title: Utilization of Functional Exercises to Build Regional Emergency Preparedness among Rural Health Organizations in the US.
abstract: Rural communities face barriers to disaster preparedness and considerable risk of disasters. Emergency preparedness among rural communities has improved with funding from federal programs and implementation of a National Incident Management System. The objective of this project was to design and implement disaster exercises to test decision making by rural response partners to improve regional planning, collaboration, and readiness. Six functional exercises were developed and conducted among three rural Nebraska (USA) regions by the Center for Preparedness Education (CPE) at the University of Nebraska Medical Center (Omaha, Nebraska USA). A total of 83 command centers participated. Six functional exercises were designed to test regional response and command-level decision making, and each 3-hour exercise was followed by a 3-hour regional after action conference. Participant feedback, single agency debriefing feedback, and regional After Action Reports were analyzed. Functional exercises were able to test command-level decision making and operations at multiple agencies simultaneously with limited funding. Observations included emergency management jurisdiction barriers to utilization of unified command and establishment of joint information centers, limited utilization of documentation necessary for reimbursement, and the need to develop coordinated public messaging. Functional exercises are a key tool for testing command-level decision making and response at a higher level than what is typically achieved in tabletop or short, full-scale exercises. Functional exercises enable evaluation of command staff, identification of areas for improvement, and advancing regional collaboration among diverse response partners. Obaid JM , Bailey G , Wheeler H , Meyers L , Medcalf SJ , Hansen KF , Sanger KK , Lowe JJ . Utilization of functional exercises to build regional emergency preparedness among rural health organizations in the US. Prehosp Disaster Med. 2017;32(2):224-230.
authors.affiliation: 1Department of Environmental,Agricultural & Occupational Health,University of Nebraska Medical Center College of Public Health,Omaha,Nebraska.
authors.forename: Jannah M
authors.initials: JM
authors.lastname: Obaid
authors.affiliation: 2Rural Region One Medical Response System,Bancroft,Nebraska.
authors.forename: Ginger
authors.initials: G
authors.lastname: Bailey
authors.affiliation: 3West Central Medical Response System,McCook,Nebraska.
authors.forename: Heidi
authors.initials: H
authors.lastname: Wheeler
authors.affiliation: 5Tri-Cities Medical Response System,Kearney,Nebraska.
authors.forename: Laura
authors.initials: L
authors.lastname: Meyers
authors.affiliation: 6Center for Preparedness Education,University of Nebraska Medical Center College of Public Health,Omaha,Nebraska.
authors.forename: Sharon J
authors.initials: SJ
authors.lastname: Medcalf
authors.affiliation: 6Center for Preparedness Education,University of Nebraska Medical Center College of Public Health,Omaha,Nebraska.
authors.forename: Keith F
authors.initials: KF
authors.lastname: Hansen
authors.affiliation: 6Center for Preparedness Education,University of Nebraska Medical Center College of Public Health,Omaha,Nebraska.
authors.forename: Kristine K
authors.initials: KK
authors.lastname: Sanger
authors.affiliation: 1Department of Environmental,Agricultural & Occupational Health,University of Nebraska Medical Center College of Public Health,Omaha,Nebraska.
authors.forename: John J
authors.identifier: http://orcid.org/0000-0002-2893-1312
authors.initials: JJ
authors.lastname: Lowe
mesh_terms: D004189:Disaster Planning / Q000458:organization & administration*; D004634:Emergency Medical Technicians / Q000193:education*; D006801:Humans; D009329:Nebraska; D016730:Program Development; D012040:Regional Health Planning / Q000458:organization & administration*; D019035:Rural Health Services / Q000458:organization & administration*; D000066908:Simulation Training; D014481:United States
keywords:  CPE Center for Preparedness Education;  EMS Emergency Medical Services;  EOC Emergency Operation Center;  HSEEP Homeland Security Exercise Evaluation Program;  IC Incident Command;  MRS Medical Response System; coalition; disaster; emergency preparedness; exercise; response