SoAZHCC

Southern Arizona Healthcare Coalition

2017 U of A Game Changer Full-Scale Exercise

Exercise Evaluation Guide (EEG) – Long Term Care

Part I: Evaluation

Instructions: Please complete the information in the table below. A space is provided in the right column for you to note any comments relating to each of the questions.

Long Term Care / Evaluator Comments
  1. Was your facility notified of the emergency incident by the AzHAN within 30 minutes of the incident?
/ □ Yes □ No
  1. Did your entire facility network activate its Mass Casualty Plan?
/ □ Performed without Challenges
□ Performed with Some Challenges
□ Performed with Major Challenges
□ Not performed
  1. Did your facility activate its Command Center and Incident Command System structure?
/ □ Performed without Challenges
□ Performed with Some Challenges
□ Performed with Major Challenges
□ Not performed
  1. Was your facility provided with periodic situational updates from ESF-8?
  1. Did your facility provide situational feedback to ESF-8?
/ □ Yes □ No
□ Yes □ No
  1. Did your facility utilize available communication platforms such as telephones, AzHAN, and Survey Monkey, to receive or exchange information with ESF-8?
/ □ Yes □ No
  1. Did your agency contact ESF-8 for support in requesting licensing waivers?
/ □ Yes □ No
  1. Was your agency contacted by at least one hospital to arrange patient transfer to your facility/agency in order to decompress hospital patient surge?
/ □ Yes □ No
  1. Did your agency staff complete at least 5 patient assessments?
/ □ Yes □ No
  1. Did your agency staff alert the Command Center about supplies and staffing needed to manage patients?
/ □ Yes □ No
  1. Optional: Did your agency activate and implement its internal evacuation plans?
/ □ Yes □ No

Part II: Strengths and Areas for Improvement

  1. Please list the top three Strengths you observed for your facility/agency during this exercise.

Strength 1:

______

Strength 2:

______

Strength 3:

______

  1. Please list the top three Areas for Improvement you observed for your facility/agency during this exercise.

Area for Improvement 1:

______

Area for Improvement 2:

______

Area for Improvement 3:

______

Part III: Additional Questions and Comments

  1. What training opportunities would help you participate in an exercise such as this in the future?

______

______

  1. Which exercise materials were most useful? Please identify any additional materials or resources that would be useful.

______

______

  1. Please provide any recommendations on how this exercise or future exercises could be improved or enhanced.

______

______

  1. Additional Comments:

______

______

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