Agency/Organization Location November 21, 2013

1. Los Angeles County Operational AreaStatewide Medical & Health Exercise 2013Player Briefing (SAMPLE) Agency/Organization Location November 21, 2013

2. Housekeeping • Exercise Documents in Hand • Player Handout • Communications Directory • EOPs, Checklists, Etc. • Wear your vests • Wear credentials outside and above the waist • Please place non-exercise related communications devices on vibrate • Emergency exits • Restrooms • Food/beverage

3. Exercise Purpose • Part of the annual Statewide Health and Medical Exercise coordinated by California Department of Public Health (CDPH) • An opportunity to exercise the entire health and medical mutual aid and response system across the State • An opportunity to identify systematic and individual areas for improvement and best practices to share with others • Can be used to meet other exercise requirements (e.g., HPP, Joint Commission)

4. Objectives • [Insert Specific Objectives here-ExPlan]

5. Functional Exercise • Players act out processes in real time as they would in a real world situation with the exception of actually deploying resources to the field • If They Are Playing – Communicate With Them! • Follow procedures and protocols • Use Communications Directory • No-Fault learning environment • Evaluation of organizational capabilities, not individuals • A focus on outcomes • Participants • Players • Exercise Staff • Controllers • Simulators • Evaluators

6. Functional Exercise (Cont.) • Simulation Cell (SimCell) • Provides scenario-related injects to drive play • Phone calls, email/information management system, and paper • Do not fight injects; instead focus on the action you should take in response • Each inject is designed to meet exercise objectives • Acts as all entities (organizations, individuals, etc.) that are not participating as players • The Communications Directory tells who is and isn’t playing • Provides contact information for SimCell • Identify the organization, agency, office, and/or individual with whom you want to speak when you call • SimCell will not make decisions for Players • Recognize the knowledge limitations of Simulators

7. Rules of Play • Real-world emergencies take priority over exercise activities • Players are expected to act in a professional manner at all times • Exercise Staff/Player Engagement • Controllers will only provide information they are specifically directed to disseminate • Obtain other information through existing information channels • Evaluators may interview Players at appropriate times • Respect the exercise staff’s efforts to maintain the integrity of the exercise • Do not engage exercise staff in casual conversation • Ask a Controller if the exercise construct confuses you

8. Rules of Play (Cont.) • All verbal, written, and electronic communication will start and end with “This is an Exercise” • Use “Real-World Emergency” to classify a real situation that might affect safety or the exercise • Notify the nearest Controller • “Timeout” is used by Controllers to temporarily stop exercise play if necessary • Under no circumstances will exercise communication interfere with real-world emergency communications • Only use contact information in the Communications Directory

9. Rules of Play (Cont.) • Respond to the exercise events and information as if the emergency were real • Demonstrate the activity • Examples: write the IAP, issue a press release, submit the resource request, communicate the decision • Verbalize processes for Evaluators • Make decisions, discuss alternatives, take calculated risks • “This is a decision for a higher pay grade” is not allowed • Lives and property depend on your action with the information available • Decisions are NOT precedent setting • Be realistic about resource availability

10. After the Exercise • Participate in the “Hotwash” • Give honest and constructive feedback • Identify strengths and areas for improvement • Complete and submit a Participant Feedback Form • Provide documentation to Evaluator • Make copies for yourself if you would like

11. Background Scenario • On November18, 2013, health care providers at community health centers, private physician’s offices, and local emergency departments began seeing previously healthy patients with complaints of abdominal pain throughout the county. • On November 19, multiple patients with bloody diarrhea and abdominal pain were reported throughout the healthcare system.

12. Background Scenario (Cont.) • On November 20, the healthcare system (including skilled nursing facilities) reported a 40-45% increase in patients seeking treatment for abdominal pain and bloody diarrhea. Of those patients, 10% were admitted to Intensive Care with symptoms of renal failure leading to hemolytic uremic syndrome. Additional cases continue to be reported throughout the county.

13. Background Scenario (Cont.) • Laboratory staff in the county have requested guidance from the local health department on appropriate protocols for specimen collection and laboratory techniques to confirm the diagnosis. Infection preventionists at local health care facilities are requesting guidance on necessary levels of isolation and personal protective equipment requirements for staff. Ambulance companies are reporting an increase in call volume and extended delays in offloading patients at local emergency departments. Hospitals are experiencing continuing surge with increasing wait times.

14. Background Scenario (Cont.) • The initial epidemiologic investigation has not revealed a consistent pattern of age, race, occupation, geographic distribution or previous symptomatology among patients which might indicate a source of the offending agent.

15. STARTEX

16. Hotwash • What strengths were demonstrated during the exercise? • What can be improved on? • Plans, policies, procedures • Training • Resources (equipment, supplies, MOUs) • Communication and coordination • Do any issues require the attention of senior leadership (e.g., policy)? • How might identified strengths be used to address identified gaps/weaknesses? • What additional things did you learn during this exercise? Any surprises? • Please complete and submit Feedback Forms

17. Thank You for Participating