Improving public health emergency preparedness through enhanced decision-making environments: A simulation and survey based evaluation

Public health emergency preparedness officials use several modes of education and training programs to improve their response capability, including tabletop exercises. Tabletop exercises allow participants to role-play during a health emergency in an experiential practice environment and evaluate performance using existing benchmarks. Although tabletop exercises are routinely used in public health to identify gaps in emergency planning, quantitative measures of the impact of participating in an exercise are less common. To this end, we have designed a state-of-the-art simulation-driven hybrid tabletop exercise which is informed by local leadership interests and options, and tied into a research platform that enables rigorous assessment and improvements. The exercise and assessment were used by the state of Arizona during the 2009 H1N1 influenza outbreak. The simulation allows participants to respond to a hypothetical pandemic influenza scenario and make iterative policy decisions in a group setting. The exercise provided a valuable forum reviewing and assessing emergency plans for schools to prepare for, respond to, and recover from an influenza pandemic. After the exercise, participants reported a significantly increased level of confidence in performing core public health functional capabilities around the five main topic areas.