PANDEMIC INFLUENZA

TABLETOP

AFTER ACTION REPORT

January 8, 2014

Lutheran Medical Center

Facilitator: Kelly Keenan

CONTENTS

Exercise Overview .......................................................................................................................................................... 3 CDPHE 2014-2015 Pandemic Tabletop AAR Improvement Tracking Form ................................................................... 4

Objectives .................................................................................................................................................................. 4 Successes ................................................................................................................................................................... 4 Improvement ............................................................................................................................................................. 4

Appendix A: List of Participants ..................................................................................................................................... 6 Appendix B: Participant Feedback ................................................................................................................................. 8

EXERCISE OVERVIEW

Exercise Name Foothills Healthcare Coalition Pandemic Influenza Tabletop

Exercise Dates January 8, 2014

Scope This exercise is a Tabletop Exercise that is planned for 4 hours at Lutheran Medical Center.

Mission Area(s) Protection, Response, Recovery

PHEP and HPP Capabilities

Community/ Healthcare System Preparedness, Emergency Operations Coordination, Public Health Surveillance and Epidemiological Investigation, Emergency Operations Coordination, Preparedness Information Sharing

Objectives

Describe your agency’s roles in the response.

Identify at least one gap in your agency’s existing Emergency Operations Plan.

Articulate the process to contact appropriate partnering agencies during business hours, as well as after hours, for response to a pandemic influenza outbreak.

Threat or Hazard Pandemic Influenza

Sponsor Jefferson County Public Health and Foothills Healthcare Coalition

Participating Organizations

Please see Appendix B.

Point of Contact

Kelly Keenan, MPH JCPH Emergency Response Planner & FHCC Lead

kkeenan@jeffco.us 303-271-8391 Kim Vowell, CSP St. Anthony Hospital Safety Manager & FHCC Co-Chair KimVowell@centura.org •720-321-0134

CDPHE 2014-2015 PANDEMIC TABLETOP AAR IMPROVEMENT TRACKING FORM

Reporting Agency: Jefferson County Public Health

Exercise Name: Pandemic Influenza Tabletop Exercise

Exercise Date: January 8, 2015

Healthcare Coalition Name: Foothills Healthcare Coalition

PHEP/HPP Capabilities Tested? Community/ Healthcare System Preparedness, Emergency Operations

Coordination, Public Health Surveillance and Epidemiological Investigation, Emergency Operations Coordination,

Preparedness Information Sharing.

OBJECTIVES

What was Objective 1? Describe your agency’s roles in the response.

Was Objective 1 achieved? Yes, all of our participants understood their role in a pandemic response.

What was Objective 2? Identify at least one gap in your agency’s existing Emergency Operations Plan.

Was Objective 2 achieved? Yes, most of our participants reported identifying gaps in their current plans. The most

common gap that was identified was the need to plan for a long-term incident.

What was Objective 3? Articulate the process to contact appropriate partnering agencies during business hours, as

well as after hours, for response to a pandemic influenza outbreak.

Was Objective 3 achieved? Yes, this process was reviewed with our participants.

Were there other objectives not previously mentioned? If they, what were they? Not applicable.

Who’s those other objectives achieved? Not applicable.

SUCCESSES

Success 1: What was the biggest success of the exercise? The biggest success of the exercise was the coalition’s

ability to bring together over 60 people from 25 different agencies to discuss this public health threat. The

collaborating and networking were considered the strongest benefit of this exercise for our participants.

Success 2: What was another big success of the exercise? Another success of this exercise was that it allowed the

exercise participants to see how the different parts of the healthcare system would be impacted, and would

respond, in this type of incident. This will help each agency with their planning assumptions.

Success 3: What was another big success of the exercise? Overall the tabletop exercise showed that we have a

strong and well-prepared healthcare community. While we did identify areas for improvement, overall the group

felt very confident in their plans and their ability to respond to a real incident.

IMPROVEMENT

Needed Improvement 1: What was the biggest needed improvement noted from the exercise? Continuity of

operations planning (COOP) was identified as an area that needs improvement for many agencies.

What will be done to make improvement 1 by the time of the next exercise/event? COOP will be addressed as an

training topic for our 2015 coalition meetings.

Needed Improvement 2: What was a big needed improvement noted from the exercise? Many agencies identified

that their pandemic plans only address the short-term impacts of a pandemic, and do not consider the long-term

consequences.

What will be done to make improvement 2 by the time of the next exercise/event? We will incorporate long-term

threats, like a pandemic, into our COOP trainings.

Needed Improvement 3: What was a big needed improvement noted from the exercise? During the exercise the

issue of civil unrest and security was highlighted as an area of improvement. Most agencies security plan relies

heavily on outside law enforcement support, which may not be available during an incident.

What will be done to make improvement 3 by the time of the next exercise/event? The coalition will coordinate

with local law enforcement agencies to provide a training about security for facilities. This training will try to

address expectations for support, and mitigation opportunities for agencies.

What barriers are there to make improvements, if any? While the coalition can provide trainings and support,

ultimately each agency is responsible for taking that information and making it actionable. This is outside of the

control of the coalition, and can pose an unavoidable barrier.

What training, if any was identified as needed by the event/exercise? COOP, management of long-term incidents

and security during an incident trainings.

Other comments. Overall the exercise was well received. The FHCC utilized the tabletop documents that were

created by CDPHE, however they had to be significantly adapted to make the scenario and information valuable for

our participants. We did use Module 5 as it was written by CDPHE, and many of our participants reported that it

felt like the “apocalypse”, which was unrealistic and was not valuable for them. Additionally, we followed CDPHE’s

recommendation to group participants by functional group, and we received feedback that they would have

preferred to have been mixed up into random groups.

APPENDIX A: LIST OF PARTICIPANTS

Name Organization Functional Group

Suzi Albo Colorado Lutheran Home Long Term

Angel Anderson Jefferson County Public Health Public Health

Steve Aseltine West Metro Fire/Rescue EMS

Brenda Barrett Mt Evans Home Health & Hospice Long Term

Christine Billings Jefferson County Public Health Evaluator

Susan Black Colorado Lutheran Home Long Term

Mitchell Brown Jefferson County Public Health Public Health

Margaret Bryan Jefferson County Public Health Evaluator

Kodi Bryant Jefferson County Public Health Public Health

Ron Celentano Jefferson County Office of Emergency Management Community

Alan Colon US Dept of Justice Community

Brandon Daruna Gilpin Ambulance Authority EMS

Diana Delgado Eaton Senior Communities Long Term

Jody Erwin Jefferson County Department of Health and Environment Public Health

Margaret Farrar Exempla Colorado Lutheran Home Long Term

Mark Fellers Gilpin Ambulance Community

Deborah French Colorado Hospital Association Observer

Alice Huges Lutheran Medical Center Hospital

Betsy Isherwood Katz Lutheran Medical Center Hospital

Dr. Mark Johnson Jefferson County Public Health Public Health

Nicolena Johnson Clear Creek EMS EMS

Kelly Keenan Jefferson County Public Health Facilitator

Dan Kipp Bear Creek Center Long Term

Ana Marin Cachu Jefferson County Public Health Evaluator

Konalyn Melon Bear Creek SWF Long Term

Dave Mitchell Arvada Fire Protection District EMS

Glenn Most Exempla West Pines Hospital

Sandra Newell Colorado Lutheran Home Long Term

Megan Nies CDPHE Public Health

Barb O'Kane Colorado School of Mines Community

Tom Olbrich Jefferson Center for Mental Health Community

Michael Piper Arvada Fire Protection District EMS

Richard Prestidge Colorado Hospital Association Hospital

Dan Pruett Jefferson County Coroner's Office Community

John Putt Alpine Rescue Team EMS

Amanda Reiff Jefferson County Public Health Public Health

Debbie Roberge Coulter Student Health Center Community

Gwyn Rodman-Rice Jefferson County Department of Health and Environment Public Health

Scott Rogers West Metro Fire Rescue EMS

Kristen Roth Jefferson Center for Mental Health Community

Kevin Schmidt West Metro Fire Rescue Evaluator

sarah schoeder Eaton Senior Communities Long Term

Ginny Schwartzer SCL Health Hospital

Lee Sholtz St. Anthony Central Hospital Hospital

Lauren Smith Exempla Colorado Lutheran Home Long Term

Pamela Stephens Jefferson County Public Health Public Health

Charles Storch Lutheran Medical Center Hospital

Ran Tao Jefferson County Public Health Evaluator

Wendy Trogdon Clear Creek County Public Health

Nicholas VanEpps Gilpin Ambulance & Gilpin County EMS

Kimberly Vowell St. Anthony Hospital Hospital

Thomas Weldon Jefferson County Coroner's Office Community

Jessa Woodward Jefferson County Public Health Public Health

Janelle Worthington Jefferson County Public Health Evaluator

APPENDIX B: PARTICIPANT FEEDBACK

Question #1: What type of agency do you represent (select only one)?

Question #2: What is your assessment of today’s exercise? 1 is strongly disagree and 5 is strongly agree.

Question #3: What was the most valuable part of today’s exercise?

Question #4: What was the least valuable part of today’s exercise?

Question #5: What changes would you make to improve this exercise?

Question #6: What additional training or experiences would you like to have?

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Local government entity (other) 5 4 5 5 5

Everyone in the room

? ? Lots

Local government entity (other) 3 3 2 5 3

Seeing the moving parts of the Colorado healthcare system.

EMS provider 4 4 3 4 4

Public health 5 5 5 5 5 Multijurisdictional

input More inputs

School, University, Education 4 4 4 4 4

Scenarios, seeing how an epidemic effects so many areas, learning how EMS/emergency response works in various areas

Long-term care provider 5 4 4 5 5

Seeing the big picture with all the players - helpful to know strengths and weaknesses of entire system for pandemic situation.

Functional groups isolated - would have been nice to have some time to split up and be at table with each group represented

time with functional group and time at table with each group at the table for "bigger picture" discussion and sharing

Resource management for emergencies. Planning functional exercises. LTC understanding emergency operations lingo (acronyms, ect.)

School, University, Education 5 4 4 4 4

Seeing the extent of resources available throughout the county.

All was valuable.

Long-term care provider 5 5 5 5 5

Realistic exercise. Creates awareness of challenges outside agencies would face. Appreciate the value of different agencies involvement.

Well organized program. For newcomers, hard to fully appreciate what some government agencies rules are.

Hospitals and other Healthcare provider 5 5 5 5 5

Broad spectrum of participants.

N/A N/A How to access to resources (infrastructure, supplies, staff, security) when traditional sources are constrained.

Public health 5 5 5 5 5

Public health 4 4 4 3 3

Good to come together with those present to collaborate.

I feel exercises tend to go to "apocalypse" when I would argue it rarely goes to that. The exercise should to ID/operate the surge sustained CPPP city.

Instead of having the same type of people at the same table, break us up (e.g. some public health sitting with long care with first responders, ect)

ICS roles among JCPH staff. Are we to fulfill any position (e.g. an EH person becomes finance chief) of should we be focusing more on ops/logs?

Public health 5 5 5 5 5

Getting all of the groups at the table to discuss

What to do when civilization collapses

Good job!

Public health 4 4 5 5 4

Seeing feedback from other entities. Better understanding of what is going on in the community.

Tough question! I found all of it valuable.

From a public health perspective, more disease info would be helpful. Such as case definition, transmission routes, demographics of who's getting sick. This information would probably be helpful to EMS, LTC, hospitals.

More trainings like this! Good job!

Public health 5 4 4 4 5 Meeting face to face with the players.

N/A Provide case definition.

Hospitals and other Healthcare provider 5 4 5 5 5

Meeting the healthcare coalition members.

Pandemic planning workshop. Review based on lessons learned from H1N1 and Ebola.

Non-profit organization 5 4 5 4 5

Learning from one another and working through the scenario.

Module 5 was too large to really work through

Scale back end module to work through recovery more than an overwhelming scenario.

Hospitals and other Healthcare provider 5 5 5 5 5

Meeting the agencies and obtaining their input.

Thought it was all good.

Microphones - lots of people in small space made it hard to hear during discussion.

Long-term care provider 2 2 2 2 2

Hospitals and other Healthcare provider 5 5 5 5 5

Awareness of the long term effects - made the team think outside the box. Identifies the need to reevaluate current policies and plans.

I found it all valuable.

No suggestions.

Public health 4 3 4 4 4

Get to meet other community partners, learn more about what JCPH's capacity in EP.

Not very realistic, people are relaxed. The presenter sounds like delivering a presentation rather than organizing an emergency preparedness exercise.

If you can separate different groups into different rooms, avoid face to face contact between different groups. Use walkie-talkie, the exercise would be more realistic.

Federal entity (e.g., NDMS, VA hospitals) 3 5 4 5 4

Questions seem t be one module ahead of the scenario.

Fix typos, focus on addressing questions based on current situation, not future situation.

Long-term care provider 5 4 5 5 5

Getting the viewpoint of other agencies.

Coroner 4 4 4 4 4

Coroner 4 4 4 4 4

Hospitals and other Healthcare provider 5 5 5 5 4

Hospitals and other Healthcare provider 5 4 5 3 5

Mental/behavioral health provider 5 4 4 5 4

Discussions that helped identify issues and areas requiring more planning and preparation.

I felt all was valuable. Great job!

Difficult to hear some participants - sometimes all the different groups discussion made it difficult to hear each other. Everyone's time is important, but some discussions could have benefited from more time.

Continue tabletops and actual disaster drills.

Local emergency management/public safety 5 5 5 5 5

Discussions were good. Glad to have LTC facilities and coroner.

All good. Tough to hear a lot of the conversations.

Better room/facility. Build on training, webEOC, plans.

Public health 5 4 5 5 4

Meeting the community players

Hard to hear in the room

Mix up the groups a little. Chance to talk to different disciplines.

Any please! Love this!

Long-term care provider 5 4 4 4 5

Networking of resources

Most are valuable.

Public health 5 5 5 5 5

The variety of disciplines represented.

Would have appreciated more state level representation.

EMS provider 5 5 3 5 4

Interaction with other agencies across many disciplines.

The cookrer. Read the communications using the actual tools should be included.

Exercise life threats more detail and more frequency.

Public health 5 5 5 3 5