SITUATION:
Coordinated Consulting Services (CCS) was hired in 2022 by the Arizona Coalition for Healthcare Emergency Response (AzCHER) to conduct a statewide functional exercise in May 2023, including after action activities. The goal of the exercise was to meet requirements set forth in the U.S. Department of Health and Human Services (HHS) Administration for Strategic Preparedness and Response (ASPR) 2021 Medical Response & Surge Exercise (MRSE) Evaluation Guide. The exercise was held on May 18, 2023.
NEED:
In December of 2022, AzCHER issued a Request for Proposal (RFP) for a consultant to plan and execute a functional exercise to meet the requirements of the HHS ASPR 2021 MRSE. In addition to meeting exercise requirements, the purpose of the exercise was to provide AzCHER and its members with an opportunity to test their surge response and preparedness capabilities. The MRSE was also designed to examine and evaluate the ability of AzCHER and other partners to support medical surge, including the ability of Arizona’s hospitals and other healthcare entities to take on a surge of patients in response to a statewide healthcare system emergency. The project required collaboration with the four core AzCHER member sectors including public health, emergency management, emergency medical services, and hospitals.
SOLUTION:
CCS worked closely with the AzCHER core planning team to identify an expanded planning team. The purpose of the planning team was to engage subject matter experts to inform the scenario and exercise play; oversee the exercise foundation, design, development, conduct, and evaluation; approve and inform exercise objectives, scenario, and evaluation approach; contribute to and approve exercise documentation, including the Master Scenario Events List (MSEL) document. CCS and AzCHER held several large meetings throughout the exercise design phase, including the Initial Planning Meeting, Mid Planning Meeting, Final Planning Meeting, and MSEL Synchronization Meeting. Both the core and expanded planning team members also participated in Controller/Evaluator Training, Simulation Cell Training, and the After Action Meeting. The majority of exercise design and planning occurred from January through mid-May 2023, with the day of exercise on May 18, 2023. All meetings were held virtually.
There were several data collection tools used for this project:
- Hospital and AzCHER hot wash forms
- Hospital Exercise Evaluation Guide (EEG) worksheets
- Statewide virtual hot wash notes and facilitated discussion boards
- Participant feedback survey data
- After Action Meeting participant feedback
Exercise participants submitted exercise data to their AzCHER Regional Managers. AzCHER Regional Managers uploaded the data to the document sharing platform in Basecamp.
OUTCOME:
There were 218 total hospital players among 15 participating hospitals who played in the exercise. These hospitals were located across all four AzCHER regions. Several organizations from public health, emergency management, and emergency medical services participated as simulation cell participants. Long term care facilities also participated by accepting phone calls from hospitals needing transportation to other healthcare facilities and by calling hospitals to offer assistance.
CCS worked with the AzCHER core planning team to develop a draft After Action Report and Improvement Plan following a full analysis of the data collected. To prepare for the After Action Meeting, AzCHER and CCS coordinated with the hospital contacts to invite their hospital executives to attend the first 30 minutes of the meeting. Held on June 20, 2023, the After Action Meeting presented high level strengths, areas for improvement, and recommendations, including an executive overview and feedback; hospital hot wash data review; exercise evaluation guide worksheet data review; improvement planning; and next steps. CCS gathered additional feedback from the After Action Meeting attendees. This feedback was incorporated into the final AAR/IP.
This exercise provided AzCHER and its members an opportunity to test surge response and preparedness capabilities. The exercise tested facility plans, policies, and procedures during a simulated anthrax bioterrorism incident while practicing operational interactions among various sector and partner organizations. The AzCHER 2023 MRSE Functional Exercise also enhanced critical healthcare partnerships, healthcare provider organizations’ preparedness and response capabilities for large-scale system disruptions, and healthcare system resilience.
