controller and evaluator training september 30, 2014
DESCRIPTION
Los Angeles County Emergency Medical Services Agency STATEWIDE MEDICAL AND HEALTH FUNCTIONAL EXERCISE. CONTROLLER AND EVALUATOR TRAINING September 30, 2014. Agenda. Exercise Overview Objectives Schedule Implementation Simulation Cell (SimCell) Control Instructions - PowerPoint PPT PresentationTRANSCRIPT
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CONTROLLER AND EVALUATOR TRAININGSeptember 30, 2014
Los Angeles County Emergency Medical Services
Agency
STATEWIDE MEDICAL AND HEALTHFUNCTIONAL EXERCISE
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Agenda Exercise Overview
o Objectiveso Scheduleo Implementation
Simulation Cell (SimCell) Control Instructions Evaluation Instructions
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EXERCISE OVERVIEW
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Program Phases – Building Block Phase 1) Multimedia training, including:
o Disaster preparedness and responseo Medical and health coordinationo Requesting medical and health resourceso California Public Health and Medical Emergency Operations Manual
training
Phase 2) Organization specific self-assessment tools to identify strengths and weaknesses
Phase 3) A tabletop exercise to discuss current plans, policies and procedures
Phase 4) A functional exercise to test current plans, policies and procedures
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Exercise Highlights Thursday, November 20, 2014 Exercise Play: 9:00 AM – 12:00
PM* Focus:
o Coordination of surveillance activities and health system capabilities anticipated when managing a medical surge caused by possible MERS-CoV infections
Play throughout the Stateo Los Angeles County Participants
• Hospitals• Clinics• Long Term Care Facilities• Surgery Centers• Dialysis Centers• Ambulance Providers• Emergency Management Providers
(DMH, DPH, DHS, CEOC, LAC-EOC)• LEMSA• Home Health
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Objectives Organized by Discipline and Capability
o Operational Communicationo Public Health and Medical Services
(Formerly Medical Surge/ Epidemiological Surveillance and Investigation)
o Operational Coordination(Formerly Emergency Operations Center Management)
o 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 needs
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Scenario Two individuals have been diagnosed with MERS-
CoV one nine days ago and a second three days ago o Significant numbers of patients with influenza like illness
inundate the healthcare system requesting testing and treatment for MERS
o Increased 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
TIP: Scenario specifics contained in the MSEL should not be given to players in advance of the exercise.
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Exercise ScheduleTime Personnel Activity
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,
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Exercise Documentation
Controller and Evaluator (C/E) Handbook Exercise Plan (ExPlan) Communications Directory (including SimCell)
o Sent directly to participants via email Master Scenario Events List (MSEL) Combined EEG/After Action Report/Improvement
Plan Template Participant Feedback Form-Coming soon Website: http://
dhs.lacounty.gov/wps/portal/dhs/ems/disastermedicalservices
Exercise materials provided on EMS website Can be used as templates for future efforts
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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. o 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.
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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).
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Exercise Implementation
Assumptionso Real-world emergencies take priorityo Exercise participants will comply with real-
world response procedures unless otherwise directed
Exercise Communicationso Exercise Language
Site Safety and Security
Exercise Identification/Credentials
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Simulation Cell (SimCell)
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SimCell Operations Three major activities
o Delivering injects to players (outgoing)o Simulating non-participating entities
(inbound)o Documenting participant responses
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SimCell Positions SimCell Lead Controller
o Track and coordinate all scenario eventso Identify how problems can be resolved o Directs and provides guidance to simulatorso Can be contacted by Controllers at play sites regarding
exercise status Simulators
o Track injects, participant calls into the SimCell, and associated follow-up responses
o Ensure realism and accuracy in all exercise communication
o Place injects, answer phones and respond to player questions, create new injects to encourage additional participation
o Conduct research and provide explanations for observed player actions during the exercise
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SimCell Operations SimCell Limits
o Only simulating non-participating entities• If they’re playing…contact them directly!
o Players need to identify who they want to talk to (be specific)
o Will not make decisions for playerso May have limited knowledge/expertiseo May need to do follow up and call back
Use the Communications Directory provided by EMS via email to registered participants-emailed to functional and full scale participants only- USE for exercise only
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SimCell Responsibilities Before the Exercise
o Review any emergency plans, procedures, and protocols available to you relevant to your assignment
o Review the exercise materials issued to you, including the objectives, scenario, MSEL/injects, and evaluation forms
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During the Exerciseo Ensure all planned injects are submitted to the
appropriate agencies on time (unless otherwise instructed) and in the correct format
o Receive player communications, then write, coordinate, and transmit appropriate responses in a timely manner
o Ensure SimCell operations are coordinated and congruent with the overall exercise operations
SimCell Responsibilities (Cont.)
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SimCell Responsibilities (Cont.)
During the Exercise o Keep the SimCell lead controller apprised of
developments, problems, issues, or concernso Attempt to accurately portray the information
contained in inject forms to the playerso Record all calls received and made on the
SimCell Activity Log o Any new injects developed for the exercise
should be submitted to the SimCell Lead Controller for approval before being used in the exercise
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SimCell Responsibilities (Cont.)
Phone Instructionso When answering a phone in the SimCell or at
another simulated entity location always answer with “This is the SimCell”
o Inquire to the participant regarding their name, agency/facility and who they are trying to reach if they do not provide this information
o Ensure you re-iterate “This is an exercise” prior to providing any answers or feedback to participants
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Exercise Control
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Controller Purpose Ensure the integrity of the exercise Responsibilities
o Exercise mechanics and functionalityo Deliver injects to drive playo Provide Player Briefingo Objectives are being meto Actor managemento Participant behavior/activitieso Safety/securityo Facilitate Hotwash
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Controller Positions Exercise Director
o Final authority on all aspects of the exercise, including starting, modifying, or ending the exercise
o Works with the Senior Controller to ensure the exercise runs smoothly and all objectives are met
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Controller Positions (Cont.)
Senior Controllero Coordinates with the Exercise Director on exercise
control and safety issueso Monitors activities at each exercise venue o Tracks whether objectives have been met or
require further attention Controllers
o Each exercise venue will have its own Controller(s)o Responsible for keeping the exercise on schedule
and suggesting potential modifications or injects o The SimCell will have a lead controller who is
responsible for managing the SimCell
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Controller Responsibilities
Before the Exerciseo Review applicable plans and procedures that
will be activated during the exerciseo Know the scenario and MSELo Arrive at the venue 60 minutes before StartEx o Provide the Player Briefing
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Controller Responsibilities (Cont.)
During the Exerciseo Locate necessary communications equipment
and test it to ensure systems are operationalo Monitor flow and sequence of events during
play according to the MSELo Manage the flow of exercise play
• “Eyes and ears” of the SimCell and Exercise Director• Controllers 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 outo If possible, capture notes to assist Evaluators
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Controller Responsibilities (Cont.)
Conduct a Hotwasho Held immediately following EndExo Hotwash slide contained in Player Briefingo Opportunity for PLAYERS to comment on
their experience• What went well?• What needs improvement?
• Plans, organization, equipment, training, exercise
• Any surprises?• Improvements to exercise
implementation?o Distribute and collect Participant Feedback
Forms
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Player Instructions Controllers ensure Players are ready to
participate Player Briefing Highlights
o Scenario (provided on website)o Exercise Objectives (provided on website)o Exercise Mechanics/Functionality
• Start time• End Time• Description of Exercise staff
o Rules of Play• Real world vs Exercise language
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Player Instructions (Cont.)
Key Messages & Enforcemento Will not have prior knowledge of the scenario
beyond the contents of the Player Briefing
o Must understand the scope of the exercise and which organizations are participating
o Expected to recognize that certain artificialities are built into the scenario to meet exercise objectives• e.g., Instruct players not to fight the scenario
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Player Instructions (Cont.)
Key Messages & Enforcement (Cont.)
o Need to follow real world response procedures and act as if the emergency were real
o Demonstrate all actions necessary to meet exercise objectives
o Players must receive information from their own sources (e.g., other players or SimCell)
Should “verbalize” their responses and maintain activity logs
Turn in all documentation to the Controller or Evaluator
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Participant Interaction Players 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
instructionso “Controller Prerogative” may countermand a
Player’s actions to preserve the continuity, integrity and/or objectives of the exercise
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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/ performance
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Evaluation
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Evaluation Purpose The fundamental purpose of the exercise
Evaluators collect data, conduct analysis, and provide findings/recommendations
Evaluator 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)
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Evaluator Guidance No fault exercise
o Learning environmento Judge the plans and capabilities, NOT the
playerso Identify Lessons Learned
• Best Practices• Areas for Improvement
o Assess the level of preparednesso Ensure opportunities for Player demonstration
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Evaluator Guidance (Cont.)
Observe and Recordo During and after exerciseo Tips and Key Focus Areas:
• Activities that directly relate to goals and objectives
• Expected actions associated with Injects• Decision-makers and key decisions• Critical events/initiating scenario events• Deviation from plans/procedures• Include times (both start and end)• Use the Exercise Evaluation Guide
(EEG)
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Evaluator Guidance (Cont.)
Tips and Key Focus Areas (Cont.)
o What to look for• What happened? When?• How did Players coordinate?• How did Players use plans & procedures?• Adequacy of equipment/facilities/resources to support
task accomplishment
o Focus on outcomes and pathways• Do not focus exclusively on specific tasks• Focus on what they accomplished and how they
accomplished it
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Evaluator Guidance (Cont.)
Be aware ofo The integration of different functionso Coordination of the overall responseo Timeline
• Discrepancies may indicate issues
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Evaluator Guidance (Cont.)
Before the Exerciseo Review the appropriate plans, procedures, and
protocolso Attend required briefingso Review and be familiar with the appropriate exercise
materials o Be familiar with After-Action Report (AAR) requirements
and write up templateso Report to the exercise location at the time designated
in the Exercise Schedule o Obtain or locate necessary communications equipment
and test it to ensure satisfactory communication between Controllers and the Exercise Staff
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Evaluator Guidance (Cont.)
During the Exerciseo Capture detailed noteso Position yourself so you can hear/seeo Ask questions of players as necessary
• Don’t interfere with exercise playo Notify the Controller of any exercise issues
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Evaluator Guidance (Cont.)
After the Exerciseo Capture notes during the Hotwasho Collect documentation from players
• Player Logs• Inject/MSEL forms• Player ICS forms, Action Plans, Press Releases, etc.
o Collect and review Participant Feedback Formso Attend C/E Debrief at your siteo Submit evaluation write-ups
• Identify strengths and areas for improvement for each objective
• Populate Improvement Plan (IP)
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Post-Exercise Activities
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Post-Exercise Activities Attend Exercise Evaluation Conference (EEC)
o Date: Thursday, December 18, 2014o Time: 0900-1200 (Registration at 0830)o Location: LA County EMS Agency, Hearing Room 10100 Pioneer Blvd, Santa Fe Springso Attendees include Senior Controller/Evaluator
• Max 2 persons per facility/organization
o Facilitated discussion of all aspects of the exercise• Design process• Review exercise in accordance with objectives and
observations• Feedback from Hotwash and Participant Critiques
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Post-Exercise Activities (Cont.)
Exercise Evaluation Conference Formato ONE representative to speak for each agency/
organizationo Provide overall summaryo Provide 3 practices to “sustain” and
recommendations on how to sustain themo Provide 3 practices to “improve” and
recommendations on how to improve themo A mix of organization-specific and system-wide
strengths and areas for improvement
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Evaluation Write Ups After-Action Report (AAR) Template
o Identify strengths and areas for improvement for each objective
o Populate Improvement Plan (IP) Due January 22, 2015
o Email to Gary Chambers, LA County EMS Agency [email protected]
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In Conclusion Review the:
o Controller/Evaluator Handbooko MSEL and scenarioo Plans and procedures
Bring appropriate materials with you o Clipboards, note pads, pens, camera,
good shoes, etc.
Be early for assignments Be prepared to complete or
participate in activities after the exercise Respect your role and take your responsibilities
seriouslyo Exercise success is more dependent on the exercise staff than
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The EEG/AAR/IP Form
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“One form to make it simple”
First few pages are for the Exercise Evaluation Guides (EEGs) for use by the evaluators during the exercise
Middle Pages are the After Action Report (AAR) to be completed by the Lead Evaluator
Last pages are the Improvement Plan (IP) to be completed by organizational management staff
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The Evaluator’s Impression
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Strengths and Improvement Needed
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Participant Feedback Form-Summary
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Participant Feedback Form-Comments
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The Improvement Plan
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Participant Feedback FormAppendix E- Exercise Plan
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Thank you!
Please contact for EEG/AAR/IP Form information or instruction:Terry Crammer562-347-1645