Healthcare Mass Fatality Management Tabletop Exercise Organization Name

Healthcare Mass Fatality Management Tabletop Exercise <<Organization Name>> <<Date>>

Exercise Agenda p Introduction & overview p Scenario and messaging with player response to follow p Break p Debrief

What is a Tabletop Exercise? p p Informal discussion using a scripted disaster scenario as a catalyst No time pressures, designed to promote free and open exchange of ideas Familiarizes players with roles, responsibilities, functions, plans, and procedures Identifies issues requiring further work

Exercise Play p p p Introductory narrative, followed by “problem statements” and subsequent updates Put yourself in the position described in the scenario When asked, describe your actions as if this were “real, ” following organizational plans and procedures There are no “right” or “wrong” answers Identification of issues, but not necessarily trying to solve them

Procedural Notes p p Parking Lot: as you come up with things that need further action as an organization, write them on a Post-It sticky note, hand to the facilitator and he/she will place it in the “parking lot”. Your Specific Department: make notes of things you want to follow up on later with your department leadership and/or colleagues.

Exercise Objectives 1. 2. 3. 4. 5. Identify organizational planning gaps relating to mass fatality response Determine <<organization name>> ability to assess and report fatalities Determine <<organization name>> ability to track, move, and store remains and personal effects Determine <<organization name>> ability to respond to family/friend inquiries following a mass fatality event Identify internal training needs to respond to multiple fatalities

Assumptions p p p An increase in demand for <<organization services>> services is predicted during an emergency. Some key decision makers are inaccessible. Our community, including law enforcement, medical services, schools, stores, food banks, shelters, vendors, etc. , will be impacted in the same ways <<organization name>> is impacted.

Scenario It is a hot summer day in King County, WA. The weather forecast is mostly sunny skies with a high of mid 80 s and an overnight low of high 60 s It is currently 5: 30 pm. 24 hours ago a magnitude 6. 7 earthquake shook the Puget Sound Region affecting King, Pierce and Snohomish Counties

Situation Update #1. SR 520, I-90, I-5 and I-405 are heavily damaged and both the I-90 and SR 520 bridges are impassable. The Alaskan Way Viaduct has collapsed. Electricity is disrupted with only intermittent service throughout the county. There are reports of numerous fatalities as well as injuries throughout the region. Most of the hospitals in the region are operational, information gathering from other healthcare sectors is ongoing. Health and Medical Area Command (HMAC) is activated and is supporting the King County Medical Examiner with response operations.

Situation #1: Questions 1. How will <<organization name>> determine the number of fatalities that have occurred within your facility as a result of the earthquake? a. 2. How will <<organization name>> gather information about deceased staff members? How will <<organization name>> organize the information to facilitate reporting to the King County Medical Examiner? a. b. c. Has <<organization name>> developed protocols for documenting non-patient deaths that occur at your facility? What types of documents will <<organization name>> use to identify and track remains to report to the Medical Examiner? How will <<organization name>> incorporate the tracking forms provided in the Fatality Management Plan template?

Situation Update #2 It is 3 days later In King County, there are 1600 reported fatalities The King County Medical Examiner will be delayed in their response to reported deaths, operations at funeral homes have also been delayed Organizations and facilities are advised that it may be several days before bodies may be picked up 30 individuals located at your facility have dies

Situation #2: Questions 1. How will <<organization>> surge to accommodate the deceased? a. What space will <<organization name>> use to store the remains? b. Have <<organization name>> developed protocols to address the following considerations with storage? a. b. c. d. e. f. g. Security Accessibility Temperature Management Appropriate Placement Privacy Ventilation Pest Control

Situation #2: Questions Cont. 2. What supplies, equipment and resources will <<organization name>> require to store the remains for several days? 3. How will <<organization name>> coordinate the tracking, movement and storage of remains? 4. a. Who will complete the forms related to each decedent and ensure proper tracking of the remains? b. How will <<organization name>> track the personal effects of decedents? How will <<organization name>> manage security issues? a. Security of human remains? b. Security of personal effects?

Situation #2: Questions Cont. 5. What infection control planning, if any, needs to be addressed? 6. How will <<organization name>> provide staff to fill the following job functions? a. b. c. d. e. Morgue Lead Personal Affects Management Morgue Security Storage Facility Maintenance Family Liaison 7. How will <<organization name>> provide training or just -in-time training to staff to be able to fill these roles? 8. How will <<organization name>> assess and support the mental health needs of staff involved in managing a mass fatality incident?

Situation Update #3 Family/friends are looking for their loved ones in any way possible Community members have begun to find their family members/friends deceased and are bringing them to your facility/organization.

Situation #3: Questions 1. How will <<organization name>> handle family/friends that show up at the facility or inquire about their family members? a. How will <<organization name>> decide what information, if any, you will provide about their deceased family member? b. How will <<organization name>> handle inquiries from families about deceased staff members? 2. How will <<organization name>> respond to inquiries from the media regarding fatalities? 3. What will <<organization name>> do if community members bring their deceased family/friends to the facility?

Addition Planning In a non-earthquake scenario there may be other planning areas to consider: 1. What is <<organization name>> protocol for continuity of death certification? a. Has <<organization name>> developed a strategy for managing a surge of natural death certifications?

Congratulations! You have successfully participated in a mass fatality exercise

Debrief

Debrief 1. What were some significant issues that came out of exercise? 2. What issues came up that you did not expect? 3. What questions/issues came up that you’ll want to discuss with your employees? 4. What are things you want to follow up on within your department? Revisit post-it notes/”parking lot issues”. 5. What follow up would you like for the agency to do?