Medical Training for High-Risk Environments
Many organizations, ranging from non-government organizations (NGOs) to government agencies to private corporations have employees working in the high-risk regions of the world. Often the project sites are remote, the infrastructure is poor, and quality medical care is hours if not days away. As part of a firm’s overall duty of care program, its employees need to be capable of self-treatment for a variety of medical issues.
Designing an effective medical training course must consider the following factors:
- Budget, time, and resources available.
- Priority listing of who needs to be trained based upon expected levels of risk exposure.
- Level of training is based on the priority listing (i.e. a basic 1st aid class or an immersive 4-day course). Higher levels of training will cost more due to the need for specialized instructor support and consumable medical supplies (bandages, tourniquets, etc.).
- Periodic refresher training. Medical skills are a perishable skill. Based on budget, time and resources available, refresher training should be conducted on a periodic basis.
- Sustainability. If feasible, an organization should strive to build an in-house training cadre capable of conducting further training. The advantages are lower costs as well as an instructor cadre that truly understands the unique needs of your organization.
- Integration. As explained below, medical problems often require input and support from various departments of your organization. Including key staff members in the training will strengthen the organization as a whole.
Designing Training Scenarios
Injuries and sickness create a multi-faceted medical, logistical, security, and business continuity problem. While the medical issue is addressed, the challenge quickly becomes:
- How do we move the patient, air or ground?
- Do we have service providers for emergency response? What is their response timeline?
- Who goes with the patient?
- Who stays behind to maintain operations?
- Is the road secure? Are additional security measures required?
- Can the employees in the field communicate effectively with headquarters staff and emergency support providers? Can movements be tracked?
- Does the patient have a passport in case of medical evacuation out of the country?
- Does the company’s insurance cover treatment, in part or all of it?
- Do any emergency funds need to be allocated?
- How should this event be messaged to local staff, the local community, the rest of the company, outside investors/donors?
- Should the family or spouses be informed of the medical emergency? Should they be informed over the phone or in person?
- What are the residual operational and psychological effects for the individual, team, and overall organization?
For high-risk medical training to be effective, training scenarios should address as many of these issues as possible. This will help the students “image” themselves through the full breadth of the problem and develop standard operating procedures for dealing with this type of scenario in the future.
Medical training should reach far outside a single classroom or venue. Beyond the students being trained on hard skills, there are opportunities to train the entire organization, learn valuable lessons from the rehearsal, and improve protocols for the future.
Medical Training Scenario
First and foremost, the employees need quality training with as much time devoted to practical application as possible. Muscle memory is critical; a conscious competence of the skills is not enough. The skills must be hardwired into the students so he or she can perform them under stress. As the common military saying goes, “one does not rise to the occasion, one sinks to his level of training.”
In addition to learning how to treat injuries, communication skills are another muscle memory that needs to be developed. The student should be well versed in how to report the status of a patient to emergency service providers, allowing them to dispatch the appropriate medical evacuation platform. Poor reporting can turn an evacuation from a multi-hour affair to a multi-day disaster.
Whenever possible, avoid “fairy dust.” If a patient needs to be moved by car, have the students load the patient into a car. If the proper equipment is not present, then they will need to improvise. This realistic training will force an organization to make hard decisions on how to allocate resources and funding in order to best prepare its employees for the harsh environments they will face.
Medical Services Provider
Global medical services providers have 24/7 assistance centers. With proper planning and preparation, test calls can be coordinated. This will allow a student to call the actual assistance center they will speak to during a real-world emergency. This is a huge step towards building up a student’s comfort level and familiarity with reporting procedures. Ideally, the training scenario is set up where everyone can hear the flow of the phone call in order to build up familiarity with the entire student group.
Crisis Response Team
Employee medical training is a great time to validate an organization’s Crisis Response Team. Protocols are only good if they are practiced. The same muscle memory built by employees bandaging wounds must be built by the staff as they coordinate and allocate resources, information, and support. It is amazing how often it is trivial things that confound a crisis response team such as communication platforms (email, Slack, WhatsApp), finding information (where is that employee’s record again), and administrative requirements (the employees next of kin information hasn’t been updated). The team will gain practice speaking with employees and the medical services provider as well.
After Action Review
Every training sessions should immediately be followed by a robust after action review to capture lessons learned. These will be translated into protocol improvements, streamlining the process in the future.
Medical training is critical to any organization that employs staff in high-risk environments. Done right, it will have a direct positive impact on an organization’s survivability, resilience, and morale. Employees who can trust their own ability and the ability of their teammates to successfully navigate a crisis form tight, cohesive teams.
Tough training develops trust. Trust builds teams. Teams win.