Critical Incident Support Planning

Experiences of many people indicate the impact of a critical incident can be very stressful. Michael Tunnecliffe suggests steps to establish "Critical Incident Support" procedures within an organisation. The following eight key steps form a planning procedure which can be adapted to most work groups.

Step 1. Identify potential critical incidents which can impact on your group.
What type of incidents can occur with your organisation? Consider any sub-groups, where there could there be some difference in the type of incident, or nature and degree of impact (eg. staff & patients, or staff and students).

Step 2. Determine and define appropriate responses to the situations identified.
Consider what information and awareness raising sessions would be appropriate. What support strategies may be required in the short, medium and long term? Are stress debriefing initiatives to be considered as part of the support for those affected? Has some provision for counselling been made, as a means of giving medium and longer term assistance?

Step 3. Establish Critical Incident Support priorities and procedures.
Plan the specifics of your support initiative:

• What is to be initiated?
• Who will initiate the response?
• Who will provide the response?
• When is this to be done?
• Where would this occur?

Step 4. Decide how planned Critical Incident Support would be communicated to staff, and initiated following an incident.
How will people be told about the Critical Incident Support Plan? If the main way of conveying the message is via inductions, what means will be used for those who do not attend inductions? Consider the following:

• Information brochures
• Special briefings
• Training video
• Organisational newsletter
• Posters and bulletins
• Staff meetings.

Step 5. Identify conditions or situations which can influence a Critical Incident Support response, and plan how these would be managed.
Are there some unique aspects of your organisation or workgroup to be considered when developing a Critical Incident Support Plan? These might include isolation or geographic location, the actual role of staff, critical functions the organisation performs, or legal responsibilities. These all have to be considered in assessing the appropriateness of the actions to be taken.

Step 6. Draw up and review the Critical Incident Support plan.
Using the information gathered, draw up a draft of the plan for consideration and comment by key people. Emphasise the plan is a draft only and may require review and modification.

Step 7. Communicate the plan to the group.
Once a satisfactory plan has been developed and accepted for use by the organisation or workgroup, communicate the plan via one or more of the ways suggested in Step 4.

Step 8. Evaluate the efficacy of the plan following its application to a critical incident.
As with any planning process, what looks appropriate on paper can often be found wanting in the real situation. The use of desktop exercises and live practice scenarios can be helpful in determining the degree to which the Critical Incident Support Plan results in the outcomes sought.

When conducting Critical Incident Support Planning, experiences of a number of organisations have provided the following tips:

1. Determine who is in charge of the plan and who will replace them if they are unavailable or move on.
2. Schedule regular reviews, as conditions and providers can change.
3. Test the plan on a regular basis.
4. Gain management support in advance for any major changes to the plan.