Emerging Infectious Disease Tabletop Exercise SW Healthcare Preparedness Coalition

Purpose Participants will engage in a discussion based exercise to review and communicate facility and coalition level planning in response an Emerging Infectious Disease incident to identify opportunities for improvement and enhance awareness of current planning. Participants will include, at a minimum, frontline facilities and EMS. This exercise was designed to meet the requirements set forth in the Hospital Preparedness Program (HPP) Ebola Preparedness and Response Activities (CFDA #93.817) Funding Opportunity Announcement. More specifically, the participating agencies, in collaboration with their regional healthcare coalition and the Minnesota Department of Health intend for this exercise to at a minimum meet the detail listed in Part A; Activity C; Strategy 1; Bullet Point 3.

Objectives Objective #1: Frontline (Assessment & Treatment) healthcare facilities discuss their ability to identify, assess and treat (to the level planned by their facility) a suspected highly infectious disease case. Objective #2: Frontline (Assessment & Treatment) healthcare facilities discuss their ability to coordinate response operations with their coalition partners. Objective #3: Participants will discuss the processes and procedures for communicating during an infectious disease response at the local, regional and state levels. Objective #4: Participants will discuss access, availability and training of Personal Protective Equipment appropriate to the care of a highly infectious individual

Exercise guidelines This is an open, low-stress, no-fault environment. Varying viewpoints, even disagreements, are expected. Respond to the scenario using your knowledge of current plans, capabilities and insights derived from your training. Decisions are not precedent setting and may not reflect your organization’s final position on a given issue. This exercise is an opportunity to discuss and present multiple options and possible solutions. Issue identification is not as valuable as suggestions and recommended actions that could improve response efforts. Problem-solving efforts should be the focus. Exercise guidelines

Module 1 Patient Presentation

Module 1 Scenario A person walks into the Emergency Department registration area of your hospital (or Urgent Care of your clinic) visibly very sick. (Modification for EMS only: You arrive at the home of a person that called 911 requesting assistance and is visibly very sick.) This person describes their symptoms as “I have been really sick; vomiting, chills, diarrhea, and the last I checked I had a fever of 102.4.” While obtaining more information the patient says that they have not traveled recently, but their spouse works for an International Bioinformatics Management organization, recently returned from a project in Sierra Leone and is currently being monitored by MDH. The patient says they believe their spouse is also sick, but is not volunteering information correctly and doesn’t want to go in for “just the flu”.

Module 1 Discussion Questions Are your registration staff asking a question set that will provide enough information to identify an individual as a high risk case? Will they ask all of the questions necessary to get travel/potential exposure history? What actions does the hospital take immediately? Who does the hospital contact (internally and externally)? Will the hospital identify the disease first or attempt to transfer this patient immediately? At what point do you notify your local public health department, coalition response entity and/or MDH?

Table Reports

Module 2 Pathogen Identified

Module 2 Scenario The patient has been correctly identified as a highly suspected (not confirmed) case of Ebola. The hospital has isolated the patient, activated its incident command structure and notified the Minnesota Department of Health, its coalition response entity, its local public/tribal health department and its local county/tribal emergency manager.

Module 2 Discussion Questions Will this patient be held in your Emergency Department, moved to an isolation unit and admitted, or transferred as soon as resources allow? Upon notification, what actions will your local Public/Tribal Health Department and local County/Tribal Emergency Manager take? Once the decision has been made to transfer the patient: Where are you going to transfer the patient? Describe this decision making and coordination process. What preparations are required for the transfer? Has your hospital identified an EMS Service that is willing to transfer Ebola patients? Does your agency, service or facility have the appropriate level and amount of personal protective equipment to safely perform your role in this response?

Table Reports

TRANSFER TO A TREATMENT CENTER Module 3 TRANSFER TO A TREATMENT CENTER

Module 3 Scenario The patient is safely transported by EMS (within a 4 hour response window) to a treatment center in the state of Minnesota.

Module 3 Discussion Questions As a sending facility, what are your facility cleaning and Medical Waste protocols? Describe the physician to physician consultation that occurs on this case? As a sending facility, describe recovery actions and concerns including staff monitoring? Describe Local Public/Tribal Health Actions as a sending or receiving county. As an unaffected agency, service or facility what expectations do you have for communication from your coalition or your state department of health? As a transferring EMS service, describe your medical waste protocols for Ebola. As a Treatment Center what communication would you offer to the other coalition hospitals, public/tribal health departments, Minnesota department of health, local/tribal emergency management and other state hospitals/coalitions?

Table Reports

Hotwash / Debrief