My last several Firefighting-360 columns have focused on communications. The last part of an effective fireground communication cycle is the mission/task debrief. Debriefs are an essential part of learning, improving and identifying how human factors affect our actions at every incident.
Firefighters were born to talk, and that’s how they should conduct a debriefing: listening and talking to each other in an open and frank manner. The discussion is conducted as soon as possible after the event, sometimes right there on the apparatus tailboard before the team leaves the scene. This is where they can learn about their strengths and weaknesses, and create a clear vision of their future needs. Debriefing an incident or training event can also generate valuable lessons learned that can be institutionalized into future operations.
Due to the tactical details and high risk involved, it has become common practice for special operations, hazmat and technical rescue teams to conduct debriefings immediately after their incidents. Because of the new challenges and risks involved in all of today’s incidents, emergency responders should perform some kind of a debriefing following every event.
Several items can be discussed when conducting a debriefing, but it all begins with evaluating the crew coordination:
- Did the team practice good crew resource management skills (followership, leadership, decision making, situational awareness, etc.)?
- Were there any deviations from the standard operating procedures (SOPs) or standard practices?
- What were the unusual situations, either positive or negative, and how were they handled?
- Was the workload management rushed, overloaded or confused?
- Were there any personnel conflicts or differences in expectations?
- Were there any maintenance discrepancies?
All of these items, and possibly more, should be addressed in an open and non-confrontational fashion.
Rules of a Debriefing
The first rule at a debriefing is that everyone must check their feelings at the door. All team members, especially the leaders, must be comfortable talking about errors they might have made. Human error is a fact of life. We all make mistakes, and there is no process or event, when the human element is involved, that is free of them. But it just doesn’t make sense to continue making them; it’s better to talk about how we can improve. So everyone must be ready to stand up for their own mistakes and be willing to constructively talk about others’ mistakes.
General Peyton C. March, chief of staff of the United States Army from 1918—1921, said, “Any man worth his salt will stick up for what he believes is right, but it takes a slightly better man to acknowledge instantly, and without reservation, that he is in error.” Be ready to provide constructive criticism and to accept it. Participate in the debriefing with honesty and candor. The focus should be on team performance. Openly congratulate, and constructively criticize, others while dissecting every phase of the operation.
The Leader’s Role
The role of the facilitator is an important part of a well-run debriefing. If you’re doing a “tailboard debrief” immediately after the incident, a company or chief officer will probably guide the discussion. But if you’re holding a more formal debrief, due to the size or complexity of the incident (also called an after-action review or post-incident analysis), then it might be best to have someone not personally involved in the incident lead the discussion. This will help ensure that at least one person is focused on staying on agenda and keeping people involved. The facilitator’s skill in planning agendas, creating the appropriate group environment, encouraging participation and leading the group to reach its objectives is essential to the success of the debrief.
Good facilitators begin by setting the expectations for crew participation. They create and maintain a safe, open and supportive environment for all group members, while guiding the session to the extent necessary to achieve the debrief objectives. The ability to draw out quiet crewmembers is a vital link to team growth and cohesiveness. Facilitators should ensure that all critical topics are covered, integrating instructional points as needed into the crew’s discussion. It’s imperative that positive aspects of the crew’s behavior are reinforced.
A debrief is a straightforward analysis of how everyone performed and should be based on three things:
- What occurred?
- How did it happen?
- What could be done differently to improve the end result?
Knowing that execution is usually our weakest link, begin by dissecting the operation. Remember: It’s not who’s right, it’s what right! Look for the facts by asking, “What did you do?”
The following are questions and responses taken from a debriefing that occurred after a house fire that involved an LP tank fire, a car fire and a problem establishing a water supply.
- Question: Describe the conditions of the emergency upon your arrival. Answer: As the first-in engine, the conditions we found on arrival were a fully-involved vehicle under a carport with a vented 250-lb. LP tank with ignition that was impinging on the B side of the structure.
- Question: Describe your actions or assignments. Answer: As the driver of E23, my assignment was pump operations consisting of supplying both 1¾” preconnects, the 2½” pre-connect and a monitor with a 1 3/8″ tip.
- Question: Identify and describe any unique problems you may have encountered. Answer: As the driver performing pump operations, I encountered communication problems while supplying the engines. Initially, I was under the assumption that E33 was supplying E23 directly, but I later found out that E26 was relaying from E33 to E23. Prior to a water supply being established, I made attempts to get tank water from RE35 and E26, but I only succeeded in getting E26’s water. A main concern is that E23 ran out of water for approximately 30 seconds waiting for E26’s tank water before the relay was set up from E33.
- Question: Any recommended changes in planning, procedures, training or equipment as a result of this incident? Answer: I saw E33 lay dual lines away from my engine. I assumed that E33 would be supplying me from the hydrant, but E33 ran out of hose. If there are any doubts about making a single lay vs. a dual lay because of distance, make the single lay! You can always lay another line later.
- Question: Did you encounter any safety problems? Answer: Yes, running out of water SUCKS!
Analyze the Execution
Now that everyone has discussed the facts, you can analyze the execution and identify the probable cause(s) of any identifiable error. This is the hardest part of a debriefing–determining a cause.
Every cause has a human component, known as the how. An example from the above debriefing: E23, the attack engine, had limited water supply for exposure protection, and at one point ran out of water. How did this happen? E33, assigned to complete a reverse lay to a hydrant, ran out of hose, which delayed the establishment of a continuous water supply. The active human error was that the crew on E33, while progressive, miscalculated the distance from the attack engine to the hydrant. That was human error.
But what was the root cause for the delay, and the loss of a continuous water supply? It points to a lack of teamwork, discipline, communication and training. The officer and firefighter from E33 departed the engine at the fire, leaving the driver completely on his own to make a difficult decision during a stressful event (house on fire, car on fire, LP tank on fire, and possibly an occupant still inside; must get water supply quickly). The driver knew he needed lots of water, which eventually would require dual lines, and really thought he could make it to the hydrant. Sometimes we have to accept reality and be disciplined with our response.
Finally, as with most events, there was a lack of communication. Once the driver realized the problem (ran out of hose), he tried to solve the problem himself and didn’t communicate the issue to command.
An Invaluable Opportunity
Critiquing a fire or other significant incident provides us with an opportunity to review the effectiveness of our actions and procedures during an actual incident, including the overall quality of our services to the community. This review can be invaluable in improving our individual, company and department performance at future incident operations. The information obtained from a critique may be used to complete an informal or formal post-incident analysis, or to develop future training and safety needs through the publication of an article or a hands-on training program.