Discover the enhanced process of Corporé’s Embrace Major Incident Rehabilitation Service (MIRS) with this early intervention response Case Study of a catastrophic event.
Phase 1 – Pre-Incident Procedure
Rehabilitation Case Managers, Expert Clinicians and the Embrace Management Team will spend time with key stakeholders (HR, Risk management, Health and Safety) to prepare for difficult situations.
The team will work to support these individuals, observing early recognition of the types of scenarios or events that warrant the Embrace MIRS approach. Training will include elements of;
- Immediate situation management (what to do and when)
- Support for all levels within the business on management of different scenarios
- Minimising psychological impact for those involved
- Problem-solving techniques
- When to notify the Embrace Team
- What happens next
- What can be expected from the Embrace response
- Potential claim capture advice
In addition to this training support, the team will agree a format and pre-prepare documents that might be useful following an incident. This will include general advice documentation and leaflets/posters that can be used following an incident to direct those involved to access the Embrace MIRS supportive services.
The Incident
An accident, involving a public bus, where three individuals, a member of the public and two bus company employees, were crushed by an out-of-control bus. One person died at the site whilst two others received significant but not life-limiting injuries. The event was witnessed by 10 other individuals, some of whom were involved in providing CPR to the member of bus staff who did not survive.
Phase 2 – Initial Response
Immediately following initial emergency response (Police, Fire, Ambulance), the appointed contact from the insurer made a call to the Embrace Hotline where preliminary details were gathered (who to contact, what was known about the incident and those affected, etc.). The reporting stakeholder was then advised that they would be contacted within one hour by a senior member of the Embrace Response Team.
The Embrace Response Team, consisting of senior members of case management, account management and clinical teams were immediately mobilised, prioritising the Embrace event over any other commitments.
The team then reviewed all available details of the event and reached out to the on-site appointed manager to offer immediate advice, gather further information and begin to formulate the response plan.
Once initial response recommendations were formulated, the response team liaised with both the on-site contact and insurer to discuss options and next steps. These initial recommendations of the Embrace Team were accepted.
Immediately, a post-incident helpline was established. The on-site contact made the helpline number known to those involved at the bus company as well as making it publicly available to others who were affected. This helpline offers immediate support and guidance to those affected, identifying individuals who may require treatment or further assessment, and gathers information which may contribute to future claims in order to support the business and insurer.
All calls to the helpline were triaged by a clinician who gave immediate support and advice, offered psychological debriefing and identified the need for further treatment and more detailed assessments for the affected individuals. All relevant details were logged and relevant information was shared with the bus company and insurer.
Phase 3 – Our Input
It was agreed that the two individuals who were injured required more detailed individual assessments. These were carried out within days of the incident, one telephonically, and one face-to-face, as determined by the severity of the injuries.
Both individuals were comprehensively assessed and individual rehabilitation plans were submitted to indicate the most appropriate path to recovery. If rehab plans are approved by the funder (either employer or insurer) then the same clinician that carried out the assessment will manage the ongoing rehabilitation needs of the individual through to recovery.
During the initial triage, it was identified that of the ten members of staff witnessing the event, seven reported psychological trauma symptoms. It was arranged for a psychological Case Manager to attend the bus depot for two full days immediately post-event.
During the two onsite days, the Embrace clinician delivered two group psychological debrief sessions including group support, anxiety management exercises and provision of psychological coping strategies. Individual sessions were also facilitated, during which the clinician supported individuals through debriefing and provision of individual coping strategies. A further drop-in session was arranged in order for those who chose not to be involved in group sessions to make use of the clinician’s expertise. In all, nine of the ten individuals who witnessed the incident were supported by the onsite clinician.
During the onsite support sessions, the clinician gathered relevant information and identified two individuals to benefit from further psychological treatment. The others entered a period of watchful waiting where the clinician made contact with them fortnightly for a six-week period to ensure that their symptoms subsided and that they no longer experienced ongoing issues. A report summarising the outcomes of the onsite intervention was submitted to the business, insurer and the onsite clinician monitoring the progress of ongoing treatment, the outcomes of which were also reported back to the business and insurer. All individual reports focused on an expedited return to work and function planning for all those involved.
Phase 4 – Follow Up
Throughout the management of the incident, the Embrace team continued to gather all information relevant to the business and insurer. Summary reports are submitted to both at regular intervals, detailing;
- Information about those affected
- Risk mitigation advice, including risks associated with claim motivated behaviours observed
- Treatment engagement, recommendations and outcomes
- Projected return to health, function and work outcomes for all involved
- Identified ongoing recommendations or needs
Our team continue to provide support for the individuals affected by the road traffic accident. During the management of the event, it was noted that managers within the bus company felt unprepared to manage and support the psychological health of their teams. The Embrace Team recommended a follow-up programme of psychological first aid training for managers which was delivered within weeks of the initial event. Feedback from managers is that they feel confident in supporting their staff with future psychological needs, but treatment and support are still provided to ensure an optimum return to work and function at the right pace for the affected individuals.
At completion, a full report will be submitted, detailing all interventions and outcomes.
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