1. Emergency preparedness: Drills and exercises in the LTC Environment Exercise planning: November 2017
Luke Bowen, MBA, EMT-P I/C
Operations Manager
Macomb County EMS Medical Control Authority
Region 2 North Healthcare Coalition
Serving Macomb, Oakland, and Saint Clair Counties

2. Introductions Luke Bowen, MBA, EMT-P I/C
Operations Manager- Macomb County EMS Medical Control Authority
30 Years in EMS
15+ years teaching experience (5 years FT)
MCA responsibilities include emergency management role in Macomb County EOC
Local, state, and national speaker on various EMS topics
Attend and teach several courses at the National Fire Academy in Emmitsburg, MD
Includes courses on drill/exercise response and design
Have created and coordinated several county-wide disaster response exercises

3. Objectives/outline
Review key principals of emergency preparedness
Importance of ERG/EOP/EP development and updates
Review hazard identification (all-hazards approach)
The role of drills and exercises to enhance response within your facility
Post exercise analysis and implementing change based on lessons learned
Hot-wash and AAR-IP
November 2017 LTC Exercise: Overview and Objective Creation

4. Fundamentals of emergency prep
Four element model
Five element model (2015)
Prepare for any emergency
Respond to the emergency
Recover from the emergency
Mitigate and prevent an emergency
Prevention. Prevent, avoid or stop an imminent, threatened or actual act of terrorism.
Protection. Protect our citizens, residents, visitors and assets
Mitigation. Reduce the loss of life and property by lessening the impact of future disasters.
Response. Respond quickly to save lives, protect property and the environment, and meet basic human needs in the aftermath of a catastrophic incident.
Recovery. Recover through a focus on the timely restoration, strengthening and revitalization of infrastructure, housing and a sustainable economy

5. All-hazards approach Nuclear event
Government de-stabilization (invaded by Canada!)
Weather
Mechanical system failure (burst water pipe)
Service interruption (power, water, sanitation)
Vendor/supplier failure (food, linen, medical supplies)
Pandemic (H1N1 influenza)
Civil unrest- terrorist event

6. HVA- Hazard vulnerability analysis

7. Why do we exercise our plans?
Currency
Intimate knowledge
Low frequency – high acuity event
Staff turn-over
Proficiency
Efficiency
LIFE SAFETY!

8. One-Minute “Time-Out” Exercise
Exercise vs. drill
One-Minute “Time-Out” Exercise

9. Exercise vs. drill

10. Planning and resources

11. Before design- we write smart objectives
(Time Based)

12. Post exercise hot-wash
A hot-wash is the immediate "after-action" discussions and evaluations of an agency's (or multiple agencies') performance following an exercise, training session, or major event.
The main purpose of a hot-wash session is to identify strengths and weaknesses of the response to a given event, which then leads to another governmental phase known as "lessons learned," which is intended to guide future response direction in order to avoid repeating errors made in the past.
A hot-wash normally includes all the parties that participated in the exercise or response activities. These events are used to create the After Action Report- Improvement Plan

13. Aar-ip after-action report - improvement plan
Detailed written report which comprehensively covers the event
Name, date, time, location
Objectives
Stakeholders
Summary of exercise MSEL
Master Scenario Event List
Assessment of objectives and outcomes
Lessons learned
Improvement plan

14. NExT STEPS See: LTC Exercise- Exercise Overview
See: Exercise Sit Man (Situation Manual)

16. Example 1 Revision as s.m.a.r.t objective
Entrance and exit to the facility.
Revision as s.m.a.r.t objective
Assess the ability to restrict access to the facility to necessary staff and identified responders during a closed pod exercise.

17. Example 2 Revision as s.m.a.r.t objective
Staging – are we really prepared to “triage” and treat victims?
Revision as s.m.a.r.t objective
Assess the ability to rapidly assess a large number of residents who were potentially exposed to residents having signs and symptoms of fever.

18. Example 3 Revision as s.m.a.r.t objective
Unified Command – blending the facility knowledge of each patient and their specific needs in order to coordinate safe evacuation technique with our community emergency responders
Revision as s.m.a.r.t objective
Assess the ability for the facility incident commander to interact with patient transport services in order to safely move affected patients to an alternate care facility.

19. Example 4 Revision as s.m.a.r.t objective
Tracking evacuated patients, sending staff with these patients, follow up with the patient to ensure new location was able to meet their needs.
Revision as s.m.a.r.t objective
Write objective here.

20. Example 5 Revision as s.m.a.r.t objective Activate our ICS
Assess the ability engage all of those with defined capability within the organizations incident command structure in order to effectively activate the incident command system.

21. Example 6 Revision as s.m.a.r.t objective
Contact the Local Health Department, along with our hospital and pharmacy.
Revision as s.m.a.r.t objective
Write objective here.