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Hospital Preparedness Exercises Atlas

Public Health Emergency Preparedness

This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.

This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.

Please go to www.ahrq.gov for current information.

Section II: Resources and Tools Alphabetical Listings

Index: A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

M (continued)

Master Scenario Events List (MSEL) Package RT

Foundation √Design & Development √Conduct √Evaluation Improvement Planning
Discussion-Based Exercise Operations-Based Exercise

Author: U.S. Department of Homeland Security, Homeland Security Exercise and Evaluation Program (HSEEP)
Publication Date: 2007
Length: 18 pages
Location: http://hseep.dhs.gov/HSEEP_Vols/upl/DocServe.aspx?dload=%27hseep_Vol4%2fVol+IV+Media%5c949_MSEL+Package+Template.doc
Hospital-Specific: No
Target Audience: Emergency Management Staff Aiming To Be HSEEP Compliant
Users: Exercise Controllers, Exercise Evaluators, Exercise Simulators
Uses:

  • Chronological listing of events critical to exercise play
  • Introducing injects into an exercise
  • Evaluating the introduction of injects in an exercise
  • Exercise documentation

Description: The MSEL Package contains a chronological listing of events critical to exercise play. According to HSEEP, the purpose of a MSEL is to provide a list of injects (events that controllers introduce to the situation) and the responsible controllers and evaluators introducing injects and assessing the reaction to injects, respectively. Injects may be either contextual injects that help reinforce exercise play, such as introduction of a suspect or threat, or contingency injects, which are event/verbal introductions that help exercise play progress (e.g., if the exercise participants are unable to locate a threat, the controller may have a player point the participants in the right direction). The MSEL also lists expected action events, which are the expected responses to injects. This MSEL template contains three parts: (1) Exercise Objectives; (2) MSEL (Summary); and (3) MSEL (Expanded). Most exercise controllers will use the shortened summary version and only use the expanded version as a reference.

Quick Reference

Accreditation Org.:
All

Federal:
√HSEEP

NHPP Overarching Req.:
Exercises, Evaluation, Correct.

NHPP Sub-Capabilities:
All

Exercise Scenario:
General

Format:
Template

Master Sign-In Sheet T

√Foundation √Design & Development √Conduct √Evaluation √Improvement Planning
Discussion-Based Exercise Operations-Based Exercise

Author: U.S. Department of Homeland Security, Homeland Security Exercise and Evaluation Program (HSEEP)
Publication Date: 2007
Length: 1 page
Location: http://hseep.dhs.gov/HSEEP_Vols/upl/DocServe.aspx?dload=%27hseep_Vol4%2fVol+IV+Media%2f968_Sign-In_Conduct+(DB+++OB).doc
Hospital-Specific: No
Target Audience: Emergency Management Staff Aiming To Be HSEEP Compliant
Users: Exercise Staff, Exercise Participants
Uses:

  • Keeping track of attendees of meetings during the exercise planning and evaluation process
  • Keeping track of exercise participants
  • Keeping track of exercise attendees

Description: This is a template for a sign-in sheet to collect contact information of participants in the exercise. The template can be used at any of the exercise planning conferences (initial, mid-term, and final), when conducting the exercise evaluation and the improvement planning conference. It is important to collect contact information to facilitate followup and for use in future exercise planning.

Quick Reference

Accreditation Org.:
All

Federal:
√HSEEP

NHPP Overarching Req.:
Exercises, Evaluation, Correct.

NHPP Sub-Capabilities:
All

Exercise Scenario:
General

Format:
Template

Medical Surge Capacity and Capability: A Management System for Integrating Medical and Health Resources During Large-Scale Emergencies RT

√Foundation √Design & Development √Conduct Evaluation Improvement Planning
Discussion-Based Exercise Operations-Based Exercise

Author: Institute for Public Research (funded by the U.S. Department of Health & Human Services)
Publication Date: 2007
Length: 274 pages
Location: http://www.phe.gov/Preparedness/planning/mscc/handbook/Documents/mscc080626.pdf
Hospital-Specific: No
Target Audience: State and Local Jurisdictions
Users: Hospital Preparedness Planners
Uses:

  • Exercise related to medical surge capacity

Description: This handbook provides an overview on management methodology related to medical surge capacity and capability (MSCC). The handbook includes: an Overview of MSCC, Emergency Management and the Incident Command System; Management of Individual Healthcare Assets (Tier 1), Management of the Healthcare Coalition (Tier 2), Jurisdiction Incident Management (Tier 3), Management of State Response and Coordination of Intrastate Jurisdictions (Tier 4), Interstate Regional Management Coordination (Tier 5), Federal Support to State, Tribal, and Jurisdiction Management (Tier 6), Implementation, Training, and System Evaluation.

Note: This handbook guides ASPR's National Hospital Preparedness Program (NHPP). State and local jurisdiction NHPP grantees are expected to be able to work within the tiered framework provided in this handbook.
Quick Reference

Accreditation Org.:
N/A

Federal:
√NHPP

NHPP Overarching Req.:
Exercises, Evaluation, Correct.

NHPP Sub-Capabilities:
All

Exercise Scenario:
General
Surge Capacity

Format:
Guidebook

Missouri Strategic National Stockpile (SNS) Exercise Handbook: A Guideline for Conducting, Receiving, Staging, Distributing, and Dispensing Exercises RT

√Foundation √Design & Development √Conduct √Evaluation √Improvement Planning
Discussion-Based Exercise Operations-Based Exercise

Author: Missouri Department of Health and Senior Services
Publication Date: 2001
Length: 86 pages
Location: http://www.dhss.mo.gov/BT_Response/PubHealthText0929-1.pdf Exit Disclaimer
Hospital-Specific: No
Target Audience: Emergency Management Staff Aiming To Be HSEEP Compliant
Users: Exercise Staff, Exercise Participants
Uses:

  • Exercises related to strategic national stockpile (SNS)

Description: This handbook provides information on training exercises, exercise planning, conduct of training exercises, exercise evaluation, and integration, among State and local agencies, related to a mass prophylaxis event. The handbook provides detailed steps and explanations related to the exercise process, as well as detailed checklists. It provides detailed overviews on tabletop exercises and full-scale exercises. The appendixes include: A) Exercise Enhancements (Ideas); B) Sample Scenarios (Natural Public Health Disaster, Nuclear Power Plant Accident, Toxic Industrial Spill, Intentional Infectious Disease Outbreak (Not Contagious), Intentional Infectious Disease (Contagious); C) Acronyms. While this document is not developed with hospitals specifically in mind, it is a useful resource, and the tools can be easily adapted for hospital usage.

Quick Reference

Accreditation Org.:
All

Federal:
HSEEP

NHPP Overarching Req.:
Exercises, Evaluation, Correct.

NHPP Sub-Capabilities:
All

Exercise Scenario:
Biological/Bioterrorism
Chemical
Communicable Disease
Mass Prophylaxis
Natural Disaster
Nuclear
SNS

Format:
Example
Guidebook
Template
Toolkit
Training Materials

Moulage Kit R

Foundation Design & Development √Conduct Evaluation Improvement Planning
Discussion-Based Exercise Operations-Based Exercise

Author: U.S. Department of Homeland Security, Homeland Security Exercise and Evaluation Program (HSEEP)
Publication Date: 2007
Length: 1 page
Location: http://hseep.dhs.gov/HSEEP_Vols/upl/DocServe.aspx?dload=%27hseep_Vol4%2fVol+IV+Docs%2fMoulage+Kit.doc
Hospital-Specific: No
Target Audience: Emergency Management Staff Aiming To Be HSEEP Compliant
Users: Exercise Staff, Exercise Participants
Uses:

  • Using moulage during an exercise
  • Creating realism in an exercise
  • Exercises that use actor-patients

Description: The Moulage Kit briefly explains the uses of moulage, which is makeup applied to victim actors to help increase the degree of realism to an exercise. Types of moulage include fake blood or plastic bones. While this resource does not give instructions for making moulage, it does provide a list of common moulage kit components. When moulage is used during an exercise it is important that signs are displayed clearly indicating “Exercise in Progress” in order not to alarm those passing by.

Quick Reference

Accreditation Org.:
All

Federal:
√HSEEP

NHPP Overarching Req.:
Exercises, Evaluation, Correct.

NHPP Sub-Capabilities:
All

Exercise Scenario:
Biological/Bioterrorism
Chemical
Explosive
Mass Casualty
Nuclear
Surge Capacity

Format:
Toolkit

Multiyear Training & Exercise Plan RT

√Foundation √Design & Development √Conduct √Evaluation √Improvement Planning
Discussion-Based Exercise Operations-Based Exercise

Author: U.S. Department of Homeland Security, Homeland Security Exercise and Evaluation Program (HSEEP)
Publication Date: 2007
Length: 1 page
Location: http://hseep.dhs.gov/HSEEP_Vols/upl/DocServe.aspx?dload=%27hseep_Vol4%2fVol+IV+Docs%5c885_629_Multiyear+Plan+Draft+Template%5b1%5d.doc
Hospital-Specific: No
Target Audience: Emergency Management Staff Aiming To Be HSEEP Compliant
Users: Exercise Staff, Exercise Participants
Uses:

  • HSEEP Compliance
  • Training and Exercise Scheduling

Description: HSEEP compliance requires that the multi-year training and exercise plan is updated annually. According to HSEEP, the Multiyear Training & Exercise Plan should: (1) represent the training activities prior to an exercise and use the exercise to validate the training activities; (2) demonstrate the exercises that the facility participates in; and (3) use a “building-block approach” to show that exercises are growing in complexity.

Quick Reference

Accreditation Org.:
All

Federal:
√HSEEP

NHPP Overarching Req.:
Exercises, Evaluation, Correct.

NHPP Sub-Capabilities:
All

Exercise Scenario:
General

Format:
EOPs
Schedule
Template

Return to Contents

N

Name Tents T

Foundation Design & Development √Conduct Evaluation Improvement Planning
Discussion-Based Exercise Operations-Based Exercise

Author: U.S. Department of Homeland Security, Homeland Security Exercise and Evaluation Program (HSEEP)
Publication Date: 2007
Length: 1 page
Location: http://hseep.dhs.gov/HSEEP_Vols/upl/DocServe.aspx?dload=%27hseep_Vol4%2fVol+IV+Docs%2fNameTents.ppt
Hospital-Specific: No
Target Audience: Emergency Management Staff Aiming To Be HSEEP Compliant
Users: Exercise Staff, Exercise Participants
Uses:

  • Identifying people during a tabletop exercise

Description: This is a template for name tents to identify people during a discussion-based tabletop exercise. Clearly displaying the identification of people in a tabletop exercise is critical to ensuring the exercise runs smoothly because participants may play roles different from their usual job function. Participants also need to know what people and resources are available to them during an exercise.

Quick Reference

Accreditation Org.:
All

Federal:
√HSEEP

NHPP Overarching Req.:
Exercises, Evaluation, Correct.

NHPP Sub-Capabilities:
All

Exercise Scenario:
General

Format:
Template

National Fire Protection (NFPA) Codes and Standards R$

√Foundation √Design & Development √Conduct √Evaluation √Improvement Planning
Discussion-Based Exercise Operations-Based Exercise

Author: NFPA
Publication Date: 2009
Length: N/A
Location: http://www.nfpa.org/aboutthecodes/list_of_codes_and_standards.asp Exit Disclaimer
Hospital-Specific: Yes
Target Audience: Hospitals That Receive Centers for Medicare & Medicaid Services (CMS) Reimbursement
Users: Hospital Preparedness Planners
Uses:

  • Complying with NFPA life safety codes
  • Complying with CMS

Description: The NFPA provides standards and codes on fire safety-related issues for hospitals. Hospitals generally need to comply with NFPA 99: Standard for Health Care Facilities and NFPA 101: Life Safety Code ®.

Note 1: Hospitals receiving CMS reimbursement are required to comply with certain NFPA standards and codes. All accreditation organizations require compliance with NFPA Standards and Codes, namely NFPA 99 and 101.
Note 2: In some hospitals, hospital preparedness and fire are under separate departments and while they collaborate with each other, they may operate independently.

Quick Reference

Accreditation Org.:
√All

Federal:
√CMS

NHPP Overarching Req.:
Exercises, Evaluation, Correct.

NHPP Sub-Capabilities:
All

Exercise Scenario:
General

Format:
Manual

National Response Framework (NRF) R

√Foundation √Design & Development √Conduct Evaluation Improvement Planning
Operations-Based Exercise Operations-Based Exercise

Author: U.S. Department of Homeland Security
Publication Date: 2008
Length: 90 pages
Location: http://www.fema.gov/pdf/emergency/nrf/nrf-core.pdf
Hospital-Specific: No
Target Audience: Government Executives, Private-Sector and Nongovernmental Organization Leaders, and Emergency Management Practitioners
Users: Hospital Leadership
Uses:

  • Understanding how the nation conducts all-hazards response

Description: The National Response Framework is a guidebook that explains the critical response principles, participants, roles, and structures in order for the Nation to conduct all-hazards responses. This document includes “specific authorities and best practices for managing incidents” from a small to very large scale. The framework includes the following chapters: Roles and Responsibilities; Response Actions; Response Organization; Planning: A Critical Element of Effective Response; and Additional Resources. This document is a useful resource for hospitals to understand how their preparedness activities fit in with the rest of the Nation.

Quick Reference

Accreditation Org.:
All

Federal:
√HSEEP

NHPP Overarching Req.:
Exercises, Evaluation, Correct.

NHPP Sub-Capabilities:
All

Exercise Scenario:
General

Format:
Guidebook

New York Presbyterian Hospital CBRNE Tabletop Exercises RT

Foundation √Design & Development √Conduct Evaluation Improvement Planning
Discussion-Based Exercise Operations-Based Exercise

Author: New York City Department of Health and Mental Hygiene Hospital Preparedness Program
Publication Date: 2008
Length: 22 pages
Location: http://www.nyc.gov/html/doh/downloads/pdf/bhpp/ttex-0311-scenario-presentation.pdf Exit Disclaimer
Hospital-Specific: Yes
Target Audience: Hospital Preparedness Planners
Users: Exercise Staff, Exercise Participants
Uses:

  • Planning for a mass casualty event, particularly one involving explosions
  • Assess, update, and improve hospital emergency planning for external threats

Description: This tabletop exercise can be used to assess the ability of a hospital to respond to an increased influx of patients due to a mass casualty situation; the scenario specifically describes an explosive event. The exercise describes the kind of patients that would likely arrive (trauma, burn, smoke inhalation, soft tissue injuries, etc), the emergency systems that should be activated in response to the disaster (additional ambulance units, New York City Office of Emergency Management (NYC OEM) Emergency Operations Center), and the volume expected in the emergency department. The exercise includes two parts, and each has a series of questions to assess response to the scenario including interactions with other departments, surge capacity, and staff fatigue. A hotwash component and evaluation conclude the exercise so that lessons can be incorporated into future planning. This tabletop exercise is tailored for a large tertiary care hospital in the New York area, but could easily be adjusted to serve a smaller community or alternate scenario.

Quick Reference

Accreditation Org.:
All

Federal:
HSEEP

NHPP Overarching Req.:
Exercises, Evaluation, Correct.

NHPP Sub-Capabilities:
All

Exercise Scenario:
General
Biological/Bioterrorism
Chemical
Explosive
Mass Casualty
Nuclear
Radiological
Staff Fatigue
Surge Capacity

Format:
Agenda
Assessment
Example
Form
Guidebook
Presentation
Toolkit

NEXS (National Exercise Schedule) (access) RT

√Foundation √Design & Development √Conduct Evaluation Improvement Planning
Discussion-Based Exercise Operations-Based Exercise

Author: FEMA
Publication Date: TK
Length: N/A
Location: https://hseep.dhs.gov (to login); Access can be requested by sending an e-mail to support@hseep.net (NEXS is part of the web-based HSEEP toolkit)
Hospital-Specific: No
Target Audience: Emergency Management Staff Aiming To Be HSEEP Compliant
Users: Exercise Staff, Exercise Participants
Uses:

  • Scheduling all National-level, Federal, State, tribal, territorial, and local exercises.

Description: NEXS provides a central location for the scheduling of exercises. Health care organizations may not be required to enter all exercises into NEXS, particularly smaller-scale internal exercises. If the exercise involves the health care organization collaborating with other stakeholders such as the local health department, the exercise may need to be entered into NEXS.

Quick Reference

Accreditation Org.:
All

Federal:
√HSEEP

NHPP Overarching Req.:
Exercises, Evaluation, Correct.

NHPP Sub-Capabilities:
All

Exercise Scenario:
General

Format:
Schedule
Web-based Software

NEXS (National Exercise Schedule) User Guide R

√Foundation √Design & Development √Conduct Evaluation Improvement Planning
Discussion-Based Exercise Operations-Based Exercise

Author: U.S. Department of Homeland Security, Homeland Security Exercise and Evaluation Program (HSEEP)
Publication Date: 2007
Length: 1 page
Location: https://hseep.dhs.gov (to login); Access can be requested by sending an e-mail to support@hseep.net (NEXS is part of the web-based HSEEP toolkit)
Hospital-Specific: No
Target Audience: Emergency Management Staff Aiming To Be HSEEP Compliant
Users: Exercise Staff, Exercise Participants
Uses:

  • User Guide for NEXS

Description: This guide for the NEXS system describes how to gain access to the system, how to enter an exercise into the schedule, and how to view the calendar and manage scheduling conflicts.

Quick Reference

Accreditation Org.:
All

Federal:
√HSEEP

NHPP Overarching Req.:
Exercises, Evaluation, Correct.

NHPP Sub-Capabilities:
All

Exercise Scenario:
General

Format:
Guidebook
Training Materials

NIMS (National Incident Management System) Implementation Activities for Hospitals and Healthcare Systems: Implementation FAQs R

√Foundation √Design & Development √Conduct √Evaluation √Improvement Planning
Discussion-Based Exercise Operations-Based Exercise

Author: Federal Emergency Management Agency (FEMA)
Publication Date: 2007
Length: 6 pages
Location: http://www.fema.gov/pdf/emergency/nims/hospital_faq.pdf
Hospital-Specific: Yes
Target Audience: Emergency Management Staff Aiming To Be HSEEP Compliant
Users: Exercise Staff, Exercise Participants
Uses:

  • NIMS Compliance

Description: This resource includes FAQs for NIMS Implementation activities for hospital and healthcare systems. This includes questions and answers related to the following topics: (1) Adoption and Implementation; (2) Training; (3) Hospital Incident Command System (HICS); and (4) Joint Commission and Centers for Medicaid and Medicare Services (CMS).

Note: This FAQ was last updated in April 2007 and may be missing some critical updates to NIMS that occurred since then. It is important to also look at the Crosswalk of 2007 & 2008/2009 NIMS Healthcare Activities/ Objectives and subsequent versions of NIMS released since 2007.
Quick Reference

Accreditation Org.:
All

Federal:
HSEEP
NHPP
NIMS

NHPP Overarching Req.:
NIMS
Exercises, Evaluation, Correct.

NHPP Sub-Capabilities:
All

Exercise Scenario:
General

Format:
Fact Sheet

Key: R = Resource; T = Tool; $ = Available for Purchase; lock symbol = Login Access Needed; P = Can be used to directly achieve compliance

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The information on this page is archived and provided for reference purposes only.

 

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