ERHMS

Lessons Learned and After Action Assessments

Purpose

At the conclusion of an event, there is a need to assess how the emergency response has been conducted through the 

pre-deployment, deployment, and post-deployment phases and to identify ways to improve during each of these periods. 

Principles of Lessons Learned and After Action Assessments

• The Emergency Responder Health Monitoring and Surveillance (ERHMS) program should be included in the 

general after-action report or similar document.

• The after-action assessment should have the specific goals listed below to help solve problems with the response 

and protect those who are aiding in an emergency event.

Functions for After Action Report in Regard to ERHMS

1Identify Problems During the Event

The evaluations completed in the responder health assessment and other modules can provide ready-made data 

about the event and its effects on responder health and should be evaluated to identify issues that were encountered or 

that developed during the emergency response.

2Examine Those Problems and Characterize Them

A panel of members from the incident command structure can be designated to gather information and assess its 

seriousness. Information from other modules can filter in and help decipher the root of problem, indicating where efforts 

should be focused in order to fix the issue.

Hypothetical example: During a flood, 

responders were identified with increased 

incidence of lead exposure. This allows for an 

investigation of the exposure’s nature to be 

launched.

Hypothetical example: A panel might decide 

to do more environmental testing and find 

that the lead could be linked to an area containing an airport where fuel had leaked into 

the flood waters.
ERHMS

3 Make Suggestions on How to Correct Those Problems in the Future

A panel can involve health professionals, safety officers, incident command management, and emergency responders 

themselves to develop solutions that are effective and practical for emergency response.

4 Implement These Changes in Current Policy and Preparedness Plans

The suggestions should be translated to literature, policy papers, and systems to be available for the next emergency. 

It is this final phase that completes the cycle of safety management.

ERHMS

The ERHMS system is a health monitoring and surveillance framework that includes recommendations and tools specific 

to protect emergency responders during the pre-deployment, deployment, and post-deployment phases of a disaster. 

The intent of ERHMS is to identify exposures and/or signs and symptoms early in the course of an emergency response 

in order to prevent or mitigate adverse physical and psychological outcomes and ensure workers maintain their ability to 

respond effectively and are not harmed in the course of this response work. Data will also help to identify during the postdeployment phase which responders would benefit from medical referral and possible enrollment in a long-term health 

surveillance program. Please refer to Chapter 11 and section 11T for more information on Lessons Learned and After Action Assessment.

National Institute for Occupational Safety and Health (NIOSH) ERHMS Contact:

! CDR Renée Funk, Coordinator, ERHMS at rfunk@cdc.gov or 404-498-1376

For more information on ERHMS, please visit: 

erhms.nrt.org & www.cdc.gov/niosh/topics/erhms

Hypothetical example: Recommendations 

could include more effective skin protection, 

screening for aviation fuel sources in rescue 

areas, and developing plans for containment 

of this product.

Hypothetical example: This could 

involve requiring skin protection, 

increasing decontamination/washing 

procedures, educational programs on 

working in fuel contaminated areas, 

and implementing screening and 

containment protocols for airports.