adversely affected the overall outcome, by restricting medical aid to the victims. IEM requires each responding agency to come together at the earliest practical point in a major, in a process labelled as ‘over the bonnet’. This label describes exactly the requirement to find the nearest vehicle, to get the bonnet and agreed on an integrated operational plan, in the now, using the actual available resources.  Not the resources you would like but the actual resources you have and can realistically rely on. 

ICM is also underpinned by the Incident Command System or ICS as its known. ICS was developed in the late 1960’s and 1970’s in North America after several wildfires, leading to significant loss of life and property. Following incident reviews, it was established that response problems often related to communication and management deficiencies rather than lack of resources or tactical failure. ICS was developed to address these failings and was collaboratively developed to provide a consistent, integrated framework for the management of all incidents from small incidents to large, multi-agency emergencies, by providing clear command and control, response structures, accountability and major incident roles, that could be pre-trained across all responding organisations. ICS is the standard major incident response system globally.

3: What is it like on the ground during a disaster?

Inspiral Health is a ‘coalition of the willing’, being built by global clinicians, educational and industry leaders and experienced disaster responders ~ all volunteers, bringing together their individual knowledge and determination into a collective effort, to help build a better reality for all.