Using Tabletop Exercises
Everything You Need to Know
... and More
Carl Osaki, MSPH, RS
Northwest Center for Public Health
Practice, Clinical Associate Professor
Department of Environmental &
Occupational Health Sciences,
SPHCM, University of Washington
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
Poll: Your Experiences I
Have you participated in a tabletop exercise?
Yes
No
Enter your answer in the
feedback poll
(on left side of screen)
If yes, tell us over the phone:
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
If yes, type your answer into the
text chat window:
What was your most significant
challenge in facilitating the tabletop?
What is a Tabletop?
 Hypothetical scenario (story) depicting a
large-scale public health emergency
 A facilitator leads the group (players) in
identifying responses to a series of
incidents in the scenario
 Low stress, no right or wrong answer
 Examines the adequacy of the plans,
policies and procedures in place
– (e.g., gaps, duplications, confusion, and the key
decision makers’ understanding of the plans)
 Debriefing to discuss next steps
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
Putting Tabletops in Context
Discussion-based exercises
 Orientation
 Tabletop
Operation-based exercises
 Drill
 Functional
 Full-Scale
Where Do I Find Tabletops?
NWCPHP
PH Preparedness Training Centers
Private firms
ASPH
NACCHO
Your Experiences III
Have you designed a tabletop exercise?
Yes
No
If yes, tell us over the phone:
What resources/tools did you use
to help design the tabletop?
How Do I Design My Own Tabletop?
NW Center BT Tabletop with
instructions
Homeland Security Web site
NACCHO BT Create
Time to design: (20 to 40 hours)
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
Top 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 (objectives met)
– The preparedness plan (policies
identified, in place, and practiced)
 After-Action Report
 Development of work plan
Q&A