How to Create a Successful Emergency Testing Kit

Transcription

1 Department of Health Influenza Pandemic Planning TABLETOP SCENARIO TESTING KIT (VERSION 3) May 2010 Original Prepared by: Cube Management Solutions This report is available at: Department of Health Page 1 of 18

2 Foreword In April 2009, the Southern Metropolitan Region (SMR) and Eastern Metropolitan Region (EMR) of the Department of Health (previously the Department of Human Services) collaborated to engage Cube Management Solutions to provide support for 17 councils in the development, preparation and testing of influenza pandemic plans. In May 2009 Cube Management Solutions commenced and the agreed project aims were to: Identify the maturity and level of preparedness of municipal influenza pandemic plans; Provide feedback, support and guidance to aid progression of plan development; Ensure consistency of approach across municipalities in SMR and EMR; Identify matters for regional or state level consideration; and Maximise the suitability and effectiveness of plans through appropriate testing mechanisms. This was an excellent opportunity to utilise the support and guidance of an independent party for pandemic planning and was highly successful thanks to the committed participants in local governments and effective and efficient project team. The project is now completed. One of the final products is the Influenza Pandemic Planning - Tabletop Scenario Testing Kit. It was trialled by three councils and this final version is recommended for use by all councils and as an important step in testing and refining plans. The kit is also of benefit to testing business continuity planning and other emergency management arrangements. For further information contact: Andrea Hay, Manager Public Health Development Department of Health, Southern Metropolitan Region P E andrea.hay@health.vic.gov.au Original: Revised: May 2010 Department of Health Page 2 of 18

3 Contents Introduction... 4 Purpose... 4 Structure... 4 Assumptions... 4 Disclaimer... 4 Resources... 4 Running a Testing Session... 5 Preparation... 5 Test Working Group... 5 Roles... 5 Room Setup... 6 Materials... 6 Session Format... 8 Outcomes... 9 Scenarios General Idea Special Ideas (Pick & Mix) Business Continuity Community Impacts Communications Long Term Considerations (Recovery) Standard Questions Tips & Tricks Testing Frequency Scheduling Environment Refreshments Document Control Constructive Criticism General Idea Response Pro Forma Special Idea #1 Response Pro Forma Special Idea #2 Response Pro Forma Special Idea #3 Response Pro Forma Special Idea #4 Response Pro Forma Department of Health Page 3 of 18

4 Introduction Purpose Structure Assumptions Disclaimer Resources The testing of plans is an important element of emergency preparedness. To evaluate and improve emergency management arrangements, this Tabletop Scenario Testing Kit (the Kit) contains the tools necessary to test pandemic, business continuity (in relation to human loss), and associated plans. The objective of the Kit is to minimise the effort required in conducting tests, and underpin a level of consistency between user groups. The Kit can be utilised for testing by one or multiple councils in one session. Therefore, the intended audience of this Kit includes the Department of Human Services (DHS), Department of Health (DH), local government emergency management, emergency services organisations and public health representatives. There are three key sections in this Kit: 1. Running a Testing Session an overview of how to run a testing session, based upon a suggested session agenda; 2. Scenarios a set of scenarios that may be used for testing; and 3. Tips & Tricks hints for the maintenance and testing of plans. Users may adapt any element of the Kit to suit their needs. This document assumes Tabletop Scenario Testing will be conducted. This involves a Tabletop walkthrough of the plan with the discussion and questions/answers guided by the use of one or more potential scenarios. The content of the Kit may be adapted for use in alternative types of testing such as: Live Scenario Testing, where a scenario is acted out as if it were happening for real. Business Recovery Testing, which involves closing down or removal of access to infrastructure or resources, to test the capability of recovery measures. Tabletop Testing, a physical examination and review of the plan for: - Completeness and relevance to strategic & operational business needs; - Relevance and currency to perceived risk exposures; and - Inconsistencies in flow, resource allocations or conflicts with other business units / external dependencies. Call-Out Communications Testing, to verify the accuracy and use of call out trees and contact details. This document has been prepared by Cube Management Solutions Pty Ltd ( Cube ) for DHS ( Client ). The content and extent of this document is limited to the Terms of Referral agreed between Cube and the Client. The document is intended to aid the development and continuous improvement of pandemic, business continuity (human loss) and other associated plans. Utilisation of the Testing Kit does not guarantee the suitability, accuracy, and effectiveness of any such plans. The following resources may be of further assistance: Office of the Emergency Services Commissioner (OESC) website Training & Exercise page Department of Health Page 4 of 18

5 Running a Testing Session Preparation Test Working Group A Test Working Group (or equivalent) should be established to oversee the preparation, conduct, and outcomes of the testing session. Members of the Test Working Group should include the Host, (refer Roles section below) and other subject matter experts as deemed appropriate. The first function of the Test Working Group is to clarify and confirm: Why the test is required; What are the specific objectives of the exercise, in addition to the generic aims of testing: - If Participants are able to explain their role and responsibilities during a pandemic (based on the arrangements outlined in the materials provided for the test session); - Mechanisms in the management and coordination of resources; and - Mechanisms for internal, inter-organisation, and external communications. What is the scope (i.e. what / which plans are being tested)? This information will inform: Whether Tabletop scenario testing is the most appropriate type (refer Assumptions section above); The content of the General Idea and Special Ideas (refer Scenarios section overleaf). Who should be involved in the testing exercise (refer Roles section below). Roles A critical element of any testing session is determination of whom to invite and what role they will play. It is important that everybody involved understands their role in advance of the testing session. Host The Host may be the person responsible for instigating the test exercise, or their superior. It is the Host s responsibility to open and close the session, and ensure that the outcomes of the session are utilised. The Host may or may also undertake one of the other roles outlined below. The is responsible for preparing and conducting the session. It is expected that the will be knowledgeable in the emergency management responsibilities of local government. Subject Matter Experts The use of local subject matter experts can be an effective way to address issues raised at the time of the exercise, rather than having to seek clarification later. For example, involvement of the local government Public Health Manager in the Test working group and exercise. Coordinators Coordinators facilitate group discussion at each table, and document discussion outcomes. There should be one Coordinator per table. The Coordinator will also take responsibility to feedback these outcomes to the broader group, unless a Participant volunteers. The Coordinator does not necessarily have to be an expert in the plans being tested, but should be familiar with the emergency management responsibilities of local government. Department of Health Page 5 of 18

6 In larger groups, the Coordinators may take on additional roles to assist the. Participants Participants work in groups to discuss the scenarios presented by the to test the plans in questions. There should be no more than about six Participants per table. Participants at tables may include a combination of both internal and external personnel, including representatives from business units/organisations such as: Emergency management Public health Environmental health Human resources Operational health and safety Payroll Finance Information technology Waste management DHS and DH Victoria Police VICSES Division of General Practitioners etc Observers Observers may be invited for a variety of reasons. In addition to acting as a Participant, the Observer may also circulate the room to observe different perspectives. Observers may include representatives from emergency service organisations, neighbouring regions or municipalities, Municipal Emergency Management Plan (MEMP) committee members, etc. The number of Observers should not exceed one per table. Room Setup The size of the room should be commensurate to the volume of people involved in the session, with good lighting and air conditioning / heating. Each table should seat six to eight people (five Participants, one Coordinator, and one Observer (if applicable)). The room should have the equipment necessary for electronic presentations (i.e. data projector, computer, an area on which to beam, power points and extension leads if required). An electronic whiteboard with paper and dry wipe markers should be available also. Materials In advance of the session the should work with the Host to determine what materials are required, which generally fall into three categories: Pre-Reading; Table Materials; and Session Handouts. Pre-Reading Participants and Observers should be provided with an agenda and an electronic copy of the plan(s) to be tested (such as the Pandemic Plan, Business Continuity Plan, Municipal Emergency Management Plan) in advance of the session. Coordinators and the Host should be given the same materials as above, plus the General Idea and Special Ideas (to be discussed in the following Scenarios section) in advance of the session. Department of Health Page 6 of 18

7 Table materials Table materials may include items such as the MEMP, Business Continuity Plan, Pandemic Plan, plus others as deemed appropriate. At least one hard copy of each should be produced for every table for reference throughout the session. Handouts During the session the will introduce the General Idea and Special Ideas. The dissemination of this information will be staggered and beamed on screen at the appropriate time. To compliment the information beamed on screen, a corresponding information handout should be given to each Participant and Observer, and a response pro forma to document discussion outcomes should be given to each Coordinator. A scribe for the table should be nominated. At the end of the session, all table materials and handouts should be collected and returned to the Host or. Department of Health Page 7 of 18

8 Session Format Below is a suggested agenda for a three hour Tabletop scenario testing exercise. The Test Working Group should tailor the agenda format and timings to suit. Item Action Owner Duration (approx) Open the session and facilitate introductions as appropriate Welcome Give a general brief on the format, purpose and objectives of the session Advise administrative procedures (e.g. facilities, emergency exits, refreshments etc) Outline the session rules (e.g. one conversation at a time, follow instructions, mobiles to silent etc) Host 10 mins Safety Briefing Advise that any participant can stop the exercise at anytime should a safety problem be identified. The standard prefix NO DUFF will be used to advise of any real incident. Upon such notification, the exercise will be suspended until the situation is resolved. 1 min Outline the method and scope of the exercise Advise participants that the General Idea sets the scene of the exercise, whilst Special Ideas are thrown in at various points to stimulate further discussion. Exercise Briefing The group should discuss the information provided to them, and make decisions based on the arrangements documented in the planning documents provided. Decisions should be documented by the table coordinator in the response sheets provided. Document any issues that need to noted, but can not be addressed at the time. (i.e. parking of issues to take away). 5 mins Exercise Commencement Issue General Idea, associated materials, and questions Allow participants fixed period to discuss and document their thoughts, issues and actions using the response sheet provided. 30 mins Issue Special Idea Issue Special Idea 1 and associated materials Allow participants fixed period to discuss and document their thoughts, issues and actions using the response sheet provided. 20 mins Break morning or afternoon tea Issue Special Idea 2 and associated materials Allow participants fixed period to discuss and document their thoughts, issues and actions using the response sheet provided. Issue Special Idea 3 and associated materials Allow participants fixed period to discuss and document their thoughts, issues and actions using the response sheet provided. 20 mins 15 mins 20 mins Exercise Closure Comfort Break Issue Special Idea 4 and associated materials Allow participants fixed period to discuss and document their thoughts, issues and actions using the response sheet provided. 20 mins Conclude the exercise 1 min Group Discussion Discuss answers utilising the outcomes from one group as a base, with input from other groups by exception. 25 mins Debrief Discuss and document what worked well and what could have been done better. 10 mins Session Closure Thank all attendees and confirm how the outputs of the session be utilised Host 5 mins Department of Health Page 8 of 18

9 Outcomes The outcomes of the testing exercise should be utilised to improve emergency preparedness. Actions arising from the session should be clearly defined, assigned an owner, and assigned a timeframe. Any actions that require updates to be made to documentation should be done so in accordance with applicable document management protocols, giving consideration to version control, sign-off, and communication requirements. Department of Health Page 9 of 18

10 Scenarios The crux of any Tabletop scenario test exercise is the scenario itself. This section contains a suite of ideas that may be adapted by the Test Working Group to suit to the particular objectives of a testing session. Specifically, this section contains: The General Idea Outlining the context of the exercise; Special Ideas Additional information for consideration at certain points in time; and Standard Questions Designed to facilitate discussion and decision making in relation to the General Idea and each Special Idea. The Test Working Group should: Adapt the General Idea to suit the agreed objectives; Select a range of Special Ideas and tailor as required (note: four Special Ideas are required for a three hour session. More or less may be utilised as appropriate); Localise the scenarios as appropriate (e.g. locations and job roles); Insert a point in time reference for each Special Idea (e.g Monday); Be clear what it is that Council is seeking to test with the selection of each Special Idea. Note: There are four categories of Special Ideas contained in the Kit. Dependant upon the aims and objectives of the exercise, Special Ideas may be chosen from one or more of the categories. General Idea Over the past week, [x]% of council employees from a variety of Council service units and locations have reported being sick with flu like symptoms. Those sick include [to be inserted]. Health authorities have also noticed an increase in hospital admissions over the weekend, with the general public showing signs of a new strain of influenza, J6M5. Currently human infection in Australia is limited to small clusters and being spread in a highly localised manner with limited human to human transmission, suggesting the virus is not well adapted to humans. Australia is currently in the Contain phase. It is anticipated that at the height of a pandemic some 30-50% of Council staff could be absent. Factors affecting attendance may include: Illness (suspected/actual/post-infectious) of the member of staff or a member of family; Fear and anxiety; Stringent infection control measures in both the community and the workplace resulting in the need to stay at home to look after children or other dependants; and Restricted transport. Other points to note: It is 0830 hours on a Monday in June. The organisation is expected to function as normally as is practical, and continue to deliver activities deemed as essential. The media are aware of this situation. Council personnel at range of sites have started to report symptoms. Department of Health Page 10 of 18

11 Special Ideas (Pick & Mix) Business Continuity The Manager Family Services has received reports that 15% of Council s Maternal & Child Health nurses are absent. The CEO has requested that staff resources are re-deployed to only those services deemed business critical and/or those which are anticipated will have extra demand during a pandemic. A key supplier has experienced a loss of 20% of their staff due to a combination of illness and perceived OH&S issues. All personnel that are trained in using Council s financial management system are absent. Today is pay day for all Council personnel. Community Impacts It has been confirmed that 23 households in the municipality have been quarantined as contacts of two suspected cases. The pandemic alert phase is upgraded to Contain. There has been a fatality in a neighbouring municipality that is yet to be confirmed as being due to the J6M5 virus. Council is notified of four children with influenza like illness who normally attend the largest child care centre in the municipality. Council has been notified by a parent that DHS, via DEECD have closed a state primary school for one week due to reports of three students with J6M5 influenza. Council has been asked by DHS to make contact with quarantined families to ascertain support requirements. Council has been notified via DHS that the largest aged care facility in the municipality has just had to hospitalise at least four of its residents. All are aged over 75 years of age, with existing acute health problems. Council has been notified via DEECD and DHS that a large special needs boarding school in the municipality has just had to hospitalise three of its pupils. The pupils are aged seven to 13, and one of those affected is autistic. It has been mis-reported in national and local newspapers that this strain is particularly prevalent in certain ethnicities. Communications It transpires that multiple Council personnel are contacting DHS with pandemic-related queries and requests. Vice versa, information from DHS is not reaching the right Council personnel. HR has received a number of queries from Council personnel regarding how to minimise the risk of infection and what is expected of staff members. The community is upset by the perceived lack of support for people quarantined or ill in their homes following the death of a 65 year old man who lived alone. The death has been confirmed as being due to J6M5. Local CALD community leaders are demanding to know what Council is doing to provide information and advice to their communities. Long Term Considerations (Recovery) There have been 43 deaths confirmed as attributable to J6M5 in the municipality. A member of Council staff has died due to the virus. The CEO has requested the reinstatement of those services that were reduced or shut down during the height of the pandemic. A Council operated child care centre that had been closed because of the pandemic is due to re-open. There is a level of anxiety amongst personnel about the next pandemic wave. The community is concerned that not enough is being done to protect vulnerable groups ahead of the next pandemic wave. The local economy has suffered significantly because of the pandemic and businesses in the main shopping area are struggling to attract custom. Department of Health Page 11 of 18

12 Standard Questions The three questions below should be considered when the General Idea is introduced and again as each Special Idea is introduced. 1. What are the key tasks that Council should carry out at this point, and who will be responsible for the implementation of each action? 2. What management structure is appropriate at this stage to oversee these actions? 3. Have you identified any areas for improvement in the plans? Answers are to be based on arrangements documented in the materials provided and should be documented in the response pro forma. Note: A new response pro forma should be issued to every table with the General Idea and each Special Idea. Questions do not need to be limited to the above. The Test Working group can include other questions and the can prompt for more specific information if time permits. Eg. For question 3 identify part of plan and who is responsible. Department of Health Page 12 of 18

13 Tips & Tricks Testing Frequency Scheduling Environment Refreshments Document Control Constructive Criticism To ensure the currency of plans and maintain awareness of emergency arrangements it is recommended that plans are tested at least annually. It is important to give plenty of lead time to ensure invitees can attend. An exercise is only as effective as the attendees. The physical environment in which a testing session takes place can have a big impact. Temperature, space, and the ability to clearly see and hear information are critical elements to consider. Providing refreshments at a testing exercise is not only important in maintaining attendee alertness, but also a good means of enticing those who otherwise may not attend. It is important to employ stringent document control measures to plans to ensure that, in an emergency situation, everyone is working to the latest arrangements ( singing from the same hymn sheet ). Plans should have a designated owner to ensure alterations are centrally coordinated. Testing sessions usually identify a number of improvement opportunities. It is important that those individuals responsible for the development of plans do not take the feedback personally. Remember, without the hard work taken to pull a plan together in the first place, there would be nothing to test. Department of Health Page 13 of 18

14 General Idea Response Pro Forma General Idea [Insert the General Idea before printing] Table # Q1. What are the key tasks that Council should carry out at this point, and who will be responsible for the implementation of each action? Q2. What management structure is appropriate at this stage to oversee these actions? Q3. Have you identified any areas for improvement in the plans? Department of Health Page 14 of 18

15 Special Idea #1 Response Pro Forma Special Idea #1 [Insert Special Idea #1 before printing] Table # Q1. What are the key tasks that Council should carry out at this point, and who will be responsible for the implementation of each action? Q2. What management structure is appropriate at this stage to oversee these actions? Q3. Have you identified any areas for improvement in the plans? Department of Health Page 15 of 18

16 Special Idea #2 Response Pro Forma Special Idea #2 [Insert Special Idea #2 before printing] Table # Q1. What are the key tasks that Council should carry out at this point, and who will be responsible for the implementation of each action? Q2. What management structure is appropriate at this stage to oversee these actions? Q3. Have you identified any areas for improvement in the plans? Department of Health Page 16 of 18

17 Special Idea #3 Response Pro Forma Special Idea #3 [Insert Special Idea #3 before printing] Table # Q1. What are the key tasks that Council should carry out at this point, and who will be responsible for the implementation of each action? Q2. What management structure is appropriate at this stage to oversee these actions? Q3. Have you identified any areas for improvement in the plans? Department of Health Page 17 of 18

18 Special Idea #4 Response Pro Forma Special Idea #4 [Insert Special Idea #4 before printing] Table # Q1. What are the key tasks that Council should carry out at this point, and who will be responsible for the implementation of each action? Q2. What management structure is appropriate at this stage to oversee these actions? Q3. Have you identified any areas for improvement in the plans? Department of Health Page 18 of 18