1. Severe Weather Table Top Exercise
<Facilitator Name>
<Organization Name>
<Date>

2. About This Tool
This tool is the result of a collaboration between the Primary Care Development Corporation (PCDC) and the National Association of Community Health Centers (NACHC).
It is intended to provide primary care centers, including community health centers, an easy to use tool to test and improve their business continuity plans.
For assistance, questions or more information on this and other business continuity and emergency preparedness tools and resources, please contact PCDC ( or ) or NACHC ( or xxx-xxx-xxxx)

3. Today’s Agenda Review information about table top exercises
Scenario injects
Group decision and discussion
Facilitator directed questions
Hotwash
Next Steps
After Action Report (AAR)
Corrective Action Plan (CAP)

4. What is a Table Top Exercise (TTX)
A Tabletop Exercise, also known as a TTX, is one type of exercise held in an informal setting intended to generate discussion of various issues regarding a hypothetical, simulated emergency incident.
TTXs can be used to:
Enhance general awareness
Validate plans and procedures
Assess the types of systems needed to guide prevention of, protection from, response to, and recovery from a defined incident.
Goal of TTXs are include
Facilitating concept understanding
Identifying strengths & weaknesses
Achieving changes in attitudes.

5. Types of Exercises

6. Why do a TTX? Testing the plan, not the people
Key organizational personnel discuss simulated scenarios in an informal setting
Assist in the promotion of understanding related concepts
Used to assess plans, policies, procedures or the systems employed by the organization
Highlight strengths and areas for improvement within current plans, policies and procedures

7. Exercise Roles Facilitator Participants (Players) Evaluators Observers
Facilitates the exercise
Participants (Players)
Key Staff & Decision Makers
External Agencies
Elected / Appointed Officials
Evaluators
Observe behavior in relation to plans & procedures
Record Information without leading Players
Report observations
Observers
Observe exercise; No interaction in exercise play

8. Hotwash, After Action Report (AAR), & Corrective Action Plan (CAP)
A debrief with the exercise planning team, controllers & evaluators held immediately following the exercise.
Allows controllers and evaluators to collect observations and thoughts about the conduct of the exercise which leads to the development of preliminary analyses of exercise observations.
After Action Report (AAR)
Chronological narrative of discussion for each capability & associated activities
Highlight both strengths and areas for improvement
Identify discussion points relevant to your site’s ability to carry out the activities
Demonstrate the capabilities being exercised
Corrective Action Plan (CAP)
Corrective actions are the concrete, actionable steps outlined in improvement plans that are intended to resolve preparedness gaps and shortcomings experienced in exercises or real-world incidents.

9. TTX Objectives & Capabilities
For the purposes of this Table Top, our site is focused on testing the following capabilities:
The objectives of today’s Table Top are:
Describe 1-3 capabilities of your BCP that you are testing for this TTX.
Capabilities can include certain business processes, BIA’s, or disruptive action policies
Be sure to delete this box prior to the TTX
Describe 1-3 SMART goals for the exercise.
SMART stands for Specific, Measurable, Achievable, Realistic and Timely
Be sure to delete this box prior to the TTX

10. TTX Intent
This tabletop exercise was specifically developed to identify gaps in business continuity plans
The intent of this TTX will be to specifically target the discussion of business continuity operations and response to an emergency event.
Processes, discussion and decision-making are more important than minute details.

11. BCP Topics to Consider During TTX
BIA Report
HVA Report
Incident Management Plan
Communications Plan
Emergency Notification Plan
Risk Communications Policy
Procedures
Disruption Actions
Individual Business Impact Analysis Forms
Appendices
Memorandums of Understanding (MOUs)
Key Contacts, Vendors & Suppliers
Other Important Documents

12. TTX Play Table Top Exercise Hotwash Next Steps Scenario injects
Group discussion and decision
Facilitator directed questions
Hotwash
Next Steps
After Action Report (AAR)
Corrective Action Plan (CAP)

13. Remember… Accept the artificialities of the scenario
“Fight the problem not the scenario”
Remember you are testing the plan, not the people
There are no right or wrong answers
Consider your current plan, facility, capacity & capabilities
There will be time for group problem-solving, discussion and decision-making
Even though a TTX is a “discussion-based” exercise, you will need to make actual decisions at the end of each discussion
Makes notes on your response
Please direct all questions to the facilitator/controller

14. TTX Scenario Day 1 The weather is cool and overcast
Tuesday in April
One hour before facility closing
The weather is cool and overcast
The site is experiencing a normal to high patient volume
The site is running with 100% of staff. All systems are running smoothly

15. TTX: Module 1
The receptionist comes to the site director informing them that his Weather Channel iPhone application mentioned something about possible severe weather.
Upon further investigation, the National Weather Service has issued a severe storm warning overnight with possible thunderstorms and localized flooding.
DISCUSS & DECIDE (5 minutes)
Discuss how you would response based on the above injects
Make decisions based on current plans and capabilities
Photo Credit: National Association of Community Health Centers

16. TTX: Module 2
Day 2
Wednesday at 7:30 am
The site director receives a phone call from the site manager stating that the health center has 2-3 feet of water in it, presumably due to the storms last night.
Additionally, a large tree has fallen over in the parking lot and is partially blocking access to the front entrance. The tree has also knocked down a power line and there is no power in the facility.
The city has closed all schools in the area due to damage and until each site can be inspected for safety.
DISCUSS & DECIDE (5 minutes)
Discuss how you would response based on the above injects
Make decisions based on current plans and capabilities
Photo Credit:

17. TTX: Module 3
Day 2
Wednesday at 11:15 am
The electric company has been able to restore power to the building, however the tree will not be able to be removed until the next day at the earliest.
Scheduled patients continue to show up at the office for appointments
All other hospitals and health centers in a ten-mile radius report overwhelming patient surges or being closed due to damage.
DISCUSS & DECIDE (5 minutes)
Discuss how you would response based on the above injects
Make decisions based on current plans and capabilities
Photo Credit:

18. TTX: Module 4
Day 2
Wednesday at 3:00 pm
The National Weather Services advises local agencies that a similar storm is expected to move through the area overnight.
DISCUSS & DECIDE (5 minutes)
Discuss how you would response based on the above injects
Make decisions based on current plans and capabilities
Photo Credit:

19. TTX: Module 5
Day 2
Thursday at 8:00 am
The expected storm did not hit the area as expected and the National Weather Service predicts good weather for the next 7-10 days
The city was able to remove the tree from the parking overnight and all the water has receded or been removed from the facility
DISCUSS & DECIDE (5 minutes)
Discuss how you would response based on the above injects
Make decisions based on current plans and capabilities
Photo Credit:

20. Activity: Hotwash
What did you learn from the TTX today about your site and your BCP?
What areas of your BCP are well developed?
What areas of you BCP need improvement?
What are your next steps?

21. Next Steps
The site will use the information gathered from the hotwash discussion to complete a draft version of the After Action Report (AAR), including a Corrective Action Plan (CAP).
The draft version will be circulated to site staff for feedback. The feedback will be incorporated into a final draft of the AAR & CAP.
Staff will meet for an After Action Conference (AAC) where the final draft will be approved and plans to implement the CAP will be adopted.

22. QUESTIONS?

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