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Original Contribution

Healthcare Leadership Offers Valuable, Relevant Training

Shannon Arledge

Among the many emergency response courses offered at the Center for Domestic Preparedness in Anniston, AL, the Healthcare Leadership and Decision-Making (HCL) course has defined its lineup of healthcare training.

In 1999, the former U.S. Army Noble Hospital was converted into a training site for health and medical education in disasters and mass casualty events. Years later, and after several changes in operational responsibility, the full potential of this facility was realized and the official name changed from the Noble Training Center to the Noble Training Facility (NTF). The CDP has operated the NTF since 2007, and completely funds all training--to include travel, meals and lodging for state, local and tribal emergency responders.

Following the terrorist attacks of September 11, 2001, members of the National Health Professions Preparedness Consortium (Vanderbilt University, University of Alabama at Birmingham, and Louisiana State University) conceived and developed the current HCL course.

"After [the terrorist attacks], the members of the healthcare consortium determined that healthcare professionals needed a course to exercise emergency functions following a disaster or mass casualty event," said Linda Pressley, CDP training specialist. "They learned of the Noble Hospital and went to the Department of Health and Human Services to possibly reuse the facility and develop the HCL course."

Three pilot courses were delivered in 2002, and eight HCL courses were offered during 2003. Since that time, nearly 3,000 healthcare professionals have become HCL graduates.

"The HCL course is based on teamwork between multiple jurisdictions," said Pressley, who has 35 years of healthcare experience. "We may have 10 different healthcare teams in one course and many of them have never worked with other professions, much less with someone from another state. Some come from hospitals with 600 beds, and some come from hospitals with 80 beds. To succeed, they must work together and communicate."

"Since emergency preparedness is relatively new to the healthcare arena, we have [responders] attending the course with various experience in the field," remarked Tammy Pass, HCL course manager, who has been in nursing for more than 20 years. "Some organizations have excelled in emergency planning and some have minimal knowledge. No matter what their experience is, I feel the ability of exercising in an actual hospital setting for an extended period of time is invaluable."

The NTF is the only functional hospital in the nation dedicated to training healthcare workers. Instructors come from a variety of backgrounds, including emergency room physicians and nurses, paramedics, pharmacists, and public health professionals.

"HCL is unique, in that we have the only location where a hospital has been transformed into a modern training facility," added Candice Gilliland, assistant course manager. "We offer the opportunity for participants to experience a mock disaster in a real hospital, under controlled conditions. Realistically, it would not be possible to run drills such as this (involving all the different healthcare entities) in the participant's home locations."

"You can never fully focus on the exercise at home," said Dr. Mary-Elise Manuell, emergency medicine director from Worcester, Mass. "[At the CDP] you operate inside an actual hospital, which is so amazing. HCL truly opens our eyes to the impact of a [disastrous event] that could occur at our homes," she stressed. "When you come down here [to Alabama] and experience these fully-functional exercises and realize the broad impact they have, you want to go back and ensure your facility is ready for just about any type of incident."

According to Pass, the HCL course is unlike any other training she's witnessed since nursing school, and believes it's ideal for everyone in all facets of healthcare who desire a better emergency plan and emergency management. She added that the instructors are among the best in the country and relate real-life stories with years of experience.

"There is a lot of training to be done, not only with the hospitals but with all other services and agencies that may be involved in a mass casualty incident," added Pass. "Having participated in HCL training, a healthcare responder will leave here with a better idea of how all the pieces should work together to accomplish this goal."

The 32-hour course lasts four days and includes both classroom instruction and realistic scenario-based exercises--complete with the expected chaos, noise, power failures, media briefs, and even victims from a mass casualty event. According to Pressley, the students learn from their mistakes during the first four-hour exercise and use that to their benefit during the final eight-hour exercise.

"HCL graduates leave with a greater sense of satisfaction in their ability to perform in an emergency," said Pressley. "They leave with the confidence that they can handle and make decisions during a crisis."

"It's an excellent course," said Trais Hutcherson, from Memphis, TN, who manages his emergency department and coordinates his hospital's disaster preparedness. "It is the most realistic disaster course that I've taken in the country, and it would benefit anyone who could possibly work a disaster response and communicate with a hospital."

"A responder can expect to gain a lot of knowledge in a very short period," stressed Gilliland. "Our instructors are recognized experts in their fields and are very enthusiastic about this course. This enthusiasm spreads to the responders and aids in their learning."

Another advantage to attending CDP's HCL training is the Continuing Education Units (CEUs) available. Physicians and nurses may earn 32 educational units. Altogether, the CDP provides nine healthcare courses. But many of the instructors would say HCL is the "capstone" healthcare course. According to Gilliland, it is a combination of the other courses, but involves a variety of agencies that may take part in a mass casualty event in a real-world incident.

The Center for Domestic Preparedness is the nation's only Congressionally-chartered Federal training facility for nerve agents--also known as chemical weapons of mass destruction--for civilian emergency responders. The CDP is a vital component of the Federal Emergency Management Agency's National Preparedness Directorate. For additional information about training opportunities at the CDP, visit https://cdp.dhs.gov.