The 3 Ds of firefighter health and wellness culture change

Starting a wellness program includes diagnosing the issue or improvement, developing the plan and implementing it


By Dan Kerrigan and Jim Moss

Change can be intimidating, even overwhelming, especially in the fire service. When it comes to our culture of health and wellness, it is important that we have a system to identify areas of improvement and develop realistic goals so that we have the best chance of implementing changes that will stick.

Fortunately, there is a simple approach focused on what we call the “3 Ds of health and wellness culture change” that can be used to assess the current state of your organization’s health and wellness efforts, then forge a path forward that will result in healthier firefighters and a stronger organization.

Kerrigan and Moss lead FDIC attendees in stretches and exercises.
Kerrigan and Moss lead FDIC attendees in stretches and exercises. (Photo/Marc Bashoor)

Let’s address each D as it relates to the steps in the process.

1. Diagnose the issue

Every fire department faces challenges that are specific to the makeup and complexity of their operation. For some departments, some elements of a comprehensive wellness program may already be in place. Others may be seeking to start a program from the ground up. Still others may even have a stout program already and are seeking to add even more value to it. Regardless of where your department is on the health and wellness program continuum, the first step is to assess the situation and diagnose the issue, problem or area of intended improvement along with any obstacles or barriers (real or perceived) that prevent implementation.

An example of diagnosing the issue may be that your department has not implemented NFPA 1582-compliant annual medical evaluations, and you need to seek a solution that will achieve buy-in from all involved. In this example, we easily identified the program element that we want to implement. The key here is not to complicate things by mixing in other elements of a health and wellness program that may also need implementation or improvement. Taking things one step at a time allows you to build your program at a practical pace and introduce new elements as you can effectively manage them.

As we work through this challenge, we also want to identify concerns and challenges. Perhaps there is a concern over confidentiality or the perception that jobs will be lost. Maybe there is an issue of cost. Scheduling could be a barrier as well (many providers come to you during a mutually agreed upon timeframe, and they work with you to make sure the exams are completed as efficiently as possible).

The best way to overcome any challenge is to create a committee or group that is representative of all facets of your organization, and then have open and honest dialogue to work toward common ground. It may seem obvious, but our experience shows that the most successful health and wellness program element implementations have started with asking questions and learning about concerns rather than assuming them. Nothing about health and wellness should be punitive. Rather, elements of a health and wellness program should be viewed and promoted as tangible benefits of being a part of your organization.

2. Develop a plan

Once the program element is decided and the barriers are identified, it’s time to formulate a plan to overcome them and move toward implementation. Using our example of implementing NFPA-compliant medical evaluations, consider the following: Although it’s ideal, there is no rule that says they need to be initiated on a mandatory basis, nor is there any reason to assume that they must occur on an annual basis right away. If you are not providing the evaluations at all, any step toward eventually making them mandatory or annual is progress.

If funding is an issue, you might consider providing medical evaluations every other year to start. Maybe there are labor-management concerns that can be overcome by establishing a voluntary-to-mandatory process that occurs over time. Perhaps the first round of physicals is even conducted on a “don’t ask, don’t tell” basis to encourage participation. Whatever the obstacle, open and honest communication that seeks to find common ground will always be an effective starting point – and doing something is always better than doing nothing.

3. Do!

Once all of the obstacles have been identified and a plan is set in place to overcome them, the only way to make a real change is through action. Using our above example, action steps should include:

  • The development of a formal policy (remember, it can be changed as your program becomes stronger). At a minimum, include in your policy the components of the examination (NFPA 1582 has a comprehensive list), who will provide the examinations, how often the exams will be administered, how confidentiality will be maintained, and what happens to members who need to address health issues. (These conversations should have already occurred during the development stage.)
  • Educating your personnel on the what, why and how of this new program. Take the time to answer questions and concerns before the initial exams take place. If necessary, consider hosting training provided by experts in the field of firefighter health and wellness to assist you in moving your program forward.
  • Identification of the provider and where the exams will be administered.
  • Setting dates and times for the exams. Are you using a provider that will come to you, or are you sending your personnel to another location? Consider compensation or incentives for their time along with this step.
  • Upon completion of the exams, the committee should re-convene and discuss what worked well and what needs improvement.
  • Meeting regularly with your health and wellness committee to lay out a strategic plan for the implementation of other elements of a comprehensive health and wellness program. This may include a fitness program, behavioral health assessments, in-depth cancer screenings, annual agility evaluations, nutrition counseling, fitness equipment evaluation and purchase, identifying grant funding opportunities, the development of a peer fitness trainer team, etc. The key is to keep everyone involved and to make sure your members feel that they are a part of the solution.

Focus on the people

Fire department health and wellness programs do not have to be intimidating. It all starts with the right mindset and attitude. Most departments implement preventative maintenance programs for their apparatus and equipment because a proactive approach reduces repair costs, keeps their equipment in peak condition, and extends the life of that equipment. It’s time we took the same approach with our most important assets – our people. Do it for your community, do it for your firefighters, and do it for the families that support them.

About the Authors

Dan Kerrigan and Jim Moss are the authors of the best-selling book “Firefighter Functional Fitness: The Essential Guide to Optimal Firefighter Performance and Longevity.” They have over 50 years of combined fire service experience and speak internationally at fire departments and conferences. Their mission is to “Create a healthier fire service, one firefighter at a time.” Learn more at FirefighterFunctionalFitness.com.

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