Using Tabletop Exercises

Everything You Need to Know

... and More

Carl Osaki, MSPH, RS

Northwest Center for Public Health
Practice, Clinical Associate Professor
Department of Environmental &
Occupational Health Sciences,
SPHCM, University of Washington
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 exercise
 Describe the purpose and objectives of
tabletops
 Discuss who uses tabletops and why
 Describe issues typically raised through
tabletops
 Discuss how to consider appropriate
tabletops and where to find them
 Suggest issues to consider in designing or
conducting your own tabletop
Poll: Your Experiences I

Have you participated in a tabletop exercise?

Yes Enter your answer in the

feedback poll
No (on left side of screen)

If yes, tell us over the phone:

What was the most significant

problem you experienced as a
participant in the process?
Your Experiences II

Have you facilitated a tabletop exercise?

Yes
No
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 exercises
 Orientation
 Tabletop

Operation-based exercises
 Drill
 Functional
 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?

Yes
No

If yes, tell us over the phone:

What resources/tools did you use

to help design the tabletop?
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

Top 10 Things to Consider:

 Facilitator  Jargon
 Audience  Recorder
 Burn-out  Debriefing
 Materials  Group size
 Reality  Group composition
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