Using Tabletop Exercises

Carl Osaki, MSPH, RSNorthwest Center for Public Health

Practice, Clinical Associate ProfessorDepartment of Environmental & Occupational Health Sciences,

SPHCM, University of Washington

Everything You Need to Know ... 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 exerciseDescribe the purpose and objectives of

tabletops Discuss who uses tabletops and whyDescribe issues typically raised through

tabletopsDiscuss how to consider appropriate

tabletops and where to find themSuggest issues to consider in designing or

conducting your own tabletop

Poll: Your Experiences I

Have you participated in a tabletop exercise?

YesNo

What was the most significant problem you experienced as a participant in the process?

If yes, tell us over the phone:

Enter your answer in the feedback poll

(on left side of screen)

Your Experiences II

Have you facilitated a tabletop exercise?

YesNo

If yes, type your answer into the text chat window:

What was your most significant challenge in facilitating the tabletop?

What is a Tabletop?

Hypothetical scenario (story) depicting a large-scale public health emergency

A facilitator leads the group (players) in identifying responses to a series of incidents in the scenario

Low stress, no right or wrong answer

Examines the adequacy of the plans, policies and procedures in place – (e.g., gaps, duplications, confusion, and the key

decision makers’ understanding of the plans)

Debriefing to discuss next steps

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

Putting Tabletops in Context

Discussion-based exercisesOrientation Tabletop

Operation-based exercisesDrillFunctional Full-Scale

Where Do I Find Tabletops?

NWCPHP

PH Preparedness Training Centers

Private firms

ASPH

NACCHO

Your Experiences III

Have you designed a tabletop exercise?

YesNo

What resources/tools did you use to help design the tabletop?

If yes, tell us over the phone:

How Do I Design My Own Tabletop?

NW Center BT Tabletop with instructions

Homeland Security Web site

NACCHO BT Create

Time to design: (20 to 40 hours)

What issues 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

Facilitator

Audience

Burn-out

Materials

Reality

Jargon

Recorder

Debriefing

Group size

Group composition

Top 10 Things to Consider:

How do I determine the success of a tabletop?

Evaluation through debriefing– The exercise (objectives met)– The preparedness plan (policies

identified, in place, and practiced)

After-Action Report

Development of work plan

Q & A