The Role for Exercises in Senior Policy Pandemic Influenza Preparedness

Abstract

Preparedness for a pandemic of influenza (PI) is a policy issue currently attracting increased attention from international organizations, governments, and private sector businesses. This is due in large part to the absenteeism rates that could be caused by a virulent strain of influenza affecting all demographics in our population, and the impact that would have on society as a whole. It is also an issue whose effects are cross cutting through both the private and public sectors equally making it a critical issue for society as a whole. Either prospectively agreeing when to implement certain strategies or having a process in place for decision making during the event, is an essential element of PI preparedness. One of the most effective and efficient methodologies to ensure readiness and evaluate preparedness is through exercises where different stakeholders are brought together to dialogue on how they will react to a given set of circumstances.Objective: To create awareness among senior policy makers as to the critical role of exercises in societal pandemic influenza (PI) preparedness and the critical process steps.Methods: Taking the collective objective experience from designing and implementing over 100 exercises for senior policy makers, 20 of which were pan flu related, the authors have advanced the science in the field, observed phenomena and drawn conclusions regarding appropriate exercise design, similarities to other forms of research and best practices for PI exercises/all-hazards preparedness.Results: Employing a decision matrix using the following factors: policy, plan, procedure, tactics and skills, an entity can determine the appropriate exercise typology and associated resource requirements. It was important to consistently raise specific issues in order to comprehensively address various preparedness and response issues.Conclusion: Despite a lack of common framework and methodology for the conduct of table top exercises (TTX), discussion based TTX have demonstrated to be an efficacious, effective, and efficient means for identifying policy gaps and fostering pandemic influenza response readiness.

Developing Public Health Emergency Response Leaders in Incident Management: A Scoping Review of Educational Interventions

“…Educational elements for structuring leadership training as part of a systematic pipeline included training design (n = 101), 18,38,43,45,80,90,94,132,137,155,185,204,217,236,239,270,271,283,284,286–292,295–302,304–312,314–316,318–321,323,327,331–335,337,338,340,341,343–350,352–354,356–359,361–363,365–374,376,377,533–542 frameworks (n = 76) 5,16,17,29,38,52,63,65,74,77,92,98,110,113,119,153,159,168,171,177,179,197,200,220,292,296,299,334,357,363,387,388,404,415,436,443,466,521,528,538,543–578 incorporating overarching principles or paradigms, competencies (n = 71), ...…”

“…Studies under this key theme addressed leadership strategies (n = 42), 28,43,80,89,301,302,374,393,495,544,571,577,580,616,631,653,654,673–675,679,684,689–708 guidance (n = 42), 71,75,92,93,99,121,192,195,340,347,352,445,492,494,543,545,551,563,580,624,639,642,659,667,709–726 and behavior/behavioral (n = 34) 38,43,47,49,60,95,116,121,162,197,202,211,233,260,275,276,285,296,301,310,331,384,388,437,532,625–627,629,631,670,689,727,728 aspects of leadership as well as critical thinking/judgment (n = 22). 30,45,60,74,80,95,97,101,148,163,299,314...…”

Twenty Challenges in Incident Planning

“…Our sample consisted of 5 table top exercises, 40 functional exercises and 5 full-scale exercises. Exercises are a critical disaster preparedness activity, aimed at training personnel and putting emergency response systems to the test under realistic conditions (Erickson and Barratt 2004;Decker and Holtermann 2009;Ottis 2014;Van Niekerk et al 2015). They help assess emergency management systems, and identify strengths and areas for improvement.…”

A New Method of Exercising Pandemic Preparedness Through an Interactive Simulation and Visualization

“…Tabletop exercises allow participants to role-play during a health emergency in a realistic but risk-free environment and evaluate performance using existing benchmarks. These discussion-based exercises are the first steps of identifying the gaps in the plans, policies, protocols, processes and procedures, which are included in the planning for pandemic mitigation [8,14,20]. At a university level, these exercises allow the organization to assess and improve their performance, while demonstrating community resolve to prepare for major incidents.…”

“…This exercise focused on several important response capabilities: isolation and quarantine, continuity of operations, disaster mental health services, travel of university students and personnel, communication problems, and meeting the needs of students and faculty during an outbreak. Decker and Holtermann [8] stated that discussion based table top exercises are effective and efficient for identifying policy gaps and fostering pandemic influenza preparedness based on their experience from implementing over 100 exercises.…”