Using Tabletop Exercises

1
Using Tabletop Exercises
Everything You Need to Know ... and More

• Carl Osaki, MSPH, RSClinical Associate
  ProfessorDepartment of Environmental
  Occupational Health Sciences,SPH, University of
  Washington

2
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

3
Overview

• Define a tabletop exercise
• Describe the purpose and objectives of tabletops
  
• Describe themes typically raised through
  tabletops
• Suggest issues to consider in designing,
  conducting, and evaluating your own tabletop
• Convene a mock design committee

4
Your experiences

• Designing
• Facilitating
• Evaluating
• Writing AARs

5
What is a Tabletop?

• A story (scenario)
• A facilitator leads a discussion about incidents
  emerging in the story
• Players identify policies and procedures needed
  to address each incident
• Hot wash to discuss policy gaps, duplications,
  confusion, resources
• Low stress, no right or wrong answer

6
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

7
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)

8
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

9
When Should a Tabletop Be Used?

• Discussion-based Exercises
• Orientation
• Tabletop
• Operations-based Exercises
• Drill
• Functional
• Full-Scale

10
Where Do I Find Tabletops?

• NWCPHP
• http//www.nwcphp.org
• PH Preparedness Training Centers
• Private firms
• ASPH
• http//www.asph.org
• NACCHO
• http//www.naccho.org

11
How Do I Design My Own Tabletop?

• NW Center BT Tabletop
• Office of Homeland Security
• https//hseep.dhs.gov/pages/1001_HSEEP7.aspx
• NACCHO BT Create
• CDC http//www.bt.cdc.gov
• Time to design (20 to 40 hours)
• Roles (player, facilitator, observer, recorder,
  evaluator, resources)

12
What themes 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)

13
Successful Tabletops 10 Things to Consider

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

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

14
How do I determine the success of a tabletop?

• Evaluation through debriefing
• The exercise (meets objectives)
• The plan (Identification of needed policies, gaps
  duplications, policies being effectively
  practiced)
• Target capabilities
• http//www.fema.gov/pdf/government/training/tcl.pd
  f
• After-Action Report
• Development of work plan

15
Questions?
Comments?