Using Tabletop Exercises

Carl Osaki, MSPH, RSClinical Associate Professor

Department of Environmental & Occupational Health Sciences,SPH, University of Washington

Everything You Need to Know Everything You Need to Know ... and More... and More

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

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

Your experiences

• Designing• Facilitating• Evaluating• Writing AARs

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

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

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)

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

When Should a Tabletop Be Used?

• Discussion-based Exercises• Orientation• Tabletop

• Operations-based Exercises• Drill• Functional • Full-Scale

Where Do I Find Tabletops?

• NWCPHPhttp://www.nwcphp.org

• PH Preparedness Training Centers• Private firms• ASPH

http://www.asph.org • NACCHO

http://www.naccho.org

How Do I Design My Own Tabletop?

• NW Center BT Tabletop • Office of Homeland Security

https://hseep.dhs.gov/pages/1001_HSEEP7.aspx

• NACCHO BT Create• CDC http://www.bt.cdc.gov

• Time to design: (20 to 40 hours)• Roles (player, facilitator, observer,

recorder, evaluator, resources)

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)

Successful Tabletops: 10 Things to Consider

• Facilitator

• Audience

• Burn-out

• Materials

• Reality

• Jargon

• Recorder

• Debriefing

• Group size

• Group composition

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 capabilitieshttp://www.fema.gov/pdf/government/training/tcl.pdf

• After-Action Report• Development of work plan