Critical decisions - firefighters on the front line
How a firefighting researcher shed light on decision-making in emergencies.
Dr Sabrina Cohen-Hatton got her PhD while working full time in the fire service. Her ground breaking research has now influenced national policy across all emergency services. She spoke to Professor Jonathan Crego of the Hydra Foundation, an expert in critical incident decision making, about her pioneering work.
Rising through the ranks
Jonathan Crego (JC): You’re a very special person in the fire service. Tell me about your journey to date.
Sabrina Cohen-Hatton (SCH): I joined the fire service when I was 18 as a firefighter. Most officers in the UK start the same way. We do our time riding out on the fire engines, putting out fires and performing the rescues that are so synonymous with the idea of what a firefighter is. I worked my way through every single rank and now I’m Deputy Assistant Commissioner of the London Fire Brigade. It’s a job that I adore, a profession that I’m passionate about.
We are the ones that are trusted to help when people are potentially having the worst day of their lives. Our daily business represents really painful traumatic life-changing events for the people that trust us to help. That’s a responsibility I take incredibly seriously.
Equally, as I’ve gone through the ranks and become a commander, I’m now asking firefighters to go into inherently dangerous situations. I’m asking them to trust me to know what to do to keep them safe in those situations, so that they can carry on keeping people safe.
JC: There’s so much depth to what you’ve said. I want to unpick that very moment you recognised ‘I want to research’.
SCH: I was called to respond to a fire where a firefighter had been incredibly badly burnt. My now husband (we were engaged at the time) was on that crew. There was a one-in-four chance it was him. It was the longest four minutes and 37 seconds of my life, it was agony driving to that fire not knowing if it was him.
When we got there I was so fortunate that it wasn’t my loved one who was injured, but it was a friend of ours, someone whom we both worked with. I felt an incredible sense of guilt for a long time, for feeling relief that it wasn’t my loved one that was burnt.
It was at that very moment I wanted to research how people make risk-critical decisions in particular on the incident ground, because we’re the ones that are trusted to know what to do, right?
We need to know how people are thinking, how they respond and how they behave. Eighty per cent of industrial accidents are caused by human error, that’s not a failure on a piece of equipment, of a policy or procedure, that’s something to do with how someone’s interpreted a situation or a cognitive bias they might have, a previous association or a previous conditioned response.
That is the basis of how we make decisions and that’s something you can’t write down in a new policy or capture in a new piece of equipment. That’s human nature.
So, the only way to reduce human error, make firefighters and the public safer, is to understand how people think and behave.
JC: You started your studying at the Open University while serving as a firefighter. What did you achieve and where did you go next?
SCH: I did my bachelor degree and master’s degree while I was serving. I decided I wanted to know more and direct my own studies, for all my looking through the literature, there were no answers. I came to Cardiff and approached Professor Rob Honey about doing a PhD.
He agreed to take me on and has been the most wonderful supervisor. He gave me seven years to complete my PhD, but I did it in just three. I was absolutely smitten with the work and couldn’t find enough hours in the day. The day I was due to start my PhD was the day my daughter was born.
I took some time out on the advice of Professor Honey. I started doing my PhD while working full-time and with a new-born baby at home.
I would go into the lab at 5am, run experiments, leave for work at 8.30, get straight to work, come home, spend time with my daughter, go back into the lab for the nightshift to run the second set of experiments and be there till 1 or 2am quite regularly. I would be fixing bits of equipment - at that time of the night there were no engineers around to fix the bits you inevitably break. I’m not quite sure if I completed a PhD in engineering or psychology!
I’d go back home, have a couple of hours sleep and be back again in the morning. But when I was spending that time with my daughter, I was so focused on her that the sky could’ve fallen in and I wouldn’t have noticed. I slept less and worked more. It was for a finite amount of time. I made it work and I finished in double time.
JC: You have an incredibly pragmatic view of psychology. Can you help me understand how you’ve applied some of that research?
SCH: I’m acutely interested in the theoretical, but I owe it to my profession to do something practical with the research and to apply it.
We’ve been fitting helmet cameras to incident commanders as they go out, it was always with the intention of what we can learn, what’s new and what can we do with it. It was about developing techniques we could put into policy.
The first piece of work we did looked at tactical command styles. The most practical evolution was to then look at strategic decision-making. Those commanders making decisions that affect the city you’re living in when that incident is happening. You may have heard the terms gold or strategic commander? They are the most senior officers coming together from different agencies, making decisions to set the strategic direction for the incident and how the city will recover.
We did some work looking at Hydra simulations. Hydra is a system where incident commanders can come together, experience a scenario, and make decisions on the situation that’s in front of them and provide their rationale for it. It allows those decisions to be compared and discussed in a forum where commanders can go on and develop it.
We looked at the way in which decisions were made in Hydra scenarios and compared it to a more realistic strategic command scenario.
London Fire Brigade set up exercise Unified Response. We buried eight train carriages under tons of rubble in a disused power station. We replicated a collapse in Waterloo station, we had 2,000 live casualties and players as far up as Government that were involved. We activated the civil protection mechanism where we would bring in resources from other countries.
It was a huge exercise run in real time over four days. We ran the strategic command as it would run in real life. What we were able to do then, by simulating the same methodology, was to collect data on the way commanders were making decisions, that we could sequence using Hydra. We were able to replicate that in a more realistic scenario and compare the two. We found that decision-making patterns were really similar, so it lends a lot of support to the way we’re training strategic commanders.
JC: Were you able to extrapolate that to live incidents and how fire officers were behaving on the ground in real incidents?
SCH: That’s something we’ve done previously using a similar method. Our first piece of research looked at how incident commanders make decisions. We had a very established national policy based with a national decision model we were using throughout the UK for our incident commanders. It had been around since 1994.
What I was really interested in was: does this model reflect the way people are making decisions, or is it something that we put in policy, so fire and rescue services can say ‘we have this, everyone should be following it’?
It’s also the same model we’re using to scrutinise a decision after an incident, so if a decision you make has consequences that you have to defend and you can’t demonstrate your process was in line with that model, where does that leave you as an individual commander, and where does that leave you as an organisation?
When we fitted helmet cameras to incident commanders as they were going out to live operational incidents, it was the first time it had been done anywhere in the world. We found the decision- making process was nothing like the decision-making guidance. The decision-making policy we were using nationally only represented 20 per cent of their decisions. However, if you were using that model to scrutinise the decisions, you’d use it to look at 100 per cent of the decisions. So, you can see where, as an individual commander, there’s a bit of a dilemma.
We did some work developing a new technique called the decision control process that helped those commanders to link their decisions to the rationale. We recognised two pathways. The very analytical, standard pathway and policy which only applied to 20 per cent of decisions and the intuitive pathway, those kind of split-second, gut-instinct decisions which represented the other 80 per cent.
Psychology will tell you that those two different types of decisions take part in two different parts of the brain. That’s something the policy doesn’t take into account. You can’t, in my view, criticise the commander for making a decision in a certain way, when it reflects the way their brain is wired as a human being.
This new technique was aimed at supporting those commanders.
Not being one to shy away from a challenge, as much as we had the academic evidence, I wanted practical evidence that would support its application. I got another 84 incident commanders and I tested them, half using the new model and half using the old model. The ones using the new decision control process, their situational awareness was much higher, up to five times more than the old decision model.
We also found there was more goal-directed decision-making. People were linking up their plans with decisions. This supports a concept we call operational discretion. This is where you recognise the incident you have doesn’t have a standard policy as it’s not a standard incident, we deal with the unexpected every day.
It allows those commanders flexibility to identify what the right operational decision is even if there is not a policy that prescribes what that decision should be. We went on to change the national incident command policy and that is now embedded in the joint emergency services interoperability programme, which is a national doctrine we have for all emergency services as to how they deal with major and complex incidents.
JC: So you're an operational firefighter and a committed researcher, trying to find out what matters in decision-making to save lives. What next?
SCH: We are going to continue to build on the work we’ve done on strategic decision-making so we can help those commanders who are operating under intense pressure and have huge responsibilities, especially when there are lives at stake.
We’re also interested in looking at virtual reality and how that can help decision makers. Joining up psychology, technology and its practical application is the next stage.