The Development of an Organizational Safety Culture in the United States Forest Service
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Journal of Forestry, 2021, 1–14
doi:10.1093/jofore/fvab025
Review Article - history
Received October 21, 2020; Accepted April 6, 2021
Advance Access publication May 6, 2021
Review Article - history
The Development of an Organizational Safety
Culture in the United States Forest Service
David Flores and Emily Haire
David Flores (david.flores2@usda.gov), USDA Forest Service, Rocky Mountain Research Station, Fort Collins, CO,
USA. Emily Haire (erhaire@mail.colostate.edu), Department of Sociology, Colorado State University, Fort Collins,
CO, USA.
Abstract
For over 100 years, the US Forest Service (USFS) has developed initiatives to improve safety out-
comes. Herein we discuss the engineered solutions used from 1910 through 1994, when the agency
relied on physical science to address the hazards of wildland fire suppression. We then interpret
safety initiatives of the subsequent 25 years, as the USFS incorporated social science perspectives
both into its understanding of emergency fire incidents and its mitigation of vulnerabilities across
all fields of work. Tracing the safety programs using a historical sociology approach, we identify,
within the agency’s narrative, three recent developments in its organizational safety culture: cul-
tural awareness, cultural management, and cultural reorganization. This article describes how the
development of top-down safety initiatives are questioned and shaped by employees who actively
influence the trajectory of a safety culture in the USFS.
Study Implications: Safety is a core value of the US Forest Service (USFS), and several safety
initiatives, along with employee feedback over the years, have shaped the organizational culture of
the agency. To build a robust and world-renowned safety culture in high-risk industries, managers
require an understanding of the origins of their organization’s current safety culture. Using a critical
social science analytical lens, we discuss how safety initiatives and the development of a safety
culture position organizations such as the USFS to move away from reactionary safety initiatives
and anchor to employee safety as a core value in order to absorb external shocks, such as rapidly
changing ecosystems, development in the wildland urban interface, and larger and more intense
wildfires.
Keywords: US Forest Service, organizational culture, safety, organizational learning, wildland fire
This article identifies the trajectory of safety initia- guidance revealed some unfortunate features of safety
tives and the development of safety culture in the programming as “scattered, redundant, and in some
United States Forest Service (USFS) by using a his- ways, ambiguous” (Withen 2005, p.3). In 1995, the
torical sociological approach. Safety culture in the USFS began promoting safety initiatives based on
USFS is rooted in over 100 years of combatting wild- human behaviors and social interactions, first within
fire and mitigating the risk of firefighter injuries and the wildland-fire sector and later across the agency
fatalities. Wildland fire safety interventions by land- more broadly (Putnam 1995, TriData 1996, Weick
management agencies were often formulated in re- 1996). Although previous efforts had informed these
action to tragedy fires, and attempts to streamline contemporary safety initiatives, the focus of each was
Published by Oxford University Press on behalf of the Society of American Foresters 2021. 1
This work is written by (a) US Government employee(s) and is in the public domain in the US.2 Journal of Forestry, 2021, Vol. XX, No. XX notably distinct. Some were carried out by USFS re- through business management, the concerns broadly gions autonomously from the Washington office regard the functions of safety culture, the production headquarters. Others were conducted with very little of acceptable safety outcomes, and the managed im- debriefing of employees regarding lessons learned provement of work performance. Historical socio- during significant fire events or changes made after- logical approaches, by contrast, see safety cultures as wards. This decentralization and frequent rebranding emerging over time, through the collective experiences of safety initiatives likely contributed to employees of their members, and as comparatively resistant to ma- seeing the initiatives as disconnected, haphazard, top- nipulation, intervention, or management (Wiegmann down measures that shifted with changes in organ- et al. 2004). They are nonetheless malleable from the izational leadership (Ghimire et al. 2016). Employees bottom up and may be sustained or changed incremen- raised important questions about safety programming: tally by employees who enact and reconstruct safety where do these USFS safety initiatives originate? Are values every day (Bisbey et al. 2019). Additionally, an they singular efforts created through the Washington organizational safety culture may bear characteristics office, or are they part of well-conceived collabor- of the greater national cultures in which employees are ations developed over the years? invested (Yorio, Edwards, and Hoeneveld 2019) and The USFS is responsible for the management of within trends of global economic and ecological his- 193 million acres (78 million hectares) of federal land tories (Turk 2018). across 43 states, Puerto Rico, and the US Virgin Islands Primarily using organizational psychology and (USDA FS 2018). Its mission to “sustain the health, di- business management perspectives, the USFS devel- versity, and productivity of the Nation’s forests and oped safety initiatives in reaction both to sporadic grasslands to meet the needs of present and future mass casualty events and the ongoing hazards of daily generations” is carried out by a workforce of approxi- work. Because many employees experienced these mately 30,000 employees and thousands of affiliates reactive initiatives as “scattered” and disconnected and volunteers (USDA FS 2019). Agency employees (Withen 2005), we offer a chrono-thematic account. work in professional fields ranging from the manage- Historical sociology allows us to chronicle the imple- ment of forests and rangelands, wildland fire, timber mentation of safety initiatives and explain the emer- production, and public recreation to the care of eco- gence of safety culture in the agency over time. This systems, wildlife, and community interests, and busi- approach recognizes that the underlying meanings of ness administration, law enforcement, and research. cultural change in the USFS exist in the broader con- The vast mission and agency workforce are strained text of the national safety discourse (Abbott 1992). by the demands of wildfire suppression, the costs A historical sociological approach also examines of which have increased from 16 % of the agency’s the interconnectedness of human agency and social budget in 1995 to 61 % by 2016 (Calkin et al. 2005, structure—a tension between individual actions and USDA FS 2015, Hoover and Lindsay 2017, Schultz social constraint—that develops through significant et al. 2019). Risk behavior in the wildland-firefighting events over time (Aminzade 1992, Sewell 1992, Griffin system contributes to these costs, fiscally and socially, 1993, Gotham and Staples 1996). Moreover, rather and is exacerbated by the conjunction of economic in- than explaining events as independent snapshots fixed centives with ecological instability (Burton 2018). in time, a historical sociological approach explains Research regarding organizational safety culture events as cascading from one event to another, wherein emerged in the mid-1980s with studies of large-scale “complex actors capture complex structures” (Abbott disasters in energy, transportation, health care, and 1991, p. 227). Historical sociology accommodates un- other high-risk industries (Fleming et al. 2018). determined change, observing both the patterns and Beginning in 2005, scholarship on safety culture grew the deviations whereby people navigate or redraw exponentially (Bisbey et al. 2019), and over time, re- social structures, with some paths taken and others searchers were compelled to create a consolidated def- abandoned. Change takes the form of “an unfolding, inition of safety culture: “a system of shared meaning open-ended story fraught with conjunctures and con- about risk and safety, which produces accepted ways tingency, where what happens, an action, in fact hap- of acting (often unquestioned) and viewing safety,” pens because of its order and position in the story” regardless of actual outcomes (Fleming et al. 2018, (Griffin 1993, p.1,099). Thus, we trace the meaning, pp. 6–7). When safety culture has been studied through sequence, and contingency of safety initiatives, as they the perspective of organizational psychology or applied are interconnected with policy and human actions,
Journal of Forestry, 2021, Vol. XX, No. XX 3
to tell the story of how the USFS developed a safety the 1910 Big Blowup fires that killed 85 people and
culture. burned 3 million acres awakened the USFS to fire as
Our identification of the trajectory of USFS safety a fundamental factor in the practice of scientific for-
culture was an iterative process. To orient ourselves estry; its handling became crucial to the organization’s
to the agency’s concept of safety, we first conducted a mission (USDA FS 1905, DuBois 1914, Pyne 2015). In
purposive sampling of USFS reports on its most recent response to these devastating fires, the USFS launched
and regularized safety program efforts between 2011 the development of wildland fire research for engin-
and 2017 (Ghimire and Cordell 2014, Lane et al. 2014, eered solutions, both for the control of wildfire and for
Flores and Haire 2016, Ghimire et al. 2016). These re- keeping firefighters and the public safe (Pyne 2015).
ports identified additional initiatives and studies that The agency built a cadre of fire managers and scientists
enhanced our understanding of the origins of agency- dedicated to learning the best methods for fire preven-
wide safety-program design (Putnam 1995, TriData tion, such as the mitigation of fuel hazards and control
1996, Dialogos 2007). The compilation of reports was of fire areas, and suppression techniques for extin-
diagnostic (exploratory studies of safety culture and guishing fires in America’s forests. Fire prevention ef-
workplace environment), evaluative (studies to assess forts quickly lost favor in the fire-prone West, however,
outcomes of safety initiatives), and included a variety and a social and political preference for complete fire
of product types: USFS general technical reports, com- suppression became clear after 1910. The desire for fire
missioned research studies, preliminary reports, and control was also part of a Western frontier mentality,
internal memos. We found supplementary context for in which urban development during the early 1900s
the safety initiatives through position papers and con- exposed workers, the public, and the environment to
ference proceedings of professional organizations, US the effects of dangerous work, including fire work
Department of Agriculture and congressional reports, (Turk 2018). Meanwhile, the USFS considered wildfire
and peer-reviewed research articles that examined the on forest reserves to be a net loss for timber production
need for and efficacy of these initiatives. Second, we (Smith 2017). In an era when workers were legally be-
assembled a chronological annotated bibliography holden to assume risk, economic interests outweighed
of these products. This allowed us to examine them firefighter health and safety. In the wake of the 1910
for moments of continuity and change in concepts of fires, the USFS supported complete fire suppression
safety, identify how the implementation of safety ini- and rejected alternative forest management practices
tiatives progressed over time, and discover junctures (Schiff 1966).
at which the agency advanced its organizational ap- Pyne has hypothesized that immediately after the
proach to safety. Third, although safety initiatives and 1910 Big Burn, the nonmilitary but nonetheless “mar-
safety studies in the USFS exist within a greater history, tial spirit” of hardiness and valor seized wildland fire-
as noted in the following assessment of the agency’s fighting, making it “a moral equivalent of war itself”
safety efforts prior to 1995, we focused this account (Pyne 1982, p. 237). Thirty years later, the events of
on their development within the context of cultural World War II solidified a war paradigm of fighting
change in the wildland-fire system and throughout the wildfire, both real and imagined. The dramatic threat
agency as a whole from 1995 onward. This approach of Japan dropping incendiary bombs on forests along
encourages understanding of how the agency began to the West Coast to create massive wildfires (and the
construct a safety culture informed by organizational actual mass fires already weaponized by the US in
psychology and how it moved away from reactionary Germany and Japan) stoked the militarism of fire-
safety initiatives toward a more orchestrated develop- fighting. In the post-war period, veterans returned
ment of employee safety promotion. from the battlefield, further infusing the ranks of the
USFS with a culture of discipline, hierarchy, and co-
hesion. Their efforts and organization, in addition to
A Background of Engineered Solutions the establishment of fire science for wartime bombing
(1910–1994) campaigns, demonstrated the “remarkable resem-
Throughout the agency’s history, trauma from blance between war and forest fire control” (Bradner
burnover incidents in which wildfire has overtaken 1945, p.1, Fox 2017, Smith 2017). The USFS believed
personnel on the fireline has motivated the USFS to in- that the battle against wildland fire could be won with
vestigate the causes and consequences of wildland fire- overwhelming force using science, technology, and
fighting incidents (Pyne et al. 1996). The experience of most importantly, firefighters on the ground. This,4 Journal of Forestry, 2021, Vol. XX, No. XX
along with the “creation and maintenance of a hege- A decade later, the 12 fatalities of the Loop fire precipi-
monic militarized masculinity that emerged in and tated a second fatality meta-review. Again, most of the
across U.S. institutions” during WWII (Jarvis 2004, post-Loop recommendations advocated the advance-
p.8), cemented in the USFS what historians have in- ment of physical science but also recommended the ap-
terpreted as a powerful “can-do” culture (Pyne 1982). plication of technical knowledge in firefighter training.
Moreover, within a broader societal context following This report, too, noted cultural issues in wildland fire,
WWII, strong, youthful, white male risk-taking occu- including continued resistance to the centralization of
pations also symbolized American dominance and its knowledge, resources, and authority—described as a
“rising status as a world power” (Jarvis 2004, p.4). failure to institutionalize “what we already know and
However, as we describe below, prioritizing a so-called what we already have” (USDA FS 1967, p. 2).
can-do attitude of defeating wildfires also had the un- Authors of the third meta-review escalated their
intended consequence of suppressing safety (Weick tone after 15 wildland fire fatalities occurred in 1979
1996, Dunsky et al. 2005, Desmond 2008, Pyne 2015). and demonstrated exasperation with the organiza-
A notable rethinking of the war metaphor oc- tional inertia of firefighting:
curred after the 1949 Mann Gulch fire near Helena,
Montana. Burning thousands of acres and propelled Numerous fire safety studies, reports, and ana-
by high winds in hot, dry conditions over steep ter- lyses dating back to the mid-1950s were re-
rain, the fire killed twelve smokejumpers and a local viewed during the course of this study. IT IS
fire guard (Pyne 2015). Findings from the investigative SIGNIFICANT TO NOTE THAT MANY OF THE
report led to greater urgency in developing research SAME ISSUES THAT EMERGED FROM THIS
STUDY WERE ALSO FOUND REPEATEDLY IN
toward “a better understanding of indicators of fire
THOSE PREVIOUS INVESTIGATIONS. Part of
behavior” and for fast, efficient, and safe firefighting
the problem, then, appears to be incomplete im-
(Hanson 1949, p. 7, Barrows 1951). The USFS es- plementation of previous study recommendations.
tablished state-of-the-art fire laboratories in the late (NWCG 1980, p. 8, emphasis original).
1950s and early 1960s in Macon, Georgia; Missoula,
Montana; and Riverside, California, where researchers In this 1980 fatality review, the multiagency task force
used physics and engineering to better predict and departed from the wartime hero model by presenting
control fire behavior (Pyne 2015). In addition, the a safety-first philosophy and advocating a no-fault
labs engaged in product development of fire shelters, ethic. They broke from the position of fire leaders at
gloves, and other personal protective equipment for the time who were saddled with an older pattern of
firefighters. Although the war mentality and its associ- determining the legal and financial liability of individ-
ated motivation of dominating nature persisted, a cor- uals. The task force was responsive to the directives
relative paradigm of fire science emerged after Mann of the Occupational Safety and Health Administration
Gulch with the aim of advancing firefighter safety and (OSHA) to protect employees. Reaching beyond oper-
eliminating fatal entrapments. ational strategies, their discussion of “human behavior”
Yet entrapments and fatalities continued during inched toward cultural issues of safety. The report de-
this period of engineered solutions and spurred thor- scribed a wildland fire culture of invincibility with an
ough reviews of the agency’s practices. The 11 deaths “unquestioning acceptance that ‘firefighting is a dan-
in the Inaja fire of 1956 prompted a meta-study of the gerous business’” (NWCG 1980, p. 17). Firefighters
previous 20 years of wildland fire fatalities—the first cohered around the value of hard work, the status of
of three early meta-reviews (USDA FS 1957, 1967, seniority, and the rewards of job security. This created
NWCG 1980). Although it prioritized research on at all levels in the wildland fire community a reluc-
fire conditions, the study also located precursors for tance to impose accountability for safety upon an “old
what would later be identified as human factors, such boys club” in “strategic places” across the organization
as weaknesses in planning, leadership, and the inter- (Laybourn 2019, p. 1). Calling one another on safety
pretation and communication of fire behavior (USDA infractions was seen not only as personally damaging;
FS 1957). It also called for structural reform by cen- it could erode an entire profession, exacerbating what
tralizing the organization and cultural reform through was “already considered to be a waning interest in fire
standardizing fire operations. The 1957 study also work” (NWCG 1980, p.50). Moving from how work
cited employee resistance: previous safety guidance is- was done to why work was done, the 1980 meta-study
sued in 1953 never gained traction with firefighters. put together the motivational paradox of safety cultureJournal of Forestry, 2021, Vol. XX, No. XX 5
in wildland fire: effective safety in the job often com- which contributed significantly to wildland-fire fatal-
peted with efficient productivity on the job. ities. Putnam therefore pushed for taking actionable
Suggesting a broader scientific rationale was pos- steps on earlier meta-review recommendations to
sible, the 1980 task force promoted a multidiscip- examine human behavior and cultural issues of safety.
linary inquiry into “all cause-effect relationships from (Putnam 1995).
which practical corrective actions can be derived” In June 1995, Putnam organized the Wildland
(NWCG 1980, p. 4, emphasis original). However, Firefighters Human Factors Workshop, hosted by the
contemporary efforts by the USFS to understand the USFS Missoula Technology and Development Center.
changed “physical, social, economic, and organiza- For the first time, the examination of human variables
tional environment” in wildland firefighting did not took center stage, redirecting inquiry toward the so-
begin in earnest until after 1994, a challenging year of cial relationships and culture in the fire community.
increased firefighter fatalities and diminished returns Among the many accomplished workshop participants
on suppression costs (USDA FS 1995, p. 2). was organizational psychologist Karl Weick, who was
known for his study of the organizational breakdown
and human factors that contributed to mass fatalities
Cultural Awareness (1995–2004)
during the 1949 Mann Gulch fire (Weick 1993). Weick
The loss of fourteen firefighters in the 1994 South pointed out disturbing similarities between the Mann
Canyon fire was a particularly deafening wake-up call Gulch and South Canyon fires. Although 45 years
that made the USFS acknowledge the dynamic com- apart, the firefighters in each incident divulged relevant
plexity of the human dimensions of organizational interpersonal and emotional experiences: inadequate
safety. We refer to the awakening after South Canyon briefings, uncertainty about leadership, physical and
as a period of cultural awareness, during which the pre- symbolic resistance to dropping their tools in order to
vious focus on safety through fire operations and fire escape, and a reluctance to acknowledge the unknown
behavior became enhanced by social science perspec- (Weick 1996). Although firefighters recognized the sig-
tives, and inquiries into wildland firefighting fatalities nificance of these issues during the incidents, no one on
took a cue from the 1980 meta-review to replace ques- the crew bucked authority or refused to engage the fire.
tions of how with explanations of why. We sketch this No one admitted that they had lost control of the situ-
period from 1995 through 2004 in two subsections ation, because a loss of control or admission of failure
that include four landmark documents of workshops was taboo in Weick’s (1996) hypothesis of a can-do
and research conducted by organizational psycholo- culture in the wildland fire organization. Moreover,
gists and public safety consultants. the social stigma of saying no to an assignment was
seen as a character flaw of the individual firefighter
The Wildland Firefighters Human Factors rather than attributed to a managerial misstep or an
Workshop and Safety Awareness Study organizational gap.
Wildland fire smokejumper-turned-psychologist Ted Consequently, the federal agencies responsible
Putnam publicly questioned the engineered-solutions for managing wildfire sponsored the first major fed-
approach to safety, which sought to explain fatality eral study of the human dimensions of wildland fire.
and injury through the lens of fire science. Technical The Wildland Firefighter Safety Awareness Study
failures predominated in the investigation reports of (WFSAS) collected data from wildland fire profes-
the South Canyon fire, as did “plain indifference” to sionals, including input from more than one hundred
the safety of employees (US Department of Labor interviewees, a dozen focus groups, and more than 700
1995, p. 12). Putnam argued that internal factors such survey respondents. The multiphase study was designed
as “stress, fear, and panic combine to erode rational to identify the organizational culture and human fac-
thinking” on the fire line (Putnam 1995, p. 54), despite tors impacting firefighter safety (TriData 1996), help
operational planning and cutting-edge gear. However, determine organizational goals toward improving the
the USFS and wildland fire community had done little safety culture (TriData 1997), and assist in the imple-
to understand how human thinking, leadership, and mentation of those cultural changes (TriData 1998). As
crew interactions impacted decision making. Although a result, programs for communicating safety informa-
fire science advanced knowledge of the external factors tion were established in the late 1990s and early 2000s.
affecting wildfire suppression, it did not include human These included the development of an improved ethic
factors like individual psychology or social interaction, of communicating and managing risk through Crew6 Journal of Forestry, 2021, Vol. XX, No. XX
Resource Management efforts and the Wildland Fire of “things that disconfirm, are unpleasant, feel uncer-
Leadership Development Program; a system for con- tain, seem impossible, are implicit—and are contested”
fidentially reporting incidents and accidents, known (Keller 2004, p. 17, emphasis original). Rather than
as SAFENET; and the Wildland Fire Lessons Learned operational recommendations, the workshop organ-
Center, a repository for incident education. izers tutored participants in processes that generate
These systemic changes in wildland fire were still the mentality, or mindfulness, of an HRO: (1) scru-
tied to the engineered-solutions ethic of individual tinize work systems for small failures, because they
savvy, which advocated “individual responsibility, illuminate where catastrophic failures might begin;
training and qualifications, strategy and tactics, and (2) resist simple solutions that reduce complexity and
personal protective clothing and equipment” (Mangan employ diverse perspectives instead; (3) maintain im-
1999, p. 17). Nonetheless, subsequent assessments re- mediate situational awareness and communicate it in
vealed that the post-WFSAS attention to human fac- order to build a predictive or anticipatory capacity;
tors of leadership training, nonpunitive reporting, (4) increase resilience among employees to improvise
and decision-making were associated with successful with resources at hand; and (5) locate expertise in the
reductions in fire entrapment fatalities (Loveless and appropriate individuals, regardless of the hierarchy of
Hernandez 2015). authority.
The rationale was that mindfulness created a cap-
Safety and Health from the Field and the acity to discover and manage unexpected events, ultim-
USFS as a High Reliability Organization ately producing a reliable sensitivity for determining
A View of Safety and Health from the Field was the safer operations (Weick 1995). Furthermore, several
first study to ask both USFS fire and nonfire personnel other elements should coexist in an informed HRO
about the “prevailing safety ‘culture’” (TriData 2003, culture: transparency in reporting, a just distribution
p. 2). Employees who participated in the study stated of responsibility, flexibility to stressors and elements
that they lacked training in identifying and evaluating of change, and a disposition for active learning. HROs
hazards and using specialty equipment and often were understood to preempt catastrophe by bringing
did not use even the most basic personal protective errors into the open and dealing with them creatively
equipment or seat belts. One-third of employees from all levels, as opposed to suppressing them.
did not conform to work-rest guidelines, and care- In the decade that followed the development of
lessness and fatigue were the most frequently cited the agency’s cultural awareness of the social aspects
factors contributing to injuries. Solitary work, night of safety, the USFS moved towards embedding that
work, and working without a radio were extremely awareness in its management practices.
common, and their combination contributed to the
“greatest concern voiced by employees…that of
being alone and having an accident” (p. iii). In add- Cultural Management (2005–2015)
ition, employees thought health and safety conditions Cultural management describes a significant shift from
were affected by the structural issue of a decreased safety initiatives focused solely on fighting wildfire
budget with an increased workload. They reiterated to national initiatives that included the normal work
tensions between safety and productivity that the environment of nonfire personnel and organizational
1980 fatality meta-review previously identified. learning across the entire USFS workforce. Senior
leaders in the agency, advised by a global manage-
The reduction in employees is causing the re-
ment consultancy, adopted a model called the Safety
maining ones to increase their workload and geo-
graphic areas of responsibility, which sometimes is
Journey and employed it in agencywide sessions. The
leading to cutting safety corners to get the job done primary realization for the USFS during these years
(TriData 2003, pp. iii-iv). was: “our safety record is not just about safety—it is
about literally everything we do, and how we do it”
Broadening organizational perspectives on safety, the (Kimbell 2007, p. 1). The USFS focused on identifying
USFS and Department of Interior convened a work- the foundational values that generated unwanted
shop in 2004 along with external stakeholders on and unanticipated outcomes in order to transform
managing unexpected consequences during prescribed the organizational safety culture of the entire agency.
fires. Participants embraced the idea of the High It attempted to modify those values in a process of
Reliability Organization (HRO) cultivating awareness self-discovery; that is, of organizational learning.Journal of Forestry, 2021, Vol. XX, No. XX 7
Integrating Mission Accomplishment with If community members speak openly and straight
Safety at the US Forest Service about difficult issues, for instance hazards in safety-
An ideological and cultural shift took shape in the related situations, they may be misunderstood, be
interagency wildland fire system and began to permeate perceived as disloyal, become ostracized, and run
the risk of being held legally accountable. At the
across the USFS in the mid-2000s, as the Washington of-
same time, the failure to bring out issues raises
fice reframed wildland fire management in a larger social-
issues of personal integrity and responsibility, and
ecological context. With a rise in USFS employee deaths likely insures [sic] that fragmentation and error will
during 2005, senior leaders in the agency were eager to persist. (Dialogos 2007, p. 6)
identify the systemic and cultural changes required to re-
duce incidents in fire and nonfire work environments. This paradox of safety accountability was an organ-
In 2006, Chief Bosworth issued a statement re- izational “catch-22” for employees who attempted to
garding the wildland fire policy reform entitled “Fire meet the rigors of work, not by cutting corners but
Suppression Foundational Doctrine.” Authors of the by developing creative workarounds in safety prac-
reform made a case for correcting the proliferation tices. These HRO-type “improvisations” inadvertently
of policies and procedures enacted since the South perpetuated situations where “things end up working
Canyon fire. They endorsed a more general guiding in spite of organization-wide difficulties” (Dialogos
philosophy (Bosworth 2006). The fire doctrine envi- 2007, p. 1). The USFS was still characterized by what
sioned a culture of HRO values, a culture of integrity researchers have argued is a can-do culture in the or-
and flexible judgment capable of accomplishing the ganization that “seems to make matters worse as
“agency mission while minimizing exposure to haz- people work harder and harder to satisfy demands, but
ards” and fostering “a work environment that is enjoy- never seem quite able to keep up” (p. 6). In turn, se-
able, rewarding, recognizes the value of diversity, and is nior management attempted to address these capacity
free of harassment” (USDA FS 2005, p. 3). Meanwhile, challenges by adding rules and rote procedures. These
a parallel discourse regarding safety and the defense often had the unintended effect of diminishing critical
of work was intensifying among USFS employees, re- thinking, contrary to the HRO precept of avoiding
flected in an agencywide safety culture study: simple solutions.
Table 1. Landmark documents in the development of USFS safety programming
Precipitating Event Publication
event date Resulting document date
Cultural South Canyon 1994 Findings From the Wildland Firefighters Human 1995
Awareness fire Factors Workshop
Human Factors 1995 Wildland Firefighter Safety Awareness Study 1996–98
workshop
Camuesa 1999 A View of Safety and Health from the Field 2003
incident
Cerro Grande 2000 Managing the Unexpected in Prescribed Fire and 2004
fire Fire Use Operations
Cultural Fire doctrine 2005 Integrating Mission Accomplishment with Safety 2007
Management at the US Forest Service
Safety Journey 2011 The Forest Service Safety Survey 2014
Safety Journey 2013 Preliminary Report on the 2013 Forest Service 2014
Safety Survey
Safety Journey 2015 2015 Forest Service All-Employee Safety Survey 2016
Cultural Life First 2016 Life First: An Exploration of the 2016 Wildland 2016
Reorganization Fire National Engagements Sessions
Life Work 2017 Life-Work Dialogue Participant Survey – Work 2017
Group Dialogues
Stand Up for 2018 This Is Who We Are 2019
Each Other
WEPO charter 2019 2019 National Work Environment Assessment pending8 Journal of Forestry, 2021, Vol. XX, No. XX
The Forest Service Safety Journey group members were the most apt to agree that safety
In 2011, the USFS implemented group dialogues in was a top priority for the USFS; they felt supported by
which employees in all work areas across the agency managers and did not feel expected to cut corners in
were required to join day-long conversations with their safety. Somewhat supportive group members reported
leaders. Known as the Safety Journey, this initiative that the engagements were temporary efforts, and the
was a way to elevate “safety consciousness and prac- skeptical group indicated comparatively negative at-
tice” for all USFS personnel in both fire and nonfire titudes regarding the Safety Journey. Survey findings
positions (Lane et al. 2014, p. iv). According to one indicate that ambivalence toward the Safety Journey
source, the dialogues “reinforced the perception of grew substantially from 2011 to 2015. Employee at-
safety as a core value rather than as a ‘program,’ intro- titudes toward the Safety Journey tempered over time,
duced new practices and tools for risk management from both extremes, into something more lukewarm.
and learning and gathered input and feedback from Although some resistance by employees to the Safety
employees” (Dialogos 2020, web page). Such cultural Journey remained throughout its three iterations, the
changes to processing, communicating, and taking de- Safety Journey demonstrated that a discursive engage-
cisive action—that is, thinking, talking, and acting— ment format, conducted in local settings and tailored
would inform future programs. to different work units, could help to identify spe-
In the followup evaluation survey, fire and nonfire cific issues that needed attention, especially rewards,
employees identified key safety concerns. Employees reprimands, and workload. In the following years,
provided open-response comments for improving the Safety Journey morphed into safety engagement
safety in the USFS that, when summarized into 10 sessions and a cultural reorganization of the USFS.
recommendations by the survey analysts, included
now familiar requests: “1. Reduce workloads; [and]
2. Revise target-based funding so that employees are
Cultural Reorganization (2016–2020)
not tempted to cut safety corners in order to meet tar- USFS safety programming reached a transition period
gets in the face of reduced personnel and budgets” of cultural reorganization during 2016–2020. During
(Lane et al. 2014, p. 40). Other suggestions advocated this time, the USFS promoted critical thinking and
employee mentorship, hiring more and fully qualified speaking, inviting a reversal of the lingering hier-
employees, reinforcing anonymous access to safety archical command that historically characterized the
violation reporting, and acknowledgment of good agency. Exercises in interpersonal communication em-
safety records. Employees also suggested modifying fu- boldened some employees to engage in frank discus-
ture safety programs to include topics such as office sions of workplace misconduct, including harassment.
workers’ health, wellness, and fitness; and emphasizing Larger forces also influenced cultural reorganization,
risk management rather than rules-based safety, which including the global watershed of the #MeToo move-
was in line with the 2005 Fire Doctrine. ment and subsequent pressure from Congress for
Throughout 2012 and 2013, USFS leadership reform. In addition to experiencing changes in infor-
undertook the second iteration of the Safety Journey, mation flow and volume, senior leadership unified
engaging agency employees in another round of group various safety and well-being programs under the
dialogues. Their conversations continued the process
of shifting from a rules-based to a values-based safety
culture and improving how work was accomplished Table 2. Employee support of the Safety Journey
(Ghimire and Cordell 2014).
Survey year 2011 2013 2015
The third Safety Journey in 2015 focused on per-
sonal and organizational resilience and managing the N 8889 9801 9244
stress of the workload-safety balance. The USFS de- Supportive/highly 43% 32% 30%
signed these sessions to develop a shared vision of supportive
safety, elaborated in the statement “We actively care Somewhat supportive/ 22% 20% 50%
for the safety of ourselves, one another, and the public. somewhat critical
Skeptical/very 35% 48% 20%
Success is safely achieving our mission—with all of us
skeptical
returning home every day” (Ghimire et al. 2016, p.4).
Groupings of employee support for the Safety Journey (Ghimire and Cordell 2014, Lane et al. 2014, Ghimire et al.
are comparable over the years (see Table 2.) Supportive 2016)Journal of Forestry, 2021, Vol. XX, No. XX 9
newly constituted Work Environment and Performance reported that a cyclical interaction between outside
Office (WEPO). pressures and a can-do identity of perseverance gener-
ated increased firefighter acceptance of risk.
Life First and Life-Work National In the summer and fall of 2017, the USFS imple-
Engagements Sessions mented Life First principles throughout the agency as
USFS Chief Thomas Tidwell, influenced by “another the Life-Work Dialogues (Tidwell 2017). Returning to
tragic fire season” in 2015, cautioned the fire commu- the target audience of all agency fire and nonfire mem-
nity in his spring 2016 letter of intent: bers, the framework continued to pursue the safety
concepts of Stop, Think, Talk, then Act and the op-
Implement strategies and tactics that commit re- tion of assignment refusal. Employee feedback from
sponders only to operations where and when they
Life First also shaped the specific content of Life-Work
can be successful, and under conditions where im-
including building trust, learning from each other, and
portant values actually at risk are protected with the
least exposure necessary while maintaining relation-
managing exposure to unhealthy and hazardous con-
ships with the people we serve. (Tidwell 2016, p.1) ditions in any work environment.
Tidwell encouraged the fire community to discern their Workplace Harassment and the Shift in
situation, to “‘stop, think, and talk’ before ‘acting’ in Safety Initiatives
any circumstance that feels like it may represent un- In the winter of 2017–2018, the #MeToo movement
necessary exposure” to risk (p.1, emphasis original). uncovered structural forms of gender discrimination
Continued learning and adaptation were seen as key to and sexual harassment that were deeply imbedded in
keeping pace with the increasingly complex wildland- organizations throughout the world. The USFS was
fire environment. no exception. After the USFS instituted the guidance
Tidwell’s guidance for wildland-fire response was of Stop, Think, Talk, then Act, a number of women
broadcast by the Life First safety initiative, launched in wildland fire publicly brought claims of harass-
by the USFS in the spring and summer of 2016. Life ment, discrimination, abuse, and retaliation against
First retained the group dialogue model and mission of some of their supervisors and coworkers (Flock and
the Safety Journeys but departed in title and audience. Barajas 2018). Harassment accusations reached the
The focus notably returned to employees working in top of the USFS administration, and on March 7,
wildland fire. Life First reminded fire responders to 2018, Chief Tony Tooke resigned amid accusations
exercise situational awareness and assess and mitigate against him of sexual misconduct in the workplace
their unnecessary exposure to risk. The USFS intended (Segerstrom 2018).
the initiative’s discursive exercises to equip wildland The USFS designed the safety engagement session for
firefighters with critical adaptive strategies toward in- 2018 based on previous Life-Work findings, including
formed and decisive action. USFS employees used the the need to address sexual misconduct as a safety issue.
dialogues as practice sessions to speak up without re- However, in response to the Tooke accusations and a
prisal, and they demonstrated a reversal of the trad- long history of claims across the agency, Congress de-
itional communication order. manded more efficient mechanisms for reporting har-
Of the 8,100 estimated wildland-fire employees assment and required comprehensive antiharassment
who participated in the Life First engagements, over training in the USFS (USDA OIG 2020). The USFS can-
2,600 offered feedback in a postengagement survey. celled the 2018 safety engagement. Instead, more than
They reported common examples of unnecessary ex- 44,000 USFS employees, summer seasonal employees,
posure to risk based on extreme driving conditions, and affiliates attended Stand Up for Each Other
tactics such as extraneous mopping up after a fire, the (Christiansen 2018 web page, USDA OSEC 2019a, b).
misuse of aircraft, and the miscommunication of work The day-long, mandatory antiharassment training con-
objectives (Flores and Haire 2016). Moreover, partici- sisted of instructional videos and group discussions re-
pants explained that their decisions to accept normal garding agency antiharassment policy, programs, and
and preventable risk were often driven by political, so- employee responsibilities for reporting.
cial, economic, and cultural pressures that surpassed The USFS introduced organizational changes in the
their ability to appropriately use established safety wake of the agency’s public reckoning with sexual mis-
practices. Across all individual, group, and organiza- conduct, including a revamped harassment-reporting
tional levels in the wildland-fire system, participants center, changes in investigation procedures, an updated10 Journal of Forestry, 2021, Vol. XX, No. XX
statement of codes and commitments, and the creation former USFS organizational learning professional who
of an employee advisory group. Notably, the USFS established an ideographic counternarrative. It is based
transformed a segment of its organizational structure in on his personal experience of implementing workplace
September 2018, creating the WEPO within the office interventions and is thoroughly informed by organiza-
of the USFS chief. Its mission was to “improve and sus- tional psychology (Pupulidy 2020).
tain a workplace culture where all employees feel safe, Here, we contribute an understanding of safety
valued, respected and supported” (Weldon 2019, p. 1). from the perspective of historical sociology. This
WEPO merged policy with culturally driven initiatives subdiscipline preserves historical inquiry within socio-
for both the fire community and the entire agency. logical studies of change. We interpret the safety initia-
In the winter of 2019–2020, the USFS planned a tives not as experiments toward desired nor fixed ends,
relaunch of safety engagements under the new cul- but as chapters in a narrative of outcomes that are often
tural banner “This Is Who We Are” (USDA FS 2019, unintended and through which the plot is continually
Christiansen 2020). The all-employee safety engage- revised. Safety is not programmed into employees; it is
ments, now called “national learning sessions,” at- coproduced between agency orchestrators of initiatives
tempted to instill in every employee “the Forest Service and agency employees who adopt, adapt, or outright
commitment to live as a values-based, purpose-driven reject those initiatives in their daily work processes.
and relationship-focused organization” (Weldon 2020, The account of events that historical sociology reveals
p. 1). Due to the overwhelming demands on employee of safety in the Forest Service insists upon the exer-
capacity during the agency’s response to the COVID-19 cise of human determination, even if it travels on well-
pandemic, however, emergency crisis response paused trodden paths. Therefore, this assembly of documents,
the implementation of the cultural-engagement sessions. analyzed for recurrent themes over time, contributes to
a more precise body of theory. Historical institution-
alism addresses how cultural meanings are embodied
Discussion in behavioral norms—that is, what our values are and
The purpose of this account has been to chronicle how the ways we typically achieve those values. It exam-
safety initiatives and development of a safety culture ines how enacted values not only flow through stable
emerged in the USFS. By adopting a historical socio- structures but also cut new channels into the embank-
logical approach to trace the development of safety ments of existing organizational boundaries. Work cul-
culture in the agency, we describe the interconnect- tures socialize their employees into accepted behaviors.
edness of safety initiatives and their existence within Employees shape their work environments.
the context of a greater national culture and history This article is limited to examinations of USFS
of wildfire suppression. A major observation of our safety initiatives that have shaped the development of
account is that, rather than being passive recipients, the organizational safety culture in the agency. We re-
agency employees have questioned and shaped the flected on the development of USFS organizational cul-
agency’s approach to safety and actively influenced the ture and safety initiatives over the past one hundred
trajectory of safety initiatives. When told to speak up, years and particularly the human dimensions of safety
they did so. since 1995. We found that since the 1910 Big Blowup,
Recent publications have also accounted for the the history of organizational culture and safety initia-
contemporary history of the agency’s safety initiatives. tives in the agency has been anchored within a con-
Our efforts in this article identify many of the same text of the high-risk occupation of wildland firefighting
historical events, albeit through different sources. We and engineered solutions for safety. Later, social sci-
diverge from this literature in the insights provided by ence research on high-risk industries informed periods
our respective disciplines. The first recent publication of cultural awareness when safety through fire oper-
was produced by the USFS for the agency’s wildland- ations and fire behavior became enhanced by social-
fire management magazine (Brown 2019). This jour- science perspectives, cultural management in the shift
nalistic documentation differs from our project in that to include fire and nonfire personnel in organizational
it represents an official narrative of safety program- learning, and cultural reorganization when a reversal
ming for the agency and seeks no scientific tradition of hierarchy and promotion of critical thinking and
in theory or methodology. It also glosses over the cul- speaking were promoted in the agency.
tural issues in the workplace that compromise safety In our document analysis, we also found a consistent
practices. The second publication was produced by a precursor to the development and implementation ofJournal of Forestry, 2021, Vol. XX, No. XX 11
USFS safety initiatives: episodes of wildland firefighter that has often appeared haphazard and disconnected
fatalities or calamitous escaped prescribed fire. Each from previous safety initiatives, our account identifies
USFS safety program originated in the hazardous con- how the agency’s contemporary safety initiatives, in-
ditions of wildland fire but later broadened in scope. formed by social and behavioral science perspectives,
Safety was applied through a more comprehensive may position agency employees to adapt to the chal-
concept of “well-being” in both fire and nonfire work- lenges that lie ahead.
place environments and through fundamental atten-
tion to the routine risks of normal work experience
Acknowledgments
across the agency’s field, office, and laboratory settings.
Research of the organizational cultures of the Forest The authors would like to thank the USDA Forest Service,
Rocky Mountain Research Station, Human Performance
Service would be improved by complementing the nar-
& Innovation and Organizational Learning Program for
ratives of historical sociology with comparatively more
generous research funding. We also want to thank the an-
quantitative studies of the organization of work, or or- onymous reviewers for their feedback and guidance. Please
ganizational sociology. Future research of the USFS send correspondence to david.flores2@usda.gov.
workforce could offer a parallel investigation into
human-resource programming efforts beyond safety.
For example, the diversification of the federal work- Funding
force is a historic backdrop to the particular develop- This research was funded by a Joint Venture Agreement (19-
ment of Forest Service diversity, equity, and inclusion N-11221636-136) between the U.S. Forest Service, Rocky
programs. Also, the devolution of federal authority to Mountain Research Station and Social Climates LLC.
the states offers a template to track the development of
stewardship programs, the implementation of coopera- Conflict of Interest
tive agreements between the USFS and the states and
David Flores and Emily Haire declare that they have no
associated impacts on Forest Service employees, and
conflict of interest. The findings and conclusions in this
the potential erosion of the can-do ethic. Additionally,
publication are those of the authors and should not be con-
a 40-year expansion of neoliberal policies provides a strued to represent any official USDA Forest Service or U.S.
timeline through which to study the increased stressors Government determination or policy.
experienced by USFS employees and the establishment
of wellness, mindfulness, and employee-assistance
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