Tabletop Exercises

Leadership buy-in, regardless of practice size, is imperative for these exercises to be successful. Depending on the scenario being reviewed during the exercise, participants could include:

• Front-line staff such as practice managers, registration, front desk, medical assistants, nursing, practitioners, and lab and radiology techs
• Administration and management staff such as CEO, CMO, CNO, CFO, COO, legal/compliance department, human resources, and team managers
• Organizational support staff such as call center, maintenance, environmental services, IT, risk management, quality improvement, supply chain, pharmacy, and laboratory.

For smaller practices that may not have multiple leadership positions, the list of management or lead personnel attendees may be much smaller and include different role types. In a small practice, the tabletop exercise attendees may include a practice owner or manager, principal provider, and lead nurse. Tabletop exercises are designed to apply to your practice’s unique setup and staff ratios.

A constructive part of the discussion may include the realization that certain coworkers or departments valuable to the discussion were not in attendance and should be included in the next session. All participants should record their attendance on a sign-in sheet to capture team members that completed the exercise.

During the exercise, attendees discuss an emergency that could feasibly occur at the practice. Participating individuals should discuss and confirm which departments and specific roles would be impacted and, therefore, should play a part in the response. It is important to discern if participants are aware of the existence of or the need for a relevant governing organizational policy or procedure. Taking these factors into account, the team will seek to lay out the consequences of the emergency, which staff must act, when they should act, and what sequential actions they will need to take individually or in tandem with other departments. Consider providing copies of relevant policies at the time of the exercise for review with the team.

The process of presenting a full-blown emergency scenario to relevant staff may yield surprising results. Oftentimes, the organization and staff members themselves realize that there is a learning gap when it comes to awareness of active policies and their content. There may be an assumption that the duty to react is someone else’s responsibility, or maybe a misunderstanding of how many and which departments should take action to mitigate the emergency. These exercises are beneficial and eye-opening, pointing out areas for continued or focused training and mindfulness. A tabletop exercise is an efficient preliminary step to a simulation or mock drill.

Consider assigning key tasks to team members along with realistic timelines to complete. Included with this packet is an evaluation form to record opportunities identified during the exercise.

Review policies and procedures for accuracy and update them as needed based on the results of the exercise.

Work the improvements into your Quality Improvement program and include any emergency response team members, if applicable.