Blueprint Training and Exercises

1. Blueprint Training and Exercises Moving from Disaster Plan to Emergency Operations Plan

2. Objectives for this presentation Provide National, State, and Local framework for training and exercises Provide background and rationale for a comprehensive Public Health and Medical (ESF8) organization training and exercise plan Facilitate review of past exercise and training efforts, and set a course for future efforts. Review new and existing training and exercise requirements (e.g., HSEEP)

3. “Hospital ER reopens after fatal police shooting” Wednesday, March 11, 2009 | 7:18 a.m. “Police say officers shot a suicidal man who pointed a gun at them.” “Our staff is trained to handle situations like this. Our staff knows what to do," Hospital spokeswoman Sasha Jackowich said. “Carnes said she saw hospital CEO Rod Davis personally pushing wheelchairs and helping people get to their cars after the shooting.”

4. “Hospital uses armed man in unannounced drill” Saturday, May 29, 2010 | 2:01 a.m. “How’s this for an ill-conceived emergency preparedness drill? An off-duty cop pretending to be a terrorist stormed into a hospital intensive care unit brandishing a handgun, which he pointed at nurses while herding them down a corridor and into a room.” One year later, the same hospital didn’t hand a “staged” situation as well as they did the REAL situation a year before.One year later, the same hospital didn’t hand a “staged” situation as well as they did the REAL situation a year before.

5. Why? The emergency room at St. Rose Dominican Hospital-Siena Campus on Eastern Avenue in Henderson reopened for patients at about 3 p.m. Wednesday after a day that began in chaos and tragedy. (2009) The staff at St. Rose Dominican Hospitals-Siena Campus, where the incident took place Monday morning, found the exercise more traumatizing than instructive. (2010) The need to exercise and the opportunity must be based in a comprehensive community plan- not in a single-scenario need to meet an objective or “deliverable” for Joint Commission!The need to exercise and the opportunity must be based in a comprehensive community plan- not in a single-scenario need to meet an objective or “deliverable” for Joint Commission!

6. A Word about the role of Public Health: “Over time, the roles of public health agencies have matured and expanded, and the Nation must ensure that these agencies can meet the evolving requirements of our time, including their contributions to national health security. The need for public health agencies to play a significant role in national health security has only recently become generally understood.”

7. All Planning should start with National level guidance to ensure that state and local organizations are heading in the same direction with common focus. Also critical is the companion document to the NHSS- the Biennial Implementation Plan. All Planning should start with National level guidance to ensure that state and local organizations are heading in the same direction with common focus. Also critical is the companion document to the NHSS- the Biennial Implementation Plan.

8. Healthcare infrastructure is capable of: meeting anticipated needs and able to surge to meet unanticipated ones; ready to prevent or mitigate the spread of disease, morbidity and mortality; able to mobilize people and equipment to respond to emergencies;

9. Healthcare infrastructure is capable of (cont.): accommodating large numbers of people in need during an emergency; and knowledgeable about its population—including people’s health needs, culture, literacy, and traditions—and therefore able to communicate effectively with the full range of affected populations, including those most at risk, during an emergency.

10. Conduct a Training and Exercise Plan Workshop: Exercises should be designed so that each one increases in complexity and scope from those held previously. Additionally, trainings and exercise should use a cyclical approach. Once a plan, policy or procedure has been developed, training is provided, the plan is exercised, and the corrective actions and lessons learned are documented.

11. Training and Exercises (cont.): The plan, policy, or procedure is then updated based upon gaps identified in the exercise. Then the cycle begins again. Using the building block approach ensures a successful progression in exercise complexity and allows for the appropriate training and preparation to occur prior to participation in exercises.

12. Creating a Training and Exercise Blueprint Moving the metaphor forward!

13. Do you already have a solid foundation? Acknowledge what you can do: Patient care Trauma and Triage Patient Tracking Supply management Volunteer Supervision Etc… Acknowledge systems in place: EMSystems, 800MHz, etc…

14. Outdated “building code”? Acknowledge the past (but revise it!) Disaster Plans Joint Commission reviews/Centers for Medicare and Medicaid reviews Incidents/Events Plans, Committees, Teams, and their contributions Individuals and Skills

15. Seasons change, so should plans! Acknowledge changes Facilities Staff Resources Relationships Requirements Community and Cultural Political and Systemic

16. Training and Exercise Annual & Cyclical (see next slide) Programs, when set up are integrated into the culture of the hospital, into the response community, and clearly communicate interdependence among all ESF8 agencies. If they are reviewed in light of the community health assessments and hazard mitigation plans they have relevance and are fundamental to the improvement plan of the hospital.

18. Framing the Support Structure: Minimum requirements: Emergency Operations Plan (EOP) Emergency Management Planning Committee Joint Commission/CMS Community response partner participation Facility, staff, patients Short (Surge) and long-term (96 hour) Integrated with County Plans

19. Interior Decorating (and plan revision): Plans: Emergency Operations Plan and Annexes Continuity of Operations (COOP) Surge of Infectious Patients Chemical Patient Decontamination Suspicious substances Training: SOP’s, Protocols, Procedures, competencies Don’t forget…these should tie to a Plan!

20. The Inspection (meeting requirements): JC, CMS, DHS, CDC, HHS Exercises Orient: sets purpose Tabletop: considers the possibilities Functional: identifies the policies Drill: tests competencies Full-Scale: makes memories!

21. Master Builders use HSEEP! The Homeland Security Exercise and Evaluation Program (HSEEP) is the national standard for exercise design, conduct, and evaluation. State Homeland Security organizations will be able to provide training support at little or no cost to any organization receiving federal DHS funding. Additionally, tools in the Blueprint Toolkit are provided for HSEEP.

22. Time for Hands On! Start with the basic information: HSEEP National Priorities and Scenarios.doc HSEEP Target Capabilities List.doc HSEEP Exercise Types.doc HSEEP Exercise Documentation.doc Training Exercise Plan Workshop Users Handbook (V30) This slide should review the need to address HSEEP.This slide should review the need to address HSEEP.

23. Thank YOU! Contact Information