Training Logistics

1. Los Angeles County Emergency Medical Services AGENCY2011-2013 Medical and Health Exercise ProgramSTATEWIDE MEDICAL AND HEALTH FUNCTIONAL EXERCISECONTROLLER AND EVALUATOR TRAININGNovember 1, 2012

2. Training Logistics • Restrooms • Emergency Exits • Breakfast! • Breaks • Cell phones • Materials

3. Agenda 9:00 AM – Check-in 9:05 AM – Opening Remarks 9:10 AM – Controller and Evaluator Training Nick Lowe California Emergency Management Agency 10:30 AM – PsyStart Training Sandra Shields Los Angeles County Department of Health Services

4. Training Overview This training is designed to provide you with the information and resources you need coordinate exercise control, evaluation, and PsyStart efforts for the Statewide Medical and Health Functional Exercise for your facility

5. EXERCISE Overview Exercise Briefing Exercise Schedule Exercise Documentation Exercise Staff Exercise Implementation

6. Exercise Briefing • Thursday, November 15, 2012 • 7:00 AM – 1:00 PM* • Play throughout the State • Hospitals • Clinics • SNFs • Emergency Management • Utility Providers • EMS Providers • EMS Agency • Public Health • Coroner • Fire • Mental Health

7. Exercise Briefing Scenario • 7.8 magnitude earthquake on the San Andreas Fault • Power loss component • Surge of patients • Surge of decedents Objectives • Organized by discipline and Core Capability • Marry State- and County- objectives & capabilities • Select your objectives TIP: Scenario specifics contained in the MSEL should not be given to players in advance of the exercise.

8. Exercise Briefing Select objectives that work best for your facility • Communications • Fatality Management • Medical Evacuation/Shelter in Place • Medical Surge • EOC Management • Onsite Incident Management • Critical Resource Logistics and Distribution

9. Exercise Schedule

10. Exercise Documentation • Controller and Evaluator (C/E) Handbook • Exercise Plan (ExPlan) • Communications Directory • Master Scenario Events List (MSEL) • Evaluation Packet/EEGs • Participant Feedback Form • Website: http://ems.dhs.lacounty.gov/Disaster/Announcement.htm • Exercise materials provided on EMS website reflect revised HSEEP • Can be used as templates for future efforts

11. Exercise Staff • Exercise Director • Safety Controller • SimCell Lead Controller • Senior Controller • Controllers • Evaluators • Simulators

12. Exercise Implementation • Assumptions • Real-world emergencies take priority • Exercise participants will comply with real-world response procedures unless otherwise directed • Exercise Communications • Exercise Language • Site Safety and Security • Exercise Identification/Credentials

13. Simulation Cell (SimCEll) SimCell Positions SimCell Operations SimCell Responsibilities

14. SimCell Positions • SimCell Lead Controller • Responsible for tracking and coordinating all scenario events • Identifies how problems could be resolved by adjustments to the scenario • Directs and provides guidance to simulators • SimCell Controllers • Responsible for tracking injects, participant calls into the SimCell, and associated follow-up responses

15. SimCell Positions • Simulators • Ensures realism and accuracy in all exercise communication • May be tasked with placing injects, answering phones and responding to player questions, creating new injects to encourage additional participation • Conducts research and provide explanations for observed player actions during the exercise

16. SimCell Operations • Three major activities • Delivering injects to players (outgoing) • Simulating non-participating entities (inbound) • Documenting participant responses

17. SimCell Operations • SimCell Limits • Only simulating non-participating entities • Players need to identify who they want to talk to • Will not make decisions for players • May have limited knowledge/expertise • May need to do follow up and call back • Use the Communications Directory provided by EMS

18. SimCell Responsibilities • Before the Exercise • Attend the C/E briefing • Review any emergency plans, procedures, and protocols available to you relevant to your assignment • Review the exercise materials issued to you, including the objectives, scenario, MSEL, and evaluation forms

19. SimCell Responsibilities Cont. • During the Exercise • Ensuring all planned injects are submitted to the appropriate agencies on time and in the correct format • Receive player communications, then write, coordinate, and transmit appropriate responses in a timely manner • Ensuring SimCell operations are coordinated and congruent with the overall exercise operations

20. SimCell Responsibilities Cont. • During the Exercise • Keep the SimCell lead controller apprised of developments, problems, issues, or concerns • Attempt to accurately portray the information contained in inject forms to the players • Record all calls received and made on the SimCell Activity Log • Any new injects developed for the exercise should be submitted to the SimCell lead controller for approval before being used in the exercise

21. SimCell Responsibilities Cont. • Phone Instructions • When answering a phone in the SimCell or at another simulated entity location always answer with “This is the SimCell” • Inquire to the participant regarding their name, agency/facility and who they are trying to reach if they do not provide this information • Ensure you re-iterate “This is an exercise” prior to providing any answers or feedback to participants

22. Control Controller Positions Controller Purpose Controller Responsibilities

23. Controller Positions • Exercise Director • Final authority on all aspects of the exercise, including starting, modifying, or ending the exercise • Works with the Senior Controller to ensure the exercise runs smoothly and all objectives are met

24. Controller Positions • Senior Controller • Coordinates with the Exercise Director on exercise control and safety issues • Monitors activities at each exercise venue • Tracks whether objectives have been met or require further attention • Controllers • Each exercise venue will have its own Controller • Responsible for keeping the exercise on schedule and suggesting potential modifications or injects • The SimCell will have a lead controller who is responsible for managing the SimCell

25. Controller Purpose • Ensure the integrity of the exercise • Responsibilities • Exercise mechanics and functionality • Deliver injects to drive play • Provide Player Briefing • Objectives are being met • Participant behavior and activities • Safety/security • Facilitate Hot wash

26. Controller Responsibilities • Before the Exercise • Review applicable plans and procedures that will be activated during the exercise • Know the scenario and MSEL • Arrive at the venue 60 minutes before StartEx • Provide the Player Briefing

27. Controller Responsibilities • During the Exercise • Locate necessary communications equipment and test it to ensure systems are operational • Monitor flow and sequence of events during play according to the MSEL • Manage the flow of exercise play and implement the scenario according to the MSEL • “Eyes and ears” of the SimCell and Exercise Director • Have patience, allow exercise to play out • If possible, capture notes to assist Evaluators

28. Controller Responsibilities • Conduct a Hot wash • Held immediately following ENDEX • Opportunity for PLAYERS to comment on their experience • What went well? • What needs improvement? • Plans, organization, equipment, training, exercise • Any surprises? • Improvements to exercise implementation? • Hot wash slide included in Player Briefing • Distribute and collect Participant Evaluation Forms

29. Evaluation Evaluator Guidance Evaluator Responsibilities

30. Evaluator Guidance • No fault exercise • Learning environment • Judge the plans and capabilities, NOT the players • Identify Lessons Learned • Best Practices • Areas for Improvement • Assess the level of preparedness • Ensure opportunities for Player demonstration

31. Evaluator Guidance • Observe and Record • During and after exercise • Tips and Key Focus Areas: • Activities that directly relate to goals and objectives • Expected actions associated with Injects • Decision-makers and key decisions • Critical events/initiating scenario events • Deviation from plans/procedures • Include times (both start and end) • Use the Evaluator Guide/Form

32. Evaluator Guidance • Tips and Key Focus Areas • What to look for • What happened? When? • How did Players coordinate? • How did Players use plans & procedures? • Adequacy of equipment/facilities/resources to support task accomplishment • Focus on outcomes and pathways • Do not focus exclusively on specific tasks • Focus on what they accomplished and how they accomplished it

33. Evaluator Guidance • Be aware of • The integration of different functions • Coordination of the overall response • Timeline • Discrepancies may indicate issues

34. Evaluator Guidance • Before the Exercise • Review the appropriate plans, procedures, and protocols • Attend required briefings • Review and be familiar with the appropriate exercise materials • Report to the exercise location at the time designated in the Exercise Schedule • Obtain or locate necessary communications equipment and test it to ensure satisfactory communication between Controllers and the Exercise Director

35. Evaluator Guidance • During the Exercise • Capture detailed notes • Position yourself so you can hear/see • Ask questions of players as necessary • Don’t interfere with exercise play • Notify the Controller of any exercise issues

36. Evaluator Guidance • After the Exercise • Capture notes during the Hot wash • Collect documentation from players • Player Logs • MSEL forms • Player ICS forms, Incident Action Plans, written Press Releases, etc. • Collect and review Participant Feedback Forms

37. Evaluator Guidance • After the Exercise Cont. • Capture notes during the Hot wash • Collect documentation from players • Player Logs • MSEL forms • Player ICS forms, Incident Action Plans, written Press Releases, etc. • Collect and review Participant Feedback Forms • Attend C/E Debrief • Submit evaluation write-ups • Identify strengths and areas for improvement for each objective • Populate Improvement Plan (IP)

38. PSYSTART TRAINING Exercise Background Purpose and Scope Exercise Schedule Exercise Documentation Exercise Staff Exercise Implementation

39. Los Angeles County Emergency Medical Services AGENCY2011-2013 Medical and Health Exercise ProgramSTATEWIDE MEDICAL AND HEALTH FUNCTIONAL EXERCISETHANK YOU!