Using Tabletop Exercises

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Using Tabletop Exercises
Everything You Need to Know ... and More

• Carl Osaki, MSPH, RSNorthwest Center for Public
  Health Practice, Clinical Associate
  ProfessorDepartment of Environmental
  Occupational Health Sciences,SPHCM, University
  of Washington

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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 agencys readiness
  for conducting a tabletop exercise

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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

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Poll Your Experiences I

• Have you participated in a tabletop exercise?
• Yes
• No

Enter your answer in the feedback poll (on left
side of screen)
If yes, tell us over the phone
What was the most significant problem you
experienced as a participant in the process?
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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?
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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

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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

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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)

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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

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Putting Tabletops in Context

• Discussion-based exercises
• Orientation
• Tabletop
• Operation-based exercises
• Drill
• Functional
• Full-Scale

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Where Do I Find Tabletops?

• NWCPHP
• PH Preparedness Training Centers
• Private firms
• ASPH
• NACCHO

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Your Experiences III

• Have you designed a tabletop exercise?
• Yes
• No

If yes, tell us over the phone
What resources/tools did you use to help design
the tabletop?
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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)

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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)

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Successful Tabletops
Top 10 Things to Consider

• Facilitator
• Audience
• Burn-out
• Materials
• Reality

• Jargon
• Recorder
• Debriefing
• Group size
• Group composition

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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

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Q A
Questions?
Comments?