The Kidney Community Emergency Response (KCER) Coalition hosted an annual mock disaster drill on July 17, 2008. This activity provided training and practice to KCER Coalition members. It also demonstrated that the KCER Coalition can support CMS, the ESRD Networks, members of the kidney community, and individuals with kidney disease during an actual emergency. The 2008 KCER Exercise aimed to validate the capability to initiate each Response Team’s activation plan and coordinate comprehensive response activities.
Design
KCER Coalition members are dispersed throughout the country. Communication between team members is limited to telephone, email, and fax transmissions. Due to these geographic constraints, the 2008 KCER Exercise combined principles from orientation seminars and tabletop exercises. The KCER Response Teams utilized their charters and activation plans to familiarize other KCER Coalition members with their roles and responsibilities.
The Exercise
More than 50 people registered for the KCER Exercise. Representatives from all the ESRD Networks and each of the eight Response Teams actively participated in the exercise. The 2008 KCER Exercise was set in “Metropolis.” This fictional city was the setting for extended severe weather, rainfall, and a landslide event impacting municipal power and water supplies, and thus, dialysis operations.
An orientation provided an overview for participants regarding roles, plans, procedures, and equipment. KCER staff then simulated an emergency situation using a facilitated discussion-based exercise. Coalition members participated in three distinct modules:
· Module 1: Incident Notification
· Module 2: Initial Response
· Module 3: Ongoing Operations and Recovery
Each module began with an update via conference call to summarize the key events occurring within that time period. Participants read through the scenarios and developed response actions to each module, engaging in functional group discussions related to response issues via direct telephone calls, conference calls, and emails. Each Response Team documented its actions and identified potential problems for all three modules.
Following completion of the last module, all exercise participants were asked to submit feedback and evaluation forms. The feedback form was a tool to allow each participant to voice their experiences during the exercise, while the evaluation tool assessed the usefulness and effectiveness of the activity.
Follow-Up
All participants were asked to join the debriefing conference call on Friday, July 19th to discuss any issues and lessons learned. Several questions and best practices were discussed, which will ultimately lead to a more efficient response in the future. Two examples were:
- Recommendation for an online training course that outlines the purpose of disaster exercises and how these activities apply to the Coalition.
- Need for a new member packet to ensure that new Coalition members understand the Coalition’s mission, activities, Response Teams, and their own roles and responsibilities as a Coalition member.
Participants on the debrief conference call expressed that the exercise structure and length were appropriate for the activity. It was recommended that the structure and length remain the same for next year’s exercise.
FMQAI is currently summarizing all feedback and evaluation forms, which will be documented in the 2008 KCER Exercise Final Report, to include concerns, as well as ideas for solutions. This Report will be a useful tool for future KCER activities, and will assist in continuously improving the renal community’s ability to provide uninterrupted quality care to our ESRD patients during emergencies.
