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Drills & Exercises

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Hospitals are required to participate in specific drills and exercises as required by their appropriate accrediting body and/or grant requirement(s). For example, the Hospital Preparedness Program grant may require participation in the Annual Statewide Medical Health Exercise. The National Incident Management System Compliance for Healthcare Element 7 states that NIMS concepts and principles are promoted into all organization-related training and exercises.

The Joint Commission in EM03.01.03 requires two emergency response exercises and at least one of them include an escalating event in which the local community is unable to support the event, and at least one includes participation in a communitywide exercise.

The California Code of Regulations 70741 (d) states the disaster plan shall be rehearsed at least twice a year. 70743 (c) requires fire and internal disaster drills shall be held at least quarterly for each shift of hospital personnel and under varied conditions.

NFPA 5.14 requires the entity shall evaluate program plans, procedures, and capabilities through periodic reviews, testing, and exercises.
 

Planning an Exercise

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The initial steps to planning an exercise include identifying:

  • Exercise purpose
  • Proposed exercise scenario, capabilities, tasks, and objectives
  • Available exercise resources
  • Proposed exercise location, date, and duration
  • Exercise planning team and exercise participants

An exercise Interim Planning Meeting can establish:

  • The exercise planning schedule 
  • Clearly defined, obtainable, and measurable exercise capabilities, tasks, and objectives 
  • Identified exercise scenario variables (e.g., threat scenario, scope of hazard, venue, conditions)

 

 

Exercise Planning

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The hospital’s Hazard Vulnerability Analysis (HVA) assists exercise planners in identifying threats facing the facility. The facility’s HVA provides a list of top scenarios to base future drills and exercises on. Additionally, past After Action Reports and Improvement Plans provide previously identified areas for improvement that can be tested.

Communitywide discussions and planning with local and regional emergency preparedness committees take into account the Multi-Year Training and Exercise Plan, which includes specific capabilities and objectives that could also be evaluated in future exercises. The identified objectives help address general exercise program goals, provide a framework for scenario development, guide development of individual organizational objectives, and supply evaluation criteria.

Additionally, The Joint Commission lists specific activities and observations to be monitored in exercises in EM.03.01.03 that can be used in future exercises.

AHRQ Tool for Evaluating Core Elements of Hospital Drills

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Hospitals must be prepared to respond to public health emergencies that may create a sudden demand on services. Disaster drills allow hospitals to test response capabilities to these emergencies in real time.

AHRQ has developed this Tool for Evaluating Core Elements of Hospital Drills. This tool can be used by hospitals to identify the most important strengths and weaknesses in disaster drills. The results can be applied to training and drill planning. 
 

HPP Healthcare Facility Drills & Exercise Report

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Use this form to report to your local HPP entity (e.g., county public health, EMS) each disaster preparedness drill and/or exercise in which the hospital/clinic participated and for which the hospital/clinic will be claiming HPP reimbursement.

After Action Reporting (AAR)

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The After Action Report (AAR) captures observations of an exercise and makes recommendations for post-exercise improvements. The AAR is then used to develop Improvement Plans (IP).

In EM 03.01.03, The Joint Commission requires a hospital to assign a designee whose sole responsibility during emergency response exercises is to monitor performance and document deficiencies and opportunities for improvement. Developing an AAR meets the criteria.

 

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