Developing community preparedness through table top exercises

Tabletop exercises can improve the preparedness of public health systems agencies to address disaster by bringing together individuals representing organizations with different roles and perspectives in specific disasters. Thus, they have the opportunity to identify each other's roles, capabilities, and limitations and to problem solve about how to address gaps and overlaps in a low threat collaborative setting. In 2005, the NC Office of Public Health Preparedness and Response developed a series of exercises to test preparedness for chemical disasters in a metropolitan region in the southeastern United States. A tabletop exercise allowed agency heads to meet in an environment promoting inter- and intra-agency, public and private coordination and cooperation. The evaluation results reported here suggest ways in which any tabletop exercise can be enhanced through recruitment, planning, and implementation. Recruitment can be improved through developing relationships with key political authorities, seeking private involvement, recruiting functional/operational leaders, and recruiting through multiple channels. Training can be improved by promoting action-based decisions, including vertical and lateral interactions, and requiring participants to bring their plans. Followup requires the development of action plans and careful dissemination and consideration of after-action reports.