Decision Support by Handling Experience Feedback of Crisis
Situations
Mohamed Sediri
1
, Nada Matta
1
, Sophie Loriette
1
and Alain Hugerot
2
1
ICD/Tech-CICO, Université de Technologie de Troyes, 12 rue Marie Curie, BP. 2060, 10010, Troyes Cedex, France
2
PhMD SAMU, 10 Emergency Department, 101 avenue A. France, 10003, Troyes Cedex, France
Keywords: Engineering and Management, Experience and Situations Representations, Emergency Crisis Management,
Scenarios, Decision Making under Stress, Time, Space, Task Dependence.
Abstract: The medical services have a key role when the crisis endangers lives. The surprising events and the time
pressure render the decisions more crucial and interventions become more complex. A lot of progress has
been made about this issue, such as improving emergency services in hospitals and establishing cell crises,
defining general and specific plans of intervention and ministerial circulars awareness to deal with most
common threats. But, challenges of optimality, decisions speed, and interventions effectiveness are still
present. These problems have, in general, three issues; communication, coordination and loss of
information. We present in this paper our results related to the definition of structure and interfaces in order
to handle experience of crisis management. The aim is to define a decision making environment based on
the emergency experience feedback (Experience representation and use).
1 INTRODUCTION
The decision makers in emergency department team
are faced with major crises; they manage big
disorganizing and destabilizing situations. In order
to preserve human life, they project during the short
time of the emergency in the imperative to act
quickly. Consequently, the decision is under an
enormous stress. It can cause prolonged inhibition or
impulsivity slowing the process of reasoning. Other
effects are so damaging: the communication and
coordination. Therefore, in order to avoid repeated
mistakes and acting more appropriately, they need
right information at the right moment; these pieces
of information are related to the crisis context,
experience feedback of previous situations and
logistics management. We present in this study our
first result aimed at representing emergency
management situations based on experience
feedback. Several dimensions are considered in this
study: organization, communication decision making
and problem solving activities.
As we are unable to prevent or anticipate
disasters sufficiently, optimal management of such
eventual situation is necessary. We have to think
first about the means and methods of recognizing
situations and provide training for stakeholders to
ensure pertinent decisions and effective
interventions. Crisis management consists in dealing
with the complexity and the interdependency of
systems (Birregah and Muller, 2012; Smith and
Elliott, 2005; Lagadec, 1993) and especially with the
combination of events. Some researchers define
approaches and techniques in order to define criteria
to help to assess the vulnerability of systems
(Whybo, 2010), they define organizations and
communications guidelines in order to avoid
vulnerability and deal with the crisis with minor
consequences.
Our study focuses on crisis management in
medical contexts. In fact, medical services have a
key role when the crisis endangers lives. The
unexpected events and the time pressure render the
decisions more crucial (Sommer, 2012) and
intervention become more complex. A lot of
progress has been made in this issue, such as
improving emergency services in hospitals and the
establishment of cell crises, definition of general and
specific plans of intervention and ministerial
circulars awareness to deal with most common
threats (Couty, 2004). But, the problems of the
optimality of decisions speed and effectiveness of
interventions are still present. Those issues have, in
general, three axis; communication, coordination
and loss of information.
351
Sediri M., Matta N., Loriette S. and Hugerot A..
Decision Support by Handling Experience Feedback of Crisis Situations.
DOI: 10.5220/0004545003510359
In Proceedings of the International Conference on Knowledge Discovery and Information Retrieval and the International Conference on Knowledge
Management and Information Sharing (KMIS-2013), pages 351-359
ISBN: 978-989-8565-75-4
Copyright
c
 2013 SCITEPRESS (Science and Technology Publications, Lda.)

2 RELATED WORKS
Several theories design decision support in the crisis.
The authors propose several psychological aspects
of crisis managers and the organizations that are
faced with these situations (Turoff et al., 2004). The
evaluation of proposals approaches provides rather
inconclusive results. Other approaches that attempt
to design a perfect system can be found in the works
of French and Turoff (French and Turoff, 2007).
These works attempt to study decision making
process in crisis situation, as well as filling the gaps
of the systems supposed manage it. Hale (Hale,
1997) and Carver (Carver and Turoff, 2007) offer a
part of their architecture to communication aspect
between actors, Caver aim to provide models for a
perfect communication between human actors and
software as a single team. Finally Kim (Kim et al.,
2007) proposed the CIMS system for critical
situations. This system is more focused on the
problem of communication taking into account a
number of small significant problems.
Other systems are focused on representing the
operational, organizational and communicational
levels (Smith and Elliott, 2005); these solutions are
either general approach (Oomes, 2004) or rigorous
techniques adapted to specific situations. (Sell and
Braun, 2009) the most commonly used techniques
and methods are based on modeling workflow
(Schoenharl et al., 2006), GIS, multi-agent systems
and rule-based systems (Johnson, 2000).
Recently, others intersecting works are
introduced. These works propose another point of
view using new techniques such as, case-based
reasoning (Moehrle, 2012) and knowledge
anthologies (Otim, 2006; Chakraborty et al., 2010).
The limitation of these proposition is that they are
either very small or they define many concepts that
are not shared between other crisis situation;
therefore they are not adapted to the dynamic aspect
of this kind of situation.
3 CRISIS MANAGEMENT
Crisis management is a special type of collaborative
approach in which the actors are subject to an
uninterrupted stress. It requires succeeding because
the consequences are important (human and
economic losses). Crisis differs from an emergency
situation by its destabilizing effects (Lagadec, 1993)
"emergency plus destabilization," an emergency is
an event for which intervention procedures are
known specialties requirements are clearly
identified, and roles and responsibilities are clearly
divided.
A variety of approaches has been identified to
deal with a crisis and can be classified in three
categories (Smith and Elliott, 2005; Lagadec, 1993).
In the first category, we can note the model
presented by Ian Mitroff and Pauchan Thierry, it is a
model of identification, one of their axes identifies
characteristics "internal" or "external” while the
other highlight the dimensions "Technical /
Economic" or "Human / Social / Organizational."
The second category focuses more on a set of points
that characterize the crisis as a result of events and
behaviours. The eventual effects caused by this
situation in terms of pressure on people supposed to
manage it, its consequences on the environment and
the difficulty of adopting adequate responses to
many concerns. The last category includes
approaches, called synthetic. It aims to give general
definitions for the crisis in terms of threats to the
objectives of stakeholders and critical choices facing
the surprising events in the crisis situations.
The authors have identified a set of common
phases in the management of crisis situations
(Johnson, 2000; Lagadec, 1993; Oomes, 2004); to
summarize, we can identify three major phases that
can occur cyclically:
• Preparation: through the classification of
situations, training and exercises, scripting events,
identification of critical sites, structuring and
computerization of library resources and the
definition of roles and tasks for structuring
feedback.
• Intervention / handling: The phases from alert to
system stabilization. It consists in four basic steps:
• Identification of the situation.
• Logistics and implementation of emergency on
site.
• The evacuation, reception and support of victims
in institutional care.
• The drafting of the comprehensive review.
• Analysis/ Feedback: learning from real-life
situations. This assessment is critical to improve
the response strategy. It will therefore help us
describe the types of situations more precisely and
enrich the feedback structure.
Through these three phases, we found the
importance of experience feedback in order to deal
with crisis situations. In our work, we use
knowledge engineering and management of
knowledge to face the problems of the three phases
described above.
In dealing with crisis, decision makers attempt to
identify or anticipate potential events that can occur,
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also the important moment, or incidents, that may
trouble in an effort to develop actions and measures
intended to avoid other incident to evolve into a
current crisis (Smith and Elliott, 2005). These
elements are attached to the crisis context that
influences the initial followed reasoning and
decision making strategies.
Until today, a lot of research work has been done
about the influence of context during the reasoning
and decision making process. A non-integral
perception of the environment may lead to limited
inferences. This process is strongly influenced by
the information received through sensorial registers,
as well as the memory capacity. In consequence, any
useful information will interact with inferential
processes during (Van der henst, 2002) premises
processing. Tulving (1976) (Richard, 1998) was the
first to draw attention to this phenomenon; he
introduced the concept of specific encoding (the
success of recovery depends on the proximity
between encoding and recall context). An
inefficiency context representation and perception
may influence the actor’s point of view and build
inappropriate decisions.
Moreover, the analogy reasoning is an essential
activity in dealing with crisis situation, which leads
us to use the techniques defined by the CBR for
recognition and representation of situations. The
term analogy (Reed, 2011; Richard, 1998) is used in
expression “reasoning by analogy” that is a general
heuristic for assumptions forging. It refers to the
form of reasoning that is involved in a task, used
extensively in the psychometric tests. It also means
the transfer of meaning from one domain to another.
Moreover, it consists in reusing a known situation
from other similar situations (Reed, 2011; Richard,
1998). The analogy is a central activity in the human
life. We use it every day when faced with unknown
situations. It allows dealing with the unknown from
what is already known. Pedagogically, it is the most
natural and the easiest way of reasoning.
According to Gentner and Toupin (1986), the
analogy (Reed, 2011), is based on a general and
calculated similarity between a source and a target.
There are three kinds of similarities: attribute
similarities, similarities between low-order
relationships and between high-order relationships.
To make the analogy, we need to match our current
situation (called base) with another past situation
(called target) based on the similarities of high rank.
Commonly, in crisis situation the similarity among
situations can be estimated using metrics and
considering that cases are represented as attribute-
value pairs (the number of victims, localization,
accident type, homogeneity, etc). The other
techniques can be used such as looking in semantic
field of some indicators. Thus, we are interested in
developing an algorithm that could provide results
within a reasonable response time. It must also be
suited to this kind of non-formal situations.
Finally, crisis management is a cooperative
activity. Therefore, we also study Computer-
Supported Cooperative Work to process
communication and coordination (Shmidt and
Simone, 1996) in such situations.
4 OUR METHOD OF WORK
In an informal field like crisis, case-based analysis
(Burke et al., 2000) seems to be the best approach,
because the actors express their knowledge through
a set of real-life situations. So, we use the techniques
of case-based reasoning (CBR) (Kolodner, 1993)
and especially the description of situations to define
a structure of crisis representation taking into
account the context of resolution. Similarly, the type
of underlying reasoning in CBR systems can be
based on an analogy of situations (Reed, 2011; Aich
and Loriette, 2007), very useful in the recognition of
crisis situations.
Moreover, in our work, we need to represent a
feedback of these situations. This experience is
generally owned by the actors of the emergency
sector, as well as the documents and reports
prepared or produced as a result of such
intervention. Knowledge Engineering provides
techniques to represent expertise in problem solving
(Reed, 2011; Richard, 1998). These techniques
allow highlighting key points as objectives or
reasons for such actions of the experts. Several
techniques of interview issued from knowledge
management and engineering are used to
communicate with experts in order to understand
and represent rules and concepts used in crisis
management experiences.
The cooperative aspect must be considered
including coordination, communication and
cooperative problem solving in order to specify
several actors with different objectives who are
involved in crisis management (Reed, 2011;
Richard, 1998; Shmidt and Simone, 1996). In this
project, we studied the dimensions of coordination
and communication conducted by a single type of
actor: the Emergency Department. Cooperative
decision making in a crisis where other types of
actors are involved (the prefecture, fire-fighters,
police,) is not studied in this work.
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To sum up, the different aspects considered in
our work are (Sediri et al., 2013):
 Representation of the context of the situation:
environmental information and available
resources.
 Dynamic representation of the problem-solving
considering the evolution of situation.
 Successes and failures pointed on each
intervention as well as rules and concepts.
 Identification of the types of situations and criteria
for recognition of these situations.
 Representation of the communication between the
actors within the spatial dimension (various
locations).
 Coordination in actions as well as human and
material logistics.
Our results are based on several meetings with
actors in the emergency department of the Troyes’
hospital; the emergency doctors, assistants and the
specialists who have experience in real crisis
situation and training exercises. First interviews
were general and helped to identify main problems
and discover the domain, Next ones aimed at
describing a specific situation like road accident,
intervention on an infirmary establishment because
of a fire alarm and a nuclear accident exercise.
5 ANALYSIS OF CRISIS
SITUATIONS
The space (place) is a major dimension of crisis
management; the representation of the organization
of actors in relation to the space will help, in one
hand, to clarify the type of existing communication
and vision that each actor has of the situation. In the
other hand it makes more clearly the manner in
which we make sense of crisis events and issues
around problems associated with managing the acute
phases of a crisis, as well as dealing with its
location, setting, victims destination and its
aftermath. Three main places have been identified
(Sediri et al., 2012; Matta et al., 2012):
 The Crisis Cell: the place of the control and the
orchestration of the intervention, its most
important roles are managing the material and
human resources. The link with outside and the
responsible of emergency department (the rear
base) is done by the communication center.
 Crisis Site: The area affected by the event, it
includes actors such as the first medical team and
advanced medical and other professionals.
 Emergencies/hospitals: These services receive
victims and their families and ensure their follow-
up. The rear base, depending on the distance of
crisis site and or available places and required
specialties for each victim, achieves the choice of
the orientation of the victims.
Several actors of emergency department are
involved in crisis situation: doctors, first aids
rescuers, assistants, secretaries etc. According to the
work place and situation ‘s state, each actor is in
contact with other professional of the domain such
as police, state services, government delegates, etc
( Figure 1). So, the communication and organization
dimensions have to be considered to represent this
type of situations.
CommunicationCenter
Responsible
Doctors
EmergencyCenter
EmergencyDepartment
Responsible
Secretary
Ambulance
AccidentPlace
FirstEmergencyPost
Responsible
Nurse
Rescuer
SecondEmergencyPost
Responsible
Secretary
Ambulances
Hospital Place
Reception Team
Responsible
Secretary
Admission
Secretary
Crisis Unit
Emergency
Delegate
State
Delegate
Police
Delegate
FireFighter
Delegate
Figure 1: Actors’ organization seen from the space
dimension.
For better configuration of the actor tasks, the time
dimension is very important in crisis management
not only in terms of life preserving as a final
objective. But it has also a major importance on each
episode during the intervention. It must be
considered so as to provide (Sediri et al., 2012) to
decision makers an empirical and control
environment in which they can have an overview of
what happens in terms of tasks and actions duration,
what must be done or what should be done
immediately etc.
Experts identify different types of situations to
represent and we work with them for acquiring
experience and definition of common structures
(Sediri et al., 2012) to represent this experience.
They are looking forward to promote the reuse of
this experience and acquiring a future one Thus, we
propose a structure that include, chronologically,
actor tasks and faced problems during an
intervention (Figure 2).
The aim of this structure is to represent the
different communication links established during the
crisis intervention and nature of its exchange. In
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
t
0
• Localization:
• RoadType
• Access
• AccidentElements:
• Vehicles NBandType
Problems:
• Localization :address confusionor
flouifHighway =>Loss Timeto
access
• Loss Time=>moreSerious Victims
Communication
Center
AccidentAlert
10‐15Minutes
Send First
Emergency
Post
First
Emergency
Post
Needs ofMaterials,resources
Victims NB,serious,etc.
• Logistics of:
• Gather Materials
• Solicit EmergencyPeople
Sollicit Crisis Unit
Problems:
• Availability ofEmergency
People(Children Care,
distances,access,etc.)
• Weather =>PbRescuer access
1Hour
Send Second
Emergency
Postand
Materials
TASKS
Actor/UnitProblems
Figure 2: The responsible of emergency department tasks
and faced problems on a time line.
addition we represent the experiences; they help
representing several tasks and associated problems
as well as consequences of the non-respect by the
tasks of its attended duration and its
recommendations.
6 DECISION SUPPORT SYSTEM
We develop several techniques in order to handle
problem solving and experience memorization. We
promote the use of experience feedback to support
learning and decision-making. As first solutions, we
offer to represent the experience feedback using on
one hand experience-based and situation
representation methods and on the other hand
knowledge engineering methods, in order to define
the specifications of a system as a decision making
support environment. We also aim at studying
scenario representation to promote learning from
this type of situations.
To guide decision makers in crisis situations we
can act at two levels. The first one concerns the
perception of the context as an important element in
reasoning process (Van der henst, 2002) by
providing additional and useful data with less
ambiguity about context using the quick and
automatic research in GIS system and situation
bases. The second one concern guiding the process
of decision making (Van der henst, 2002; Reed,
2011; Richard, 1998) as a cognitive process. We aim
at guiding the reasoning process during each phase
of the crisis using available cases in the situation
base.
Information processing in dynamic situations can
be distinguished by a number of dimensions from
decision making in the normally used static task
environments. First, because the environment
changes, time is an inherent dimension of the
decision making process. Second, strategies can be
used that benefit from feedback. Third, time pressure
can be defined from the evolving situation itself
rather than by some external criterion (Kerstholt,
1994).
Cognitive psychology is assumed to contribute
significantly to the improvement of analytical issues
and the quality of solutions offered in decision
support and problem solving. This could be achieved
by methods and tools for firstly making the analysis
of decision maker’s query; secondly, providing high
quality methodologies and systems evaluations. It
can thus define gaps to be narrowed. Finally, it
provides the knowledge and methods needed to
evaluate the proposed solutions.
Mental activities are a part of cognitive activities
(Van der henst, 2002; Reed, 2011; Richard, 1998).
They are located between sensorial and action
programming activities. It helps building an
understanding of the situation, developing new
knowledge and making decisions. Considering
information processing types, we can distinguish
three broad categories of mental activities (Reed,
2011): The understanding which consists in
constructing a situation interpretation, the reasoning
that is looking for links between information
collected via inferences using knowledge eventually
stored in the memory, then finally all the control
mechanisms of mental activity.
Figure 3: Petri network of crisis management -- P:
Actors/unit – T: event/tasks/exchanges (P0: the stable
system .-P1: Communication Center. -P2: Emergency
department.-P3: Intervention Teams. P4: hospitals. -P5:
Victims’ evacuation).
For better understanding of the intervention and
decision making steps, we may represent emergency
department crisis management as a set of couples of
states and events figure 3) using a basic Petri
network (Aich and Loriette, 2007). Each state of the
system match a crisis stage, it is represented by a
place of Petri network (figure 4):
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 Type: It’s a sort of index referencing a complete or
episode of a crisis situation. It indicates the main
class (category) of current situation. (E.g. road-
accident, fire, etc). Providing this index help the
system to do research by keyword, it allows
recognition and rebuilding of such situation
through previous situations and keeping the link
with central event of crisis.
 Actor/ role: is the concerned person or unit in each
system state (crisis stage).
 Time: is the moment to do an action by the
concerned actor according to place’s type.
 Data: is the available data for concerned actor in
each moment, this information are related to the
characteristics of crisis situations, localization,
weather and victims.
 Action: is the action to execute considering
previous elements.
 Place: is the actor location.
The event (transition) is defined as the result of
the action processing. It lends the next state the new
information.
Figure 4: Petri network’s State and transition of crisis
situation.
The starting point of our proposition is based on the
exchanges, the events and the tasks. All these
elements are important to determine the following
tasks to do or the decisions to make. Their definition
on situation structure (figure 1) helped us to identify
a set of system states, transitions and conditions
between them. Representation of these elements
inside the same structure for all actors is difficult.
Indeed. A concrete structure is relatively complex
considering the time and the space dimensions
(Figure 1 and Figure 2), it make its interpretation
difficult. While the transcription of a Petri network
allowed us to see these elements in the form of a
state / transition graph (figure 3) more simply and,
especially better defined. Transitions represent the
interactions between actors and events that can
change the system state and parts. The places (state)
represent the major interactions between the system
parts.
We use several techniques in order to identify a
representation structure of an accident. In fact,
works on situations representations give (Schreiber
et al., 1994) techniques to represent a situation as
states and events. CBR (Kolodner, 1993), (Burke et
al., 2000) proposes to define the context as well as
the solution of a problem. It also provides processes
for case retrieval and adaptation. Otherwise,
Knowledge engineering (Matta et al., 2002; Chebel
Moreloo, 2008; Cablé et al., 2011) techniques help
to extract and formalize expertise as strategies
(Dieng, 1998), plans, and concepts.
An efficient decision support environment has to
take into consideration the characteristics of crisis
situations (Turoff et al., 2004), the status of people
supposed using it and, space and time dimensions.
To sum up, firstly the provided information has to be
precise; the decision maker in crisis situation has no
tolerance or time to spend for things unrelated to the
management of crisis. Secondly, the context must be
understood and the experience reused; learning and
understanding what happened before, during, and
after the crisis is extremely important for the
improvement of the system capacities. Thirdly,
everything in a crisis is an exception, thus less
generalization is recommended. Finally, the
information exchange and its validity in timeliness is
required, in fact the crises require for many hundreds
of individuals with different roles to be able to
exchange information which is critical to those who
may risk lives and resources, these information must
the most up-to-date and notified by alerts.
The maps of emergency interventions represent
an essential tool; they show main information such
as the locations, the networks of streams and rivers,
and the locations of man-made features such as
trails, roads, towns, boundaries, and buildings. They
also show what the crisis site is like and distances
between useful crisis management stakeholders. All
of these are important considerations in emergency
planning. It make easier to decide where to go and
where to position things. Therefore, our system is
fitted with interactive maps allowing actors to zoom
to a custom scale for a detailed view of a specific
area of interest associated to several information.
These information concern essentially localization of
risk places, Human / materials resources,
emergency, rescuers means and services
information. So, we identified a number of risk
places and their characteristics in the AUBE’s State.
Further, used GIS should allow defending more
position and information on maps.
The environments integrate multiple data sources
(figure 5); the main one is our situation databases
which contextualize requested information. It allows
the data processing to use efficiently other data
sources.
The emergency department database contains
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Figure 5: System data and information sources.
information about emergency department (human
resources, equipments, procedures, hospitals, etc).
The GIS database contains personalized
geographical information about risks and vulnerable
places and much other personalized information.
7 HUMAN MACHINE
INTERFACE
Figure 6: Emergency Responsible Interface Board.
We have proposed a human machine interface that
helps to handle the experience of emergency actors
(Sediri et al., 2013).
The main part of this interface is the map which
is an important tool for emergency department.
Several functionalities are offered by our
proposition, the top panel “Fig. 6” that help to
follow the evolution of the situations, the map and
top menu GIS that help to locate accident, around
risk sites, rescue materials resources, Hospitals, etc.,
a street view system that help to show the road
configuration, and a communication Interface that
help to send and collect information from and to
other actors. All these parts are interrelated (figure
5).
8 CONCLUSIONS
We show in this paper, our results on analyzing
crisis management. Our approach aims mainly at
identifying the experience feedback and representing
it (Sediri et al., 2013) the aim of this study is to
define a decision making environment for crisis
management, related to emergency activity. Future
work aim is to provide specification of the interface
of the system to promote decision support for each
role conceding the objectives of stakeholders in the
main project. Finally, we will focus on the definition
of experience traceability module for our system.
We use several approaches in order to represent this
experience:
 We use GIS as base of the machine interface, it’s
the main part system for emergency department
that represent their experience feedback.
 Crisis situations are a collaborative activity, so
organization, coordination and communication
dimensions have to be described.
 Situations have to be represented in this
experience, so the dynamic dimension considering
events has to be defined. We use time thread,
which is an important aspect in crisis management
for this purpose.
 Experience feedback has to be shown, so we use
knowledge engineering techniques (interviews
based on tasks, concepts and problem solving) in
order to represent at each step tasks, related
problems, success/fails keys, and related
consequences
Our purpose in the future work is to define the
model of the knowledge traceability. We aim also
with involved ergonomist analyzing the emergency
activity in order to define an adapted interface that
helps to use the emergency experience.
ACKNOWLEDGEMENTS
We thank The Champagne-Ardennes Region and
FEDER, sponsors of this work.
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