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Disaster Preparedness: Laboratory Table Top Exercise
Suzanne H. Butch, MA, MLS(ASCP)CM
Clinical Pathology Quality Assurance
University of Michigan Hospitals and Health Centers
Department of Pathology, Division of Quality and Healthcare Improvement
Disaster Preparedness
• Involves each lab, facility, local, area, state, regional and national resources
•Defined structure for communicating needs
• Stockpiles of supplies
•Mobile response system
Exercises
• Required to participate in an exercise by accrediting agencies
• Recent national exercises • Earthquake • Cyber • Chemical • Terrorist
• Local focus • Active shooter • Nuclear plant • Biohazard • Chemical hazard
Continuum of Exercises
• More Experience
• Greater Complexity
• More Preparation Time
• Increased Cost
Table Top
Full Scale/ Comprehensive
Plan and Review
Photo US Coast Guard, Missouri 2008
Table Top Exercise
•Review of the processes and procedures that would be used in a real disaster
•Used to detect issues that may interfere with conducting a realistic simulation
Walk Through Exercise
• Shift from paper based to hands-on
•Physical actions are required
•Determine if procedures in a plan will work
Modular/Component Exercise • Focuses on a single critical business
function • Call tree
• Computer server
Simulation/Mock Exercise
• Simulates a disaster
• Exercises the response and recovery roles
•Realistic
Photo: MTA New York City Transit / Marc A. Herman
Comprehensive
• Extensive and complex exercise
• Engages many parts of the organization
•Re-enact the worst case scenario
What is a Table Top Exercise?
•Definition: • A planned exercise where decision making
individuals react to a sequence of events related to a themed incident
• No pretend or real patients are involved
Why Do a Table Top Exercise? • Tests the interactions and
communications of individuals and groups
•Practices decision making
•Aids in identifying weaknesses and co-dependencies
•Provides practice for all involved
Exercise Purpose
•Provide participants with an opportunity to evaluate current response concepts, plans, and capabilities for a specific incident
•Discuss roles, responsibilities and anticipated activities – plans, policies and procedures
Who Participates?
•Decision making individuals
•A representative of all the groups that would be involved in the event
Laboratory Involvement
•Often overlooked by planners
• It is more than specimen collection
•Patient identification is critical
•What changes in lab testing need to be made to support the disaster scenario?
Selecting a Topic
• Involvement • Involves only lab
• Involves other areas of the institution
• Outside the institution
•Relevant to location
My Location
• Snow/ice storm
•President giving graduation speech in Michigan Stadium
•100,000 (extra) people • Hockey games on New Years Day in Michigan
Stadium
• Ann Arbor Art Fair on hot July day
• Football Saturdays
Photo by Michael Barera Michigan Stadium 2010
Incidents from Elsewhere
•Boston Marathon
•Paris terrorism
•US shootings
• Earthquakes
•Hurricanes
• Tornadoes
• Snow, more snow, and even more snow
Exercise Plan Development
•Use a committee to write the exercise
•Not the same people who wrote the plans for disaster response
•Don’t make it too big or complicated
•Disaster not a doomsday scenario
• It is about team building and relationships
Participants
•No more than 15
•Right participants – decision making
• Train participants • Plan
• Process
• Roles
Creating the Exercise
• Scenario setting – critical business function
•Consider what is going to be done and not done
• Take people out of their comfort zone
•Create the sequence of events
Creating the Exercise
• End with a positive outcome in the scenario
• Support for recording participant reactions
•Debrief
Let’s Practice
•Volunteers Needed • Laboratory Director
• Laboratory Supervisor
• Technologist
• Security Representative
• Maintenance Representative
• Computer Services Representative
• Observers
Scenario
• It is 3:00 pm in the afternoon in August in the Midwest.
•Power goes out – 3 seconds later emergency power sources come alive