Toward best practice for tracking potentially traumatic events exposure and organisational responses in emergency services

Background and purpose

Emergency service workers are exposed to repeated potentially traumatic events (PTEs) throughout their careers due to the nature of their roles. These events can have negative and lasting impacts on individual mental health and wellbeing, as well as on the organisation more broadly. While tracking PTE exposure and organisational responses occurs in various ways across many high-risk organisations, there is a lack of evidence regarding the best approaches for such systems.

The Australasian Fire and Emergency Services Authorities Council (AFAC) Mental Health and Wellbeing Group identified the need to determine current best practice approaches for tracking. Natural Hazards Research Australia engaged Phoenix Australia - Centre for Posttraumatic Mental Health to undertake this project.

This project aimed to identify good practices for tracking:

• fire and emergency services workers' exposure to PTEs
• organisational responses to PTE exposure.

Given the lack of international evidence related to tracking systems, this report has drawn heavily on industry expertise, experience and current practice. It represents the industry's initial attempt to articulate potential good practice principles for PTE tracking systems.

Methodology

The project was conducted in three phases:

Phase 1: Best practice review: Comprised a literature review and expert consultations to identify and define tracking system elements, an environmental scan survey of current practices with Australian and international agencies and thematic analysis of survey data.

Phase 2: Developing good practice principles: Involved drafting an initial set of principles, two workshop consultations and Project Management Committee review to refine and finalise the principles.

Phase 3: Translation for practice: Involved development of a brief guidance document to assist fire and emergency service agencies in implementing good practice, development of a presentation pack to assist with dissemination, as well as conference presentations and other dissemination activities.

Key findings

Literature review: Very little published research on tracking cumulative PTE exposure in high-risk organisations, with no evidence-based best practices identified in either peer reviewed or grey literature. While nine different approaches to tracking PTEs/responses were found, primarily in grey literature, limited details were available on the implementation and effectiveness of these existing systems.

Environmental scan survey: Twenty-two emergency service agencies and high-risk organisations participated, providing a diverse and representative sample. Over half (64%) of these agencies had some form of PTE tracking system in place, while 73% tracked organisational responses to PTEs. Of the 14 implemented systems, 57% were rated as performing well to fulfil their purpose, while 21% were rated as underperforming. There was wide variability in approaches across agencies, including differences in definitions of recordable PTEs, data collection methods and technologies, analysis and reporting processes and the purposes and utilisation of tracking data.

Good practice principles: Through an iterative consensus building process, six key elements were identified, each with associated principles and sub-principles, categorising the range of considerations and characteristics for PTE and organisational response tracking systems into clearly delineated dimensions (see Figure A). The elements are:

1. Element 1: The primary purpose of a tracking system considers the motivations for having a tracking system, including the goals, purpose/s, and perceived benefits of the system for individuals, teams and organisations. The core purposes influence all stages in the design and development of any system/s and other elements.
2. Element 2: The design and implementation of the system considers the specific design, development and implementation aspects that are unique to an organisation’s tracking system. This element interplays across all elements of a tracking system.
3. Element 3: What data is collected by the tracking system considers what type of information is collected when a PTE exposure and/or organisational response occurs.
4. Element 4: How is data collected and stored considers the processes used to collect PTE exposure and organisation response data, as well as how data is stored by an organisation.
5. Element 5: How is the data analysed, reported and utilised considers how organisations analyse and report the PTE exposure, organisation response data and the purposes for which it is utilised.
6. Element 6: Monitoring and evaluation of the system considers the specific monitoring, evaluation and continuous improvement of tracking systems within the emergency service context. It ensures the system meets its purpose while minimising unintended negative consequences.

Implications and next steps

This project represents the industry's initial attempt to articulate good practice principles for PTE and organisational response tracking systems. Their implementation should be closely monitored for unintended impacts and the principles should be reviewed within two to three years. The principles are designed to be flexible and tailored to each agency's context. They are not intended to be prescriptive standards, but rather to guide decision-making and system improvement.