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Exercises and Training: Virginia Department of Health Emergency Preparedness and Response Programs

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Exercises and Training: Virginia Department of Health Emergency Preparedness and Response Programs Lisa G. Kaplowitz, M.D., M.S.H.A. Deputy Commissioner – PowerPoint PPT presentation

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Title: Exercises and Training: Virginia Department of Health Emergency Preparedness and Response Programs


1
Exercises and TrainingVirginia Department of
Health Emergency Preparedness and Response
Programs
  • Lisa G. Kaplowitz, M.D., M.S.H.A.
  • Deputy Commissioner

2
Unique Aspects of Virginia
  • Large state Significant urban, suburban and
    rural populations
  • Large military presence (including Pentagon,
    Langley)
  • Part of National Capital Region (Northern
    Virginia)
  • Rural areas provide unique challenges

3
Unique Aspects of Virginia Department of Health
(VDH)
  • Most of local health districts are part of the
    state health department (32/35)
  • Very close collaboration between health districts
    and VDH Central Office
  • Created new regional teams to coordinate
    emergency planning and response efforts

4
Regional Approach to Planning and Response
  • Northern Region National Capital Region (with
    Maryland and Washington DC), involvement of
    federal agencies
  • Eastern Region Military bases, tourism
  • Central Region State government
  • Northwest Region Rural and suburban Washington
    DC
  • Southwest Region Rural, large geographic area
    with geographic barriers borders
    North Carolina, Tennessee,
    Kentucky, West Virginia

5
(No Transcript)
6
Exercise Design, Control and Evaluation
  • Phase 1 Exercise pre-planning
  • Phase 2 Exercise planning
  • Phase 3 Control
  • Phase 4 Assessment and evaluation

7
Phase I Exercise Pre-planning
  • Develop
  • Plan of Action and Milestones
  • Mission Essential Task List
  • Exercise Objectives
  • Exercise Story Line
  • Participant List
  • In-house
  • Partner Agencies
  • Identify
  • Exercise Audience
  • Technologies to be Tested
  • Policies, Procedures to be Exercised
  • Exercise Locations
  • Communications Requirements

8
Phase II Exercise Planning
  • Coordinate Use MOAs, Partner Agency Participation
    Support Requirements
  • Develop Pre-exercise Training Plan
  • Arrange Mentor / Facilitator Participation
  • Prepare Exercise Concept Plan
  • Core Scenario
  • Master Events Scenario List
  • Prepare Observation and Assessment Plan
  • Observer Team
  • Exercise Control Group

9
Exercise Control
  • Observers
  • Record / review reaction.
  • Elicit response.
  • Measure task accomplishment.
  • Collect data deliverables.
  • Coordinate w/ Umpires.
  • Conduct on-the-spot training.
  • Umpires
  • Control clock.
  • Ensure timely and timed responses
  • Input items from Master Events Scenario List
  • Reconcile issues.
  • Maintain a time log.
  • Keep exercise on schedule/participants on task.

10
Phase IV Analysis Reporting
  • Record reactions to inputs against desired
    responses
  • Evaluate degree to which objectives met
  • Conduct an immediate Hot Washup
  • Prepare an after-action report within 2 wks
  • Develop a Lessons Learned database
  • Establish an Implementation Panel

11
VDH Exercises 2002-2003
  • Multiple local, regional exercises, including
    National Capital Region
  • Statewide exercises
  • Hurricane Isabel in Sept, 2003
  • Statewide bioterrorism exercise in Oct, 2003
  • Anthrax event in Nov, 2003 VMI and medication
    clinic
  • Collaboration with hospitals, laboratories, VDEM,
    MMRS, localities establishment of exercise
    calendar for all state agencies

12
Bioterrorism Exercise October 2003
  • Release of the plague at large alumni event
  • Cases of pneumonia present to hospitals statewide
  • Involve epidemiology and state laboratory to
    identify event and organism
  • Strategic National Stockpile delivered to state
    and distributed statewide to 6 regions
  • 6 mass medication/vaccination clinics established

13
Bioterrorism Exercise October 2003
  • All District Health Departments participated
  • Multiple offices in VDH EPR, Epidemiology,
    Chief Medical Examiner
  • CDC
  • 82 of hospitals, state laboratory, state police,
    emergency management agencies, UPS, local
    governments and volunteers participated
  • VDH Emergency Coordination Center (ECC) and state
    EOC operational
  • Test of communication systems, as well as disease
    control and prevention

14
Bioterrorism ExerciseObjectives Days 1-2
  • Identification of pneumonia cases presenting to
    hospitals throughout Virginia, with deaths
  • Recognition of outbreak situation
  • Recognition that outbreak could be related to
    intentional release of organism (BT event)
  • Request Strategic National Stockpile Push Pack,
    prior to identification of organism
  • Identification of organism after SNS requested
  • Key objectives Communication
  • and decision making

15
Bioterrorism ExerciseObjectives Day 3
  • Response to BT event by VDH, other emergency
    response agencies/organizations
  • Confirm identification of organism
  • Identification of event where organism released
  • Determination of infection control, treatment and
    prophylactic response
  • Key objectives Communication and decision making

16
Objectives Day 3Tabletop component
  • Opportunity for district health directors and
    their response teams to discuss and make
    decisions with their local emergency manager(s)
    and their local hospital(s)
  • 79/96 (82) acute care hospitals participated
  • Provide a low stress event to clarify roles and
    responsibilities for the management of a large
    scale BT event

17
Objectives Day 3Tabletop Component
  • Decisions regarding surge capacity
  • What facilities would be established?
  • Procedures for patient movement
  • Decisions regarding isolation and quarantine
  • Analysis of impact on daily business (schools,
    EMTs, Fire, Law, transportation..)
  • A checklist provided to each participating site
    to assist with work flow

18
Bioterrorism ExerciseDeliverables Day 3
  • All districts asked to produce and submit
  • Local press release coordinated with agency PIO
  • Summary Report documenting communication with
    participating local emergency managers
  • Dispensing Site Management Plan that identifies 2
    dispensing sites and outlines the staffing and
    management plans for each site.
  • Incident Action Plan
  • Surge Capacity Plan

19
Bioterrorism Exercise Deliverables Day 3
  • Conducted a Hot-Wash debrief immediately
    following the end of exercise activity at each
    site
  • Top 10 things that went well
  • Top 10 areas that need improvement
  • Brainstorm list of issues/comments, checklist
    provided
  • Submit an after action report
  • Phase 1 All hot-wash notes (same day)
  • Phase 2 District Director Report with action
    plan to address lessons learned. (within 2 weeks)

20
Bioterrorism Exercise SNS Segment Day 3
  • Push Pack arrived in Virginia in AM, transported
    to RSS facility in Richmond area
  • Training Education Demonstration (TED) package
  • Receive, Stage Store (RSS) Site Manager and
    State signatory authority at RSS facility
  • Push Pack broken down, inventoried, managed and
    distributed to 6 dispensing sites and 6 treatment
    centers throughout Virginia transport by UPS

21
Bioterrorism ExerciseSNS Segment (cont)
  • Materials arrived by UPS at dispensing and
    hospital sites prior to 6 PM on Day 3
  • Materials utilized on Day 4 at dispensing sites
    and treatment centers.
  • Tracking and control were key issues.
  • Dispensing sites dispensed materials for 2.5
    hours from 900-1130 AM.
  • Materials returned to RSS site and then to CDC by
    7 PM on Day 4

22
Bioterrorism ExerciseObjectives Day 4
  • Distribution of SNS to all parts of state
  • Establish 5 dispensing clinics in all parts of
    the state (6th site in No. VA 3 days later)
  • Winchester, Norfolk, Richmond, Roanoke, Abingdon
  • Non designated districts provided personnel to
    assist at dispensing sites.
  • Two sites actually provided influenza vaccine
  • Media involvement encouraged
  • Evaluation of functioning of mass medication or
    vaccination clinics

23
Bioterrorism ExerciseSNS Segment (cont)
  • Fairfax County (Northern Virginia) operated a
    dispensing site on following Saturday
  • Involve volunteers
  • Use schools
  • County transportation of public to dispensing
    site from distant site
  • County law enforcement provide security

24
Hurricane Isabel Sept, 2003 The Other
Exercise
  • VDH Emergency Coordination Center established
  • Staffed ESF 8 at state EOC for 10 days
  • Water and power issues for hospitals, nursing
    homes, health departments, homebound
  • Impact on hospital, institutional, home
    healthcare
  • Public health and public information issues
  • Water safety boil water alerts
  • Hurricane related injury, disease and deaths
  • Restaurant inspections, food safety
  • Mosquito control

25
Anthrax Scare, Nov 7 03
  • Positive anthrax test at postal facility
  • Partners
  • Arlington HD
  • DHS, HHS, CDC, USPS
  • VA Office of Commonwealth Preparedness
  • Antibiotics from VMI delivered, Arlington HD
  • Dispensing clinic staffed/operational within 4
    hrs
  • Confirmatory test negative
    no antibiotics given

26
Assessment and Evaluation
  • Lessons Learned combined for exercise, hurricane
    and anthrax event one document
  • Lessons Learned Implementation Panel established
  • Recommend changes in VDH and state emergency
    operations plans
  • Institutionalize all lessons learned
  • Report due by June, 2004
  • Revise VDH emergency operations
    plan prior to DP 04

27
Determine Promise 04
  • Department of Defense exercise, August 2004
  • Major components of exercise in Eastern and
    Central Virginia chemical and explosive events,
    biologic threats
  • VDH major participant
  • Test revised VDH emergency operations plan
  • Response to chemical, explosive events and bio
    threat
  • Test surge plan
  • Bring in VDH personnel from other parts of the
    state as local resources become overwhelmed

28
Education and Training
  • Ensure the development and delivery of
    appropriate education and training to
  • Public Health Professionals
  • Physicians
  • Emergency Response Personnel
  • Other Healthcare Providers
  • Collaboration with academic health centers,
    poison control centers

29
Education and Training
  • Training needs assessment done
  • Public Health personnel
  • Hospital personnel ER physicians and nurses,
    security officers
  • Infection control practitioners
  • Focus training efforts on greatest identified
    needs
  • Chemical agents and exposures
  • Incident command
  • Communications

30
Education and Training
  • Link directly to exercises and programmatic
    initiatives
  • Conduct and evaluation of exercises
  • Incident command and emergency management
  • Mental health response
  • Special needs populations
  • Collaborate with all emergency management
    agencies and organizations, avoid
    duplication of efforts

31
Education and Training
  • Use of new technologies to increase access to
    training programs
  • Videoconferencing, DVD/CD
  • Webcasting, internet based training
  • TRAIN Learning Management System
    http/va.train.org
  • Portal for EPR health training
  • Search for courses
  • Register online tracks individual learning
    records

32
Other Training Resources
  • Available through VDH web site
    www.vdh.virginia.gov
  • Information on biologic and chemical agents
  • Links to other resources, including CDC
  • Recent VDH news and information
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