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Utah HCC’s Rockin’ Roundup Mass Casualty Exercise

The time allowed to prepare for an emergency or disaster— whether natural or manmade— is unpredictable, and in many cases, not enough. Even in the best of circumstances, it is difficult to feel prepared to address the uncertainty of an emergency. To proactively address a lack of preparedness, the CMS Emergency Preparedness Rule aimed to equip health care organizations with an awareness and understanding of disaster policies and procedures, as well as their role within the broader emergency response. The CMS Emergency Preparedness Rule provided an opportunity for health care coalitions (HCC) to engage with partners who were not previously involved in response efforts, including ambulatory surgical centers, hospice organizations, and rural health clinics.

To appeal to this wide variety of stakeholders, the Utah/Wasatch County HCC designed a creative, hands-on emergency preparedness training program. This full-scale, day-long mass casualty simulation referred to as “The Rockin’ Roundup – Mass Casualty Exercise”, involved more than 30 coalition facilities/members. These included representatives from hospitals, home health facilities, long term health, surgery centers, pediatric centers, development center, Intermediate Care Facility- Individuals with Intellectual Development (ICF-ID), and dialysis centers as well as groups that are not impacted by the CMS Emergency Preparedness Rule, such as the Medical Reserve Corps (MRC),

CMS Emergency Preparedness Rule

In 2017, the Centers for Medicare and Medicaid Services (CMS) issued a rule establishing national emergency preparedness requirements. Coalitions are required to offer HCC members TA or consultative services in meeting the CMS Emergency Preparedness Rule: Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers.

search and rescue teams, and other community emergency response groups. Through this event, participants had the opportunity to not only witness the operations behind an emergency response but also indentify areas for collaboration with other community partners. Given that many participants had not participated in an exercise like this before, coalition members began by providing information on the fundamentals of what an exercise involves, and then introduced participants to planning and after-action activities. Each participating facility was given guidance on establishing objectives that ensured their participation in the planning process and execution of the exercise.

The Rockin’ Roundup was an overwhelming success in demonstrating to participants the function of an HCC and the value of building relationships with its members. It allowed partners to network and become familiar with one another, supporting future collaboration and a community-based approach toward emergency response. By becoming involved in the HCC (e.g., attending HCC meetings), coalition members built a sense of community and trust with one another, incentivizing them to take ownership over their role in emergency response.

The coalition had several takeaways from this exercise. First, the Utah/ Wasatch HCC learned that what seems second nature to one facility may be a foreign concept to another. The CMS guidelines have helped bridge this gap and allow all coalition facilities to be on the same page. To help facilities comply with new CMS Emergency Preparedness Rule requirements, the Rockin’ Roundup provided coalition and their members with firsthand experience on execution of an exercise. For those members that had been doing training and exercise for years, it provided them an opportunity to refine their procedure and became mentors to those who were new to the training and to the exercise. From this exercise, the participants were able to learn the planning process for an exercise, so that they could hold one on their own with their individual facilities on a smaller scale.

Next, the coalition learned that they could work together to share resources across facilities to fill gaps during an emergency. For example, representatives from long-term health care facilities were able to meet other representatives from other long-term health care facilities, which facilitated enhanced collaboration within their organization. The coalition was surprised to learn of the number of home health clinical staff in the community and of the variety of resources that can be tapped into during a mass casualty situation.

Another valuable lesson learned was that a call center almost always needs more people than you think. The number of calls, emails, and texts that came in from the exercise left the call center understaffed in a matter of minutes. They quickly learned that they needed additional assistance to better support the coalition with its communication efforts.

The Roundup was also a valuable learning experience for coalition leadership and members. The coalition learned the importance of pacing out the exercise, given participants’ varied levels of experience in emergency preparedness and response and understanding that not all partners can be involved in each training activity. In addition, while this one-day event was a success, it also reinforced the need for sustained engagement among coalition members throughout the year.

Rockin’ Roundup Participant Feedback

“I am able to see what other health care organizations may need, [such as] home health, and be a resource to them in the event of a large-scale disaster” – HCC member

“The CMS Emergency Preparedness Rule has created the opportunity to see organizations at the emergency preparedness and planning table that have not been there before. We have seen an increase in participation and awareness to those in the health care field” – HCC member

Finally, on a broader scale, coalition members saw firsthand how the CMS Emergency Preparedness Rule can be practically applied toward benefiting their region’s emergency preparedness. As a result of hard work and creativity, the Utah/Wasatch County HCC was able to leverage the CMS requirement into a beneficial exercise that both increased health care preparedness and strengthened coalition unity.

There is a saying that goes: “You don’t want to be exchanging business cards at a disaster.” Exercises like the Rockin’ Roundup strengthened the partnership between the coalition and the community and increased their preparedness for a real event. This exercise taught the community and its health care facilities about the role of a health care coalition during an emergency and how they will work together to respond.