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CONTROLLER & EVALUATOR HANDBOOK

LOS ANGELES COUNTY

DISASTER HEALTHCARE VOLUNTEERS

FULL SCALE EXERCISE

EXERCISE DATES: APRIL 22 - 26, 2013C/E HANDBOOK DRAFT: VERSION 3, 2/11/2013

Controller and Evaluator Handbook 2013 Los Angeles County Disaster Health Volunteers

Full-Scale Exercise

This exercise was funded by the Los Angeles County Emergency Medical Services Agency with funds from the FY 2012 Emergency System for the Advance Registration of Volunteer Health Professionals grant program, Department of Health and Human Services, Assistant Secretary for Preparedness and Response. (Grant number: ESREP100003-03-02)


Full-Scale Exercise

PREFACEThe Los Angeles County Disaster Healthcare Volunteers Full-Scale Exercise is sponsored by the Los Angeles County Emergency Medical Services Agency with funding from the United States Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response through a three-year Emergency System for the Advance Registration of Volunteer Health Professional supplemental grant. This Exercise Plan was produced with input, advice, and assistance from the response partners, local healthcare facilities, and the Exercise Design Team.

This Exercise Plan provides officials, observers, media personnel, and players from participating organizations the information they need to observe or participate in an exercise focused on the deployment of Disaster Healthcare Volunteers (DHVs) to local area healthcare facilities in an earthquake scenario. The exercise will test the county and local healthcare facilities’ ability to request, mobilize, deploy, receive, and manage disaster healthcare volunteers. The information in this document is current at the date of publication and is subject to change as dictated by the Los Angeles County Disaster Healthcare Volunteers Full-Scale Exercise Design Team. The Exercise Design Team includes healthcare facility, EMS Agency, public health department, and consulting staff.

ACRONYMS

Acronym MeaningDHV Disaster Healthcare Volunteer system and registryDHVs Individual volunteers registered in the DHV systemDOC Department Operations CenterDPH Department of Public HealthDSW Disaster Service WorkerECL Emergency Credential LevelEMS Agency Emergency Medical Services AgencyESAR-VHP Emergency System for the Advanced Registration of

Volunteer Health ProfessionalsFOUO For Official Use OnlyHICS Hospital Incident Command SystemICS Incident Command SystemLAC Los Angeles CountyMHOAC Medical Health Operational Area CoordinatorMRC Medical Reserve CorpsSUV Spontaneous Unaffiliated VolunteerVLA Volunteer Los Angeles

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Preface ii


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HANDLING INSTRUCTIONS1. The title of this document is the Los Angeles County Disaster Healthcare Volunteers

Full-Scale Controller & Evaluator Handbook.

2. Information gathered in this Handbook is designated as For Official Use Only (FOUO). Reproduction of this document, in whole or in part, is at the discretion of the exercise planner for the EMS Agency and participating healthcare facilities.

3. At a minimum, the attached materials will be disseminated strictly on a need-to-know basis.

4. For more information about the exercise, please consult the following points of contact:

Sandra Stark Shields, LMFT, CTSSr. Disaster Services AnalystLA County Department of Health ServicesEmergency Medical Services Agency10100 Pioneer Blvd, Suite 200Santa Fe Springs, CA 90670(562) 347-1648Email: [email protected]

Michael Ciraolo, RN MSPrincipalCiraolo Consulting, LLC1053 Talbot Ave.,Albany, CA 94706(510) 528-9495Email: [email protected]

Handling Instructions iii

mailto:[email protected]

mailto:[email protected]


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Handling Instructions iv


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CONTENTSPreface...................................................................................................................iAcronyms...............................................................................................................iHandling Instructions.........................................................................................iiiChapter 1: General Information..........................................................................1

Introduction.............................................................................................................1Confidentiality.........................................................................................................1Exercise Summary..................................................................................................1Target Capabilities..................................................................................................2Exercise Participants...............................................................................................3Exercise Implementation and Rules........................................................................4Site Access..............................................................................................................5Exercise Identification.............................................................................................5Logistics..................................................................................................................6Public Affairs...........................................................................................................6

Chapter 2: Exercise Scenario..............................................................................7Scenario.................................................................................................................. 7Safety......................................................................................................................7

Chapter 3: Controller Information and Guidance............................................10Exercise Controller Organization...........................................................................10Exercise Control....................................................................................................11Communications Plan............................................................................................12Controller Instructions...........................................................................................13Assessment, Review, and Analysis of Exercise.....................................................15Exercise Report.....................................................................................................16

Chapter 4: Evaluator Information and Guidance............................................17General Information..............................................................................................17Exercise Evaluation...............................................................................................17Evaluator Instructions and Guidelines...................................................................20Assessment, Review, and Analysis of Exercise.....................................................22Exercise Report.....................................................................................................23

Appendix A: Exercise Schedule.......................................................................24Appendix B: Exercise Site Maps And Assembly Information........................25Appendix C: Controller and Evaluator Assignments.....................................31

Contents v


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Contents vi


Full-Scale Exercise

CHAPTER 1: GENERAL INFORMATIONIntroduction

The Los Angeles County Disaster Healthcare Volunteers Full-Scale Exercise is designed to establish a learning environment for players to exercise Disaster Healthcare Volunteers deployment procedures and the overall management of volunteer health professionals at local healthcare facilities.

The Los Angeles County Disaster Healthcare Volunteers Full-Scale Exercise is sponsored by the Los Angeles County (LAC) Emergency Medical Services (EMS) Agency with funding from the United States Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response through a three-year Emergency System for the Advance Registration of Volunteer Health Professional (ESAR-VHP) supplemental grant. This Exercise Plan was produced with input, advice, and assistance from the response partners, local healthcare facilities, and the Exercise Design Team.

Confidentiality

The Los Angeles County Disaster Healthcare Volunteers Full-Scale Exercise is an unclassified exercise. Control of information is based on public sensitivity regarding the nature of the exercise rather than actual exercise content. Some exercise material is intended for the exclusive use of exercise planners, controllers, and evaluators, but players may view other materials that are deemed necessary to their performance. All exercise participants may view this Exercise Plan. The Controller and Evaluator Handbook is a restricted document that is intended for controllers and evaluators only.

All exercise participants should use appropriate guidelines to ensure proper control of information within their areas of expertise and protect this material in accordance with their current institutional directives.

Exercise Summary

General

The 2013 Los Angeles County Disaster Healthcare Volunteers Full-Scale Exercise is designed to establish a learning environment for players to exercise the deployment of Disaster Healthcare Volunteers to multiple hospitals and clinics throughout the county in response to an earthquake-based scenario.

Chapter 1: General Information 1


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Purpose

The purpose of this exercise is to test plans and procedures for deployment of Los Angeles Disaster Healthcare Volunteers to local area hospitals and clinics.

Scope

The scope of play for the 2013 Los Angeles County Disaster Healthcare Volunteers Full-Scale Exercise includes county Mobilization Centers located at each of the six hospitals which will receive Disaster Healthcare Volunteers, as well as those six hospitals and several clinics. Activities will include the county’s processes for calling up volunteers, processing them through Mobilization Centers, and later demobilizing them. Additional activities will include healthcare facilities’ intake, briefing, and assignment processes.

Assumptions

Assumptions constitute the implied factual foundation for the exercise and are assumed to be present before the exercise starts. The following general assumptions apply to this exercise:

The exercise will be conducted in a no-fault learning environment wherein systems and processes, not individuals, will be evaluated.

Exercise simulation will be realistic and plausible and will contain sufficient detail from which players can respond.

Exercise players will react to information and situations as they are presented, in the same manner as if the simulated incident were real.

Constructs and Constraints

Constructs are exercise devices designed to enhance or improve exercise realism. Constraints are exercise limitations that may detract from exercise realism. Constraints may be the inadvertent result of a faulty construct, or they may pertain to financial and staffing issues. Although there are constructs and constraints (also known as exercise artificialities) for any exercise, the Exercise Design Team recognizes and accepts the following as necessary:

Exercise communication and coordination will be limited to participating exercise venues and the Simulation Cell.

Only communication methods listed in the Communications Directory will be available for players to use during the exercise.

Participating organizations/jurisdictions may need to balance exercise play with real-world emergencies. Real-world emergencies will take priority.

Target Capabilities

This exercise tests Capability 15: Volunteer Management, in both the U.S. Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response’s Healthcare Preparedness Capabilities: National Guidance for Healthcare System Preparedness and the U.S. Department of Health and Human Services Centers for Disease Control and Prevention’s Preparedness and Response’s Public Health Preparedness Capabilities: National



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Standards for State and Local Planning. The four functions of these target capabilities are identified in the table below.Functions Mapping for Capability 15: Volunteer Management

Healthcare Preparedness Capabilities: National Guidance for Healthcare System Preparedness

Public Health Preparedness Capabilities: National Standards for State and Local Planning

Function 1: Participate with volunteer planning processes to determine the need for volunteers in healthcare organizations

Function 1: Coordinate volunteers

Function 2: Volunteer notification for healthcare response needs

Function 2: Notify volunteers

Function 3: Organization and assignment of volunteers

Function 3: Organize, assemble, and dispatch volunteers

Function 4: Coordinate the demobilization of volunteers

Function 4: Demobilize volunteers

Source: U.S. Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response

Source: U.S. Department of Health and Human Services Centers for Disease Control and Prevention

Exercise Participants

The term participant encompasses many groups, not just those playing in the exercise. Groups of participants involved in the exercise are:

Players. Players are organization/jurisdiction personnel who have an active role in responding to the simulated emergency and perform their regular roles and responsibilities during the exercise. Players initiate actions that will respond to and mitigate the simulated emergency.

Controllers. Controllers prepare the exercise site, plan and manage exercise play, and act in the roles of response individuals and agencies that are not playing in the exercise. Controllers direct the pace of exercise play and are typically members of the Exercise Planning Team. They provide key data to players and may prompt or initiate certain player actions to ensure exercise continuity.

Simulators. Simulators are control staff personnel who role play nonparticipating organizations or individuals. They most often operate out of the Simulation Cell but they may occasionally have face-to-face contact with players. Simulators function semi-independently under the supervision of Simulation Cell controllers, enacting roles (e.g., media reporters or next of kin) in accordance with instructions provided in the Master Scenario Events List. All simulators are ultimately accountable to the Exercise Director and Senior Controller.



Full-Scale Exercise

Evaluators. Evaluators provide feedback on a designated functional area of the exercise. They are chosen based on their expertise in the functional area(s) they have been assigned to review during the exercise and their familiarity with emergency response procedures. Evaluators assess and document participant’s performance against established emergency plans and exercise evaluation criteria, in accordance with Homeland Security Exercise and Evaluation Program standards. Evaluators are typically planning committee members or agencies/organizations participating in the exercise.

Disaster Healthcare Volunteers. Disaster Healthcare Volunteers are volunteer healthcare and supporting professionals who have previously registered with the County’s Disaster Healthcare Volunteers system.

Actors. Actors are volunteers who simulate specific circumstances or conditions during exercise play. In this exercise, they are likely to be Disaster Healthcare Volunteers who are coached in specific roles prior to the exercise.

Observers. Observers visit or view selected segments of the exercise. Observers do not play in the exercise, nor do they perform any control or evaluation functions. This exercise offers Observers from non-playing local healthcare facilities to better understand the management of Disaster Healthcare Volunteers in a clinic or hospital environment. Dignitaries and public officials are also observers, but they frequently are grouped separately and will be assigned to a dedicated team of exercise controllers.

Media Personnel. Some media personnel may be present as observers, pending approval by County EMS Agency. A dedicated group of exercise controllers will be assigned to manage media personnel.

Support Staff. The exercise support staff includes individuals who are assigned administrative and logistical support tasks during the exercise (e.g., registration, catering).

Exercise Implementation and Rules

Exercise play will be spread over the five-day work week of April 22-26, 2013, with functional simulation leading up to Exercise Day on Friday April 26, 2013. Play will commence with the simulation of a resource request from each playing healthcare facility to the county. During the week, players will engage in simulated and real-world activities to plan and coordinate the deployment of Disaster Healthcare Volunteers, including the notification, rostering, and confirmation of which volunteers will report to which facilities. Play culminates on Friday, April 26, 2013, the full-scale “Exercise Day”, when volunteers will deploy to local area healthcare facilities. Exercise play is scheduled to end at 1800 Friday April 26, 2013, or when the Exercise Director and Senior Controller determine that the exercise objectives have been met at each venue.

Limited controller and evaluator activities will accompany exercise activities prior to Friday, April 26, 2013. With the limited exceptions of the controller and evaluators assigned to the EMS Agency DOC, all controller and evaluator activities will occur on Friday, April 26, 2013.

The following general rules govern exercise play: Real-world emergency actions take priority over exercise actions.



Full-Scale Exercise

Exercise participants will comply with real-world response procedures, unless otherwise directed by the control staff.

All communications (e.g., written, radio, telephone) during the exercise will begin and end with the statement “This is an exercise.”

Exercise participants who place telephone calls or initiate radio communication with the Simulation Cell must identify the organization, agency, office, or individual with whom they wish to speak.

Site Access

Security

Exercise play will occur at Mobilization Centers and the healthcare facilities to which DHVs are deployed. The Mobilization Centers will be co-located at each of the six playing hospitals. Site access is essentially unrestricted, as access to healthcare facilities is unrestricted. Access of DHVs to each healthcare facility, as the volunteers report for deployment duty, will be regulated through the Mobilization Center and healthcare facility intake process.

Observer and Evaluator Coordination

Observers and Evaluators will identify themselves to the Mobilization Center managers and incident commanders at each healthcare facility.

Exercise Identification

Identification hats and/or badges will be issued to the exercise staff. All exercise personnel and observers will be identified by uniforms or identification hats and/or badges distributed by the exercise staff. Table 1.1 lists these identification items.

Table 1.1. Exercise Identification (delete if not applicable)

Group Hat Color Badge ColorExercise Director White WhiteExercise Staff Black BlackControllers Green GreenEvaluators Red RedActors None OrangeSupport Staff None YellowObservers None BlueMedia Personnel None PinkPlayers, Uniformed None NonePlayers, Civilian Clothes None Gray



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Logistics

Parking and Transportation

Controllers and evaluators will be responsible for transportation to their respective exercise locations. Parking will be available at the exercise sites.

Lunch

Food and refreshments will be provided for all exercise participants.

Restroom Facilities

Restroom facilities will be located onsite at each healthcare facility.

Recording and Documenting Activities

Participating media camera crews and still photographers may be operating throughout the exercise. All participants should be advised of their presence and instructed to cooperate fully.

Cleanup and Restoration

After the exercise, controllers, evaluators, and players will begin cleanup operations to restore the area to pre-exercise conditions. All agencies will assist in these efforts.

Public Affairs

CONTENT TO COME



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CHAPTER 2: EXERCISE SCENARIO Scenario

This exercise is driven by a major earthquake affecting the Los Angeles basin. The earthquake, and its associated aftershocks, produce extensive damage and cause hospitals to consider requesting Disaster Healthcare Volunteer resources. Six area hospitals request volunteers who are expected to report for five or more days with each hospital providing lodging and meals. Key scenario facts are as follows:

1,800 fatalities 53,000 injured 300,000 buildings damaged 1,600 fires Lifelines disrupted (water, gas, electric) Communication systems overloaded

Six hospitals and several clinics request assistance for five (5) days with lodging and meals to be provided by hospital and clinics.

Safety

General

Exercise participant safety takes priority over exercise events. Although participants involved in the Los Angeles County Disaster Healthcare Volunteers Full-Scale Exercise come from various agencies and entities, they share the basic responsibility for ensuring a safe environment for all personnel involved in the exercise. Due to the inherent danger associated with any emergency response activities, professional health and safety ethics should guide all participants to operate in their assigned roles in the safest manner possible. The following general requirements apply to the exercise:

A Safety Officer will be designated and assigned responsibility for participant safety.

All controllers, evaluators, and exercise staff members will serve as safety observers while exercise activities are underway. Any safety concerns must be immediately reported to the Safety Officer.

Each participating healthcare facility will designate a Safety Officer through its incident command structure, and each facility will be responsible for local site safety.

Participants will be responsible for their personal safety and the safety of others participating in the exercise. All persons associated with the exercise must stop play if, in their opinion, a real safety problem exists. After the problem is assessed exercise play will be resumed by the Exercise Director or Senior Controller.

All organizations/agencies will comply with their respective environmental, health, and safety plans and procedures, as well as appropriate Federal, State, and local environmental health and safety regulations.

Chapter 2: Exercise Scenario 7


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Accident Reporting

For an emergency that requires assistance, use the phrase “real-world emergency.” The following procedures should be used in case of a real emergency during the exercise:

Anyone observing a participant who is seriously ill or injured will first advise the nearest controller and then, if possible, render aid commensurate with their training.

Any controller informed of a real emergency will initiate the “real-world emergency” broadcast using the process established for the exercise to provide the following information to the Senior Controller and Exercise Director:

Venue and function Location within the venue and function Condition Requirements

The Simulation Cell will be notified as soon as possible if a real emergency occurs.

If the nature of the emergency requires suspension of the exercise at the venue or function, all exercise activities at that facility will immediately cease. Exercise play may resume at that venue or function after the situation has been addressed.

Exercise play at other venues and functions should not cease if one venue or function has declared a real-world emergency, unless they rely on the affected venue.

If a real emergency affects the entire exercise, the exercise may be suspended or terminated at the discretion of the Exercise Director and Senior Controller. Notification will be made from the Simulation Cell.

Alcohol

Alcohol consumption will not be allowed during the exercise. If a controller detects the presence of alcohol on a participant or if a participant is believed to be under the influence of alcohol, the controller will remove the participant from the exercise and report the participant to his or her supervisor for appropriate follow-on action.

Prescription Medication

Participants who take prescription medication must report this information through their chain of command. Supervisors should inform the Safety Controller of the decision to allow these individuals to participate.

Illegal Drugs

Use of illegal drugs is strictly prohibited. If a controller detects the presence of drugs on a participant or if a participant is believed to be under the influence of illegal drugs, the controller will remove the participant from the exercise and report the participant to his or her supervisor for appropriate follow-on action.

Chapter 2: Exercise Scenario 8


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CHAPTER 3: CONTROLLER INFORMATION AND GUIDANCE

Exercise Controller Organization

Controllers, evaluators, and personnel essential to the exercise are collectively referred to as the exercise staff organization. The exercise staff organization, current at the publication of this document, is shown in Figure 3.1. Control of the exercise will be established through an exercise controller organization. This organization will control all exercise activities at all exercise locations.

Chapter 3: Controller Information 9and Guidance


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Figure 3.1. Exercise Staff Organization

Exercise Control

Exercise Start, Suspension, and Termination Instructions

The 2013 Los Angeles County Disaster Healthcare Volunteers Full-Scale Exercise will be conducted on April 26, 2013, with preliminary activities occurring during the week leading up to exercise day. The Controller and Evaluator Briefing will occur Monday, April 22. The responsibilities detailed below apply to Exercise Day, April 26, 2013. The exercise will begin at


Exercise Director

Safety Controller

Lead Controller

On-site at Hospitals and Mob Centers

California Hospital

Medical Center

Henry Mayo Newhall

Memorial Hospital

Providence Little Company

of Mary San Pedro

Presbyterian Intercommunity

Hospital

Northridge Hospital

UCLA Medical Center

Clinics

Clinic 1

Clinic 2

Clinic 3

Clinic 4

Sim Cell Lead Evaluator

On-site at Hospitals and Mob Centers

California Hospital

Medical Center

Henry Mayo Newhall

Memorial Hospital

Providence Little Company

of Mary San Pedro

Presbyterian Intercommunity

Hospital

Northridge Hospital

UCLA Medical Center

Clinics

Clinic 1

Clinic 2

Clinic 3

Clinic 4

DOC?

Logistics

Mobilization Centers

Transport?

PIO


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0800 and end at 1600. Exercise play is scheduled for eight hours or until the Exercise Director and Senior Controller determine that the exercise objectives have been met at each venue. The Exercise Director will announce exercise suspension or termination and will instruct participants to stop in place safely.

If an actual emergency occurs, the exercise may be suspended or terminated at the discretion of the Exercise Director or lead controllers at individual healthcare facilities, depending on the nature of the incident. The designated phrase in case of a medical or other emergency is “real-world emergency.” The Exercise Director will announce resumption of the exercise.

Controller Responsibilities

Table 3.1 details specific controller responsibilities.

Table 3.1. Controller And Command Staff Responsibilities

Controller ResponsibilitiesExercise Director Oversees all exercise functions Oversees and remains in contact with controllers and evaluators Oversees setup and cleanup of exercise and positioning of controllers and evaluators Serves as safety officer for his or her site

Public Information Officer Provides escort for observers Provides narration and explanation during exercise events, as needed Performs pre-exercise and post exercise public affairs duties May act as media briefer and escort at exercise site Oversees implementation of the Exercise Media Plan Serves as safety officer for his or her site/physical location

Lead Controllers (at each healthcare facility) (Venue Controllers) Issues exercise materials to players Monitors exercise timeline Provides input to players (i.e., injects) as described in MASTER SCENARIO EVENTS LIST Serves as safety officer for his or her site in conjunction with healthcare facility safety officers

Simulation Cell Controller Issues exercise materials to players Monitors exercise timeline Provides input to players (i.e., injects) as described in MASTER SCENARIO EVENTS LIST

For specific controller assignments, please see Appendix C.

Controller Package

Controllers and evaluators will receive their exercise materials at the Controller and Evaluator Briefing, or electronically prior to the briefing. This briefing will occur at a teleconference Monday April 22, 2013, at 1000. The controller package will consist of the Exercise Plan,



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Controller/Evaluator Handbook, activity logs, badges, and other exercise tools as necessary. Controllers may reorganize the material so information that is critical to their specific assignment is readily accessible. Controllers must bring their packages to the exercise. Controllers may also bring additional professional materials specific to their assigned exercise activities.

Scenario Tools

The Master Scenario Events List (separate document) outlines benchmarks and injects that drive exercise play and provides realistic input to exercise players. It provides information that is expected to emanate from simulated organizations (e.g., nonparticipating organizations, agencies, and individuals that usually would respond to a situation). The Master Scenario Events List consists of the following two parts:

Timeline. This is a list of key exercise events, including scheduled injects and expected player actions. The timeline is used to track exercise events relative to desired response activities.

Injects. An individual event inject is a detailed description of each exercise event. The inject includes the following pieces of information: inject time, intended recipient, responsible controller, inject type, a detailed description of the event, and the expected player action.

Communications Plan

All spoken and written communication will start and end with the statement “THIS IS AN EXERCISE.”

Controller Communications

The principal method of communication for controllers during the exercise will be [means of communication, i.e. radio (channels), telephone]. A list of key telephone and fax numbers and radio call signs will be available in a Communications Directory before the exercise starts. Controller communications will link control personnel at all play areas and will remain separate from player communications. In no case will controller communications interfere with or override player communications.

Player Communications

Players will use routine, in-place organization/jurisdiction communication systems. A key element of this exercise is the communication with Disaster Healthcare Volunteers using the DHV system, and appropriate communications will occur via that system prior to Exercise Day. The need to maintain a capability for a real-world response may preclude the use of certain communication channels or systems that usually would be available for an actual emergency incident. In no instance will exercise communications interfere with real-world emergency communications. Each venue will coordinate its own internal communication networks and channels.



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Controller Instructions

Before the Exercise

Review appropriate emergency plans, procedures, and protocols. In particular, review the Los Angeles County DHV Deployment Operations Manual, (included as part of the C/E package as a separate document).

Review appropriate exercise package materials, including the objectives, scenario, injects or implementers, safety and security plans, and evaluator instructions.

Attend required briefings.

Review the exercise objectives and controller package for your area of responsibility.

Report to the exercise check-in location at the time designated in the exercise schedule and meet with the exercise staff assigned to your location.

Be at the appropriate location at least 15 minutes before the exercise starts. If you are not assigned to a specific site, be in place to meet participants at least 15 minutes before the exercise starts.

Obtain or locate necessary communications equipment, and test it to ensure that you can communicate with other controllers and the Exercise Director.

During the Exercise

Wear controller identification items (i.e., hats and/or badges). Controller hats and/or badges will be issued at the Controller and Evaluator Briefing on [Date].

Avoid personal conversations with exercise players.

If you have been given injects, deliver them to appropriate players at the time indicated in the Master Scenario Events List (or as directed by the Exercise Director). Note: If the information depends on some action to be taken by the player, do not deliver the inject until the player has earned the information by successfully accomplishing the required action.

When you deliver an inject, notify the Exercise Director and note the time you delivered the inject and player actions.

Receive and record exercise information from players that would be directed to nonparticipating organizations.

Record all significant events you observe.

Observe and record exercise artificialities that interfere with exercise realism. If an exercise artificiality interferes with exercise play, report it to the Exercise Director.



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Begin and end all exercise communications with the statement “This is an exercise.” This precaution is taken so that anyone who overhears the conversation will not inadvertently mistake exercise play for an actual emergency.

Do not prompt players regarding what a specific response should be, unless an inject directs you to do so. Clarify information as long as doing so does not provide coaching.

Do not give information to players about scenario event progress or other participants’ methods of problem resolution. Players are expected to obtain information through their own resources.

The Exercise Director will notify you when the exercise has been suspended or terminated. The exercise will be terminated when the Exercise Director determines that all exercise objectives have been met or enough time has elapsed for exercise objectives to have been demonstrated.

Direct media inquires to the Public Information Officer.

After the Exercise

Distribute copies of Participant Feedback Forms and pertinent documentation. After participants have completed these forms, collect the forms and give them to the Exercise Director. Coordinate this task with the evaluator in your area.

All controllers are expected to conduct two Hot Washes at their respective venues. Both Hot Washes represent opportunities to quickly gather input from participants. The first Hot Wash (“DHV Hot Wash”) debriefs Disaster Healthcare Volunteers at their venue and, in coordination with the venue evaluator, take notes on findings identified by exercise players. (Hot Wash instructions and questions appear in the Exercise Evaluation Guide.) Before the Hot Wash, do not discuss specific issues or problems with exercise players. At exercise termination, summarize your notes and prepare for the Controller and Evaluator Debriefing. Have your summary ready for the Exercise Director. The DHV Hot Wash should take no longer than 30 minutes. The content of the DHV Hot Wash will be of high interest to healthcare facility staff and incident command staff leads, so this hot wash should occur with those staff in attendance (or even playing a facilitation role with the lead controller). Evaluators will take notes during the Hot Wash.

The second Hot Wash (“Staff Hot Wash”) includes Mobilization Center staff, healthcare facility staff, and evaluators at their assigned location. This meeting is primarily geared toward non-volunteer participants and their supervisors. The Hot Wash is an opportunity for staff to express their opinions about the exercise and their own performance while the events are still fresh in their minds. The Hot Wash should not last more than 30 minutes. (Hot Wash instructions and questions appear in the Exercise Evaluation Guide.) Evaluators should take notes during the Hot Wash and include these observations in their analysis.



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Assessment, Review, and Analysis of Exercise

Hot Washes

Controllers will lead two Hot Washes, immediately before and after the end of the exercise, for Disaster Healthcare Volunteers and staff, respectively. These are described in the preceding section. Each Hot Wash should not last more than 30 minutes. Evaluators should take notes during the Hot Wash and include these observations in their analysis.

Controller and Evaluator Debriefing

Controllers, evaluators, and selected exercise participants will attend a facilitated Controller and Evaluator Debriefing via teleconference on May 6, 2013 from 1:00 p.m. to 3:00p.m.. The conference call number is ###-###-####, code ######. During this debriefing, controllers and evaluators will discuss their observations of the exercise in an open environment to clarify actions taken during the exercise. Evaluators should take this opportunity to complete their Exercise Evaluation Guides for submission to the Lead Evaluator and begin the analysis process outlining issues to be included in the After Action Report.

Evaluations

All evaluations are preliminary and may be revised based on information from other controllers, evaluators, or players. If a controller or evaluator did not observe specific aspects of an organization’s performance, exercise players may be asked to comment. The evaluation should indicate that this information was provided by players.

Participant Feedback Forms

Participant Feedback Forms will be used to document participant information about the exercise. The controller will distribute these forms during the Hot Wash. The forms will be collected afterward, along with attendance or participation rosters. Controllers should emphasize to players that these forms provide the opportunity for them to comment candidly on emergency response activities and exercise effectiveness. Participant Feedback Forms can be found in the Exercise Plan and Exercise Evaluation Guide.

After Action Conference

The After Action Conference is a forum for organization/jurisdiction officials to hear the results of the evaluation analysis, validate findings and recommendations in the draft After Action Report, and begin development of the Improvement Plan. The After Action Conference will be held at [Location] on [Date], beginning at [Time].

Exercise Report

An exercise After Action Report/Improvement Plan will be prepared to document the evaluation of overall exercise performance. The After Action Report/Improvement Plan will include the



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exercise schedule, scenario, players’ activities, evaluations, issues, opportunities, and best practices. The After Action Report also will contain the following:

A brief summary, with introductory and general statements noting the exercise scope, purpose, objectives, players, and overall performance assessment

Assessments for each capability observed

Issues and recommendations suggested by controller, evaluator, and player comments

A draft After Action Report will be provided to participating organizations for comment before the After Action Conference is held.



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CHAPTER 4: EVALUATOR INFORMATION AND GUIDANCE

General Information

The goal of exercise evaluation is to validate strengths and identify improvement opportunities for the participating organization/jurisdiction(s). The overarching goals of this exercise are to:

Fully exercise the LAC Disaster Healthcare Volunteer (DHV) system using a scenario which deploys DHVs to local health care facilities, spanning the request for DHV assistance through DHV deployment to six area hospitals and several clinics, to release of volunteers.

Evaluate incident command infrastructure, coordination, and communication between the Los Angeles County Emergency Medical Services Departmental Operating Center (DOC) and playing hospitals/clinics.

Test the ESAR-VHP operational requirements and LAC DHV deployment process, from request for DHV assistance to release of volunteers.

Exercise the playing hospitals’ and clinics’ ability to request, receive, check credentials of, assign, orient, and release from duty DHVs.

Evaluate and refine the LAC Disaster Healthcare Volunteer Deployment Operations Manual and relevant training materials prior to rolling training out to all Los Angeles area hospitals.

Improve the ability of non-playing Los Angeles area hospital staff to validate credentials, check the health status of, and utilize, request, and receive DHVs by including evaluators and observers from non-playing hospitals.

This validation is accomplished by the following means:

Observing the event and collecting supporting data,

Analyzing the data to compare performance against expected outcomes, and

Determining what changes need to be made to procedures and key operational manuals.

The evaluation results will provide an opportunity to identify ways to build on strengths and improve capabilities. Because jurisdictions are testing new and emerging plans, skills, resources, and relationships in response to a changed homeland security environment, every exercise or event can be expected to result in multiple findings and recommendations for improvement.

Exercise Evaluation

This exercise will be evaluated using four principle methods and toolsets:

On-site evaluators using exercise evaluation guides tailored to their assignments/venues;

17


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Two Hot Washes of volunteers and staff at the end of the exercise, each conducted by the lead controller and recorded by the lead evaluator at each venue;

Participant evaluation forms, made widely available and collected at the end of the exercise; and,

An on-line survey of participating Disaster Healthcare Volunteers.

After Action Report and Improvement Plan

The After Action Report/Improvement Plan will be organized by exercise objectives and target audience. For each objective and subordinate activity, the Lead Evaluator will provide an assessment of how well the executing agency or personnel performed, including best practices and areas for improvement. Specific issues and observations will be identified for each capability and activity, and recommendations for resolving issues will be provided, based on input from controllers, evaluators, and exercise planners.

Exercise Evaluation Guides

The content for the After Action Report/Improvement Plan will be drawn from the Exercise Evaluation Guides. Each evaluator will be provided with an Exercise Evaluation Guide that will give specific guidance regarding what data to collect during the exercise, how to record it, and how to analyze it before submission to the Lead Evaluator. All evaluator submissions will be compiled into the first working draft of the After Action Report/Improvement Plan. Each Exercise Evaluation Guide provides a list of subordinate activities and tasks that players are expected to perform during the exercise to demonstrate the specified capability.

Evaluator Responsibilities

Evaluators document player performance by using Exercise Evaluation Guides and information obtained during the Hot Wash. The evaluations, documentation, Hot Wash, and debriefing discussion(s) provide important information that substantiates exercise conduct and performance. The After Action Report/Improvement Plan will summarize the overall results of the exercise and provide a comprehensive assessment of capabilities and plans that were demonstrated. Specific evaluator activities include the following tasks.

Before the Exercise

Review appropriate plans, procedures, and protocols, particularly the Los Angeles County Deployment Operations Manual.

Attend required evaluator training and other briefings.

Review appropriate exercise materials, including the exercise schedule and evaluator instructions.

Review the Exercise Evaluation Guides and other supporting materials for your area of responsibility.

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Report to the exercise check-in location at the time designated in the exercise schedule, and meet with the exercise staff.

Be at the appropriate location at least 15 minutes before the exercise starts. If you are not assigned to a specific site, be in place to deploy as necessary at least 15 minutes before the exercise starts.

Obtain or locate necessary communications equipment, and test it to ensure that you can communicate with other evaluators and the Exercise Director.

During the Exercise

Wear evaluator identification items (i.e., hat and badge). Evaluator hats and badges will be issued at the Controller and Evaluator Briefing on [Date].

Avoid personal conversations with exercise players.

Do not prompt players with specific responses or interfere with player performance in any way.

Your primary duty is to document player performance and capture improvement recommendations. After the exercise, that information will be used to determine whether the exercised capabilities and plans were effectively implemented or demonstrated and to identify strengths and improvement items.

After the Exercise

Participate in the two Hot Wash (DHV and staff), and take notes on findings identified by participants. Before the Hot Wash, do not discuss specific issues or problems with participants. After the Hot Wash, summarize your notes and prepare for the Controller and Evaluator Debriefing. Have your summary ready for the Lead Evaluator.

Documenting the Event

Evaluators must keep accurate records and notes because these records will form the basis for evaluation of player performance. Evaluation is valuable because it provides constructive feedback (positive and negative) to improve the effectiveness of an organization’s response to emergencies. Accurate and detailed documentation is critical to facilitate a full record of all the events in an exercise and to understand player actions.

Evaluators will document the exercise by using the appropriate Exercise Evaluation Guides for actions in their area. The Exercise Evaluation Guides are provided separately as part of the evaluator package. Evaluators should document key activities and those activities that require a timely response for later evaluation.

Evaluators should review their forms and notes immediately after the exercise to ensure an accurate reconstruction of events and activities for discussion at the Controller and Evaluator Debriefing. Evaluation materials, including notes and forms, become part of the exercise

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documentation. Checklists and evaluation forms must be completed as thoroughly and accurately as possible.

Evaluator Package

Evaluators will receive their materials for review at or before the Controller and Evaluator Briefing. Materials may be distributed electronically. The evaluator package contains this Controller/Evaluator Handbook, the Exercise Plan, Exercise Evaluation Guides, and other items as necessary. Evaluators should bring the package to the exercise. They may reorganize the material so information that is critical to their specific assignment is readily accessible. Evaluators may bring additional professional materials specific to their assigned activities.

Controller and Evaluator Briefing

This briefing will occur via teleconference on Monday April 22, 2013, at 1000. This briefing will assist in preparing evaluators for performance of their functions and will include a detailed review of event activities. This briefing is the time for evaluators to ask questions and ensure that they completely understand their roles and responsibilities. Evaluator questions should be addressed and information clarified so that controllers and evaluators feel confident that they can perform their assignments effectively.

Evaluator Instructions and Guidelines

General

Evaluators should avoid personal conversations with players. Evaluators should not give information to players about event progress or other participants’ methods of problem resolution. Players are expected to obtain information through their own resources.

Evaluation Basics

Remember, your experience and expertise are your most important tools. Experienced evaluators use the following techniques for effective evaluation:

Use Exercise Evaluation Guides to confirm that evaluation objectives are met.

Take detailed notes concerning significant activities observed, including the time they were initiated or completed.

When more than one evaluator is assigned to an area, divide responsibilities to ensure detailed evaluation of player activities.

Stay in proximity to player decision makers.

Focus on critical tasks, as specified in the Exercise Evaluation Guides.

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Recording Important Events

Although numerous events may occur simultaneously, evaluators do not need to record all the action. Knowing which events are important helps evaluators eliminate superfluous data and provide the kind of information that is most useful for evaluation. Important events that evaluators should record include the following:

Initiating scenario events

Actions of players in relation to the event

Key decisions made by managers and the times these decisions are made

Deviations from plans and implementation procedures

Times when significant actions are completed

What to Look For

Individuals preparing the exercise report will analyze the results provided by all evaluators to achieve an integrated evaluation of exercised plans and capabilities. Their analysis will focus on the timing of key events, decisions made, and actions taken. To assist in that analysis, you should focus on the following areas:

Timeliness in actions

Communication among players and organizations

Direction and coordination of field activities

Monitoring and assessing events

Command and control

Creative player problem-solving, potentially beyond current plans and implementation procedures

Plans or procedures that affect player efforts

Placement and Monitoring

Evaluators should be located so they can observe player actions and hear conversations without interfering with those activities. In certain conditions, more than one evaluator may be needed in a particular setting or area.

For exercise site maps highlighting key locations, please see Appendix B.

For specific evaluator assignments please see Appendix C.

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Post Exercise Activities

The Lead Evaluator will notify you when evaluation of the event has been suspended or terminated. The evaluation will be terminated when the Exercise Director determines that all exercise objectives have been met or enough time has elapsed for exercise objectives to have been demonstrated.

All evaluators are expected to participate in both Hot Washes and take notes on findings identified by players. Before the Hot Wash, evaluators should not discuss specific issues or problems with participants. After the Hot Wash, summarize your notes and prepare for the Controller and Evaluator Debriefing. Have your summary ready for the Lead Evaluator.

Assessment, Review, and Analysis of Exercise

Hot Washes

Controllers will lead two Hot Washes, immediately before and after the end of the exercise, for Disaster Healthcare Volunteers and staff, respectively. These are described in the preceding section. Each Hot Wash should not last more than 30 minutes. Evaluators should take notes during the Hot Wash and include these observations in their analysis.

Controller and Evaluator Debriefing

Controllers, evaluators, and selected exercise participants will attend a facilitated Controller and Evaluator Debriefing via teleconference on May 6, 2013 from 1:00 p.m. to 3:00p.m.. The conference call number is ###-###-####, code ######. During this debriefing, controllers and evaluators will discuss their observations of the exercise in an open environment to clarify actions taken during the exercise. Evaluators should take this opportunity to complete their Exercise Evaluation Guides for submission to the Lead Evaluator and begin the analysis process outlining issues to be included in the After Action Report.

Evaluations

All evaluations are preliminary and may be revised based on information from other controllers, evaluators, or players. If a controller or evaluator did not observe specific aspects of an organization’s performance, exercise players may be asked to comment. The evaluation should indicate that this information was provided by players.

Participant Feedback Forms

Participant Feedback Forms will be used to document participant information about the exercise. The controller will distribute these forms during the Hot Wash. The forms will be collected afterward, along with attendance or participation rosters. Controllers should emphasize to players that these forms provide the opportunity for them to comment candidly on emergency response activities and exercise effectiveness. Participant Feedback Forms can be found in the Exercise Plan and Exercise Evaluation Guide.

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After Action Conference

The After Action Conference is a forum for organization/jurisdiction officials to hear the results of the evaluation analysis, validate findings and recommendations in the draft After Action Report, and begin development of the Improvement Plan. The After Action Conference will be held at [Location] on [Date], beginning at [Time].

Exercise Report

An exercise After Action Report/Improvement Plan will be prepared to document the evaluation of overall exercise performance. The After Action Report/Improvement Plan will include the exercise schedule, scenario, players’ activities, evaluations, issues, opportunities, and best practices. The After Action Report also will contain the following:

A brief summary, with introductory and general statements noting the exercise scope, purpose, objectives, players, and overall performance assessment

Assessments for each capability observed

Issues and recommendations suggested by controller, evaluator, and player comments

A draft After Action Report will be provided to participating organizations for comment before the After Action Conference is held.

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APPENDIX A: EXERCISE SCHEDULETime Personnel Activity

Monday, April 22, 20131000 Controllers, evaluators, and Exercise

Planning Team membersController and Evaluator Briefing

1100 Limited group of controllers and evaluatorsHealthcare facility disaster plannersDOC staff

Start Exercise Healthcare facilities submit

resource requests Logistics and coordinating

discussions begin between DOC and healthcare facility staff

Tuesday, April 23, 2013 – Thursday, April 25, 2013Ad hoc/on-going Limited group of controllers and

evaluatorsHealthcare facility disaster plannersDHVs (receiving notifications)DOC staff

Notification, rostering of DHVs

Resolution of logistics and coordinating discussions between DOC and HCF staff

Friday, April 26, 20130730 Controllers and evaluators Check-in0745 Controllers and evaluators Communications check0800 All Start of exercise0800 Mobilization Center teams Mobilization Center set-up0900 DHVs and Mobilization Center

teamsReport to Mobilization Centers at six hospitals and commence check in

1000 DHVs and healthcare facility personnel

DHVs check in/credentialing at assigned healthcare facility

1100 – 1500 DHVs and healthcare facility personnel

DHVs at healthcare facilities – individual facility programs

1500 – 1530 DHVs and healthcare facility personnelEvaluators

Hotwash for DHVs

1530 – 1600 DHVs and Mobilization Center teams

Check-out and demobilization of DHVs

1600 All End of exerciseImmediately after the exercise

Participants, controllers, and evaluators

Hot Wash

May 6, 20121300 - 1500 Controllers, evaluators, and Exercise

Planning Team membersController and Evaluator Debriefing - teleconference

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APPENDIX B: EXERCISE SITE MAPS AND ASSEMBLY INFORMATION

Figure B.1 California Hospital Medical CenterCalifornia Hospital Medical Center1401 S. Grand Ave., Los Angeles

Parking for the public is conveniently located on the hospital campus at 15th street. To access the parking lot:

From Grand Ave (one way south bound only) - go south on Grand, make a right on Venice, go north on Hope, make a right into 15th street.

From Hope Street (if you are south bound) - go south on Hope, make a left into 15th street.

From Hope Street (if you are northbound from Venice Blvd.) - go about 500 yards north on Hope, make right into 15th street

Mobilization Center and assemply point for Controllers and Evaluators: Keck Hall located in the Leavey Hall building. When you enter the building go straight back to the end of the hallway.

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Figure B.2 Henry Mayo Newhall Memorial HospitalContent to come

[Insert map]

Figure B.3 Northridge HospitalContent to come

[Insert map]

Figure B.4 Presbyterian Intercommunity HospitalContent to come

[Insert map]

Figure B.5 Providence Little Company of Mary San PedroContent to come

[Insert map]

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Figure B.6 UCLA Santa Monica

1250 16th St., Santa Monica, CA 90404Hospital information: (424) 259-6000

Mobilization Center and assemply point for Controllers and Evaluators: Conference Room 3 (G-370) in the Central Wing.Driving Directions

From the 10 Freeway WestExit at Cloverfield Boulevard (north) to Santa Monica Boulevard. Turn left (west) on Santa Monica Boulevard. Turn

right (north) on 16th Street to 1250 16th Street. Valet parking is available at our main entrance, and parking garages are located on 15th and 16th Streets.

From the 405 Freeway (San Diego Freeway)Connect with the 10 Freeway West and follow the directions above or exit Wilshire Boulevard West (from the San

Fernando Valley), merge onto Wilshire Boulevard. Turn left (south) on 16th Street to 1250 16th Street. Valet parking is available at our main entrance, and parking garages are located on 15th and 16th Streets.

Parking

Parking is in short supply throughout Santa Monica, including the area near UCLA Medical Center, Santa Monica.

Valet Service -- 1250 16th Street; Weekdays on a 24-hour basis. Park here and we will validate.

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Figure B.7 [Map Title][Insert map]

Figure B.8 [Map Title][Insert map]

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APPENDIX C: CONTROLLER AND EVALUATOR ASSIGNMENTS

Position Assigned Personnel Cell Phone NumberExercise Director

Controller Lead

Evaluator Lead

Logistics Lead

Safety Controller

Sim Cell Lead (?)

Location / Venue

Lead Controller

Cell phone number

Lead Evaluator

Cell phone number

Additional Evaluators

Cell phone numbers

California Hospital Medical Center

Henry Mayo Newhall Memorial Hospital

Providence Little Company of Mary San Pedro

Presbyterian Intercommunity Hospital

Northridge Hospital

UCLA Medical Center

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Location / Venue

Lead Controller

Cell phone number

Lead Evaluator

Cell phone number

Additional Evaluators

Cell phone numbers

Venice Family Clinic

South Bay

American Indian Clinic

Eisner Pediatric Clinic

EMS DOC

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2011 controller and evaluator handbook - disaster ...dp.ccalac.org/policies/planning policies...

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