Benefits of Tabletop Exercises and Drills
Tabletop exercises and drills are crucial for children’s hospitals in improving pediatric disaster preparedness for many reasons. These events:
- Help staff to become familiar with emergency protocols/procedures
- Foster collaboration among different hospital areas, departments, and units
- Improve effective communication in a crisis
- Ensure effective resource allocation during an emergency
- Offer opportunities for various scenarios and related response planning
- Identify gaps and stimulate efficiencies/improvements for better preparedness
Ultimately, these preparations enhance the hospital’s ability to provide safe, effective care to children during emergencies, disasters, and pandemics to save lives and reduce trauma.
Exercises and the Disaster Response Collaborative (DRC)
During the DRC, registered children’s hospital participants are asked to conduct at least one tabletop exercise and two drills to assess gaps in disaster response planning/protocols, identify areas to focus updates on within their disaster plan, and monitor achievement/improvements. The focus areas include evacuation, pediatric surge capacity, pediatric patient tracking and family reunification, and triage/infection control/decontamination. To guide each team through these exercises and drills, the DRC is offering the following options.
Facilitated DRC-Hosted Virtual Tabletop Exercise Opportunities
The DRC Drills & Exercises Team will host free virtual tabletop exercises (VTTXs) to provide a collaborative environment and materials/guidance for DRC participants to validate and strengthen their pediatric disaster plans in a facilitated and consistent manner. Informed by the EIIC Checklist of Essential Pediatric Considerations for Every Hospital’s Disaster Policies (AKA the Disaster Checklist) recommendations for each DRC focus area (see domains 3, 4, 5, and 6 in the checklist), these pre-planned exercises align with Homeland Security Exercise and Evaluation Program (HSEEP) standards, ensuring compliance with existing hospital requirements. Information on how to participate in a DRC-hosted VTTX, including steps for DRC teams to take now and how to sign up for training and VTTXs, can be found in the DRC Virtual Tabletop Exercise Checklist. The benefits of this approach include:
- Flexible Virtual Exercise Environment: Each DRC-supported exercise incorporates pediatric patient scenarios to encourage facility-wide participation and optional engagement with community partners, such as pre-hospital and public health representatives, if desired.
- Training/Guidance for a Facilitator and an Evaluator: To be included in one of the topic-specific VTTXs, the DRC team will identify a facilitator (to moderate facility specific discussions) and an evaluator (to observe, take notes, and help complete the improvement plan). A 1-hour training session will be offered for these individuals (and recorded for those who are unable to attend in person).
- Facility Specific Breakout Discussions: The hosted VTTXs include breakouts for the people participating in the exercise from your facility to hold their own internal discussions to validate the contents of their disaster plans aligning with the selected DRC focus area. Scenario(s), discussion points, and questions to consider will be provided.
- HSEEP Consistent Materials: The DRC Drills & Exercise Team will provide all documents required to participate in the exercise, document breakout discussions, and complete an After-Action Report and improvement plan.
Materials for the VTTXs will be provided early in once facilitators and evaluators have attended training. The DRC team’s and exercise participants’ review of the facility’s disaster plans/protocols and discussions within the DRC VTTXs will occur in March/April/May 2025. A proposed scenario and related discussion points will be provided to encourage facilities to examine what is or should be included in the disaster plans (e.g., notification/communication process, necessary staffing and equipment, and facility areas that can be used to address additional needs in a disaster event). For details see the DRC October 2024 session recording and slides.
Plan a Facility-Led Tabletop Exercise
Perhaps your children’s hospital already has plans to conduct a tabletop exercise and would be willing to incorporate concepts specific to the selected focus area and related plans/protocols. DRC teams can elect to not participate in the facilitated VTTXs and instead, plan and conduct their own TTX. If your team decides on this approach, the TTX should be convened within the first 6 months of 2025. Resources with details on how to conduct a TTX and templates/materials are offered below.
Drills
The goal of the DRC is to demonstrate improvement over time within hospital disaster response plans in the chosen focus area. Drills (after a TTX) will allow DRC teams to test changes to updated plans, new protocols, and pre-identified focus area performance measures. Materials on conducting a DRC pre- and post-intervention drill in your own facility will be provided in 2025. DRC teams are asked to plan and implement an initial drill for the focus area in late 2025. The second drill can be planned for approximately 6 months after the first, no later than May 2026.
Sample Timeline
Sample Options
Option One
The DRC-registered children’s hospital chooses their DRC focus area in January 2025 and signs up for their facilitator and evaluator training to be held in February 2025. Simultaneously, the team identifies their preferred VTTX date (in coordination with all participants) to occur in May 2025. Participants are notified so all attendees can attend and calendars could be blocked. The existing disaster plan is distributed with other materials, asking everyone to review the plan with the focus area in mind. Drills are scheduled for August 2025 and April 2026, based on actions identified in the VTTX follow-up report.
Option Two
The hospital has just conducted a TTX and finds that results are relevant and plan drills for fall 2025 and spring 2026.
Option Three
The hospital already has several exercises/drills scheduled throughout 2025 and is starting to look at plans for 2026. The team decides to participate in a facilitated VTTX and decides that only one drill will be held, and certain gaps will be addressed as part of other planned exercises/drills.
Resources
Checklist of Essential Pediatric Considerations for Every Hospital’s Disaster Policies
Homeland Security Exercise and Evaluation Program
Tabletop Exercise (TTX) Toolkit by PPN Hub Site Children’s Mercy Kansas
Tabletop Exercise (TTX) Toolkit by PPN Drills & Exercises Domain: Enhance Your Preparedness for Pediatric CBRNE Emergencies
Disaster Preparedness: Pediatric Tabletop Exercise Resource Kit by the American Academy of Pediatrics
For assistance or if you have questions, email DNCPPN@austin.utexas.edu.