Slide 1 Severe Weather Table Top Exercise. Slide 2 About This Tool This tool is the result of a collaboration between the Primary Care Development Corporation.

Slide 1

Severe Weather Table Top Exercise

<Facilitator Name><Organization Name>

<Date>

Slide 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 (www.pcdc.org or 212-437-3900) or NACHC (www.nachc.org or xxx-xxx-xxxx)

Slide 3

Today’s Agenda• Review information about table top exercises

• Table Top Exercise– Scenario injects– Group decision and discussion

• Facilitator directed questions

• Hotwash

• Next Steps– After Action Report (AAR)– Corrective Action Plan (CAP)

Slide 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.

Slide 5

Types of Exercises

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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

Slide 7

Exercise Roles• Facilitator

– 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

Slide 8

Hotwash, After Action Report (AAR), & Corrective Action Plan (CAP)

• Hotwash– 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.

Slide 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

SMART goals for the exercise.

• SMART stands for Specific, Measurable, Achievable, Realistic and Timely

• Be sure to delete this box prior to the TTX

• 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

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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.

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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

Slide 12

TTX Play• Table Top Exercise

– Scenario injects– Group discussion and decision

• Facilitator directed questions

• Hotwash

• Next Steps– After Action Report (AAR)– Corrective Action Plan (CAP)

Slide 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

Slide 14

TTX Scenario• Day 1

• 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

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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

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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: http://aspergillusblog.blogspot.com/2008/06/mould-and-flooded-homes.html

Slide 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: http://singaporeseen.stomp.com.sg/stomp/3552/4126/287756

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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: http://thepeoplescube.com/peoples-competition/caption-a-perfect-storm-t3041.html

Slide 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: http://voices.washingtonpost.com/capitalweathergang/2009/07/forecast_summer_shine.html

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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?

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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.

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QUESTIONS?

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