1.  Presented by: Barbara Dodge BA-E  Prepared by: Kristine Sanger, BS, MT (CHPCP) &Barbara Dodge, BA-E Ten-Minute drills for Hospitals: Creative Methods to Engage Your Staff in Emergency Preparedness

2. 10- minute drill as opposed to what? What are my options? Which type of exercise is best for my needs?

3. Seminar (discussion-based) Used for: Information sharing Assessment Characteristics: Casual Lecture based Considerations: Inexpensive Brief Doesn’t test anything; information only

4. Used for:  Developing  Ideas  Processes  Procedures  Build consensus Workshop (discussion-based) Considerations: Inexpensive One person can manage it Doesn’t require evaluators

5. Tabletop (discussion-based) Used for:  Identify gaps  Reinforce understanding Characteristics:  Scenario  In-depth discussion  Problem solving Considerations: Inexpensive Takes more time to put together More components (objectives, scenario, questions) Includes AAR

6. Used for:  Explore decision making / “what if”  Test strategies Considerations:  Off the shelf – limited to that scenario  Hard to find  Produce your own – very expensive and/or time consuming (Second Life)  Fun; friendly competition Games (discussion-based) Games (discussion-based)

7. Used for:  Testing specific operation or function of a single agency or function of a single agency  Train on equipment  Test a procedure  Deploys resources Characteristics:  Immediate feedback  Realistic but isolated environment Drills (operations-based) Drills (operations-based) Considerations: More complex because deploying resources Requires more time to develop Need evaluators Good way to test specific skills to prep for complex exercises

8. Used to:  Evaluate capabilities of multiple functions  Evaluate EOCs, Command Centers, etc. Characteristics:  Simulated resource deployment  Rapid problem solving  Fast-paced and stressful Functional (operations-based) Considerations: Needs more people involved Design Team Simulation Cell Takes more to develop and conduct Develop scenario/injects Location for SimCell Need communications Requires coordination Need evaluators Still relatively inexpensive

9. Used to:  Evaluate capabilities of multiple functions  Evaluate EOCs, Command Centers, etc. Characteristics:  Simulated resource deployment  Rapid problem solving  Fast-paced and stressful Full Scale (operations-based) Considerations: Needs more people involved Design Team Simulation Cell Takes more to develop and conduct Develop scenario/injects Location for SimCell Need communications Requires coordination Need evaluators Still relatively inexpensive All that and deploy resources

10.  Drill  Tests ONE function by DEPLOYING resources  Functional  Tests MANY functions by SIMULATING deployment of resources  Full Scale  Tests MANY functions by DEPLOYING resources The Difference Between Types of Operations Based Exercises

11. Example: The purpose of the this exercise is to improve our response in the use of PPE and decon equipment by involving our decon team and ED staff in a drill exercise simulating a chemical spill at the intersection of X St and 1 st St near the high school. For ANY Exercise you need objectives

12.  Primary purpose is to share a common scenario among multiple, simultaneous tabletops Webinar Tabletop Strengths: Convenience/no need to travel Cost Variety of special presenters Weaknesses Convenience/technology challenges Learning from other groups is limited Missing out on face-to-face interactions

13. But what if you only have a little time?

14. And, you’d like to remind your staff of key response issues? Lock down HVAC Bomb Threat Who to call? What to do first?

15. Help your staff to be continually mindful of disaster response issues Do you have 10 minutes? Do THEY have 10 minutes?

16. Ten – Minute Drills Then you can do a drill!

17. Steps to creating 10-minute drills  Consider what parts of your plan you want to test  Determine which areas of your hospital to focus on  Write objectives  ONLY THEN … Can your write the drill questions.  Write the answers to the questions  Discuss how you will evaluate the answers  Plan the timing  Deliver the questions  Collect the answers  Evaluate the answers  Provide responses, corrective actions or education as needed Steps 1) 2) 3)

18. Evaluate the entire exercise process.

19. Or try it this way…

20.  Design objectives  Create a scenario with questions that pertain to your objectives  Hand out scenario and let employee pick a question to answer from the bucket  Go to their workstations for this type of exercise “Bucket” tabletops

21. Now you try it!

22.  Choose a disaster plan (evacuation, shelter in place, hazmat)  Show up in a department in the hospital (get permission of supervisor)  Spend 10 – 15 minutes going through the process (i.e. have nursing staff gather everything they need to walk out the doors with their patients right now.) Mini – drills

23.  Operating room – Test a mass casualty plan by having staff gather up the supplies that they would need for a mass casualty incident (i.e. 15 gunshot wound surgeries)  Pharmacy – Test a infectious disease exposure plan by having staff pull all supplies needed in the event of an anthrax exposure Other ideas for mini - drills

24.  Maternity – Test evacuation by having staff do a quick “evacuation” of the NICU babies, have them gather supplies and talk through what it would look like without power  Clinic – Test medical surge by presenting the scenario of the hospital needing to triage low acuity patients to the clinic, present paper patients with symptoms and have them go through the treatment process to gauge how much time and what supplies they might need Other ideas for mini - drills

25.  Kitchen staff – Test for power outage or shelter in place by using a winter storm scenario. Ask the staff to prepare menu plans for the next 5 – 7 days with only the supplies that they have in house at that time due to truck delays  Environmental Services – Test a infectious disease exposure plan with a Norovirus incident (oatmeal) scenario – have staff go through the clean up process with proper PPE  Maintenance (or all) – Test SIP plan by asking someone to show you how they would shut down the HVAC system Other ideas for mini - drills

26.  All staff– Test active shooter response – set a picture of a gun in front of a staff member and ask them their immediate response  All nursing departments– Test evacuation plan by asking what is the current census and where would they send each of their patients  LTC – Practice with go bags for patients. Let the patients get involved and pack their own. Suggest food, blanket, something they like to do. What? There’s more?!

27. The Center for Preparedness Education www.preped.org www.preped.org www.preped.org Homeland Security Exercise Evaluation Program (HSEEP)  https://www.llis.dhs.gov/HSEEP/documents https://www.llis.dhs.gov/HSEEP/documents California Emergency Services Authority www.emsa.ca.gov/hics/hics.asp www.emsa.ca.gov/hics/hics.asp www.emsa.ca.gov/hics/hics.asp Center for HICS Education and Training www.hicscenter.org www.hicscenter.org www.hicscenter.org Where to go…