Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects.

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Our Wellness and Cultural Drift Date Location

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP)

Our Goals  Discuss what role health and wellness should have in our organization  Examine our current practices  Discuss how to improve our wellness  Review Cultural Drift  Identify Solutions

Cultural Drift or The Red Badge of Courage

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Should Wellness Be a High Priority in our Organization How big is the problem of accidents and injuries?  $2,500 per firefighter a year  $2.7 billion direct costs each year

What is Wellness  Wellness is a term that refers to an individual’s state of mind as well as their physical state, balancing between health and physical, mental, emotional and spiritual fitness

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Should Risk Leadership Be a High Priority in our Organization  Insurance companies spend $1.5 to $2 Billion on firefighter injuries  For every dollar an insurance company spends on a Fire Department claim, the Fire Department will spend an additional $4.00in other expenses  And, 23 criminal charges in 2011

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Why Firefighting is Dangerous  Long work hours  Strenuous physical demands  Emotional involvement  Exposure to human suffering  Exposure to heat  Exposure to chemicals  Our culture

The Leading Cause of Death  For all age groups of firefighters less than 30 years of age is MVA’s –Responding to the station –Responding to the alarm –Returning to quarters

NFPA FIREFIGHTER INJURIES IN THE US

FIREFIGHTER DEATHS

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) If it is PREDICTABLE It is PREVENTABLE  Regulations and standards are only the starting point for a quality wellness program 7.5% of injuries are attributed to things  Focusing on the Human Factor is the key to a successful Cultural change 92.5% of all injuries have one common thread!

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) If it is PREDICTABLE It is PREVENTABLE YOU & I

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) 92.5% of All Injuries are Preventable What is Predictable Is Preventable

WORKERS COMP RATES FOR FIREFIGHTERS YEARS 199120012011 RANK 26 1 4 RATE $6.60 $2.50 $1.69 Washington $2.04

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) THE HIDDEN COSTS OF ACCIDENTS Decreased Production OSHA Investigation Re-training Costs Pain & Suffering Low Morale Litigation Family Workers Compensation Costs

Structural Firefighter Deaths WA OR 1972-1981 18 14 1982-1991 17 15 1992-2001 12 4 2002-2011 7 2

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) The Law and Then Some “Close only Counts in Horseshoes”  Occupational Safety and Health Act of 1970  Risk Management that missed the mark –Fixing blame doesn’t fix problems –L & I is the law and the minimum standard

National Fallen Firefighters Foundation  Initiative #1 Cultural Change ‒ Define and advocate the need for a cultural change within the fire service relating to safety; ‒ Incorporating leadership, management, supervision, accountability and personal responsibility.

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Normalization of Deviance  Violating standards to achieve success –Better –Faster –Cheaper  Pushing our limits to be successful

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Normalization of Deviance  Seeing others take risks and then taking larger risks ourselves  Positive rewards  Unpleasant, Predictable Surprise  The result - Frequently Injury or even Death Mike Mullane; Normalization of Deviance

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Normalization of Deviance  Normalization of Deviance is the difference between a written policy and the practice Policy Practice

Historical Axioms  The Three E’s ‒ Engineering, Education, Enforcement  The Four Element’s ‒ Engineering, Education, Enforcement and Culture

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Building on the Basics  The 5 steps to Changing Our FS Culture –Identify –Analyze –Make a Plan –Execute the Plan –Monitor/Modify the Plan –Take two aspirin, this will not be easy

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Walls of defense between an action and an event P E T C Policy PPE/Equipment Training Culture

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Walls of defense between an action and an event P E T C Policy PPE/Equipment Training Culture 1

Walls of defense between an action and an event  POLICY ‒ Meets the needs of the department ‒ Resolves the problem

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Walls of defense between an action and an event  PPE/EQUIPMENT ‒ Acquire that equipment meets standards ‒ Require the equipment to be used ‒ Use the equipment as intended football vs. rugby

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Walls of defense between an action and an event  TRAINING ‒ Demonstrate to and ensure everyone understands the training ‒ Train in the same manner that you will use the equipment

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Walls of defense between an action and an event  CULTURE ‒ Involve personnel in the process ‒ Provide experience ‒ Pair the assignment to the knowledge ‒ Make sure your personnel are trained

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Cultural Drift How the Fire Service Approaches Safety  The Process ‒ Injury ‒ Policy ‒ Personal Protective Equipment/Tools ‒ Training ‒ Cultural

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) WHEN AN ACCIDENT OCCURS  BECAUSE OF POLICY ‒ Policy error ‒ Policy and Practice alignment ‒ Policy Defiance

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) THE BASIC REASONS FOR ERROR  A conscious decision to err  A subconscious decision to err  Accident proneness  Environmental Issues

WE NEED TO ELIMINATE  UNSAFE TRAINING EVENTS ‒ Training fatalities continue to represent roughly 10 deaths annually ‒ Over 10% of all injuries to fire fighters

WE NEED TO ELIMINATE  INADEQUATE TRAINING ‒ Effective Training ‒ Training must prepare firefighters for the dangers they will face

WE NEED TO ELIMINATE  MEDICALLY UNFIT FIREFIGHTEERS ‒ Fit for duty - fit to train ‒ 48-52 % of all injuries to firefighters are sprains and strains ‒ Every age group above 40 years of age the leading cause of death is heart attack

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Sudden Cardiac Death Study Between 1995-2004, 440 LODD’s were due to sudden cardiac death

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) 50% of LODD are SCD  Of 440 deaths over a 10 year period, 308 (43.5%) had a known heart condition  If you start with the number of deaths attributed to firefighters with a known heart condition, and add in age, other health conditions, and smoking, that number accounts for roughly 75% of all heart related deaths  Roughly 8 to 12 SCD’s lack root cause factors

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Cultural Change  5 keys goals to transforming your organizations safety program from the Classic Approach to a Dynamic Process of Effecting Cultural Change

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Cultural Change Solutions 1. Develop a Safety Strategic Plan ‒ Keep your Standards of Cover Document current

Cultural Change Solutions 2. Focus on Health and Wellness ‒ Fit for duty ‒ Firefighters should treat their bodies and themselves as athletes ‒ Health and wellness is a family value

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Cultural Change Solutions 3.Raise the bar for your safety committee to be Risk Managers ‒ Educate members their task is to fix problems through a “just culture” ‒ Review Injuries/near misses/unusual events/property losses ‒ The safety committee should move toward a Best Practices

Cultural Change Solutions 4.Preach “The Rights” ‒ Doing the right thing ‒ At the right time ‒ In the right way ‒ With the right attitude ‒ ALL THE TIME

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Cultural Change Solutions 5.Embrace the High Reliability Organization concept ‒ Be preoccupied with safety ‒ Understand decision-making ‒ Communicate effectively ‒ Change to a non-punitive review system

WELLNESS-FITNESS INITIATIVE  LABOR AND MANAGEMENT WORKING TOGETHER ‒ MEDICAL EVALUATION ‒ FITNESS ‒ REHABILITATION ‒ INJURY PREVENTION ‒ BEHAVIORAL HEALTH ‒ DATA COLLECTION

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Wellness-Fitness Components  Medical  Fitness  Injury and Medical Rehabilitation  Behavioral Health  Cost Justification  Data Collection

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Medical Exams  Physical exams –Entry Level Physical Exam –Utilize an agreed on Standard –Mandatory Annual Physical Exam Preventative in purpose Non-punitive in administration  Physical exams

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Medical Exams  Physiological stressors  Long term Chemical Exposures  Long term Biological Exposures

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Fitness  Aerobic Capacity  Muscular Endurance  Muscular Strength  Flexibility  Body Composition  Individualized Programs

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Fitness  Screen for Medical Fitness to Participate  On-duty time to Exercise  Our Body’s Flexibility  Our Organizations Culture

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Nutrition  Nutrition ‒ Nutrition is important to energy levels, recovery time, and a strengthened immune system ‒ Nutrition is important in reducing stress ‒ We need to provide education on eating healthier

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Obesity  Obesity ‒ Increases the risk of injury ‒ Decreases performance levels ‒ Decreases the ability to dissipate body heat ‒ Encouraged by Culture of the Fire Service

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Hydration  Hydration ‒ Recent studies have revealed that less than 10% of FF are well hydrated prior to any emergency activity ‒ This is likely the result of caffeinated drinks such as coffee and soda producing; Impaired energy output Reduced blood volume Less oxygen to muscles, rapid onset of fatigue

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Hydration  Hydration is important to; ‒ Stroke Volume, the amount of blood pumped by each heart beat ‒ Maintaining body cooling capacity ‒ Physical and mental capabilities

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Hydration  FF’s can lose > 2.6 liters per hour in sweat ‒ Greater than 2% body water weight loss can have significant effects on our physical/mental status ‒ Increased body temperature, decreased cardiac output ‒ Reduced mental capabilities

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Injury and Medical Rehabilitation  A sequence of clinical services that maximize a patient’s physical function and wellness following an illness or injury  Injury and illness often account for over 50% of a department’s retirements  Medical review after being off three months  Transitional Duty  When unfit, untrained, unwell report to work, the outcome is predictable

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Behavioral Health  Chaplain, Employee Assistance Program (EAP), Critical Incident Stress Management (CISM)  Medical, Physical, Emotional, Behavioral  Provide balance in life  Comprehensive Counseling  Watch  Recommend

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Data Collection  Injuries ‒ Type of Injury ‒ Body Part ‒ Root Cause ‒ Cost ‒ Anecdotal evidence ‒ Savings from program implementation

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) UNDERSTANDING THE POWER OF THE NEAR MISS 10 Disabling 1 Fatality 30 Minor 600 Near Misses

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) TO REPORT A NEAR MISS  firefighternearmiss.com OVER 1,000 NEAR MISSES SINCE INCEPTION

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) NEAR MISS SITES  thesecretlist.com  firefighternearmiss.com  The Daily Dispatch  firefighterclosecalls.com  rescue1.com  Fireengineering.com  Chief Owens safety video 1.avi  Mike Millane, Normalization of Deviance

QUESTIONS ?

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects (SHIP) Chief Owens FF Safety Video 1.avi dailydispatch.com firefighterclosecalls.com The Secret List firefighternearmiss.com firerescue1.com fireengineering.com firefighternation.com firefighterspot.com Resources

Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects.

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Funding and support for this project has been provided by the State of Washington, Department of Labor & Industries, Safety & Health Investment Projects.

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