1. Using Tabletop Exercises Carl Osaki, MSPH, RS Clinical Associate Professor Department of Environmental & Occupational Health Sciences, SPH, University of Washington Everything You Need to Know... and More

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 agency’s 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.a spx NACCHO BT Create CDC http://www.bt.cdc.gov 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.pdf After-Action Report Development of work plan