Why Drill???
AND HOW TO DO SO…
WHY DRILL??
We will default to our training…for good and ill.
 We need to know what we don’t know.
 Details, details, details.
 Most importantly: Evaluate our efficacy -- and
identify how individuals will actually react -- in a
relatively low stress environment.
 Planning is important. Drilling is essential.

DRILL TYPES

Four Types
 Drills:
Test a single operation, such as activating a
notification system or measuring response times.
 Tabletop Exercises : Low-stress events designed to
identify major gaps or conflicts in planning. Discuss
actions would take when faced with a given
emergency. No real resources are used.
DRILL TYPES

Four types (cont’d)
 Functional
Exercises: Higher stress events where
many participants simulate their actions within an
Emergency Operations Center (EOC) and must
make immediate, specific decisions, but real field
equipment and personnel are not deployed.
 Full-scale Exercises: Most realistic, most complex,
and most costly events. Field personnel perform as
many of their actual duties as possible in a
simulated emergency in order to best assess the
true capabilities of the response system.
DRILL CHALLENGES
Time and Staffing
 Accurate Simulations
 Useful Evaluation

DRILL ELEMENTS
Planning
 Implementation
 Evaluation


Incorporates recommendations by the Harvard School of Public
Health Center for Public Health Preparedness, The Johns
Hopkins University Evidence-based Practice Center, The Johns
Hopkins University Bloomberg School of Public Health, The
Johns Hopkins University Applied Physics Laboratory and
www.hicscenter.org.
PLANNING: BEFORE THE DRILL
Calendar drills/exercises a year in advance.
 Assign a “drill sergeant.”
 Allow for pre-drill planning and post drill
evaluation.
 Train observers.
 Maximize applicability (ex. Earthquake, Fire,
Evacuation, Surge.)
 Just do it.

PLANNING: BEFORE THE DRILL

Identify Objectives:
 Typically
include focus upon 5 to 10 elements:
 Emergency
plan
 Notification procedures
 Communications
 Roles and responsibilities
 Resources
PLANNING: BEFORE THE DRILL

Identify Objectives:
 Risk
communication
 Emergency Operations Center (EOC) operations
 Mutual aid
 Coordination with state and federal agencies
 Coordination with public safety
 Coordination with local government
 Issues with special populations
PLANNING: BEFORE THE DRILL

Train Observers
 Monitor
without affect.
 Train to evaluation tool/Must be competent to
assess what they are seeing.
 Harvard recommends one evaluator per set of 5-10
similar objectives.
 Alternative: Videotape drill/exercise for later
evaluation.
PLANNING: BEFORE THE DRILL

Use Pre-Drill Checklist:
 What
will the disaster scenario include?
 Type of drill/exercise
 Objectives
 Proposed date of drill/exercise
 Estimated start time of drill/exercise
 Estimated length of drill/exercise
PLANNING: BEFORE THE DRILL

Pre-Drill Checklist (cont’d):
 Disaster
announcement
 How many “victims?”
 How many observers?
 How many additional staff?
 Will drill/exercise take place in active patient
areas?
 What outside agencies will participate?
IMPLEMENTATION
Determine type (Drill, Tabletop, Functional, FullScale).
 Choose Scenario to best measure objectives.
 Utilize and ADAPT existing tools, such as
scenarios at www.hicscenter.org.

IMPLEMENTATION

Example from HICS:
 BOMB
THREAT SCENARIO: Your Clinic’s main
switchboard receives a call stating that an explosive
device has been placed within your facility and will
detonate within 60 minutes. Based on the amount
of detail provided by the caller, it is determined that
this poses a credible threat to your facility, and you
activate the bomb threat procedures.
IMPLEMENTATION
Use your EOP.
 Activate Incident Command Center
 Determine appropriate scale of response
 Utilize Job Action Sheets

EVALUATION
Evaluation Tool MUST match objectives.
 Recommended Drill/Exercise Evaluation Tool:

 Initiation
 Effectiveness
of Incident Command
 Incident Command Center
 Communication
 Recording
 External Communication
EVALUATION

Recommended Drill/Exercise Evaluation Tool:
 Security
 Documentation
 Rotation
of Staff
 Summary
CONCLUSION
Drills/Exercises are a process not an outcome.
“There are a lot of different kinds of exercises, a
lot of different methodologies used to conduct
exercises. There are exercises that sometimes
seem to be destined to ensure success or at
least a successful outcome in the exercise.”
-Michael Wermuth,

Director of Homeland Security programs at RAND