Online Training Format Stretches Dollars, Meets Guidelines

By: Ric Skinner on December 21, 2011

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Photo courtesy of Elissa Jun/FEMA

A major cost factor in staging exercises is in bringing all the players together in one location. There’s travel time, food, sufficient room capacity and not to mention the production of handouts and provision of presentation tools to accommodate the entire assembled audience. What if some of a hospital or health-care organization’s exercise requirements could be met more cost-effectively, leveraging dwindling exercise dollars by using online technology in custom-designed exercises?

Using an online format, ONX System, which has already been used by nearly 1,500 preparedness groups and hospitals across the United States for tabletop and functional exercises means that more participants from a facility or organization can be engaged in smaller functional groups from decentralized locations, significantly reducing exercise costs. This stretches funding dollars to support more exercises and strengthens an organization’s overall preparedness.

These are exercises that follow the Homeland Security Exercise and Evaluation Program (HSEEP) guidelines to meet the Joint Commission’s (formerly the Joint Commission on Accreditation of Healthcare Organizations) or other accrediting organization’s emergency management requirements. Exercises are also designed to meet all expectations associated with the use of the U.S. Department of Health and Human Services Preparedness and Response funding requirements.

The Caduceus Shield Exercise Initiative was created to provide America's health system, including hospital, health-care providers and public health agencies, with a comprehensive approach for assessing various disaster preparedness, response and recovery capabilities.

The initiative has been designed to provide an opportunity for health providers and agencies across the U.S. to participate in meaningful exercises with measurable outcomes. By using an Internet-based system that supports exercise design, facilitation and evaluation in accordance with HSEEP guidelines, the initiative provides an alternative to the traditional time-consuming and costly approach to conducting tabletop and functional exercises. A menu of core hospital exercises has been created and scheduled in 2012. These exercises are offered at a fee of $1,500 per hospital.

The first Caduceus Shield exercise is Accommodating Accommodations, a hospital staff sheltering exercise. This exercise will be offered at no cost to participating hospitals. Initially scheduled for one offering in December, the overwhelming response necessitated scheduling a second offering in January, with a standby list being started for a possible third offering.

This exercise will serve as an opportunity for the management and staff that make up a hospital incident command team to work through a number of thought-provoking scenarios and includes caring for hospital staff and their families during an event that necessitates staff sheltering at the hospital.

All Caduceus Shield exercises are facilitated via an Internet-based application entitled the ONX System, which allows individuals and teams to participate in an exercise from their normal base of operation or any other convenient location with Internet access.

Caduceus Shield exercises are being designed for the six key components of America’s health-care preparedness infrastructure:

•    Hospitals: All Caduceus Shield exercises are aligned with various emergency management standards for hospital accreditation organizations such as the Joint Commission. The hospital exercises have been specifically developed to assist with hospital disaster and emergency planning and response efforts. In addition, the exercise series will help hospital management and employees thoroughly understand how to respond to realistic scenarios that the hospital's hazard vulnerability assessment has ranked as the most likely situations for which it needs to be prepared.

The country's community, rural and tribal health-care centers are the lifeline for providing fundamental health and medical assistance to America's underserved populations. This component of the initiative is designed to ensure that the nation's health-care centers have the ability to remain operational in the aftermath of natural and man-made disasters.

•    Medical Reserve Corps (MRC): As a cadre of local health and medical volunteers it is imperative to be able to respond to a disaster as part of a unified team. This component of the initiative gives members of local and regional MRCs the opportunity to experience the various roles and responsibilities in responding to a medical emergency. From helping to establish and manage a point of dispensing site to assisting in a medical needs shelter, the exercises in this component of the initiative will enhance the knowledge, skills and capabilities of MRC members to assist community residents before, during and after the next emergency or disasters.

•    Metropolitan Medical Response System (MMRS): The nation's 124 MMRS jurisdictions have the unique role of integrating emergency management, health and medical systems into a coordinated response to mass casualty incidents caused by any hazard. For instance, one of the exercises in this component of the initiative provides a means for jurisdictions to assess the knowledge and capabilities of a local MMRS team to manage a surge of hospital patients due to a disaster.

•    Public Health Agencies: Whether it is responding to an influenza pandemic or having the ability to remain operational in the event of a commercial fire, today's public health agencies must remain prepared to assist local residents at all times. A primary part of this component of the initiative is to provide the management and staff of public health boards, agencies and departments an opportunity to meet the goals and objectives of Project Public Health Ready.

•    Residential Care/Skilled Nursing Facilities: It is imperative for today's long-term residential care facilities to have meaningful plans and procedures in place to respond to disasters and emergencies that threaten their communities. In addition to having well established plans, it is also imperative for residential care/skilled nursing facilities to take the opportunity to assess their plans via exercises on a recurring basis. This component of the initiative gives managers and staff a chance to measure their capabilities to plan and prepare for, respond to and recover from a wide variety of hazards.

Ric Skinner is owner/consultant at The Stoneybrook Group in Sturbridge, Mass.

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