Introduction
Organizational travel represents a vital aspect of global business operations, enabling organizations to expand their reach, foster relationships, and pursue growth opportunities. This includes dignitary travel, corporate travel for business professionals, travel of high-net-worth clients, and extends to non-governmental organizations deploying personnel to distant and challenging environments. In light of the coronavirus disease 2019 (COVID-19) pandemic, natural disasters, and evolving geopolitical landscapes, the need for robust organizational travel health and security risk management has become increasingly apparent.
Drawing inspiration from the meticulous protocols employed in safeguarding the health and security of very important persons (VIPs) and dignitaries during their travels, this Editorial advocates for a comprehensive approach to organizational travel risk management. By integrating insights from VIP and presidential protocols, organizations can fortify their duty of care and ensure the well-being and safety of their personnel amidst the complexities of global travel.
Organizational Travel Health and Security Risk Management
The convergence of health and security considerations in organizational travel necessitates a multifaceted risk management approach. While traditional security measures remain indispensable, the integration of advanced medical care within operational plans emerges as a critical component. Band, et al describe the importance of the amalgamation of medicine, security, logistics, transport, and other expertise domains, and a deep understanding of the patient and their overall mission as “mission-oriented medicine,” emphasizing the need for comprehensive strategies tailored to the unique needs and risks faced by VIP travelers. Reference Band, Wasser, Tubb, Keystone, Kozarsky, Connor, Nothdurft, Mendelson and Leder1
By considering the health implications alongside security protocols, organizations can better safeguard the well-being of their principal and personnel during missions, ensuring physical safety and mitigating and addressing potential medical challenges that may arise in diverse and often demanding travel environments.
This holistic approach underscores the significance of proactive planning and collaboration across disciplines to mitigate risks effectively and uphold the duty of care owed to VIP travelers, as well as ensure overall mission success.
Dignitary Protective Medicine and Proactive Risk Management Strategies
Central to effective organizational travel risk management is the adoption of proactive strategies aimed at identifying and mitigating potential risks before they escalate.
In recent years, Dignitary Protective Medicine has emerged as a Disaster Medicine subspecialty, driven by the imperative to mitigate personal risk, preserve workforce efficiency, and guarantee the safe travel of business executives and other prominent figures. Reference Al Mulhim, Darling and Sarin2
Deriving from a diverse array of policies and protocols originating from travel planning and the experiences of dignitaries, this field integrates insights from varied medical disciplines including tactical medicine, travel medicine, and prehospital medical care.
Presidential and VIP protocols highlight the importance of comprehensive individualized risk assessments covering both health and security domains. Key components of a medical operational plan encompass a medical threat assessment, logistics and supply planning, management of medical records, evacuation procedures, preventive medical measures, and a communication strategy. Reference Band, Callaway and Connor3
These special considerations for dignitaries and VIPS are often aligned with global health insurance coverage agreements which require a unique model that will facilitate the appropriate delivery of care, especially during major diplomatic and political events.
By conducting comprehensive risk assessments tailored to organizational travel contexts, organizations can anticipate and address potential threats, ranging from individual medical emergencies, natural disasters, and conflicts to security breaches and other threats specific to the region. This proactive approach enables organizations to implement preventive measures and contingency plans, thereby minimizing the impact of adverse events on travelers.
Client Medical Assessment
Individualized medical plans will often require disclosure of personal health histories and are often done in conjunction with the primary health care provider of the individual. Medical client assessment entails a thorough and standardized inquiry into current and past medical histories (both physical and mental health), aimed at gaining deeper insights into the likelihood of exacerbating underlying conditions and enabling the development of risk mitigation plans. The documentation of advanced directives and Power of Attorney should be considered, alongside a nuanced understanding of the distinctive sensitivities associated with the health statuses of VIPs making compliance with protocols governing the storage and disclosure of medical information an utmost priority.
Medical Threat Assessments
The medical threat assessment serves as a vital tool in evaluating and mitigating potential risks to the health and safety of VIP travelers. These assessments involve systematic evaluations of travelers’ health status, potential medical risks, and available medical resources. Reference Band, Callaway and Connor3 Tailored to individual travelers and the specific nature of their missions, the assessment ensures that all pertinent risks are identified and addressed during pre-trip planning, thus minimizing the likelihood of unforeseen health-related incidents during travel.
For organizational travelers, the importance of the medical threat assessment cannot be over-stated. Unlike leisure travelers who may have more flexibility in their itinerary and activities and thus a more dynamic exposure to risks, organizational travelers often operate within tight schedules and may be less-familiar with the health hazards associated with their destinations. By conducting a thorough medical threat assessment, organizations can proactively identify and mitigate potential health risks, thereby safeguarding the well-being of their employees and minimizing disruptions to organizational operations.
Furthermore, considering the duty of care owed to employees, particularly those of high-profile or influential stature, a robust organizational medical threat assessment not only enhances the safety and security of their employees, but also reinforces the organization’s commitment to their welfare.
Strategic Planning and Medical Advance
Strategic planning and medical advance are essential for translating risk assessments into actionable measures to address potential contingencies and to better streamline responses to emergent situations. It also facilitates the identification and allocation of resources (such as medical staff, clinics, and hospitals at destination) and the establishment of communication and evacuation plans prior to a crisis emerging. A pre-trip walk-through of the itinerary by the security and medical team may be warranted. Additionally, education and training on both security and medical protocols (early recognition and management of acute-on-chronic conditions and other high-risk conditions, tourniquet application in high-risk environments, use of telehealth instruments) should be provided to VIPs and their entourage.
Hospitalization of VIPs also mandates careful consideration of several critical factors. Firstly, the attending physician’s decision-making responsibility must align with collaboration with the VIP’s personal physician, who may possess specialized expertise. Secondly, the potential presence of covert and more insidious threats should be considered. Thirdly, the patient’s condition may intersect with national security or other high-level corporate/political concerns, demanding discretion in communication and access to support staff. Additionally, ensuring the in-hospital safety of the VIP and safeguarding their medical results and records is paramount. Reference Conley and Ciottone4,Reference Mahler, Nissim and Shalom5
Finally, preparedness for rapid evacuation and facility transfer underscores the imperative for logistical readiness. These facets highlight the complexity inherent in providing medical care to VIPs during hospitalization.
Integration of Medical Care
The integration of advanced medical care within operational plans represents a paradigm shift in organizational travel risk management. Traditionally, security personnel focused primarily on physical security measures, relegating medical considerations to secondary importance. However, the COVID-19 pandemic has underscored the interconnectedness of health and security, necessitating a holistic approach to risk management. Reference Mungaomklan, Atsawawaranunt and Kochakarn6 By incorporating medical expertise into security operations, organizations can bridge the gap between health and security domains, thereby enhancing their capacity to address emergent medical situations effectively.
Conclusion
Organizational travel health and security risk management require a comprehensive approach that integrates insights from VIP and presidential protocols. By adopting proactive risk management strategies, conducting robust assessments, and integrating medical care within operational plans, organizations can enhance their capacity to safeguard the well-being and safety of their personnel during travels. In an increasingly complex and dynamic global landscape, the integration of advanced medical care within organizational travel risk management frameworks emerges as a critical imperative, ensuring organizations can navigate challenges with resilience and confidence.
Conflicts of interest/funding
The authors have declared no conflicts of interest. No funding was received for this article.
Author Contributions
DT contributed to the conception and design of the article. DT, MG, FG, and MA contributed in the drafting of the article. FG, MA, and GC participated in critically revising the manuscript for important intellectual content. GC supervised and gave final approval of the version to be submitted.
