Post mortem crisis analysis : Dissecting the London bombings of July 2005

Purpose – Taming the complexity of crisis and integrating diverse narratives and sources regarding crisis events is a serious challenge. The purpose of this paper is to present a methodology for reconstructing, dissecting, and thematically comparing crisis experiences, using the 7/7 London bombings of 2005 as an illustrative empirical application. Design/methodology/approach – A cognitive-institutional process-tracing methodology suitable compatible with structured focussed comparison of crisis cases (Stern and Sundelius, 2002; cf. George and Bennett, 2005) is used. This cognitive-institutional process tracing and analysis strategy consists of four steps: contextualization, development of a synthetic chronological narrative, identification and reconstruction of decision occasions, and (comparative) thematic analysis. Findings – The paper demonstrates the feasibility of applying the methodology to real-world cases in the UK and concludes with reflections about the need for contextualized, systematic post mortem crisis analysis taking into account problem and process complexity, differential crisis performances of individuals and organizations under adverse conditions, and the increasing importance of social media and personal communications devices for crisis research and practice. Practical implications – The methodology used in this paper has the potential to improve the effectiveness of organizational learning and reform efforts in the wake of crisis experiences. Social implications – Insights associated with the application of this methodology can lead to improved post-crisis learning and fairer accountability processes, and thus contribute to enhancing societal resilience. Originality/value – The study not only presents an original methodology developed by one of the authors, but also provides a systematic, relatively comprehensive and theoretically informed analysis of the July 7 London bombings based not only upon the documentary record, but also upon a substantial number of interviews

Shaken, not stunned : The London Bombings of July 2005

Executive summary - The bombings of July 2005 On July 7th, the morning rush hours in London formed the backdrop for the first suicidebombings in Western Europe in modern times. Three different parts of the London subwaysystem were attacked around 08.50: Aldgate, Edgware Road, and Russell Square. The three Tube trains were all hit within 50 seconds time. A bomb on the upper floor of a double-deckerbus at Tavistock Square was detonated at 09.47. In the terrorist attacks, four suicide bombers detonated one charge each, killing 52 people. Seven people were killed by the blasts at Aldgate, six at Edgware Road, 13 at Tavistock Square, and 26 at Russel Square – in addition to the suicide bombers themselves. More than 700 people were injured. Hundreds of rescue workers were engaged in coping with the aftermath. Over 200 staff from the London Fire Brigade, 450 staff and 186 vehicles from the London Ambulance Service, several hundred police officers from the Metropolitan Police and from the City of London Police, as well as over 130 staff from the British Transport Police were involved. Patients were sent to 7 area hospitals

Reducing readmission rates for individuals discharged from acute psychiatric care in Alberta using peer and text message support: Protocol for an innovative supportive program

Abstract Background Individuals discharged from inpatient psychiatry units have the highest readmission rates of all hospitalized patients. These readmissions are often due to unmet need for mental health care compounded by limited human resources. Reducing the need for hospital admissions by providing alternative effective care will mitigate the strain on the healthcare system and for people with mental illnesses and their relatives. We propose implementation and evaluation of an innovative program which augments Mental Health Peer Support with an evidence-based supportive text messaging program developed using the principles of cognitive behavioral therapy. Methods A pragmatic stepped-wedge cluster-randomized trial, where daily supportive text messages (Text4Support) and mental health peer support are the interventions, will be employed. We anticipate recruiting 10,000 participants at the point of their discharge from 9 acute care psychiatry sites and day hospitals across four cities in Alberta. The primary outcome measure will be the number of psychiatric readmissions within 30 days of discharge. We will also evaluate implementation outcomes such as reach, acceptability, fidelity, and sustainability. Our study will be guided by the Consolidated Framework for Implementation Research, and the Reach-Effectiveness-Adoption-Implementation-Maintenance framework. Data will be extracted from administrative data, surveys, and qualitative methods. Quantitative data will be analysed using machine learning. Qualitative interviews will be transcribed and analyzed thematically using both inductive and deductive approaches. Conclusions To our knowledge, this will be the first large-scale clinical trial to assess the impact of a daily supportive text message program with and without mental health peer support for individuals discharged from acute psychiatric care. We anticipate that the interventions will generate significant cost-savings by reducing readmissions, while improving access to quality community mental healthcare and reducing demand for acute care. It is envisaged that the results will shed light on the effectiveness, as well as contextual barriers and facilitators to implementation of automated supportive text message and mental health peer support interventions to reduce the psychological treatment and support gap for patients who have been discharged from acute psychiatric care. Trial registration clinicaltrials.gov, NCT05133726 . Registered 24 November 202