CONTROLLER AND - PowerPoint Presentation

Slide1

CONTROLLER AND EVALUATOR TRAININGSeptember 30, 2014

Los Angeles County Emergency Medical Services AgencySTATEWIDE MEDICAL AND HEALTHFUNCTIONAL EXERCISESlide2

Agenda

Exercise OverviewObjectivesScheduleImplementationSimulation Cell (SimCell)Control InstructionsEvaluation Instructions2Slide3

EXERCISE OVERVIEWSlide4

Program Phases – Building BlockPhase 1) Multimedia

training, including:Disaster preparedness and responseMedical and health coordinationRequesting medical and health resourcesCalifornia Public Health and Medical Emergency Operations Manual trainingPhase 2) Organization specific self-assessment tools to identify strengths and weaknesses Phase 3) A tabletop exercise to discuss current plans, policies and proceduresPhase 4) A functional exercise to

test

current plans, policies and procedures

4Slide5

Exercise HighlightsThursday, November 20, 2014

Exercise Play: 9:00 AM – 12:00 PM*Focus: Coordination of surveillance activities and health system capabilities anticipated when managing a medical surge caused by possible MERS-CoV infectionsPlay throughout the StateLos Angeles County ParticipantsHospitalsClinicsLong Term Care Facilities

Surgery

Centers

Dialysis

Centers

Ambulance Providers

Emergency Management Providers

(DMH,

DPH, DHS, CEOC, LAC-EOC)

LEMSA

Home Health

5Slide6

ObjectivesOrganized by

Discipline and CapabilityOperational CommunicationPublic Health and Medical Services (Formerly Medical Surge/ Epidemiological Surveillance and Investigation)Operational Coordination (Formerly Emergency Operations Center Management)Public and Private Services and Resources

(Formerly Volunteer Management and Donations)

Marry State

and

County

 objectives &

capabilities

Each sector

selected its own

objectives

Each participant organization can tailor to their needs6Slide7

ScenarioTwo individuals have been diagnosed with MERS-

CoV one nine days ago and a second three days ago Significant numbers of patients with influenza like illness inundate the healthcare system requesting testing and treatment for MERSIncreased numbers of ILI cases with a 10% increase in admissions with acute respiratory illnesses Guidance on specimen collection, laboratory techniques, and necessary levels of isolation and personal protective equipment Ambulance companies and 9-1-1 system are overwhelmed

7

TIP: Scenario

specifics contained in the MSEL should not be given to players in advance of the

exercise.Slide8

Exercise Schedule8

TimePersonnelActivity

November

20, 2014

7:30 am

Selected controllers and exercise staff members

Exercise site setup

8:00am

Participants (players, observers, actors)

Registration

8:15am

Controllers and evaluators

Communications check

8:30am

Participants

Participant briefings

9:00am

All

Start of exercise

12:00pm

All

End of exercise

Immediately after the exercise

Participants, controllers, and evaluators

Hotwash

December

18, 2014

9:

00am-12:00pm for all participants

Controllers, evaluators, and Exercise Planning Team members

Exercise Evaluation Conference at LAC DHS located on 10100 Pioneer Blvd., Santa Fe Springs, Slide9

Exercise DocumentationController and Evaluator (C/E) HandbookExercise Plan (ExPlan)

Communications Directory (including SimCell)Sent directly to participants via emailMaster Scenario Events List (MSEL)Combined EEG/After Action Report/Improvement Plan TemplateParticipant Feedback Form-Coming soonWebsite: http://dhs.lacounty.gov/wps/portal/dhs/ems/disastermedicalservices 9

Exercise materials provided on EMS website

Can be used as templates for future effortsSlide10

Exercise Participants

Players: Active role in performing their regular roles and responsibilities in response to the scenario. Individuals and performance are evaluated.Controllers: Controllers plan, manage and ensure the integrity of the exercise. Direct the pace, provide key data to players, and may prompt certain player actions to ensure exercise continuity. Simulators: Simulators play the role of non-participating

organizations or individuals.

Provide injects to players to prompt actions in accordance with scenario. Operate from

the Simulation Cell (SimCell), but

may

occasionally have face-to-face contact with players.

Evaluators

:

Assess the performance of players and the design of the exercise and

provide feedback

on designated functional areas.

10Slide11

Exercise Participants (Cont.)

Actors: Realistically act out the roles of individuals involved with or impacted by the scenario for players to directly respond to in person. Usually asked to evaluate the performance of players as well. Observers: Observers do not play in the exercise, nor do they perform any control or evaluation functions. They are not to interfere with exercise play. Support Staff: Individuals who perform administrative and logistical support tasks during the exercise (e.g., registration, catering).11Slide12

Exercise ImplementationAssumptions

Real-world emergencies take priorityExercise participants will comply with real-world response procedures unless otherwise directedExercise CommunicationsExercise LanguageSite Safety and SecurityExercise Identification/Credentials

12Slide13

Simulation Cell (SimCell)Slide14

SimCell OperationsThree major

activitiesDelivering injects to players (outgoing)Simulating non-participating entities (inbound)Documenting participant responses14Slide15

SimCell PositionsSimCell Lead Controller

Track and coordinate all scenario eventsIdentify how problems can be resolved Directs and provides guidance to simulatorsCan be contacted by Controllers at play sites regarding exercise statusSimulatorsTrack injects, participant calls into the SimCell, and associated follow-up

responses

Ensure

realism and accuracy in all exercise communication

Place

injects,

answer

phones and

respond

to player questions,

create

new injects to encourage additional participationConduct research and provide explanations for observed player actions during the exercise

15Slide16

SimCell OperationsSimCell Limits

Only simulating non-participating entitiesIf they’re playing…contact them directly!Players need to identify who they want to talk to (be specific)Will not make decisions for playersMay have limited knowledge/expertiseMay need to do follow up and call backUse the Communications Directory provided by EMS via email to registered participants-emailed to functional and full scale participants only- USE for exercise only

16Slide17

SimCell ResponsibilitiesBefore the Exercise

Review any emergency plans, procedures, and protocols available to you relevant to your assignmentReview the exercise materials issued to you, including the objectives, scenario, MSEL/injects, and evaluation forms17Slide18

During the ExerciseEnsure all planned injects are submitted to the appropriate agencies on

time (unless otherwise instructed) and in the correct formatReceive player communications, then write, coordinate, and transmit appropriate responses in a timely mannerEnsure SimCell operations are coordinated and congruent with the overall exercise operations18SimCell Responsibilities (Cont.)Slide19

SimCell Responsibilities (Cont.)

During the Exercise Keep the SimCell lead controller apprised of developments, problems, issues, or concernsAttempt to accurately portray the information contained in inject forms to the playersRecord all calls received and made on the SimCell Activity Log Any new injects developed for the exercise should be submitted to the SimCell Lead Controller for approval before being used in the exercise

19Slide20

SimCell Responsibilities (Cont.)

Phone InstructionsWhen answering a phone in the SimCell or at another simulated entity location always answer with “This is the SimCell”Inquire to the participant regarding their name, agency/facility and who they are trying to reach if they do not provide this informationEnsure you re-iterate “This is an exercise” prior to providing any answers or feedback to participants20Slide21

Exercise ControlSlide22

Controller PurposeEnsure the integrity of the exercise

ResponsibilitiesExercise mechanics and functionalityDeliver injects to drive playProvide Player BriefingObjectives are being metActor managementParticipant behavior/activitiesSafety/securityFacilitate Hotwash22Slide23

Controller PositionsExercise Director

Final authority on all aspects of the exercise, including starting, modifying, or ending the exercise Works with the Senior Controller to ensure the exercise runs smoothly and all objectives are met23Slide24

Controller Positions (Cont.)Senior Controller

Coordinates with the Exercise Director on exercise control and safety issuesMonitors activities at each exercise venue Tracks whether objectives have been met or require further attentionControllersEach exercise venue will have its own Controller(s)Responsible for keeping the exercise on schedule and suggesting potential modifications or injects

The

SimCell will have a lead controller who is responsible for managing the

SimCell

24Slide25

Controller ResponsibilitiesBefore the

ExerciseReview applicable plans and procedures that will be activated during the exerciseKnow the scenario and MSELArrive at the venue 60 minutes before StartEx Provide the Player Briefing 25Slide26

Controller Responsibilities (Cont.)

During the ExerciseLocate necessary communications equipment and test it to ensure systems are operationalMonitor flow and sequence of events during play according to the MSELManage the flow of exercise play “Eyes and ears” of the SimCell and Exercise DirectorControllers must work with the SimCell to maintain appropriate exercise pacing“Speed up” play if Players aren‘t challenged“Slow down

”

play if Players are overwhelmed

Have

patience, allow exercise to play out

If possible, capture notes to assist Evaluators

26Slide27

Controller Responsibilities (Cont.)

Conduct a HotwashHeld immediately following EndExHotwash slide contained in Player BriefingOpportunity for PLAYERS to comment on their experienceWhat went well?What needs improvement?Plans, organization, equipment, training, exerciseAny surprises?Improvements to exercise implementation?Distribute

and collect Participant

Feedback

Forms

27Slide28

Player InstructionsControllers ensure Players are ready to participate

Player Briefing Highlights Scenario (provided on website)Exercise Objectives (provided on website)Exercise Mechanics/FunctionalityStart timeEnd TimeDescription of Exercise staffRules of

Play

Real world vs Exercise language

28Slide29

Player Instructions (Cont.)

Key Messages & EnforcementWill not have prior knowledge of the scenario beyond the contents of the Player BriefingMust understand the scope of the exercise and which organizations are participatingExpected to recognize that certain artificialities are built into the scenario to meet exercise objectivese.g., Instruct players not to fight the scenario29Slide30

Player Instructions (Cont.)

Key Messages & Enforcement (Cont.)Need to follow real world response procedures and act as if the emergency were realDemonstrate all actions necessary to meet exercise objectivesPlayers must receive information from their own sources (e.g., other players or SimCell)Should “verbalize” their responses and maintain activity logsTurn in all documentation to the Controller or Evaluator30Slide31

Participant InteractionPlayers direct requests for additional info to Controllers and the SimCell

Players and Controllers/Evaluators will not engage in casual conversation Players must adhere to all Controller instructions“Controller Prerogative” may countermand a Player’s actions to preserve the continuity, integrity and/or objectives of the exercise31Slide32

Participant Interaction (Cont.)Controllers only provide Players with info when specifically designated (e.g., injects)

Controllers and Evaluators should not provide players with feedback or guidance on their actions/ performance32Slide33

EvaluationSlide34

Evaluation PurposeThe fundamental purpose of the exercise

Evaluators collect data, conduct analysis, and provide findings/recommendationsEvaluator findings/recommendations based on evaluation guides, plans/procedures, personal expertise and experience Provide the foundation for the After Action Report (AAR) and Improvement Plan (IP) 34Slide35

Evaluator GuidanceNo fault exercise

Learning environmentJudge the plans and capabilities, NOT the playersIdentify Lessons LearnedBest PracticesAreas for ImprovementAssess the level of preparednessEnsure opportunities for Player demonstration35Slide36

Evaluator Guidance (Cont.)

Observe and RecordDuring and after exerciseTips and Key Focus Areas:Activities that directly relate to goals and objectivesExpected actions associated with InjectsDecision-makers and key decisionsCritical events/initiating scenario eventsDeviation from plans/proceduresInclude times (both start and end)Use the Exercise Evaluation Guide (EEG)36Slide37

Evaluator Guidance (Cont.)Tips and Key Focus Areas

(Cont.) What to look forWhat happened? When?How did Players coordinate?How did Players use plans & procedures?Adequacy of equipment/facilities/resources to support task accomplishmentFocus on outcomes and pathwaysDo not focus exclusively on specific tasksFocus on what they accomplished and how they accomplished it

37Slide38

Evaluator Guidance (Cont.)Be aware of

The integration of different functionsCoordination of the overall responseTimelineDiscrepancies may indicate issues38Slide39

Evaluator Guidance (Cont.)Before the Exercise

Review the appropriate plans, procedures, and protocolsAttend required briefingsReview and be familiar with the appropriate exercise materials Be familiar with After-Action Report (AAR) requirements and write up templatesReport to the exercise location at the time designated in the Exercise Schedule Obtain or locate necessary communications equipment and test it to ensure satisfactory communication between Controllers and the Exercise Staff

39Slide40

Evaluator Guidance (Cont.)During the Exercise

Capture detailed notesPosition yourself so you can hear/seeAsk questions of players as necessaryDon’t interfere with exercise playNotify the Controller of any exercise issues40Slide41

Evaluator Guidance (Cont.)After the Exercise

Capture notes during the HotwashCollect documentation from playersPlayer LogsInject/MSEL formsPlayer ICS forms, Action Plans, Press Releases, etc.Collect and review Participant Feedback FormsAttend C/E Debrief at your siteSubmit evaluation write-ups

Identify strengths and areas for improvement for each objective

Populate Improvement Plan (IP)

41Slide42

Post-Exercise ActivitiesSlide43

Post-Exercise Activities

Attend Exercise Evaluation Conference (EEC)Date: Thursday, December 18, 2014Time: 0900-1200 (Registration at 0830)Location: LA County EMS Agency, Hearing Room 10100 Pioneer Blvd, Santa Fe SpringsAttendees include Senior Controller/Evaluator Max 2 persons per facility/organizationFacilitated discussion of all aspects of the exerciseDesign processReview exercise in accordance with objectives and observationsFeedback from Hotwash and Participant Critiques

43Slide44

Post-Exercise Activities (Cont.)

Exercise Evaluation Conference FormatONE representative to speak for each agency/ organizationProvide overall summaryProvide 3 practices to “sustain” and recommendations on how to sustain themProvide 3 practices to “improve” and recommendations on how to improve themA mix of organization-specific and system-wide strengths and areas for improvement44Slide45

Evaluation Write Ups

After-Action Report (AAR) TemplateIdentify strengths and areas for improvement for each objectivePopulate Improvement Plan (IP)Due January 22, 2015Email to Gary Chambers, LA County EMS Agency gchambers@dhs.lacounty.gov 45Slide46

In Conclusion

Review the:Controller/Evaluator HandbookMSEL and scenarioPlans and proceduresBring appropriate materials with you Clipboards, note pads, pens, camera, good shoes, etc. Be early for assignmentsBe prepared to complete or participate in activities after the exercise Respect your role and take your responsibilities seriouslyExercise success is more dependent on the exercise staff than on the players46Slide47

The EEG/AAR/IP FormSlide48

“One form to make it simple”

First few pages are for the Exercise Evaluation Guides (EEGs) for use by the evaluators during the exerciseMiddle Pages are the After Action Report (AAR) to be completed by the Lead EvaluatorLast pages are the Improvement Plan (IP) to be completed by organizational management staff48Slide49

The Evaluator’s Impression

49Slide50

Strengths and Improvement Needed

50Slide51

Participant Feedback Form-Summary

51Slide52

Participant Feedback Form-Comments

52Slide53

The Improvement Plan

53Slide54

Participant Feedback Form

Appendix E- Exercise Plan54Slide55

Thank you!

Please contact for EEG/AAR/IP Form information or instruction:Terry Crammer562-347-1645tcrammer@dhs.lacounty.gov