Public Health Emergency Preparedness

Chapter 5. Foundation

This section provides an overview of the Foundation phase for a hospital preparedness exercise in the following sections:

• Overview: Foundation.
• Developing a Support Base.
• Forming an Exercise Planning Team.
• Conducting Planning Conferences.
• Creating a Timeline.
• Checklist: Foundation.
• Useful Resources and Tools.

Overview: Foundation

According to HSEEP, the Foundation phase involves laying down the groundwork for an exercise. It involves conducting the following steps:

• Developing a support base.
• Forming an exercise planning team.
• Creating a timeline of key milestones.
• Setting up planning conferences.

Developing a Support Base

Developing a Support Base for a hospital preparedness exercise program involves having the buy-in of key hospital emergency preparedness stakeholders. This may be done by means of an emergency management committee that includes senior management personnel.

Examples of Key Stakeholders

The following are groups that may be important to include in discussions concerning hospital preparedness exercises and essential in forming a support base for your exercise program:

• Hospital Senior Management.
• Hospital Facilities Management.
• Key Hospital Departments (emergency department, inpatient/outpatient departments, radiology, diagnostic laboratories, and other support services).
• Local Stakeholders (e.g., Police, Fire, etc.)
• Local Emergency Management Office.

Key Benefits of Having a Support Base

Having executive-level buy-in is crucial in creating and maintaining a strong exercise program. Several benefits of having executive level support are:

• Creates alignment with strategic and organizational goals.
• Helps in receiving continuous or additional funding support.
• Helps with increasing exercise staffing and/or staff participation.
• Develops community partnerships.
• Develops partnerships with other health care organizations.
• Improves hospital operations.

Tip: In order to receive funding and other support for exercises from key hospital executives, it may be useful to point out exercise requirements of various accreditation bodies, Federal agencies, State laws or licensures. Showing key executives the HVA may also be useful to demonstrate the potential emergencies faced by their hospitals.

Forming an Exercise Planning Team

Forming an exercise planning team involves identifying individuals to participate in the exercise planning process. These individuals may come from a subcommittee of the emergency management committee.

Key Factors to Consider When Forming an Exercise Planning Team

Factors to consider when forming a planning team are:

• Time requirements.
• Duration of exercise planning.
• Supervisor notification.
• Exercise scale.
• Financial cost of the exercise (e.g. compensation/overtime for staff, supplies).
• Roles needed for exercise.
• Experience and background needed for exercise planning.

Assigning Preliminary Roles

After planning team members have been identified, preliminary roles can be assigned. This helps exercise planning team leaders in preparing for the exercise planning meetings. According to HSEEP, the suggested roles for an exercise planning team and their respective duties are:

1. Exercise Planning Team Leader: Coordinates exercise planning process.
2. Safety Manager: Exercise safety.
3. Operations Manager: Exercise location, organizations involved, resources needed.
4. Planning Manager: exercise documentation, exercise evaluation.
5. Logistics Manager: Actors and props, volunteers, communications.
6. Administration/Finance Manager: Compliance with regulations and standards, budgeting.

Some hospitals may choose to combine or divide these roles, based on available staff, or they may choose different titles for these roles. Some exercises are also done in conjunction with the community (required by some accreditation organizations) and, if so, a representative from each of those agencies (i.e., police, fire, public health department.) should be involved in the exercise planning team.

Tip: In general, members of the exercise planning team should not also be exercise participants. For smaller organizations, this may be difficult to accomplish. If this is the case, it may be helpful to limit full knowledge of the exercise details to a handful of "trusted agents."

Creating a Timeline

According to HSEEP, an exercise planning team is responsible for creating a timeline of meeting dates and milestones that are to be completed prior to the Initial Planning Conference (IPC). The Exercise Planning Timeline can include items such as planning meetings, deadlines for completion of tasks/documents and after action conferences (AAC).

The timeline may be continuously modified and updated depending on the progression of the exercise.

Conducting Exercise Planning Conferences

After an exercise planning team has been formed, the next step is to conduct exercise planning conferences. Several conferences must be conducted according to HSEEP methodology. According to HSEEP, it is important for participants at planning conferences to refer to previous after action reports/improvement plans to effectively move through the exercise cycle.

Types of Exercise Planning Conferences

Name	Attendees	Purpose
Concept and Objectives (C&O) Meeting	Senior Officials, Lead Exercise Planner	Identify exercise scope, type, objectives and purpose. Can be combined with the Initial Planning Conference (IPC).
Initial Planning Conference (IPC)	Exercise Planning Team	Receive feedback from exercise planning team on scope, design, objectives, scenario, location, schedule, duration. Develop exercise documentation. Assign tasks to planning team members.
Mid-Term Planning Conference (MPC)	Exercise Planning Team	Generally only conducted for operations-based exercises/full-scale exercises. Opportunity for additional problem-solving related to logistical and organizational issues encountered in planning stages.
Master Scenario Events List (MSEL) Conference	Exercise Planning Team	Generally only conducted for operations-based exercises/full-scale exercises. Create the MSEL, a chronological list that supplements the exercise scenario with event synopses; expected participant responses; capabilities, tasks, and objectives; and responsible personnel.
Final Planning Conference (FPC)	Exercise Planning Team	Review and finalize exercise processes and procedures, final drafts of exercise material, and logistical requirements. Check all requirements met and issues resolved.

Checklist: Foundation

The following are some of the essential steps in the Foundation phase:

Developing a Support Base

• Identify key stakeholders.
• Involve key stakeholders in exercise planning (form an emergency management committee).

Forming an Exercise Planning Team

• Identify team members.
• Assign roles.

Creating a Timeline

• Determine necessary meetings and milestones.
• Set dates and deadlines of completion.

Conducting Exercise Planning Conferences

• Discussion-based Exercises
  • Concept/Objectives Meeting.
  • Initial Planning Conference.
  • Final Planning Conference.
• Operations-based Exercises
  • Concept/Objectives Meeting.
  • Initial Planning Conference.
  • Midterm Planning Conference.
  • Master Scenario Events List Conference.
  • Final Planning Conference.

Useful Resources and Tools

Below is a list of useful resources and tools related to the Foundation phase of exercise planning.

Forming an Exercise Planning Team

• Organizational Chart (HSEEP Vol. IV*)
  This sample organization chart shows the hierarchy of key members in the exercise planning team.

Creating a Timeline

• Discussion-based Exercises
  • Project Management Timeline (HSEEP Vol. IV, see under Foundation > Exercise Planning Team)
    This template lists key tasks to be completed to create, conduct, and evaluate an exercise, and has space to fill in a time frame or due date for each task.
• Operations-Based Exercises
• Planning Timeline (HSEEP Vol. IV, see under Foundation > Master Task List) This is an example of an exercise planning timeline for an operations-based exercise that lists key tasks and approximate due dates.

Conducting Exercise Planning Conferences

• Discussion-based Exercises
  • Initial Planning Conference (Briefing, Agenda, Minutes) (HSEEP Vol. IV, see under Foundation > Planning Conference Materials)
    These materials, created to help the exercise planning team hold an initial planning conference, consist of a briefing presentation, an agenda of topics to be covered in the meeting, and a template for taking minutes during the meeting.
  • Final Planning Conference (Briefing, Agenda, Minutes) (HSEEP Vol. IV, see under Foundation > Planning Conference Materials)
    These materials help the exercise planning team hold a final planning conference and consist of a briefing presentation, an agenda of topics to be covered in the meeting, and a template for taking minutes during the meeting.
• Operations-based Exercises
  • Initial Planning Conference (Briefing, Agenda, Minutes) (HSEEP Vol. IV, see under Foundation > Planning Conference Materials)
    These materials, created to help the exercise planning team hold an initial planning conference, consist of a briefing presentation, an agenda of topics to be covered in the meeting, and a template for taking minutes during the meeting.
  • Mid-Term Planning Conference (Briefing, Agenda, Minutes) (HSEEP Vol. IV, see under Foundation > Planning Conference Materials)
    These materials, which assist the exercise planning team in holding a mid-term planning conference, consist of a briefing presentation, an agenda of topics to be covered in the meeting, and a template for taking minutes during the meeting.
  • MSEL Package (HSEEP Vol. IV, see under Design and Development > Documentation)
    This is a template for developing a Master Scenario Events List for an exercise, which includes a chronological listing of events in exercise play as well as injects.
  • Final Planning Conference (Briefing, Agenda, Minutes) (HSEEP Vol. IV, see under Foundation > Planning Conference Materials)
    These materials help the exercise planning team hold a final planning conference and consist of a briefing presentation, an agenda, and a template for taking minutes during the meeting.

*Note: These resources and tools can be found as part of the HSEEP Volume IV Library: Sample Exercise Materials under Exercise Planning. https://hseep.dhs.gov/hseep_vols/default1.aspx?url=home.aspx

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