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Designing, Conducting, and Evaluating Tabletop Exercises for Pandemic Influenza Business Continuity Planning. Kristine Moore, MD, MPH Medical Director Jill DeBoer, MPH Associate Director. Workshop Outline. Overview of Exercises (30 minutes)

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Designing, Conducting, and Evaluating Tabletop Exercises for Pandemic Influenza Business Continuity Planning

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Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Designing, Conducting, and Evaluating Tabletop Exercises for Pandemic Influenza Business Continuity Planning

Kristine Moore, MD, MPH

Medical Director

Jill DeBoer, MPH

Associate Director


Workshop outline

Workshop Outline

  • Overview of Exercises (30 minutes)

  • The Tabletop Exercise Planning Process: From Conception to Action (60 minutes)

  • Facilitating a Tabletop Exercise; Exercise Evaluation and Follow-up (30 minutes)


Overview of exercises

Overview of Exercises


Presentation outline

Presentation Outline

  • Steps in Business Continuity Planning

  • Purpose and Timing of Exercises

  • Five Major Types of Exercises

  • Unique Features of Pandemic Influenza Exercises

  • Designing Exercises to Meet Your Needs


Steps in business continuity planning

Steps in Business Continuity Planning

  • Conduct a Risk Assessment

  • Conduct a Business Impact Analysis (BIA)

  • Develop a Business Continuity Plan (BCP)

  • Implement the BCP

  • Test, Refine, and Revise the BCP


Steps in business continuity planning1

Steps in Business Continuity Planning

  • Conduct a Risk Assessment

    • Identify internal and external threats, hazards, and vulnerabilities that could impact your company

    • Hazards may be industry-specific or may be general

    • Rank hazards by probability and severity

    • Pandemic influenza is a hazard with a high potential severity and high probability (at some point)


Steps in business continuity planning2

Steps in Business Continuity Planning

  • Conduct a Risk Assessment

  • Conduct a Business Impact Analysis (BIA)

    • Define how different hazards (such as pandemic influenza) could impact your business

    • Identify critical job functions and operations

    • Assess assets for response

    • Consider minimal requirements for continuing operations


Steps in business continuity planning3

Steps in Business Continuity Planning

  • Conduct a Risk Assessment

  • Conduct a Business Impact Analysis (BIA)

  • Develop a Business Continuity Plan (BCP)

    • Utilize an all-hazards approach with annexes for specific issues

    • Make key decisions (based on the BIA)

    • Develop policies and procedures as necessary

    • Define trigger points as needed

    • For pandemic planning, consider unique stresses (CIDRAP 10-point framework)


Steps in business continuity planning4

Steps in Business Continuity Planning

  • Conduct a Risk Assessment

  • Conduct a Business Impact Analysis (BIA)

  • Develop a Business Continuity Plan (BCP)

  • Implement the BCP

    • Educate staff and conduct training as needed

    • Conduct steps necessary to implement policies and procedures


Steps in business continuity planning5

Steps in Business Continuity Planning

  • Conduct a Risk Assessment

  • Conduct a Business Impact Analysis (BIA)

  • Develop a Business Continuity Plan (BCP)

  • Implement the BCP

  • Test, refine, and revise the BCP


Purpose and timing of exercises

Purpose and Timing of Exercises

An exercise is a focused practice activity that

places the participants in a simulated situation

requiring them to function in the capacity that would

be expected of them in a real event.

Excerpt from FEMA Emergency Management Institute Independent Study Course, Exercise Design (March, 2003)


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Why Exercise?

  • Identify successes and strengths to be maintained and built upon

    • Plans, policies, and procedures

    • Resources

  • Reveal areas needing further improvement

    • Plans, policies, and procedures

    • Resources

  • Educate on plans, policies, and procedures

  • Educate on the complexities of a specific emergency scenario


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Why Exercise? (continued)

  • Improve organizational coordination and communications

  • Train personnel in roles and responsibilities

  • Improve individual performance

  • Satisfy regulatory and/or funding requirements

  • Evaluate response systems


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

When to Exercise

  • According to planned exercise program schedule

  • But also…

  • Revision of Business Continuity Plan

  • Changes in key personnel

  • Shifts in sector/industry trends

  • New regulatory requirements

  • Changes in information technology systems

  • In response to recent past incidents or events

  • In anticipation of upcoming events


Exercise categories

Exercise Categories

  • Orientation

  • Drill

  • Tabletop Exercise

  • Functional Exercise

  • Full Scale Exercise


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Orientation

  • Purpose

  • Familiarize staff to organization’s emergency response plan

  • Familiarize current staff to changing information or procedures

  • Bring together various departments for better understanding and coordination

  • Identify planning and response priorities prior to plan development


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Orientation

  • Methods

  • Talk Through

  • Brain Storming

  • Case Study

  • Training Workshop


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Orientation

  • Example

  • Cross Border Orientation Exercise


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Scenario 1:

Foodborne Botulism Outbreak


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

  • Suspect Botulism Cases

  • Cranial nerve dysfunction

  • Bilateral proximal muscle weakness


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Largest Foodborne Botulism

Outbreak Reported

in North America

176 cases


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Small Group Discussion

  • Review Identified Issues

  • Prioritize Issues

  • Brainstorm Realistic Action Steps


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Orientation

  • Good for:

  • Educating, building awareness

  • Gathering new ideas or feedback

  • Exercising before a plan is started

  • Exercising before a plan isfinalized


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Drill

  • Purpose

  • Instruct thoroughly through repetition and practice

  • Focus is usually on one aspect of the response plan in one organization

  • Can be used to test staff training, response time, interdepartment cooperation and resources, manpower and equipment capabilities

  • Can be preceded by orientation


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Drill

  • Sometimes referred to as:

  • Procedure verification exercise

  • Validation exercise

  • Walk-through exercise


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Drill

  • Examples

  • After Hours Notification Drill

  • Emergency Operations Center Drill

  • IT System Recovery Drill

  • Mass Dispensing Site Drills


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Tabletop Exercise

  • Purpose

  • Focus on constructive problem solving as a group

  • The success of a tabletop exercise is determined by feedback from participants and the impact this feedback has on evaluation and revision of policies, plans, and procedures


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Tabletop Exercise

  • Methods

  • A discussion guided by a facilitator based on a simulated emergency situation

  • BasicTabletops: Participants discuss problems as a group; leader summarizes conclusions

  • Advanced Tabletops: Series of messages requiring rapid response; facilitator guides the discussion


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Tabletop Exercise

  • Advantages(FEMA Exercise Design Manual)

  • Is a good way to acquaint key personnel with emergency responsibilities, procedures, and one another

  • Is an effective method for reviewing plans, procedures, and policies

  • Requires only a modest commitment in terms of time, cost, and resources


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Tabletop Exercise

  • Disadvantages(FEMA Exercise Design Manual)

  • Lacks realism and thus does not provide a true test of an emergency management system’s capabilities

  • Provides only a superficial exercise of plans, procedures, and staff capabilities

  • Does not provide a practical way to demonstrate system overload


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Functional Exercise

  • Purpose

  • Fully simulated interactive exercise that tests the capability of an organization to respond to a simulated event

  • Tests multiple functions and coordinated response in a time-pressured, realistic simulation (without deploying resources)


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Functional Exercise

  • Methods

  • Participants gather where they would actually operate in an emergency (usually an EOC or other operating center)

  • Participants are briefed immediately prior to the start of the exercise as to objectives, procedures, time frame and recording requirements

  • Simulated information is delivered to players by paper, telephone, or radio


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Functional Exercise

  • Methods (continued)

  • Players respond as they would in a real emergency, in real time, making on-the-spot decisions and taking on-the-spot actions

  • Similar to full-scale exercise without the equipment

  • Involves controllers, simulators, and evaluators

  • May consider “no-notice” design


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Functional Exercise

  • Sometimes referred to as:

  • Simulation exercise

  • Operational exercise


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Functional Exercise

  • Examples

  • Strategic National Stockpile Exercises

  • Nuclear Power Plant Exercises


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Full Scale Exercise

  • Purpose

  • Tests the comprehensive response capacity of multiple organizations by simulating a real event as closely as possible


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Full Scale Exercise

  • Methods

  • Field personnel proceed to the location of a mock emergency

  • EOC activities are combined with on-scene use of simulated victims, equipment, and manpower (enactment)

  • Activities at the scene serve as input and require coordination with the simulation at the EOC


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Full Scale Exercises

  • Example

  • City/County Emergency Management Exercises

  • Airport Disaster Exercises


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Exercises are Everywhere

  • Military

  • Emergency Management

  • Hospital Disaster Planning

  • Nuclear Power Plants

  • Airports

  • Businesses

  • Public Health


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Unique Features of Pandemic Influenza Exercises

  • Rapid decision-making with limited information

  • Staged decision-making

  • Long term event

  • Global event

  • Impacts all sector of society

  • Exploring relationships with the public health system

  • Anticipated public panic


Designing exercises to meet your needs

Designing Exercises to Meet Your Needs

  • Choose Type of Exercise Carefully

    • Based on Exercise Goal and Objectives

  • Choose Exercise Format Carefully

    • Unlimited possibilities

  • Consider the Roles of Internal Teams and External Consultants


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Early in the Design Process: Visualize

“That was a

smashing success!”


Designing conducting and evaluating tabletop exercises for pandemic influenza business continuity planning

Three Key Questions:

What did the participants learn?

What was documented?

How do the participants feel?


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