1. Central Minnesota healthcare preparedness LTC 2018 Shelter-in-place exercise Controller training

2. Introduction
The main goal of this exercise is that facilities/staff recognize a potential hazardous material spill outside of their facility and take the appropriate measures to limit exposure of the patient to other patients and staff.
This exercise is adaptable for each facility – some may chose to do the exercise as a tabletop discussion, others may want to make it more functional.

3. Review Identify Discuss Explore Questions?
Evacuation – vs – Shelter-in-Place
Review
Identify how we are going to work around the differences
Identify
Discuss the role of the Controller/Participants/SIMCell
Discuss
Explore the Situation Manual
Explore
Discuss the communication pathways
Review the Healthcare MSEL
Questions?

4. So what is the difference?
Shelter-in-Place
Evacuation
What is Shelter in Place?
Shelter in place is a short-term safety procedure that will help protect staff and residents by taking shelter inside the facility if hazardous materials are released into the atmosphere.
Why Would You Shelter in Place?
Shelter in place would be necessary if chemical, radiological or biological contaminants are accidentally or intentionally released into the environment. During a release of hazardous materials, the air quality may be threatened and an evacuation may take you through a plume of toxic materials that could lead to serious health problems. Please note that sheltering in place is usually a few hours in duration, not days or weeks.
Shelter in Place Supplies
• Pre-cut plastic sheeting and duct tape to cover windows, doors, air vents or other openings. • Battery- powered radio. • Flashlight (with extra batteries). • Telephone or communication device. • Hygiene items if restroom facilities are not available (e.g., plastic bucket with a tight lid, garbage bags). • First aid kit. • Water and snacks. • Activities. • Any specialized health care items including medications and equipment.
What is Evacuation?
Evacuation is to leave or relocate from your current location due to a threat and relocate to a safer location.
Urgent – vs – Emergent Evacuation
Urgent evacuation means that you must evacuate, but you have a small amount of time and there is no immediate life threat (loss of power of potable water, minor damage to building, etc.)
Emergent evacuation means that you must evacuate, and it must be done as soon and as fast as safely possible due to an immediate life threat (fire, structural damage to building, etc.)
Horizontal – vs – Vertical Evacuation
Horizontal evacuation means to move laterally, usually into a different smoke compartment or “wing” of a facility to seek safety.
Vertical evacuation means to move down to safety. This usually requires special equipment and a significant amount of people power

5. What does this mean?
We will be doing an exercise that has two possibilities.
Shelter-in-Place – vs - Evacuate
A rapid assessment of the situation will need to be conducted to determine the most appropriate action to be taken
Is it safer to stay and attempt to shelter-in-place
Should we make a run for it, as it is too dangerous to stay in our current location

6. Roles & Responsibilities
Facility Controller/Facilitator
Facilitates Briefing/Debriefing (see handout)
Provide written injects
Check the inject off on the MSEL when it is given
Collect the written injects from participants
Facilitate discussion and actions as necessary to reach desired outcomes
Submit the survey monkey review after completion of the exercise

7. Roles and Responsibilities
Participants
Take real steps to develop solutions to the situations presented.
Develop action plans and situation reports when requested.
Participate in the briefing/de-briefing
Assign people to the Nursing Home Incident Command Center positions
Communicate/coordinate thru multi agency coordination.
Complete the participant evaluation

8. SIMCell
This exercise will NOT be controlled by the SIMCell. This is atypical from previous exercises conducted by the region.
WHY:
Makes the exercise scalable by the participating facilities
Allows for added injects
Allows the facility to follow their own timeline

9. So what is the simcell going to do?
The SIMCell will play the role of any agency that is not actively playing at the facility level.
MDH, EMS, Law Enforcement, Fire Department, Local/Regional/State Emergency Management, and the Coalition

10. Master Scenario Events List (MSEL)
Approximate time, ordered by number, allows for flow of discussion, but provide time for any functional aspects of your locations exercise
Master Scenario Events List (MSEL)
Written--Verbal
Seeking participant outcomes/action items
Check for accuracy
Patient Census and Scenarios – use real or create, decide if you want to evaluate functional areas within your facility and inform your coalition representative.
Injects
Timeline & Injects

11. Controller Communication to the SIMCELL
Phone Call ( or ) 01
Text ( or ) 02 03
Review radio communication – provide radios/check-in/out
Controller Communication to the SIMCELL

12. Participant Communication
Phone Calls (Internal or SimCell ( or ))
(Internal or
MNTrac (if needed)
Runners
Message Forms (NHICS Form #213)
Face to face
Situation Reports
HAM Radio??
Participant Communication

13. End of exercise process
The controller will collect the evaluation form from each participant. 1
A survey monkey link to an evaluation will be sent to the controller to complete using the information obtained from the participant evaluations 2
The controller will give the sign in sheet and the participant evaluation forms to the facility emergency preparedness representative to maintain. 3
An After Action Report (AAR) will be completed based upon the survey monkey evaluation. 4
The AAR will be sent to facility emergency preparedness representatives for review and approval. 5
Once the AAR is approved by the coalition – it will be submitted to MDH. 6

14. Questions?