short introduction to Cindynics and their application to disaster medicine

1. April 25-28, 2017 Dr jan-Cedric Hansen 1
CS09-10: Cindynics Contribution to Crisis/Disasters Strategic
Steering
Dr Jan-Cedric Hansen
Member of the Board for the French Society for Disaster Medicine
Member of the Board for StratAdviser Ltd
Registered BCNR/Cindynician European Expert-Auditor under EX2016D276660
contact : jc.hansen@stratadviser.com

2. April 25-28, 2017 Dr jan-Cedric Hansen 2
The author(s) declare(s) that there is no
conflict of interest regarding the release of
this presentation
Presenting Author: Dr Jan-Cedric Hansen
CS09-10: Cindynics Contribution to Crisis/Disasters Strategic
Steering
(Abstract 869)

3. Crisis/Disaster specificities
Crisis
• Limits/boundaries (geophysical,
administrative, social, psychic, …) are
more or less preserved
• Limited number of casualties
• Psychic/socioeconomic impact limited
to relatives/community
• Assets adapted to needs
• Routine response
• Management
• “Protect – Alert – Rescue”
• Deserves mainly Tactical reactions
Disaster
• Limits/boundaries (geophysical,
administrative, social, psychic, …) are
disrupted
• Immediate/delayed mass casualties
• Psychic/socioeconomic impact
extends to society/nation
• Assets insufficient to cover needs
• Continuous reinvention of response
• Steering
• “Confront – Regulate – Overcome”
• Deserves mainly Strategic reactions
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4. Tactical/Strategic reactions
Tactical
• Paratelic mind-set
• Doxa drives actions
• Preparedness state
• Coping with field findings
• Manage local and simple
adaptations
• Limited or immediate
purpose/end in view
Strategic
• Telic mind-set
• Episteme drives decisions
• Planning & conduct kinetic
• Imagining the unthinkable
• Steer broad and complex
adaptations
• Anticipated goals and criteria of
success
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5. Key decision makers
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Confront
Disruptions during the length of
time
Multiple problems emerging
simultaneously
constant changes of situation
Multiple and unstable partners
Non stop demands for aids and
reliefs
Regulate
Numerous skids about:
Aims, Priorities
Roles and positions
Information (given or requested),
Communication systems
Procedures
Overcome
Consequences of Risky choices
Responsibility, guilt problems
Subjectivities, bias
Clear shortages

6. Cindynics define
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Environment Context
Organisation Documentation Production Actors

7. Cindynics recognise
April 25-28, 2017 Dr jan-Cedric Hansen 7
Environment Context
Organisation Documentation Production Actors
Vulnerability

8. Cindynics acknowledge
• “Anything that can go wrong will go wrong”
– Murphy’s law (as well as Entropy/second law of thermodynamics)
• Prevention/Preparedness/Safety are of
asymptotic nature
• Dynamic of context, environment, flows,
…influence the vulnerability of any organism
• Actors’ play role at “Global”, “Individual”,
“interpersonal” & “Organisational” levels are
critical
April 25-28, 2017 Dr jan-Cedric Hansen 8

9. Cindynics define
April 25-28, 2017 Dr jan-Cedric Hansen 9
Teleological axis
(goals)
Epistemic axis
(models)
Statistical axis
(data)
Deontological axis
(rules)
Axiological axis
(values)
Global limited unlimited
Individual mastered unmastered
Interpersonal shared unshared
Organisational determined undetermined

10. Cindynics Clarify
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Global level (organism) Systemic Cindynogenic Deficits
Actor’s level Individual Cindynogenic Deficits
Individual interactions’ level Cindynogenic Dissonances
Organisational level Organisational Cindynogenic Deficits
All are qualified and possibly quantified, using documentary analysis, observation of practices and direct or semi-
directive interviews, individually or in groups, through the themes suggested by the qualifiers of the 5 axes

11. Cindynics define
April 25-28, 2017 Dr jan-Cedric Hansen 11
Teleological axis
(goals)
Epistemic axis
(models)
Statistical axis
(data)
Deontological axis
(rules)
Axiological axis
(values)
Global limited unlimited
Individual mastered unmastered
Interpersonal shared unshared
Organisational determined undetermined
“Global
“typology of a given
International DMAT

12. Outcomes of “Global” Typology
(examples)
• Infallibility culture (SCD 1)
– Strong belief that Emergency/Humanitarian skills are enough to
cope with disasters
• Simplism culture (SCD 2)
– Reduction of problems to a false simplicity by ignoring complicating
factors such as logistic and congestion ones
• Navel-gazing culture (SCD 3)
– Coexistence of metric and imperial system without reciprocal
acknowledgement nor conversion of values
• Dilution of responsibilities (SCD 4)
– Multiplicity of actors and the differences in technical competencies
between the different actors without a clear hierarchy matrix
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