Using Tabletop Exercises Carl Osaki, MSPH, RS Northwest Center for Public Health Practice, Clinical Associate Professor Department of Environmental & Occupational Health Sciences, SPHCM, University of Washington Everything You Need to Know... 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 Discuss who uses tabletops and why Describe issues typically raised through tabletops Discuss how to consider appropriate tabletops and where to find them Suggest issues to consider in designing or conducting your own tabletop

Poll: Your Experiences I Have you participated in a tabletop exercise? Yes No What was the most significant problem you experienced as a participant in the process? If yes, tell us over the phone: Enter your answer in the feedback poll (on left side of screen)

Your Experiences II Have you facilitated a tabletop exercise? Yes No If yes, type your answer into the text chat window: What was your most significant challenge in facilitating the tabletop?

What is a Tabletop? Hypothetical scenario (story) depicting a large-scale public health emergency A facilitator leads the group (players) in identifying responses to a series of incidents in the scenario Low stress, no right or wrong answer Examines the adequacy of the plans, policies and procedures in place –(e.g., gaps, duplications, confusion, and the key decision makers’ understanding of the plans) Debriefing to discuss next steps

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

Putting Tabletops in Context Discussion-based exercises Orientation Tabletop Operation-based exercises Drill Functional Full-Scale

Where Do I Find Tabletops? NWCPHP PH Preparedness Training Centers Private firms ASPH NACCHO

Your Experiences III Have you designed a tabletop exercise? Yes No What resources/tools did you use to help design the tabletop? If yes, tell us over the phone:

How Do I Design My Own Tabletop? NW Center BT Tabletop with instructions Homeland Security Web site NACCHO BT Create Time to design: (20 to 40 hours)

What issues 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 Facilitator Audience Burn-out Materials Reality Jargon Recorder Debriefing Group size Group composition Top 10 Things to Consider:

How do I determine the success of a tabletop? Evaluation through debriefing –The exercise (objectives met) –The preparedness plan (policies identified, in place, and practiced) After-Action Report Development of work plan

Q & A