Blueprint Training and Exercises

Moving from Disaster Plan to Emergency Operations Plan

Objectives for this presentation

• Provide National, State, and Local framework for training and exercises

• Provide background and rationale for a comprehensive Public Health and Medical (ESF8) organization training and exercise plan

• Facilitate the review of past exercise and training efforts, and set a course for future efforts.

• Review new and existing training and exercise requirements (e.g., HSEEP)

Hospital ER reopens after fatal police shooting

• Police say officers shot a suicidal man who pointed a gun at them

• Comments from Published Wednesday, March 11, 2009 | 7:18 a.m.

• “Our staff is trained to handle situations like this. Our staff knows what to do," Hospital spokeswoman Sasha Jackowich said.

• “Carnes said she saw hospital CEO Rod Davis personally pushing wheelchairs and helping people get to their cars after the shooting.”

• http://www.lasvegassun.com/news/2009/mar/11/police-shoot-gunman-dead-in-henderson-hospital-er/

“Hospital uses armed man in unannounced drill”

• Saturday, May 29, 2010 | 2:01 a.m.“How’s this for an ill-conceived emergency

preparedness drill? An off-duty cop pretending to be a terrorist stormed into a hospital intensive care unit brandishing a handgun, which he pointed at nurses while herding them down a corridor and into a room.”

http://www.lasvegassun.com/news/2010/may/29/hospital-uses-armed-man-unannounced-drill/

Why?

• The emergency room at St. Rose Dominican Hospital-Siena Campus on Eastern Avenue in Henderson reopened for patients at about 3 p.m. Wednesday after a day that began in chaos and tragedy. (2009)

• The staff at St. Rose Dominican Hospitals-Siena Campus, where the incident took place Monday morning, found the exercise more traumatizing than instructive. (2010)

A Word about Public Health:

• Over time, the roles of public health agencies have matured and expanded, and the Nation must ensure that these agencies can meet the evolving requirements of our time, including their contributions to national health security. The need for public health agencies to play a significant role in national health security has only recently become generally understood.17

National Health Security Strategy (NHSS)

Healthcare infrastructure is capable of:

• meeting anticipated needs and able to surge to meet unanticipated ones;

• ready to prevent or mitigate the spread of disease, morbidity and mortality;

• able to mobilize people and equipment to respond to emergencies;

National Health Security Strategy (NHSS)

Healthcare infrastructure is capable of:

• capable of accommodating large numbers of people in need during an emergency;

• and knowledgeable about its population—including people’s health needs, culture, literacy, and traditions—and therefore able to communicate effectively with the full range of affected populations, including those most at risk, during an emergency.

National Health Security Strategy (NHSS)

State TEPW:

• “Exercises should be designed so that each one increases in complexity and scope from the previous.

• Additionally, trainings and exercise should use a cyclical approach.

• Once a plan, policy or procedure has been developed, training is provided, the plan is exercised, and the corrective actions and lessons learned are documented.

State TEPW:

• The plan, policy or procedure is then updated based upon gaps identified in the exercise. Then the cycle begins again.

• Using the building block approach ensures a successful progression in exercise complexity and allows for the appropriate training and preparation to occur prior to participation in exercises.”

Creating a Training and Exercise Blueprint

Moving the metaphor forward!

Identify the solid foundation:

• Acknowledge what you can do:– Patient care– Trauma and Triage– Patient Tracking– Supply management– Volunteer Supervision– Etc…

• Acknowledge systems in place:– EMSystems, 800MHz, etc…

Outdated building code?

• Acknowledge the past– Disaster Plans– Joint Commission reviews/CMS reviews– Incidents/Events– Plans, Committees, Teams, and their contributions– Individuals and Skills

The change of seasons:

• Acknowledge changes– Facilities– Staff– Resources– Relationships– Requirements– Community and Cultural– Political and Systemic

Training and Exercise

• ANNUAL & Cyclical (see next slide)• Programs when set up are integrated into the

culture of the hospital, into the response community, and clearly communicate interdependence between all ESF8 agencies.

• If they are reviewed in light of the community health assessments and hazard mitigation plans they have relevance and are fundamental to the improvement plan of the hospital.

https://hseep.dhs.gov/pages/1001_HSEEP7.aspx

Framing the Support Structure:

• Minimum requirements– Emergency Operations Plan– Emergency Management Planning Committee– Joint Commission/CMS– Community response partner participation– Facility, Staff, Patients– Short (Surge) and long-term (96 hr)– Integrated with County Plans

Interior Decorating:

• Plans:– Emergency Operations Plan and Annexes– Continuity of Operations (COOP)– Surge of Infectious Patients– Chemical Patient Decontamination– Suspicious substances

• Training:– SOP’s, Protocols, Procedures, competencies– Don’t forget…these should tie to a PLAN!

The Inspection:

• JC, CMS, DHS, State Health• Exercises– Orient: sets purpose– Tabletop: considers the possibilities– Functional: identifies the policies– Drill: tests competencies– Full-Scale: makes memories!

Time for Hands On!

• HSEEP National Priorities and Scenarios.doc• HSEEP Target Capabilities List.doc • HSEEP Exercise Types.doc• HSEEP Exercise Documentation.doc• Training Exercise Plan Workshop Users

Handbook (V30)

Thank YOU!

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