DESIGNING A SUCCESSFUL EXERCISE WITH MEASUREABLE OBJECTIVES; INCLUDING JOINT COMMISSION’S SIX CRITICAL AREAS

Patient Movement in the Midst of a Disaster

Objectives

By the end of this session, you will be able to: Define the Homeland Security Exercise

Evaluation Program (HSEEP)List the seven building blocks of exercise in

orderIdentify how SMART elements are used in

writing objectivesDefine the key elements of facilitating an

exerciseReview a table top active shooter exercise

HSEEP - Defined

“Homeland Security Exercise Evaluation Program”

Capabilities-based exercise programEnsures consistent terminologyProvides tools and resources to help build

self-sustaining exercise programs.Generic process that is flexible.Meets the NIMS goals in HSPD-8

Benefits of HSEEP

Proven effective to validate plans, policies, agreements, procedures,

Streamlines the exercise processBuilds on same elements for each type of

exercise (discussion-based or operational)Identifies gapsIdentifies strengthsThus identifying priorities for funding,

resources, time, etc…..

Building-Block Approach to Exercise Scheduling

Uses a cycle of increasingly complex exercises

Builds upon lessons learned from previous exercises

x

Seminar

Discussion-based exerciseInformal discussionDesigned to orient participants to new or

updated plans, policies, or procedures.

Example: A Seminar to review the hospitals evacuation/surge capacity plans.

Workshop

Discussion-based ExerciseUsed to build a specific product such as a

draft plan or policy

Example: A workshop to develop a new plan for patient placement during an evacuation.

Tabletop Exercise (TTX)

Discussion-based ExerciseInvolves key personnelDiscusses simulated scenariosInformal settingUsed to assess plans, policies, and

procedures, agreements

Example: Hospital Command Center staff, Facilities, Security and nursing leadership meets to discuss an ICU evacuation based off of a fire scenario.

Game

Discussion-based ExerciseSimulation of operationsInvolves two or more teams (competitive)Uses rules, data, and procedures designed to

depict an actual or assumed real-life situation.

Example: Emerging technology with online scenarios.

Drill

Operations-based ExerciseCoordinated, supervised activityTests a single, specific operation or

function within a single entity using internal SOPs

Example: Hospital conducts a decontamination drill

Functional

Operations-based ExerciseExamines and/or validates coordination,

command, and control through use of injects

Between various multi-agency coordination centers with key personnel

Does not involve any “boots on the ground”

Example: Fire in hospital scenario. Hospital Command Central activates and coordinates with first responders for patient movement

Full-Scale

Operations-based ExerciseMulti-agency, multi-jurisdiction, multi-

disciplineInvolves coordinating responseInvolves “boots on the ground” response

Example: Earthquake scenario, one hospital in the region severely damaged and must evacuate to surrounding hospitals. This would involve, fire, hospital, EMS, transportation, law, EOCs, etc.

You Tell Us!

What building blocks are needed to successfully evaluate the following:

(Sample) Patient care during an incident• Seminar to explain plans• Tabletop to walk through the plan, setup, and resources

• Drill to triage patients, as walkthrough

• Full scale exercise – from activation request to actually moving patientsActivate the Hospital Command

Center

What are Objectives ?

Cornerstone of design and developmentDefine specific goalsProvide framework for scenario developmentDrive formulation of Master Scenario Events

List (MSEL)Guide development of individual

organizational objectivesProvide evaluation criteria by focusing on

what needs to be accomplished during exercise

Exercise Design Planning Team Creates the Objectives

Uses HICS structureIncludes representation from key

participating agenciesIncorporates Subject Matter Experts

(SMEs)Employs project management principlesFollows a standardized

design/development processSupport of leadership in each

participating agency

Differences in Objectives

Discussion-Based Exercise Objectives:• Typically focus on strategy and policy-

oriented issues (discuss/review plans, SOPs)

Operations-Based Exercise Objectives:• Typically focus on integration of

multiple entities and systems-level and tactical-level issues (activation of plans, SOPs)

SMART Objectives

Simple: an easily understood statementMeasurable: can be gauged against a

standardAchievable: challenging but not impossibleRealistic: plausible for your jurisdiction and

germane to what you want to accomplishTask-oriented: tied to a task and measures

what you want to exercise

Example Objective

Discuss the process for establishing…WHO: Hospital commandWHAT: to include naming the incident and

setting incident objectives and prioritiesCONDITIONS: during a chemical/hazmat

spillSTANDARDS: in accordance with existing

standard operating procedures (SOPs).

Sample Objective

Discuss the process for establishing hospital command to include naming the incident and setting incident objectives and priorities during a chemical/hazmat spill in accordance with existing standard operating procedures (SOPs).

Who is Involved in an Exercise?

Participants Evaluators Observers/VIPs Facilitators Recorders Controllers Actors Volunteers Simulators

Facilitators

Discussion-Based: Facilitates discussion and coordinates issues

between groups Focuses the group’s discussions on specific areas

and questions Recognizes issues to be resolved Verifies notes provided by the recorder

Operations-Based: N/A

Roles and Characteristics: Should be comfortable talking in front of large

groups of people Knowledgeable on plans and policies

Review Active Shooter Table Top Exercise…

Thank you for your participationMarci Scott, Program Manager

Pierce County Dept. of Emergency Management

mscott@co.pierce.wa.us