Using Tabletop Exercises
Everything You Need to Know
... and More
Carl Osaki, MSPH, RS
Clinical Associate Professor Emeritus
Dept of Environmental & Occupational
Health Sciences,
School of Public Heatlh, Univ of WA
Objectives

Describe the value and use of tabletop
exercises to prepare for public health
emergencies

List 10 suggestions for conducting or
facilitating a successful tabletop exercise

Discuss how to evaluate your agency’s
readiness for conducting a tabletop
exercise
Overview

Define a tabletop exercise

Describe the purpose and objectives of
tabletops

Discuss who uses tabletops and why

Describe issues typically raised through
tabletops

Discuss how to consider appropriate
tabletops and where to find them

Suggest issues to consider in designing
or conducting your own tabletop
Your Experiences I
Have you participated in a tabletop exercise?
Yes
No
What was the most significant problem you
experienced as a participant in the process?
Your Experiences II
Have you facilitated a tabletop exercise?
Yes
No
What was your most significant challenge
in facilitating the tabletop?
Your Experiences III
Have you designed a tabletop exercise?
Yes
No
What resources/tools did you use
to help design the tabletop?
What is a Tabletop?

Hypothetical scenario (story) depicting a largescale public health emergency

A facilitator leads the group (players) in a
discussion about a series of incidents
(problems) which emerge in the scenario

Players identify and discuss the policies and
procedures needed to address each incident
Hotwash to discuss the significance of the
policies to their own organization (e.g., gaps,
duplications, confusion, and whether people
are trained to carry out the policies)
Debriefing to discuss exercise, next steps
Low stress, no right or wrong answer



Types of Tabletops
Basic: players respond to scenario as it
unfolds, can be a mix of different disciplines,
not necessarily key decision makers. More
oriented to learning, rather than evaluation of
current system
Advanced: players in own role as defined by
the emergency response plan; typically those
that would be involved in decision making;
identifies gaps, inconsistencies, or
duplications in policies, plans, or procedures
Who Uses Tabletops in Public Health?

PH Agencies
(local, state, tribal)

Schools/PH Institutes
(summer institutes, classroom)

Local emergency response agencies

Professional disciplines
(MDs, nurses, veterinarians,
environmental health specialists,
epidemiologists, etc)
What are Typical Tabletop Objectives?

Identify the policy issues associated with a
public heath emergency

Identify gaps in local preparedness

Discuss measures that can be performed at
the local level

Promote interagency collaboration &
coordination

Recognize the roles of public officials

Identify training needs

Demonstrate a teaching tool

Evaluate self-reported assessment
When Should a Tabletop Be Used?

Discussion-based Exercises
– Orientation
– Tabletop
 Operations-based Exercises
– Drill
– Functional
– Full-Scale
Where Do I Find Tabletops?

NWCPHP
http://www.nwcphp.org
PH Preparedness Training Centers
 Private firms
 ASPH

http://www.asph.org

NACCHO
http://www.naccho.org
How Do I Design My Own Tabletop?
NW Center BT Tabletop
 Office of Homeland Security

http://www.ojp.usdoj.gov/odp/exercises.htm
NACCHO BT Create
 CDC (http://www.bt.cdc.gov)
 Time to design: (20 to 40 hours)
 Roles (player, facilitator, observer,
recorder, evaluator, resources)

What issues are raised through tabletops?

Communication (vertical, horizontal, news media)

Resources (manpower, material, technical
assistance)

Data (collection, analysis, mgmt, communicating)

Coordination (chain of command, leadership)

Legal (medical, criminal, quarantine,
confidentiality)

Systems (interagency protocols, surveillance, ICS)

Mental health (public fears, responders – stress)
Successful Tabletops: 10 Things to Consider

Facilitator

Jargon

Audience

Recorder

Burn-out

Debriefing

Materials

Group size

Reality

Group
composition
How do I determine the success of a tabletop?

Evaluation through debriefing
– The exercise (meets objectives)
– The hotwash (Identification of needed
policies, gaps & duplications, policies
being effectively practiced)
 After-Action Report
 Development of work plan