Disaster
Medical System
After-Action
Assessment
Function 1: Development and
Maintenance of Medical and Health Disaster Plans, Policies, and Procedures for
the Operational Area
Element 1.4: After Action reviews
Guideline 1.4.1: After Action Reviews
AFTER-ACTION ASSESSMENT
I. PURPOSE
The purpose of this policy is to provide a framework
for critical assessment of a disaster or MCI response.
II. AUTHORITY
Division 2.5, Health and Safety Code, Section
1797.150-152
III. DEFINITIONS
A.
Incident Command System (ICS) means the nationally used standardized on-scene
emergency management concept specifically designed to allow users to adopt an
integrated organizational structure equal to the complexity and demands of a
single or multiple incidents without being hindered by jurisdictional
boundaries.
B.
Operational Area Emergency Operations Center (EOC) means the organization that coordinates activities
during an emergency response for the county and all political subdivisions
within the county.
C.
Departmental Operations Center (DOC) means the center for coordinating
discipline-specific activities outside the city or county Emergency Operations
Center (e.g. Medical/Health DOC).
D.
Standardized Emergency Management System (SEMS) means an adaptation of ICS adopted by the state of
California for management of incidents.
E.
Critical Incident Stress Debriefing Management (CISDCISM) means a specific form of counseling designed to
mitigate responder distress following a situation producing or potentially producing
emotional distress.
IV. POLICIES
A.
All incidents
requiring mutual medical aid or activation of the Disaster Medical System
should be followed by a multi-disciplinary review of all aspects of the
response.
B.
The review should
include the following:
1.
Feedback from all
agencies and levels of response involved;
2.
Review of all
response-related reports, correspondence and records; and
3.
Generation of
recommendations for changes in existing plans, or mitigation of identified
issues.
C.
Responsibility for
convening an after-action review lies with (position specified in the local
plan) and should occur within (time element specified in the local plan) of the
termination of the incident.
D.
Evaluation should
include assessment of the following aspects, including whether follow-up action
is indicated
(the following indicators are based on the SEMS After-Action Report):
1.
Appropriate
policies/procedures were in place for this response.
2.
Policies/procedures in
place were utilized to organize the initial and on-going response.
3.
ICS was used to manage
field response activities. All ICS
sections were/were not utilized.
4.
Unified Command was
considered/used/not used.
5.
The Operational Area
EOC/the Departmental Operations Center were/were not activated.
6.
The functions of the DOC M/H OAC were/were
not organized around the five SEMS functions.
7.
Personnel who
responded were/were partially/were not trained in SEMS/the local plan.
8.
Action plans were/were
not used.
9.
Coordination with
volunteer and community agencies occurred/did not occur/was not necessary.
10.
Mutual Aid was
requested/not requested/sent out of the area.
Mutual Aid activities were/were not coordinated adequately.
11.
Communication was
established and maintained/was problematic between operation centers.
12.
CISD CISM services were
available/utilized/not indicated.
13.
Public Information was
disseminated/not disseminated according to procedure. Information was appropriate/less than adequate for the situation.
E.
Summary of the
after-action report with recommendations and an Action Plan for implementation
of the recommendations should be distributed to all participating agencies.
V. CONSIDERATIONS
A.
The development of a
standard evaluation tool to be used to evaluate all responses should be
considered. (The RIMS After-Action Reporttool is suggested for reference.)
B. The development of a follow-up mechanism to assure that recommendations made in the after-action reports are acted upon should be in place, e.g. multi-disciplinary advisory or steering committee.