Using Tabletop Exercises

1. Using Tabletop Exercises Everything You Need to Know ... and More Carl Osaki, MSPH, RSClinical Associate ProfessorDepartment of Environmental & Occupational Health Sciences,SPH, University of Washington

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 • Describe themes typically raised through tabletops • Suggest issues to consider in designing, conducting, and evaluating your own tabletop • Convene a mock design committee

4. Your experiences • Designing • Facilitating • Evaluating • Writing AARs

5. What is a Tabletop? • A story (scenario) • A facilitator leads a discussion about incidents emerging in the story • Players identify policies and procedures needed to address each incident • Hot wash to discuss policy gaps, duplications, confusion, resources • Low stress, no right or wrong answer

6. 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

7. 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)

8. 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

9. When Should a Tabletop Be Used? • Discussion-based Exercises • Orientation • Tabletop • Operations-based Exercises • Drill • Functional • Full-Scale

10. 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

11. How Do I Design My Own Tabletop? • NW Center BT Tabletop • Office of Homeland Security https://hseep.dhs.gov/pages/1001_HSEEP7.aspx • NACCHO BT Create • CDC http://www.bt.cdc.gov • Time to design: (20 to 40 hours) • Roles (player, facilitator, observer, recorder, evaluator, resources)

12. What themes 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)

13. Successful Tabletops: 10 Things to Consider • Facilitator • Audience • Burn-out • Materials • Reality • Jargon • Recorder • Debriefing • Group size • Group composition

14. How do I determine the success of a tabletop? • Evaluation through debriefing • The exercise (meets objectives) • The plan (Identification of needed policies, gaps & duplications, policies being effectively practiced) • Target capabilities http://www.fema.gov/pdf/government/training/tcl.pdf • After-Action Report • Development of work plan

15. Questions? Comments?