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Command Failure
Command Failure
Here’s an interesting item that was recently posted on the FireGeezer( http://www.firegeezer.com/ ) regarding Command Systems Failure. Excepts from the posting and from the Minneapolis Star-Tribune are included.
The questions for reflection and dialog are:
Have you experienced incident situations in which command decision making has been less than timely, command has not been implemented or command has exhibited signs of a melt-down?
Share your examples, how those deficiencies were overcome at the immediate time and what were the corrective actions, if any after the fact.
What defines the level of competencies and skills required to be possessed by an incident command?
How do you overcome inept Incident Command during an incident operation, when you know things are not going right and its becoming self-revealing that the commander is failing to command?
Report Overview
Inadequate preparation and the misreading of conditions by Oak Grove Fire Department commanders allowed a March house fire -- in which an 86-year-old man died -- to go unchecked for up to 10 minutes and build out of control, according to an investigator's report released Friday.
The report's theme -- a "delay to action" -- echoes many of the concerns expressed by angry Oak Grove firefighters, who said indecision and delay by superiors during the March 5,2008 fire may have cost the life of the occupant.
The report, never blames the occupant’s death on the Oak Grove Fire Department. But it does say that the department's commanders "allowed the fire to build and destroy any chance for early control" and that "aggressive ventilation and speedy attack" by the department "should have resulted in prompt fire control."
"Delay and indecision was the result of inadequate procedures and preparation, incomplete training and inexperience," the report states.
It cites the department's lack of an Incident Command System, in which one officer takes command during an emergency. It questioned the lack of authoritative command and control of officers. It also questioned why a ladder was not brought to the second floor, where the occupant was observed when the fire erupted.
The July 11, 2008 published report on the fire department’s actions provided the following insights :
The Fire Department did not have an Incident Command System in place to manage the scene of the fire…
As a result of an “incomplete evaluation” of the scene, command misread fire conditions and delayed implementation. This delay allowed the fire to develop unchecked for 7-10 minutes.
Delay and indecision was the result of inadequate procedures and preparation, incomplete training and experience.
However, procedural and policy issues faced by Oak Grove Fire Department did not contribute to the occupant’s death.
Inept communication delayed crews’ ability to effectively manage the fire.
“The central theme presented in this review is a ‘delay to action,’” wrote the consultant hired to conduct the review. “If Command had ordered the prompt entry of the attack line, ordered aggressive ventilation, and followed with a timely order for a ‘primary search’ — this report would not have been written.” Source: Minneapolis Star-Tribune
References:
http://www.firegeezer.com/
http://www.startribune.com/local/north/24541629.html?page=1&c=y
Here’s an interesting item that was recently posted on the FireGeezer( http://www.firegeezer.com/ ) regarding Command Systems Failure. Excepts from the posting and from the Minneapolis Star-Tribune are included.
The questions for reflection and dialog are:
Have you experienced incident situations in which command decision making has been less than timely, command has not been implemented or command has exhibited signs of a melt-down?
Share your examples, how those deficiencies were overcome at the immediate time and what were the corrective actions, if any after the fact.
What defines the level of competencies and skills required to be possessed by an incident command?
How do you overcome inept Incident Command during an incident operation, when you know things are not going right and its becoming self-revealing that the commander is failing to command?
Report Overview
Inadequate preparation and the misreading of conditions by Oak Grove Fire Department commanders allowed a March house fire -- in which an 86-year-old man died -- to go unchecked for up to 10 minutes and build out of control, according to an investigator's report released Friday.
The report's theme -- a "delay to action" -- echoes many of the concerns expressed by angry Oak Grove firefighters, who said indecision and delay by superiors during the March 5,2008 fire may have cost the life of the occupant.
The report, never blames the occupant’s death on the Oak Grove Fire Department. But it does say that the department's commanders "allowed the fire to build and destroy any chance for early control" and that "aggressive ventilation and speedy attack" by the department "should have resulted in prompt fire control."
"Delay and indecision was the result of inadequate procedures and preparation, incomplete training and inexperience," the report states.
It cites the department's lack of an Incident Command System, in which one officer takes command during an emergency. It questioned the lack of authoritative command and control of officers. It also questioned why a ladder was not brought to the second floor, where the occupant was observed when the fire erupted.
The July 11, 2008 published report on the fire department’s actions provided the following insights :
The Fire Department did not have an Incident Command System in place to manage the scene of the fire…
As a result of an “incomplete evaluation” of the scene, command misread fire conditions and delayed implementation. This delay allowed the fire to develop unchecked for 7-10 minutes.
Delay and indecision was the result of inadequate procedures and preparation, incomplete training and experience.
However, procedural and policy issues faced by Oak Grove Fire Department did not contribute to the occupant’s death.
Inept communication delayed crews’ ability to effectively manage the fire.
“The central theme presented in this review is a ‘delay to action,’” wrote the consultant hired to conduct the review. “If Command had ordered the prompt entry of the attack line, ordered aggressive ventilation, and followed with a timely order for a ‘primary search’ — this report would not have been written.” Source: Minneapolis Star-Tribune
References:
http://www.firegeezer.com/
http://www.startribune.com/local/north/24541629.html?page=1&c=y
Replies to This Discussion
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Permalink Reply by Don Zimmerman on
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Chris, where do you want me to start. Ya, if has happened to me. I had a wildland fire that was getting bigger and as a Type 4 IC I was handling the IA and getting it done. The Battalion Chief on duty came in and took the command from me (he was not rated at anything) and proceeded to lose the fire. 20 minutes later another IC came in and took command and with the fire out of control a delay occurred in placement of equipment to be in the right place at the right time causing a 3-4 day event when in my opinion if I had remained in command the fire might have been smaller than 3-4 days worth, still big but smaller. I would have turned the fire over to a Type III team and then stepped out of the whole thing. Instead we have a chain of command issue getting in the way of who was trained and capable to handle the incident. I have learned from this incident, it won't happen again ever. Not like that for sure.
More of the same happened in my opinion at the Charleston incident, I think and again my opinion only that the chain of command got in the way of someone who knew what to do and was moved aside and then all hell broke loose. It hurts a lot to think 9 brothers died because of command failure. We as a working group of emergency workers have got to stop being 200 yrs out of wack with the rest of the world, we are not doing ourselves any good at all.
It bothers me a lot when we on the west side of the US, see some stuff going on back east and see people die from issues on the fireground that were avoidable and we don't seem to be making those mistakes. Don't get me wrong we make our share of mistakes too, but not like that. It is hard to put into words, I hope everyone understands what I am saying. I am not throwing stones, that solves nothing. Zimm -
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