1. All Hands on deck! Introducing emergency preparedness via a tabletop exercise [ttx] Beverly Mihalko, PhD, MPH Eastern Michigan University Mary Helen McSweeney-Feld, PhD, LNHA Towson University Linda Spang, JD, MS, EMT-P AUPHA ANNUAL MEETING 2016 1

2. Session Objectives 1. Describe mission-critical functions to meet the demand of a disaster incident. 2. Identify opportunities to address emergency planning and preparedness in their curriculum. 3. Create a simulation exercise to introduce students to emergency preparedness planning and response. AUPHA ANNUAL MEETING 20162

3. Session Agenda Disaster defined Disaster preparedness [PRE-disaster Paradigm TM ] Table-top exercise [TTX] Exercise de-brief Implications for health administration curriculum AUPHA ANNUAL MEETING 20163

4. What is a Disaster? Natural Flood Hurricane/tornado Wildfire Pandemic Earthquake/tsunami Man-made Power failure Nuclear meltdown War/conflict Terrorism AUPHA ANNUAL MEETING 20164

5. What is a Disaster? 5 DISASTER = NEEDS > RESOURCES AUPHA ANNUAL MEETING 2016

6. The PRE -DISASTER Paradigm™ P lanning and practice R esilience E ducation and training 6 AUPHA ANNUAL MEETING 2016

7. P lanning and practice   All- hazards approach   At-risk populations   Identify stakeholders   Develop a valid plan   Training /exercise & drills   Plan review & revision 7 AUPHA ANNUAL MEETING 2016

8. P lanning and practice Risk Analysis Assess potential vulnerabilities Understand the consequences When we understand our vulnerabilities, we can mitigate and plan for them 8 AUPHA ANNUAL MEETING 2016

9. P lanning and practice Continuity of Operations Mission-critical functions to meet the demand must be identified Contingency planning must support these mission-critical functions 9 AUPHA ANNUAL MEETING 2016

10. P lanning and practice Health System Surge   Surge capacity Where do you put the extra patients?   Surge capability How do you take care of them? SpaceStaffingSuppliesSystems AUPHA ANNUAL MEETING 2016 10

11. R esilience Ability of individuals and communities to adapt and overcome adversity due to disaster 11 AUPHA ANNUAL MEETING 2016

12.   Essential to the workforce and community   Competency based   Standardized   Supports inter-agency collaboration and cooperation E ducation and Training 12 AUPHA ANNUAL MEETING 2016

13. Tabletop exercise (txx) Hypothetical, plausible situation Hypothetical, plausible situation Informal setting Informal setting Participants discuss issues and consider response options Participants discuss issues and consider response options Slow-paced problem solving Slow-paced problem solving No textbook solutions No textbook solutions Varying viewpoints welcome Varying viewpoints welcome Test and strengthen response plans Test and strengthen response plans AUPHA ANNUAL MEETING 2016 13

14. Why Pandemic flu? Q Q: With all the public health dangers the CDC helps track and solve, is there any one thing that keeps you up at night? “The one that has the most potential to kill people is influenza. More than 50 million people died during the 1918-1919 pandemic”. Tom Friedan, Director Centers for Disease Control and Prevention AARP Bulletin, April 2016 Q Q: With all the public health dangers the CDC helps track and solve, is there any one thing that keeps you up at night? “The one that has the most potential to kill people is influenza. More than 50 million people died during the 1918-1919 pandemic”. Tom Friedan, Director Centers for Disease Control and Prevention AARP Bulletin, April 2016 AUPHA ANNUAL MEETING 2016 14

15. Who we are Group #1 435 bed community- teaching hospital Group #2 80 bed nursing home Group #3 Public Health/Community AUPHA ANNUAL MEETING 2016 15

16. TTX Scenario Break into Groups AUPHA ANNUAL MEETING 201616

17. Scenario De-Brief Q & A AUPHA ANNUAL MEETING 201617

18. Emergency management and Healthcare management programs Despite a remarkable flow of man-made and natural disasters in the US since 9/11, the amount of emergency preparedness training in HCM programs has not increased in a decade Despite a remarkable flow of man-made and natural disasters in the US since 9/11, the amount of emergency preparedness training in HCM programs has not increased in a decade (Houser and Houser, 2006) (Houser and Houser, 2006) AUPHA ANNUAL MEETING 201618

19. emergency management and Healthcare management programs 70% AUPHA member programs viewed emergency preparedness as an important curriculum item 70% AUPHA member programs viewed emergency preparedness as an important curriculum item Only 30% of programs include coursework with 3 hours of instruction as the typical amount of training Only 30% of programs include coursework with 3 hours of instruction as the typical amount of training Faculty interest and access to training are key determinants of the decision to offer emergency preparedness course content Faculty interest and access to training are key determinants of the decision to offer emergency preparedness course content (McSweeney-Feld, Nelson, Whitner & Engineer, 2016) (McSweeney-Feld, Nelson, Whitner & Engineer, 2016) AUPHA ANNUAL MEETING 201619

20. Training Resources Many free and low-cost training resources are available Many free and low-cost training resources are available www.ready.gov www.ready.gov www.ready.gov FEMA free online training classes https://training.fema.gov/is/crslist.aspx FEMA free online training classes https://training.fema.gov/is/crslist.aspx https://training.fema.gov/is/crslist.aspx American Red Cross Ready Rating programs for businesses and schools http://www.readyrating.org/The-Red-Cross-Ready-Rating- Program American Red Cross Ready Rating programs for businesses and schools http://www.readyrating.org/The-Red-Cross-Ready-Rating- Programhttp://www.readyrating.org/The-Red-Cross-Ready-Rating- Programhttp://www.readyrating.org/The-Red-Cross-Ready-Rating- Program National Disaster Life Support Programs for HC professionals http://www.ndlsf.org National Disaster Life Support Programs for HC professionals http://www.ndlsf.org http://www.ndlsf.org Community Emergency Response Teams https://www.fema.gov/community-emergency-response-teams Community Emergency Response Teams https://www.fema.gov/community-emergency-response-teams https://www.fema.gov/community-emergency-response-teams

21. Training resources 989 U.S. Medical Reserve Corps units – volunteers who train to protect the health and safety of their communities https://www.medicalreservecorps.gov/HomePag e 989 U.S. Medical Reserve Corps units – volunteers who train to protect the health and safety of their communities https://www.medicalreservecorps.gov/HomePag e https://www.medicalreservecorps.gov/HomePag e https://www.medicalreservecorps.gov/HomePag e Contact your County and State emergency management agencies – they may have specialized programs and can help you and your students get training. Contact your County and State emergency management agencies – they may have specialized programs and can help you and your students get training. AUPHA ANNUAL MEETING 201621

22. for participating in our ttx

23. REfrences Houser, S.H., & Houser, H.W. (2006). Are we preparing health services administration students to respond to bioterrorism and mass casualty management. Journal of Health Administration Education 23:2, 169-180. McSweeney-Feld, M.H., Nelson, H.W., Whitner, W., Engineer, C.Y. (2016). Emergency Preparedness Content in Health Care Administration Programs: A Decade Later (paper under review) AUPHA ANNUAL MEETING 201623