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Using Tabletop Exercises
Carl Osaki, MSPH, RSClinical Associate Professor
Department of Environmental & Occupational Health Sciences,SPH, University of Washington
Everything You Need to Know Everything You Need to Know ... and More... and More
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
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
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
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
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)
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
When Should a Tabletop Be Used?
• Discussion-based Exercises• Orientation• Tabletop
• Operations-based Exercises• Drill• Functional • Full-Scale
Where Do I Find Tabletops?
• NWCPHPhttp://www.nwcphp.org
• PH Preparedness Training Centers• Private firms• ASPH
http://www.asph.org
• NACCHO
http://www.naccho.org
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)
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)
Successful Tabletops: 10 Things to Consider
• Facilitator
• Audience
• Burn-out
• Materials
• Reality
• Jargon
• Recorder
• Debriefing
• Group size
• Group composition
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