Academic journal article Homeland Security Affairs

Preparedness Exercises 2.0: Alternative Approaches to Exercise Design That Could Make Them More Useful for Evaluating -- and Strengthening -- Preparedness

Academic journal article Homeland Security Affairs

Preparedness Exercises 2.0: Alternative Approaches to Exercise Design That Could Make Them More Useful for Evaluating -- and Strengthening -- Preparedness

Article excerpt

Introduction

Preparedness exercises play a significant role in the national preparedness system. In the Federal Emergency Management Agency's Comprehensive Preparedness Guide-101, exercises are identified as a central element of an area's effort to refine and execute a preparedness plan as well as contributing to red-teaming efforts to test plans against different sets of assumptions.1 For medical institutions, periodic exercising is part of the accreditation requirements imposed by the Joint Commission on Accreditation of Healthcare Organizations. For rare types of incidents or large-scale events, use of simulated incidents is viewed as particularly important, since emergency response and management personnel are unlikely to encounter many of the challenges associated with such incidents during their day-to-day activities.

The general term preparedness exercise includes activities that fall over a wide range of scale, scope, and complexity. Described in detail in the first volume of guidebooks produced by the Homeland Security Exercise and Evaluation Program (HSEEP), exercise can range from the most basic of seminar-type interactions up to full-scale response simulations where units, equipment and personnel operate as they would at a real incident and volunteers serve in the role of victims requiring treatment (Figure 1 illustrates the range of exercise types, in order of increasing complexity).

Figure 1: Varieties of Discussion-based and Operations-based Exercises2

As one component of a preparedness program, exercises of these varied types are seen as a versatile tool that can help contribute to achieving a variety of different goals. Though taxonomies of exercise objectives vary in the literature, most include the following:3

* Planning ? Exercises provide a structure to advance planning for a particular incident scenario, identifying problems and explore their solutions in focused way.

* Interagency Coordination ? Exercises can act as a venue for members of different agencies to meet and interact, to build relationships that are important to effective coordination in a real event, to identify issues potentially falling in gaps of authority, jurisdiction, etc., to test mechanisms and technologies for interagency information sharing that might seldom be used in routine events, and to identify if there are agencies "missing" from plans that would be needed at a large scale disaster, accident, or terrorist attack.

* Public Education ? Exercises can act as an "event" that, by being covered by the media and discussed publically, makes it possible to teach the public about the capabilities of response systems, creates the opportunity to educate them about preparedness actions they could take, and informs them about preparedness efforts of their local, state, or the federal government.

* Training ? Exercises can make it possible to expose response staff to rare incidents and their unique demands ? rather than their encountering them for the first time at a real emergency. Such simulations make it possible to teach responders or volunteers specific tasks, practice equipment use, and to learn or refresh other knowledge specific to an unusual incident.

* Evaluation ? Exercises have been used to evaluate emergency preparedness activities in a variety of ways. Such evaluations range from very broad, qualitative assessments (e.g., ensuring all significant issues were considered in planning) to very detailed, quantitative studies (e.g., directly measuring the patient throughput of a medical facility). More elaborate and realistic evaluative exercises have the potential to assess not just that a preparedness plan can be executed, but how well it can be put into practice under the simulated conditions of the exercise scenario.

Given the effort and expense involved in designing them, a single exercise is sometimes expected to pursue some or all of these goals simultaneously. …

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