This report highlights how leadership has been proactively addressing safety issues, specifically, how the Safety Engagement sessions and Life First dialogues have already begun to address many of the systemic weaknesses that have been identified up to this point during the Twisp River Learning Review process. Recommendations are provided that explore new terrain, such as new ways to learn, the need to map our current system of work, and the need to improve change-recognition, sensemaking, and communication.

This interagency report completes the Sensemaking and Analysis phase of the Learning Review process. The report represents the first ever interagency Learning Review to be completed under the newly adopted process. It is the result of three focus groups (two with firefighters and one with line officers) and individual interviews with firefighters, agency administrators, and academic specialists. Academic specialists also collaborated with each other and Learning Review personnel via face-to-face conversations, video conferences, and conference calls. The ideas expressed in this report are the result of these interactions. A Safety Action Plan outlines recommended preventative measures.