South Dakota Public Health Exercises Case Study

96% of Hospitals Play in Statewide Bioterrorism Exercise

Background

In 1999, South Dakota established a terrorism task force and since then, the South Dakota Department of Health (SDDOH) has stepped up emergency response initiatives involving health care providers across the state. Recent regional planning efforts have focused on hazard vulnerability, pandemic influenza, and hospital surge capacity while the state has implemented a state-wide Health Alert Network and an emergency radio communications system. The federal Health Resources and Services Administration (HRSA) requires sub-state (regional) and state level terrorism preparedness exercises that includes the department and healthcare facilities.

Public Health Experience Critical in Choosing a Partner

In August 2006, the SDDOH began plans for conducting its first statewide bioterrorism exercise. With only nine staff in the Office of Public Health Preparedness and Response, and just one devoted fulltime to the HRSA grant, the department knew it would need to bring in outside expertise. Top priorities in the selection criteria were finding a vendor with extensive experience in conducting hospital and public health-led exercises.

“Because this was the first statewide bioterrorism preparedness exercise conducted in South Dakota, we knew we needed to partner with an expert with extensive experience,” said LaJean Volmer, Hospital Preparedness Coordinator with SDDOH. “Global Secure Systems was able to meet that need. Their unique experience and focus on conducting exercises specifically with public health entities in the lead role was precisely what we sought. They also were familiar with our redundant communication system.”

Global Secure Systems’ dynamic exercises are designed, facilitated, and evaluated by medical and public health professionals, each with a minimum of 20 years’ experience in emergency operations design, planning and execution. That experience enables public health officials to test specific medical and public health capabilities with a level of detail that was important.

“Global Secure Systems’ team knew the right questions to ask, and what the medical and public health challenges are,” said Volmer. “Unlike any other provider we considered, they knew precisely how to develop scenarios, objectives, expected outcomes and evaluation criteria for a comprehensive and relevant test.”

As the leading provider of bio-surveillance and public health emergency preparedness and response solutions, Global Secure Systems has worked extensively with the U.S. Department of Homeland Security BioWatch Program and state public health agencies on public health emergency preparedness and response programs. Since SDDOH officials faced a tight HRSA reporting deadline, the department knew it would benefit from Global Secure Systems’ experience in conducting exercises that meet and exceed the standards set forth in HRSA Hospital Bioterrorism Preparedness Program Critical Benchmark #6 and the CDC Public Health Preparedness Cooperative Agreements.

Flexibility, Customization Resulted in Broad Participation

The exercise marked the first time hospitals from across the state, as well as other public health and emergency responders, collectively responded to a mock bioterrorism disaster drill intended to test communications and response systems between hospitals, local public health departments and the state.

To ensure that South Dakota’s emergency response plans were comprehensively tested, Global Secure Systems relied on its proprietary Mass Customization process. Through it, the team integrated various jurisdictions’ demographics, population statistics, geographic considerations and local capabilities into the exercise design, so that the exercise would be uniquely relevant to South Dakota’s specific situation.

“The beauty of this exercise was that hospitals could participate at whatever level they wanted,” said Volmer. “Some set up a full-scale simulated Emergency Operations Centers, even bringing in sample patients. Some made calls to the sheriff and coroner’s office as part of the drill. Others used the exercise to test things like their infection control and risk management plans and do limited level simulation.”

Timely, Responsive Service

To meet federal program requirements, the SDDOH faced an extremely tight timeline for conducting its first exercise. “We pulled the statewide exercise off in an extremely short time frame; we signed the contract August 9, and held the exercise on September 13. That’s not much time to develop and meet all the grant program criteria,” said Volmer.

Global Secure Systems’ familiarity with large-scale public health exercises, HRSA requirements, and South Dakota’s Health Alert Network factored in as a key advantage in meeting the tight deadline. The exercise was led by a seasoned team composed of senior epidemiologists, a senior hospital disaster planner for single hospitals and regional hospital systems and one of the country’s most recognized leaders in emergency management with emphasis on chemical, biological and large-scale disasters.

“In addition, because Global Secure Response Manager is the platform for South Dakota’s Health Alert Network, they already were extremely familiar with our redundant communications systems, which made this project a natural fit for them,” said Volmer.

With less than five weeks to prepare, Global Secure Systems worked with an Exercise Development team of SDDOH and hospital personnel to create the exercise. “Global Secure Systems’ team came in so well prepared, they made it seem easy,” said Volmer.

Unique Post-Exercise Services Add Value

Aside from meeting the HRSA grant requirements, the real value in conducting bioterrorism exercises comes through incorporating the lessons learned into policies and procedures and making the changes that are recommended. However, other vendors provide less immediate post-exercise planning services or change management guidance, leaving clients on their own to carry out those critical tasks.

By partnering with Global Secure Systems, however, SDDOH was able to capitalize immediately on exercise feedback through Global Secure Systems’ unique Super Conference service. At the Super Conference, held soon after the exercise’s conclusion, participants and stakeholders shared feedback, identified best practices and categorized gaps and needs in the communications and response systems.

Based on the feedback and root cause and gap analysis, the Global Secure Systems team then guided the hospitals and public health officials in prioritizing their improvement plans. Lead agencies were assigned, execution timelines were created and the additional resources needed to execute the plans were identified.

Successful Outcomes

According to Volmer, both participation in and feedback on the exercise were overwhelmingly positive. An impressive 97 percent of the state’s hospitals took part in the exercise. “And, from the overwhelmingly positive feedback we received, everyone learned and got value out of this, even those at the minimum participation level,” she said.

“Our Office of Public Health Preparedness and Response is small and we just don’t have the expertise to have conducted an exercise of this magnitude internally,” said Volmer. “We might have cobbled something together, but it would not have had the same impact. It was critical to have a vendor with expertise with public health, hospitals, Homeland Security and emergency management. This exercise went exceedingly well, and we are grateful for the responsiveness and customer service provided by Global Secure Systems.”