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Health System Preparedness for Bioterrorism: Bringing the Tabletop to the Hospital

Published online by Cambridge University Press:  02 January 2015

Kelly J. Henning ,
Patrick J. Brennan ,
Cindy Hoegg ,
Eileen O'Rourke ,
Bernard D. Dyer  and
Thomas L. Grace
Kelly J. Henning*
Affiliation:
Division of Infections Diseases, Department of Medicine, University of Pennsylvania School of Mediane, Philadelphia, Pennsylvania Infection Control and Hospital Epidemiology, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania
Patrick J. Brennan
Affiliation:
Division of Infections Diseases, Department of Medicine, University of Pennsylvania School of Mediane, Philadelphia, Pennsylvania Clinical Effectiveness and Quality Improvement, University of Pennsylvania Health System, Philadelphia, Pennsylvania
Cindy Hoegg
Affiliation:
Infection Control Department, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
Eileen O'Rourke
Affiliation:
Infection Control Department, The Pennsylvania Hospital, Philadelphia, Pennsylvania
Bernard D. Dyer
Affiliation:
Safety Management Program, University of Pennsylvania Health System, Philadelphia, Pennsylvania
Thomas L. Grace
Affiliation:
Safety Management Program, University of Pennsylvania Health System, Philadelphia, Pennsylvania
*
Division of Epidemiology, 125 Worth Street, Box 315-CN6, New York, NY 10013
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Abstract

Objective:

To evaluate the acceptance and usefulness of a hospital-based tabletop bioterrorism exercise.

Design:

A descriptive study of responses to a smallpox scenario delivered as a tabletop exercise in three modules.

Setting:

A large, multi-institutional urban health System.

Participants:

Healthcare workers representing 16 hospital departments.

Results:

Thirty-nine (78%) of 50 invited employees from 4 hospitals participated. Key responses highlighted the importance of pre-event planning in intra-departmental communication, identification of resources for the dependents of health-care workers, clarification of the chain of command within the hospital, establishment of a link to key governmental agencies, and advanced identification of negative pressure rooms for cohorting large numbers of patients. Almost one-fourth of the participants described their hospital departaient as poorly prepared for a bioterrorism event of moderate size. At the conclusion of the tabletop, 79% of the participants stated that the exercise had increased their knowledge of preplanning activities. Seventy-nine percent of all participants, 94% of physicians and nurses, and 95% of participants from non-university hospitals ranked the exercise as extremely or very useful. The exercise was completed in 3% hours and its total direct cost (excluding lost time from work) was $225 (U.S.).

Conclusions:

Tabletop exercises are a feasible, well-accepted modality for hospital bioterrorism preparedness training. Hospital employees, including physicians and nurses, rank this method as highly useful for guiding preplanning activities. Infection control staff and hospital epidemiologists should play a lead role in hospital preparedness activities. Further assessment of the optimal duration, type, and frequency of tabletop exercises is needed.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 2 , February 2004 , pp. 146 - 155
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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