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Mastering Tabletop Exercises for Public Health Readiness

Learn the value of tabletop exercises, facilitating tips, and designing tools. Understand their objectives, use, and evaluation. Explore different types and who uses them. Discover typical objectives, timing, and resources.

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Mastering Tabletop Exercises for Public Health Readiness

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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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