Title: Exercises and Training: Virginia Department of Health Emergency Preparedness and Response Programs
1Exercises and TrainingVirginia Department of
Health Emergency Preparedness and Response
Programs
- Lisa G. Kaplowitz, M.D., M.S.H.A.
- Deputy Commissioner
2Unique Aspects of Virginia
- Large state Significant urban, suburban and
rural populations - Large military presence (including Pentagon,
Langley) - Part of National Capital Region (Northern
Virginia) - Rural areas provide unique challenges
3Unique Aspects of Virginia Department of Health
(VDH)
- Most of local health districts are part of the
state health department (32/35) - Very close collaboration between health districts
and VDH Central Office - Created new regional teams to coordinate
emergency planning and response efforts
4Regional Approach to Planning and Response
- Northern Region National Capital Region (with
Maryland and Washington DC), involvement of
federal agencies - Eastern Region Military bases, tourism
- Central Region State government
- Northwest Region Rural and suburban Washington
DC - Southwest Region Rural, large geographic area
with geographic barriers borders
North Carolina, Tennessee,
Kentucky, West Virginia
5(No Transcript)
6Exercise Design, Control and Evaluation
- Phase 1 Exercise pre-planning
- Phase 2 Exercise planning
- Phase 3 Control
- Phase 4 Assessment and evaluation
7Phase I Exercise Pre-planning
- Develop
- Plan of Action and Milestones
- Mission Essential Task List
- Exercise Objectives
- Exercise Story Line
- Participant List
- In-house
- Partner Agencies
- Identify
- Exercise Audience
- Technologies to be Tested
- Policies, Procedures to be Exercised
- Exercise Locations
- Communications Requirements
8Phase II Exercise Planning
- Coordinate Use MOAs, Partner Agency Participation
Support Requirements - Develop Pre-exercise Training Plan
- Arrange Mentor / Facilitator Participation
- Prepare Exercise Concept Plan
- Core Scenario
- Master Events Scenario List
- Prepare Observation and Assessment Plan
- Observer Team
- Exercise Control Group
9Exercise Control
- Observers
- Record / review reaction.
- Elicit response.
- Measure task accomplishment.
- Collect data deliverables.
- Coordinate w/ Umpires.
- Conduct on-the-spot training.
- Umpires
- Control clock.
- Ensure timely and timed responses
- Input items from Master Events Scenario List
- Reconcile issues.
- Maintain a time log.
- Keep exercise on schedule/participants on task.
10Phase IV Analysis Reporting
- Record reactions to inputs against desired
responses - Evaluate degree to which objectives met
- Conduct an immediate Hot Washup
- Prepare an after-action report within 2 wks
- Develop a Lessons Learned database
- Establish an Implementation Panel
11VDH Exercises 2002-2003
- Multiple local, regional exercises, including
National Capital Region - Statewide exercises
- Hurricane Isabel in Sept, 2003
- Statewide bioterrorism exercise in Oct, 2003
- Anthrax event in Nov, 2003 VMI and medication
clinic - Collaboration with hospitals, laboratories, VDEM,
MMRS, localities establishment of exercise
calendar for all state agencies
12Bioterrorism Exercise October 2003
- Release of the plague at large alumni event
- Cases of pneumonia present to hospitals statewide
- Involve epidemiology and state laboratory to
identify event and organism - Strategic National Stockpile delivered to state
and distributed statewide to 6 regions - 6 mass medication/vaccination clinics established
13Bioterrorism Exercise October 2003
- All District Health Departments participated
- Multiple offices in VDH EPR, Epidemiology,
Chief Medical Examiner - CDC
- 82 of hospitals, state laboratory, state police,
emergency management agencies, UPS, local
governments and volunteers participated - VDH Emergency Coordination Center (ECC) and state
EOC operational - Test of communication systems, as well as disease
control and prevention
14Bioterrorism ExerciseObjectives Days 1-2
- Identification of pneumonia cases presenting to
hospitals throughout Virginia, with deaths - Recognition of outbreak situation
- Recognition that outbreak could be related to
intentional release of organism (BT event) - Request Strategic National Stockpile Push Pack,
prior to identification of organism - Identification of organism after SNS requested
- Key objectives Communication
- and decision making
15Bioterrorism ExerciseObjectives Day 3
- Response to BT event by VDH, other emergency
response agencies/organizations - Confirm identification of organism
- Identification of event where organism released
- Determination of infection control, treatment and
prophylactic response - Key objectives Communication and decision making
16Objectives Day 3Tabletop component
- Opportunity for district health directors and
their response teams to discuss and make
decisions with their local emergency manager(s)
and their local hospital(s) - 79/96 (82) acute care hospitals participated
- Provide a low stress event to clarify roles and
responsibilities for the management of a large
scale BT event
17Objectives Day 3Tabletop Component
- Decisions regarding surge capacity
- What facilities would be established?
- Procedures for patient movement
- Decisions regarding isolation and quarantine
- Analysis of impact on daily business (schools,
EMTs, Fire, Law, transportation..) - A checklist provided to each participating site
to assist with work flow
18Bioterrorism ExerciseDeliverables Day 3
- All districts asked to produce and submit
- Local press release coordinated with agency PIO
- Summary Report documenting communication with
participating local emergency managers - Dispensing Site Management Plan that identifies 2
dispensing sites and outlines the staffing and
management plans for each site. - Incident Action Plan
- Surge Capacity Plan
19Bioterrorism Exercise Deliverables Day 3
- Conducted a Hot-Wash debrief immediately
following the end of exercise activity at each
site - Top 10 things that went well
- Top 10 areas that need improvement
- Brainstorm list of issues/comments, checklist
provided - Submit an after action report
- Phase 1 All hot-wash notes (same day)
- Phase 2 District Director Report with action
plan to address lessons learned. (within 2 weeks)
20Bioterrorism Exercise SNS Segment Day 3
- Push Pack arrived in Virginia in AM, transported
to RSS facility in Richmond area - Training Education Demonstration (TED) package
- Receive, Stage Store (RSS) Site Manager and
State signatory authority at RSS facility - Push Pack broken down, inventoried, managed and
distributed to 6 dispensing sites and 6 treatment
centers throughout Virginia transport by UPS
21Bioterrorism ExerciseSNS Segment (cont)
- Materials arrived by UPS at dispensing and
hospital sites prior to 6 PM on Day 3 - Materials utilized on Day 4 at dispensing sites
and treatment centers. - Tracking and control were key issues.
- Dispensing sites dispensed materials for 2.5
hours from 900-1130 AM. - Materials returned to RSS site and then to CDC by
7 PM on Day 4
22Bioterrorism ExerciseObjectives Day 4
- Distribution of SNS to all parts of state
- Establish 5 dispensing clinics in all parts of
the state (6th site in No. VA 3 days later) - Winchester, Norfolk, Richmond, Roanoke, Abingdon
- Non designated districts provided personnel to
assist at dispensing sites. - Two sites actually provided influenza vaccine
- Media involvement encouraged
- Evaluation of functioning of mass medication or
vaccination clinics
23Bioterrorism ExerciseSNS Segment (cont)
- Fairfax County (Northern Virginia) operated a
dispensing site on following Saturday - Involve volunteers
- Use schools
- County transportation of public to dispensing
site from distant site - County law enforcement provide security
24Hurricane Isabel Sept, 2003 The Other
Exercise
- VDH Emergency Coordination Center established
- Staffed ESF 8 at state EOC for 10 days
- Water and power issues for hospitals, nursing
homes, health departments, homebound - Impact on hospital, institutional, home
healthcare - Public health and public information issues
- Water safety boil water alerts
- Hurricane related injury, disease and deaths
- Restaurant inspections, food safety
- Mosquito control
25Anthrax Scare, Nov 7 03
- Positive anthrax test at postal facility
- Partners
- Arlington HD
- DHS, HHS, CDC, USPS
- VA Office of Commonwealth Preparedness
- Antibiotics from VMI delivered, Arlington HD
- Dispensing clinic staffed/operational within 4
hrs - Confirmatory test negative
no antibiotics given
26Assessment and Evaluation
- Lessons Learned combined for exercise, hurricane
and anthrax event one document - Lessons Learned Implementation Panel established
- Recommend changes in VDH and state emergency
operations plans - Institutionalize all lessons learned
- Report due by June, 2004
- Revise VDH emergency operations
plan prior to DP 04
27Determine Promise 04
- Department of Defense exercise, August 2004
- Major components of exercise in Eastern and
Central Virginia chemical and explosive events,
biologic threats - VDH major participant
- Test revised VDH emergency operations plan
- Response to chemical, explosive events and bio
threat - Test surge plan
- Bring in VDH personnel from other parts of the
state as local resources become overwhelmed
28Education and Training
- Ensure the development and delivery of
appropriate education and training to - Public Health Professionals
- Physicians
- Emergency Response Personnel
- Other Healthcare Providers
- Collaboration with academic health centers,
poison control centers
29Education and Training
- Training needs assessment done
- Public Health personnel
- Hospital personnel ER physicians and nurses,
security officers - Infection control practitioners
- Focus training efforts on greatest identified
needs - Chemical agents and exposures
- Incident command
- Communications
30Education and Training
- Link directly to exercises and programmatic
initiatives - Conduct and evaluation of exercises
- Incident command and emergency management
- Mental health response
- Special needs populations
- Collaborate with all emergency management
agencies and organizations, avoid
duplication of efforts
31Education and Training
- Use of new technologies to increase access to
training programs - Videoconferencing, DVD/CD
- Webcasting, internet based training
- TRAIN Learning Management System
http/va.train.org - Portal for EPR health training
- Search for courses
- Register online tracks individual learning
records
32Other Training Resources
- Available through VDH web site
www.vdh.virginia.gov - Information on biologic and chemical agents
- Links to other resources, including CDC
- Recent VDH news and information