Blackout Table Top Exercise <Facilitator Name> <Organization Name> <Date>

About This Tool This tool is the result of a collaboration between the Primary Care Development Corporation (PCDC) and the National Association of Community Health Centers (NACHC). It is intended to provide primary care centers, including community health centers, an easy to use tool to test and improve their business continuity plans. For assistance, questions or more information on this and other business continuity and emergency preparedness tools and resources, please contact PCDC (www.pcdc.org or 212-437-3900) or NACHC (www.nachc.org or xxx-xxx-xxxx)

Today’s Agenda Review information about table top exercises Scenario injects Group decision and discussion Facilitator directed questions Hotwash Next Steps After Action Report (AAR) Corrective Action Plan (CAP)

What is a Table Top Exercise (TTX) A Tabletop Exercise, also known as a TTX, is one type of exercise held in an informal setting intended to generate discussion of various issues regarding a hypothetical, simulated emergency incident. TTXs can be used to: Enhance general awareness Validate plans and procedures Assess the types of systems needed to guide prevention of, protection from, response to, and recovery from a defined incident. Goals of TTXs include: Facilitating concept understanding Identifying strengths & weaknesses Achieving changes in attitudes.

Types of Exercises

Why do a TTX? Testing the plan, not the people Key organizational personnel discuss simulated scenarios in an informal setting Assist in the promotion of understanding related concepts Used to assess plans, policies, procedures or the systems employed by the organization Highlight strengths and areas for improvement within current plans, policies and procedures

Exercise Roles Facilitator Participants (Players) Evaluators Observers Facilitates the exercise Participants (Players) Key Staff & Decision Makers External Agencies Elected / Appointed Officials Evaluators Observe behavior in relation to plans & procedures Record Information without leading Players Report observations Observers Observe exercise; No interaction in exercise play

Hotwash, After Action Report (AAR), & Corrective Action Plan (CAP) A debrief with the exercise planning team, controllers & evaluators held immediately following the exercise. Allows controllers and evaluators to collect observations and thoughts about the conduct of the exercise which leads to the development of preliminary analyses of exercise observations. After Action Report (AAR) Chronological narrative of discussion for each capability & associated activities Highlight both strengths and areas for improvement Identify discussion points relevant to your site’s ability to carry out the activities Demonstrate the capabilities being exercised Corrective Action Plan (CAP) Corrective actions are the concrete, actionable steps outlined in improvement plans that are intended to resolve preparedness gaps and shortcomings experienced in exercises or real-world incidents.

TTX Objectives & Capabilities For the purposes of this Table Top, our site is focused on testing the following capabilities: The objectives of today’s Table Top are: Describe 1-3 capabilities of your BCP that you are testing for this TTX. Capabilities can include certain business processes, BIA’s, or disruptive action policies Be sure to delete this box prior to the TTX Describe 1-3 SMART goals for the exercise. SMART stands for Specific, Measurable, Achievable, Realistic and Timely Be sure to delete this box prior to the TTX

TTX Intent This tabletop exercise was specifically developed to identify gaps in business continuity plans The intent of this TTX will be to specifically target the discussion of business continuity operations and response to an emergency event. Processes, discussion and decision-making are more important than minute details.

BCP Topics to Consider During TTX BIA Report HVA Report Incident Management Plan Communications Plan Emergency Notification Plan Risk Communications Policy Procedures Disruption Actions Individual Business Impact Analysis Forms Appendices Memorandums of Understanding (MOUs) Key Contacts, Vendors & Suppliers Other Important Documents

TTX Play Table Top Exercise Hotwash Next Steps Scenario injects Group discussion and decision Facilitator directed questions Hotwash Next Steps After Action Report (AAR) Corrective Action Plan (CAP)

Remember… Accept the artificialities of the scenario “Fight the problem not the scenario” Remember you are testing the plan, not the people There are no right or wrong answers Consider your current plan, facility, capacity & capabilities There will be time for group problem-solving, discussion and decision-making Even though a TTX is a “discussion-based” exercise, you will need to make actual decisions at the end of each discussion Makes notes on your response Please direct all questions to the facilitator/controller

TTX Scenario Day 1 Tuesday in August at 11:00 am The weather is hot and sunny and the local government has issued a heat advisory for the remainder of the week The site is experiencing a normal to high patient volume The site is running with 80% of normal staff due to employee vacation. All systems are running smoothly

TTX: Module 1 Day 1 Suddenly the site experiences a loss of power Tuesday in August at 11:00 am Suddenly the site experiences a loss of power The interior of the site is receiving only natural light, where available A few people yell out when the power goes out. A few of them remain agitated after the initial loss of light. DISCUSS & DECIDE (5 minutes) Discuss how you would response based on the above injects Make decisions based on current plans and capabilities Photo Credit: http://phoenix.fanster.com/2009/10/29/the-sports-retorter-cardinals-fans-and-blackouts-used-to-be-a-normal-occurrence/

TTX: Module 2 Day 1 Tuesday in August at 11:00 am Preliminary reports are that it is a widespread black out of unknown cause. A neighbor informs your staff that they heard the power would be restored in 1-2 hours. Patients continue to arrive for regular appointments Some of the patients in the building refuse to leave Some staff have begun gathering in the reception area wondering what to do DISCUSS & DECIDE (5 minutes) Discuss how you would response based on the above injects Make decisions based on current plans and capabilities

TTX: Module 3 Day 1 Tuesday in August at 12:30 pm The electric company is estimating power restoration in 1-2 hours Scheduled patients continue to show up at the office for appointments A non-patient enters the building complaining of being overheated and faint Unconfirmed reports of libraries, child care centers, day camps, summer school, etc. are being closed and children are being sent home DISCUSS & DECIDE (5 minutes) Discuss how you would response based on the above injects Make decisions based on current plans and capabilities Photo Credit: http://www.sumitomocorp.co.jp/english/news/2008/20080922_095736.html/

TTX: Module 4 Day 1 Tuesday in August at 2:00 pm The electric company is now estimating that power will not be restored for 24-48 hours Fewer scheduled patients show up at the office for appointments however walk in visits due to heat issues are rising DISCUSS & DECIDE (5 minutes) Discuss how you would response based on the above injects Make decisions based on current plans and capabilities Photo Credit: http://fulltimerver.com/dont-let-summer-injuries-spoil-your-rving//

TTX: Module 5 Day 3 Thursday in August at 11:30 am 48 hours since the initial blackout, the electric company restores power to the entire neighborhood but requests everyone to conserve energy for the remainder of the week Paper files, reports, notes, faxes, etc. are piled up in the office No site equipment requiring electricity has been used since the blackout DISCUSS & DECIDE (5 minutes) Discuss how you would response based on the above injects Make decisions based on current plans and capabilities Photo Credit: http://www.greatcircle.com.au/2007/09/28/clean-desk-clear-head/

Activity: Hotwash What did you learn from the TTX today about your site and your BCP? What areas of your BCP are well developed? What areas of you BCP need improvement? What are your next steps?

Next Steps The site will use the information gathered from the hotwash discussion to complete a draft version of the After Action Report (AAR), including a Corrective Action Plan (CAP). The draft version will be circulated to site staff for feedback. The feedback will be incorporated into a final draft of the AAR & CAP. Staff will meet for an After Action Conference (AAC) where the final draft will be approved and plans to implement the CAP will be adopted.

QUESTIONS?

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