Why every corrections officer should be a risk manager
Reporting and dissecting close calls will improve safety while decreasing liability
Running Central Control for the fifth 12-hour shift in a row, an officer got the call to open a cell door in a housing unit with inmates from several different classifications. The cell he was called upon to open housed a medium-security inmate who could be escorted out of the housing unit with one escort officer. The escort officer who called Control had initiated his radio microphone after he started speaking and cut himself off.
The control officer heard a different cell number than what the escort officer said on the radio and opened a different cell door. This cell housed a maximum-security inmate who was also a mental health patient and prone to violence. He was only to come out of his cell in handcuffs and with two officers present. Yet here he was, out of his cell, surprised and staring at the escort officer.
The escort officer ordered the inmate back in his cell and the inmate followed the order. The control officer saw what had happened and closed the door. No harm, no foul. The officers finished their shift and had a laugh about the close call in the locker room.
Dodging a bullet
How many times have you written an incident report, shaking your head and counting your lucky stars that a series of missteps did not lead to one of your partners getting hurt, or an outcome in your facility that would end up in the news? How many times have you breathed a sigh of relief after seeing your career flash before your eyes because something pretty bad almost happened?
In the corrections world, new corrections policies and training are often implemented after bad outcomes. When someone gets hurt, an agency sued, or an inmate escapes, the response can be swift and the changes can be dramatic. Corrections staff are fired, and policies picked apart.
When a bad set of circumstances does not create a bad outcome, however, we laugh in relief and shake our head. Maybe we give the officer who almost lost their job some tough love and let them know, “You just dodged a bullet.”
What we generally do not do is tell anyone in authority about the incident. We don’t want to get a partner in trouble for a mistake that didn’t cause any issues. But what happens the next time one of your partners makes the same mistake and something bad does happen? Could an institution avoid that injury, that lawsuit, or that riot with some risk management?
Near Misses and Close Calls
In 1976, NASA established the aviation safety reporting system (ASRS) with the mission of improving safety. The program serves commercial aviation, as well as government agencies involved in flying. This reporting system encourages pilots, air traffic controllers and others involved in the aviation world to submit reports when they see something that could potentially lead to a bad outcome. Two of the key components of the program’s success are anonymity and limited immunity. The program processed over 1.6 million reports by 2019 and produced over 60 safety studies.
In the manufacturing sector, risk management departments pay attention to near misses and close calls. There is a cultural expectation, which is spurred on by the certifications of factories, that when a mistake is made, the employees involved will self-report to their factory floor managers. There is also an expectation that when a mistake is made, management will not punish an employee who self-reports an honest mistake or judgment call that could have ended badly.
You are the risk manager
If the control officer and escort officer were to sit down and seriously talk about what went wrong in the scenario above, what would be the most effective way to dissect the close call and produce a lesson?
Starting with self-reflection is important when generating a report about a close call. The control officer should have double-checked the classification of the inmate he was letting out of a cell; especially knowing he was dealing with a mixed-classification unit. The escort officer should speak more clearly when he uses his radio and make sure his entire transmission is broadcasting.
Telling someone else what you think they did wrong can be a little dicier, as you have to do it without attacking character. For example, the control officer can tell the escort officer that the escort officer is keying his mic after he starts speaking. He shouldn’t tell the escort officer that no one can understand anything he says on the radio. As the receiver of constructive criticism, you will get more honesty if you invite and appreciate the criticism knowing you will improve based on the useful information. Constructive criticism is a powerful communication tool for a team, but it takes a lot of trust between team members to give and receive criticism. If you are giving constructive criticism you have to trust the receiver won’t blow up and shut down when hearing your remarks. If you are receiving constructive criticism you have to remember that your teammate is on your side.
Once you find out what you can personally improve to avoid a tragedy down the road, start looking for how a policy or procedure can help. Perhaps in a mixed housing unit, any movement should start with two officers. In some cases, it is much safer to open cell doors within the unit instead of from Central control. A good risk manager may find that working a corrections officer 60 hours a week will cost more in liability than it saves in paying staff enough to attract a full roster.
When you come up with as much information as you can and find possible solutions to avoid a bad result in the future, put together a report to send up the chain of command. A good commander will be thrilled to have the information if it is presented with integrity.
Refining policies, best practices and procedures before disaster strikes in your correctional facility will save you and your team a lot of problems down the road. Reporting and dissecting close calls is an investment that will improve correctional officer safety while decreasing correctional facility liability. Having an effective reporting system in place will help protect the controlling agency against liability by illustrating that decision-makers are actively seeking improvements in safety before critical incidents can cause damage.