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Using Tabletop Exercises

Everything You Need to Know ... and More. Using Tabletop Exercises. Carl Osaki, MSPH, RS Clinical Associate Professor Emeritus Dept of Environmental & Occupational Health Sciences, School of Public Heatlh, Univ of WA. Objectives.

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Using Tabletop Exercises

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  1. Everything You Need to Know ... and More Using Tabletop Exercises Carl Osaki, MSPH, RSClinical Associate Professor EmeritusDept of Environmental & Occupational Health Sciences,School of Public Heatlh, Univ of WA

  2. Objectives • Describe the value and use of tabletop exercises to prepare for public health emergencies • List 10 suggestions for conducting or facilitating a successful tabletop exercise • Discuss how to evaluate your agency’s readiness for conducting a tabletop exercise

  3. Overview • Define a tabletop exercise • Describe the purpose and objectives of tabletops • Discuss who uses tabletops and why • Describe issues typically raised through tabletops • Discuss how to consider appropriate tabletops and where to find them • Suggest issues to consider in designing or conducting your own tabletop

  4. Your Experiences I Have you participated in a tabletop exercise? Yes No What was the most significant problem you experienced as a participant in the process?

  5. Your Experiences II Have you facilitated a tabletop exercise? Yes No What was your most significant challenge in facilitating the tabletop?

  6. Your Experiences III Have you designed a tabletop exercise? Yes No What resources/tools did you use to help design the tabletop?

  7. What is a Tabletop? • Hypothetical scenario (story) depicting a large-scale public health emergency • A facilitator leads the group (players) in a discussion about a series of incidents (problems) which emerge in the scenario • Players identify and discuss the policies and procedures needed to address each incident • Hotwash to discuss the significance of the policies to their own organization (e.g., gaps, duplications, confusion, and whether people are trained to carry out the policies) • Debriefing to discuss exercise, next steps • Low stress, no right or wrong answer

  8. Types of Tabletops Basic: players respond to scenario as it unfolds, can be a mix of different disciplines, not necessarily key decision makers. More oriented to learning, rather than evaluation of current system Advanced: players in own role as defined by the emergency response plan; typically those that would be involved in decision making; identifies gaps, inconsistencies, or duplications in policies, plans, or procedures

  9. Who Uses Tabletops in Public Health? • PH Agencies(local, state, tribal) • Schools/PH Institutes(summer institutes, classroom) • Local emergency response agencies • Professional disciplines(MDs, nurses, veterinarians, environmental health specialists, epidemiologists, etc)

  10. What are Typical Tabletop Objectives? • Identify the policy issues associated with a public heath emergency • Identify gaps in local preparedness • Discuss measures that can be performed at the local level • Promote interagency collaboration & coordination • Recognize the roles of public officials • Identify training needs • Demonstrate a teaching tool • Evaluate self-reported assessment

  11. When Should a Tabletop Be Used? • Discussion-based Exercises • Orientation • Tabletop • Operations-based Exercises • Drill • Functional • Full-Scale

  12. Where Do I Find Tabletops? • NWCPHP http://www.nwcphp.org • PH Preparedness Training Centers • Private firms • ASPH http://www.asph.org • NACCHO http://www.naccho.org

  13. How Do I Design My Own Tabletop? • NW Center BT Tabletop • Office of Homeland Security http://www.ojp.usdoj.gov/odp/exercises.htm • NACCHO BT Create • CDC (http://www.bt.cdc.gov) • Time to design: (20 to 40 hours) • Roles (player, facilitator, observer, recorder, evaluator, resources)

  14. What issues are raised through tabletops? • Communication(vertical, horizontal, news media) • Resources (manpower, material, technical assistance) • Data (collection, analysis, mgmt, communicating) • Coordination (chain of command, leadership) • Legal (medical, criminal, quarantine, confidentiality) • Systems(interagency protocols, surveillance, ICS) • Mental health (public fears, responders – stress)

  15. Successful Tabletops: 10 Things to Consider • Facilitator • Audience • Burn-out • Materials • Reality • Jargon • Recorder • Debriefing • Group size • Group composition

  16. How do I determine the success of a tabletop? • Evaluation through debriefing • The exercise (meets objectives) • The hotwash (Identification of needed policies, gaps & duplications, policies being effectively practiced) • After-Action Report • Development of work plan

  17. Questions? Comments?

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