Patient Movement in the Midst of a Disaster

1. Patient Movement in the Midst of a Disaster Designing a successful exercise with measureable objectives; including Joint Commission’s six critical areas

2. Objectives By the end of this session, you will be able to: • Define the Homeland Security Exercise Evaluation Program (HSEEP) • List the seven building blocks of exercise in order • Identify how SMART elements are used in writing objectives • Define the key elements of facilitating an exercise • Review a table top active shooter exercise

3. HSEEP - Defined • “Homeland Security Exercise Evaluation Program” • Capabilities-based exercise program • Ensures consistent terminology • Provides tools and resources to help build self-sustaining exercise programs. • Generic process that is flexible. • Meets the NIMS goals in HSPD-8

4. Benefits of HSEEP • Proven effective to validate plans, policies, agreements, procedures, • Streamlines the exercise process • Builds on same elements for each type of exercise (discussion-based or operational) • Identifies gaps • Identifies strengths • Thus identifying priorities for funding, resources, time, etc…..

5. Uses a cycle of increasingly complex exercises Builds upon lessons learned from previous exercises Building-Block Approach to Exercise Scheduling x

6. Seminar • Discussion-based exercise • Informal discussion • Designed to orient participants to new or updated plans, policies, or procedures. • Example: A Seminar to review the hospitals evacuation/surge capacity plans.

7. Workshop • Discussion-based Exercise • Used to build a specific product such as a draft plan or policy • Example: A workshop to develop a new plan for patient placement during an evacuation.

8. Tabletop Exercise (TTX) • Discussion-based Exercise • Involves key personnel • Discusses simulated scenarios • Informal setting • Used to assess plans, policies, and procedures, agreements • Example: Hospital Command Center staff, Facilities, Security and nursing leadership meets to discuss an ICU evacuation based off of a fire scenario.

9. Game • Discussion-based Exercise • Simulation of operations • Involves two or more teams (competitive) • Uses rules, data, and procedures designed to depict an actual or assumed real-life situation. • Example: Emerging technology with online scenarios.

10. Drill • Operations-based Exercise • Coordinated, supervised activity • Tests a single, specific operation or function within a single entity using internal SOPs • Example: Hospital conducts a decontamination drill

11. Functional • Operations-based Exercise • Examines and/or validates coordination, command, and control through use of injects • Between various multi-agency coordination centers with key personnel • Does not involve any “boots on the ground” • Example: Fire in hospital scenario. Hospital Command Central activates and coordinates with first responders for patient movement

12. Full-Scale • Operations-based Exercise • Multi-agency, multi-jurisdiction, multi-discipline • Involves coordinating response • Involves “boots on the ground” response • Example: Earthquake scenario, one hospital in the region severely damaged and must evacuate to surrounding hospitals. This would involve, fire, hospital, EMS, transportation, law, EOCs, etc.

13. You Tell Us! What building blocks are needed to successfully evaluate the following: • (Sample) Patient care during an incident • Seminar to explain plans • Tabletop to walk through the plan, setup, and resources • Drill to triage patients, as walkthrough • Full scale exercise – from activation request to actually moving patients • Activate the Hospital Command Center

14. What are Objectives ? • Cornerstone of design and development • Define specific goals • Provide framework for scenario development • Drive formulation of Master Scenario Events List (MSEL) • Guide development of individual organizational objectives • Provide evaluation criteria by focusing on what needs to be accomplished during exercise

15. Exercise Design Planning Team Creates the Objectives • Uses HICS structure • Includes representation from key participating agencies • Incorporates Subject Matter Experts (SMEs) • Employs project management principles • Follows a standardized design/development process • Support of leadership in each participating agency

16. Differences in Objectives • Discussion-Based Exercise Objectives: • Typically focus on strategy and policy-oriented issues (discuss/review plans, SOPs) • Operations-Based Exercise Objectives: • Typically focus on integration of multiple entities and systems-level and tactical-level issues (activation of plans, SOPs)

17. SMART Objectives • Simple: an easily understood statement • Measurable: can be gauged against a standard • Achievable: challenging but not impossible • Realistic: plausible for your jurisdiction and germane to what you want to accomplish • Task-oriented: tied to a task and measures what you want to exercise

18. Example Objective • Discuss the process for establishing… • WHO: Hospital command • WHAT:to include naming the incident and setting incident objectives and priorities • CONDITIONS: during a chemical/hazmat spill • STANDARDS: in accordance with existing standard operating procedures (SOPs).

19. Sample Objective • Discuss the process for establishing hospital command to include naming the incident and setting incident objectives and priorities during a chemical/hazmat spill in accordance with existing standard operating procedures (SOPs).

20. Who is Involved in an Exercise? • Participants • Evaluators • Observers/VIPs • Facilitators • Recorders • Controllers • Actors • Volunteers • Simulators

21. Facilitators Discussion-Based: • Facilitates discussion and coordinates issues between groups • Focuses the group’s discussions on specific areas and questions • Recognizes issues to be resolved • Verifies notes provided by the recorder Operations-Based: • N/A Roles and Characteristics: • Should be comfortable talking in front of large groups of people • Knowledgeable on plans and policies

22. Review Active Shooter Table Top Exercise… Thank you for your participation Marci Scott, Program Manager Pierce County Dept. of Emergency Management mscott@co.pierce.wa.us