MSEL 2023 - Final revised 9.28.23.xls

	A	B	C	D	E	F	G	H	I	J	K	L	M
1	Event	Date	Time	Category	Inject Mode	Synopsis	From	To	Message	Expected Action	Responsible Organization	Objectives	Comment
2	Alpha Numeric Value (See Numbering Guide)	month/day/year	0:00am/pm	Inject	Electronic Mail	20 words or less summary	Agency name and any known contact info.	Agency Name & any known contact info	Text that serves as the implementer script for an inject.	Description of what is expected to occur as a result of participant action	Organization responsible for the event.	Align Objectives with Capabilities	Additional notes, comments, to support development of the event.
3									Scenario (Pre-Exercise Play)
4		11/16/2023	6:00am to 8:00am	Other	In Person	Explosion in Metrorail tunnel	Exercise Director for all Sectors	Players	• At 06:00 hours a large underground explosion occurred in a Metrorail tunnel under Vermont Avenue between Sunset Boulevard and De Longpre Avenue near Children’s Hospital Los Angeles (CHLA) • People are coming up out of the nearby Metrorail station located on the northeast corner of Sunset and Vermont with various injuries and complaints • First responders arrive on scene at the Metrorail Station and begin triaging the victims in the Immediate, Delayed, and Minor categories and are preparing patients for transport to local hospitals • News crews respond to the scene of the explosion and begin emergency broadcasting • Metrorail and utility crews from various City and County departments arrive on scene to assess damage to the Metrorail tunnel, the road surface, and other infrastructure impacted by the explosion • 07:30 hours the Los Angeles City Fire Department has cleared the MCI and all patients from the incident have been transported to various emergency departments in the County. • Metrorail and utility crews remain on scene assessing damage to the tunnel and other infrastructure	This pre-exercise MCI component is an optional component to facilitate play for those facilities wanting to expand the exercise internally Facilities that adopt this component can add additional victims if needed to meet accreditation requirements MAC will support this MCI component until 08:00 hours
5		11/16/2023	6:00am	Inject	ReddiNet	MCI initiated due to explosion in Metrorail tunnel	Medical Alert Center (MAC)	All 9-1-1 Receiving Hospitals on ReddiNet	The Medical Alert Center (MAC) initiates a MCI poll titled, "Metrorail Tunnel Explosion" and sends a ReddiNet message informing all Hospitals of an underground explosion in the Metrorail tunnel under Vermont between Sunset and De Longpre near CHLA. MAC begins assigning victims to 9-1-1 receiving hospitals	9-1-1 receiving hospitals respond to MCI poll and enter bed availability	All 9-1-1 receiving hospitals on ReddiNet		This pre-exercise MCI component is an optional component to facilitate play for those facilities wanting to expand the exercise internally. Facilities that adopt this component can add additional victims if needed to meet accreditation requirements. MAC will support this MCI component until 08:00 hours.
6									Day of Exercise
7		11/16/2023	TBD	Other	In Person	Each facility determine player check-in time and exercise area setup	Local (Hospital, Clinic, etc.) Controller / Evaluator (C/E)	Players	Players, Controller/Evaluators (C/E) Check-In	All participants check-in before 7:45 a.m. for internal (local) briefing from C/E. All players receive appropriate material and report to their assigned area	All players
8		11/16/2023	7:45am	Other	In Person	Local Player Briefing	Local (Hospital, Clinic, etc.) Controller / Evaluator (C/E)	Players	Player Briefing (Plan a 15-minute briefing)	Players receive an exercise and safety briefing	All players
9									Exercise Play
10	1	11/16/2023	8:00am	Message	ReddiNet	Start Exercise	Medical Alert Center (MAC)	Players	Start Exercise (StartEx)	Exercise play initiated by players	All players
11	2	11/16/2023	8:00am	Message	ReddiNet	Evacuation of Children's Hospital Los Angeles (CHLA)	MAC	All Health Care Partners (HCP) on ReddiNet	Children’s Hospital Los Angeles (CHLA) requires a full evacuation due to loss of water. Hospital administration reports the water interruption is related to the explosion that occurred in the nearby Metrorail tunnel. Engineers estimate CHLA will be without water for a minimum of 48 hours. CHLA evacuating all patients. The current census of CHLA is 490 patients	Exercise participants acknowledge ReddiNet message	All players	ASC, Clinic, HHH, and Urgent Care: Objective 1 Dialysis and Long Term Care: Objective 2 Hospital: Objective 5 Provider Agencies: Objectives 1 and 2	To: Dialysis, HHH, and LTC sectors Hospitals may request to decompress adult patients to your sites to make space for pediatric patient surge Consider preparing for possible transfer requests to support decompression efforts
12	3	11/16/2023	8:00am	Message	ReddiNet	Activate Pediatric Surge Plan	MAC	All Hospitals	The EMS Agency is activating the Pediatric Surge plan to support the full evacuation of CHLA	• All hospitals determine your appropriate surge plan, level of activation, and hospital decompression effort to increase capacity • Exercise participants acknowledge ReddiNet message	All players	Hospital: Objective 4
13	4	11/16/2023	8:00am	Inject	ReddiNet	Service Level Poll	MAC	All Hospitals	MAC initiates service level poll for Hospitals only	Each Hospital will determine which service level color they fit into and respond via ReddiNet with the appropriate color code within 60 minutes	All Hospital on ReddiNet	Hospital: Objective 5	All Hospitals report status. CHLA report status as Black
14	5	11/16/2023	8:00am	Message	ReddiNet	EMS Agency activates the Medical Coordination Center (MCC)	MAC	All HCP on ReddiNet	The EMS Agency is activating the MCC to support CHLA evacuation efforts	The EMS Agency activates MCC and sends out the Communication Plan via ReddiNet	All players	ASC and Clinic: Objective 1 Dialysis and LTC: Objective 2 HHH: Objective 1 Hospital: Objective 5 Provider Agencies: Objective 1 Urgent Care: Objective 1
15	6	11/16/2023	8:00am	Other	ReddiNet	MCC opens an incident in the Resource Request module	MCC	All HCP on ReddiNet	A new incident in the Resource Request (RR) module has been opened and is titled "2023 MRSE Exercise"	MCC opens a new incident in the RR module titled "2023 MRSE Exercise" to receive and process all exercise related RR	All players	ASC and Clinic: Objective 1 Dialysis and LTC: Objective 2 HHH: Objective 3 Hospital: Objective 5 Urgent Care: Objective 2
16	7	11/16/2023	8:00am - 8:10am	Inject	Phone	Public Health Notification of CHLA Evacuation	MCC/MHOAC	Public Health	The MCC/MHOAC updates OEM and MHOAC partners on satus of CHLA evacuation	MCC/MHOAC updates OEM and Public Health (HFID or EPRD) of CHLA evacuation	MCC/MHOAC	OEM: Objective 1 Public Health: Objective 1	Hospital Evacuation policy Reference No. 1112
17	8	11/16/2023	8:00am - 8:10am	Inject	Phone	FOAC Activation	LA County - Sim Cell	Provider Agencies	Due to size and scope of incident more ambulances are needed	Fire Operational Area Coordinator (FOAC) is activated. Additional EMS providers prepare to respond to Children's Hospital Los Angeles	Provider Agencies	Provider Agencies: Objective 3
18	9	11/16/2023	8:00am - 8:10am	Inject	Survey / ReddiNet Assessment Poll	Hospital capacity survey sent to players	MAC/EMS	All Hospitals	i) Number of staffed beds (includes both vacant and occupied beds) at the beginning of the exercise, prior to receiving patients, for the five (5) required bed types only ii) Number of existing patients (census) at the beginning of the exercise, prior to receiving patients iii) Number of patients who could be safely discharged to accommodate surge patients (decompress) During and Post Exercise (Patient Surge Data): iv) Number of surge patients requiring admission for inpatient care based on triage assessment v) Number of surge patients requiring outpatient care who will not be admitted based on your triage assessment (discharged from ED) vi) Number of inpatients and surge patients admitted for inpatient care with an appropriate staffed bed and after safe discharge of patients from the original patient census vii) Number of surge patients that required admission that need transfer to another facility due to no capacity or service not available	Respond to ReddiNet assessment poll using available resources and data. Data must be entered and submitted no later than 1 hours following conclusion of exercise	Hospital IMT	Hospital: Objectives 2 and 5
19	10	11/16/2023	8:00am - 8:10am	Inject	In Person	Delivery of emergency incident notifications to appropriate stakeholders	Hospital C/E LTC C/E	Players	Incident notifications are delivered to appropriate personnel based on incident severity	Hospital and LTC activates disaster protocol in response to the incident	Players	Hospital: Objectives 1 and 2 LTC: Objective 1
20	11	11/16/2023	8:00am - 8:10am	Inject	In Person	Activation of the Incident Management Team (IMT)	Hospital C/E LTC C/E	Players	Activation of pre-identified members of the IMT	IMT responds to the incident	Hospital IMT LTC IMT	Hospital: Objective 2 LTC: Objective 4
21	12	11/16/2023	8:10am - 8:15am	Inject	In Person	Initial Incident Action Plan (IAP) development	Hospital C/E LTC C/E	Players	IMT begin the process of developing an IAP for the incident	IMT begins IAP development to plan for the tactics for the next operational period based on what resources are available, what they need, and the challenges they foresee	Hospital IMT LTC IMT	Hospital: Objective 3 LTC: Objective 4
22	13	11/16/2023	8:10am - 8:15am	Inject	In Person	Incident Commander (IC) Initial Briefing	Incident Commander	Players	IMT IC provides the team with the initial incident information and expectations	Incident commander provides the team a summary of events	Incident Commander	Hospital: Objective 3 LTC: Objective 4
23	14	11/16/2023	8:20am	Inject	In Person	CHLA begins contacting facilities to coordinate patient transfer. (SimCell will contact each Pediatric receiving facility and relay which pediatric patients on the victim list are assigned to the contacted hospital) NOTE: Pediatric victim cards on EMS website	SimCell	Designated POC at Hospital	Each participating hospital to receive designated quantity of pediatric patients based upon the facility's Tier level in the Pediatric Surge Plan. Tier 1 to Tier 3 hospitals will receive 12 pediatric patients each. Tier 4 to Tier 5 hospitals will receive 7 pediatric patients each. Tier 6 hospitals will receive 5 pediatric patients each. Tier 7 and undesignated hospitals will not receive any pediatric patients. SimCell will call the designated point of contact at each receiving hospital. The SimCell caller will relay which patients on the Pediatric Victim list are assigned to the contacted hospital. SimCell Script: Hello, this is SimCell May I speak with (POC)? This is an Exercise I am calling from CHLA to give you your pediatric patient assignments You will receive (12, 7, 5) pediatric patients Are you ready? Your patients are numbers (1,2,3, etc.) on the list Would you like to confirm and relay to me your assigned patients? Thank you	Designate appropriate clinical personnel to conduct patient assessment to determine level of care and appropriate bed type needed for admission based on the data provided on the victim cards. All admissions will need an appropriate staffed bed in this exercise	Hospital IMT	Hospital: Objective 4
24	15	11/16/2023	8:25am	Message	ReddiNet	Ambulance patients arrive to each Tier 7 and unassigned hospital with patients from other hospitals. To support decompression efforts. NOTE: Adult patient cards on EMS website	MAC	All Hospitals	Each participating Tier 7 and unassigned hospital to be assigned 10 patients	Designate appropriate clinical personnel to conduct patient assessment to determine level of care and appropriate bed type needed for admission based on the data provided on the victim cards. All admissions will need an appropriate staffed bed in this exercise	Hospital IMT	Hospitals: Objective 4
25	16	11/16/2023	8:45am	Inject	In Person	Identify patients from current census that require transfer to another facility	Hospital C/E	Players	Determine number of patients in need of transfer to specialty care in a different facility	Evaluate patients impacted by the incident and identify individuals to be transferred to alternate care location	Hospital IMT	Hospital: Objective 4
26	17	11/16/2023	8:50am	Inject	ReddiNet	LTC Bed Availability Poll	MAC	All Long-Term Care (LTC) Facilities	Hospitals are decompressing and seeking to transfer stable patients to your facility for post-acute care. Identify open beds and implement strategies to expand capacity	LTC facilities enter your bed availability on ReddiNet within 60 minutes	IMT	LTC: Objective 3 and 4
27	18	11/16/2023	9:00am	Message	ReddiNet	Power Outage	MAC	All HCP	Received report of power outages sporadically occurring throughout the County.	Power outages occurring for extended periods of time impacting operations requiring use of back-up generators or other power source to maintain operations. Impacted facilities with backup generators opening space for those with durable medical equipment that need power	Incident Management Team	ASC: Objectives 1 and 3 Clinic: Objectives 1 and 2 Dialysis: Objectives 2 and 3 HHH: Objective 1 and 4 Long Term Care: Objectives 1 and 2 Urgent Care: Objective 1	This inject is optional for Hospitals. If selected, Hospitals cannot divert Pediatric patients.
28	19	11/16/2023	9:00am	Inject	ReddiNet	Service Level Poll	MAC	All HCP on ReddiNet (Except Hospitals)	MAC initiates service level poll for all Sectors (ASC, Clinics, Dialysis, HHH, Urgent Care sectors)	Each HCP will determine which service level color they fit into and respond via ReddiNet with the appropriate color code within 60 minutes	All healthcare partners on ReddiNet (Except Hospitals)	ASC, Clinics, HHH, and Urgent Care: Objective 1 Dialysis: Objectives 1 and 2 Long Term Care: Objective 2
29	20	11/16/2023	9:30am	Inject	In Person	Identify locations of charging stations to support those on DME that need power	MCC	ASC	MCC drafts message to obtain locations of charging stations	MCC drafts and sends message to appropriate recipients on ReddiNet and other platforms if needed to obtain locations of charging stations	(EMS Agency) Medical Coordination Center	EMS Agency: Objective 2
30	21	11/16/2023	9:40am	Inject	In Person	Share location of charging stations with HHH and others in HCC if needed	MCC	HHH	MCC shares locations of charging stations with HHH and others in HCC if needed	MCC drafts and sends message to appropriate recipients on ReddiNet and other platforms sharing the locations of charging stations	(EMS Agency) Medical Coordination Center	EMS Agency: Objective 2
31	22	11/16/2023	10:00am	Inject	In Person	Supplies Running Low	ALL HCP C/E except Hospitals	Players	Your supplies are running low and below PAR levels	Complete a resource request to the MHOAC via ReddiNet	IMT except Hospitals	ASC and Clinic : Objective 1 Dialysis, LTC, and Urgent Care: Objective 2 HHH: Objective 3
32	23	11/16/2023	10:00am	Inject	In Person	Hospitals enter in one resource request into ReddiNet	Hospital C/E	Players	Hospital command center identifies a critical pediatric resource need that is unavailable in their health care system (pediatric equipment, pediatric supplies, pediatric specific pharmaceuticals, pediatric staff, PPE for pediatric patients, etc.)	Complete a resource request to the MHOAC via ReddiNet	Hospital IMT	Hospital: Objective 5	Sample: IV tubing, needles, pediatric dialysis
33	24	11/16/2023	11:30am	Other	In Person	IAP completed and to be approved by IMT/IC	Hospital C/E LTC C/E	Players	Incident Action Plan to be discussed, revised, and approved by the IMT as necessary	Goals, objectives, tactics, and logistics requests discussed and approved or the plan	LTC and Hospital IMT	Hospital: Objective 3 LTC: Objective 4
34									End of Exercise
35	25	11/16/2023	12:00pm	Other	ReddiNet	End Exercise	MAC	All Participants	End of Exercise (EndEx)	At the direction of the Exercise Director, all Exercise activities will conclude
36	26	11/16/2023	12:15pm	Other			Exercise Director for all Sectors	All Participants	Conduct hotwash with all players. The Senior Evaluator will collect all Participant Feedback forms	Controllers will ensure direction is provided. Hot Wash will capture brief, high-level feedback on the exercise and player performance
37	27	11/16/2023	12:30pm	Other			Exercise Director for all Sectors	Controller and Evaluators (C/E)	C/E Debriefing	A C/E Debrief will be conducted for all exercise Controllers and Evaluators to capture observations and feedback
38	28	11/16/2023	1:00pm	Other			Hospital C/E	Players	Be sure to complete and submit the Assessment Poll	Completes the Assessment Poll ensuring all data has been entered and submitted within 1 hour following the conclusion of the exercise	Hospital IMT
39	29	11/16/2023	1:00pm	Other			Exercise Director for all Sectors	All Participants	Adjourn	Collect all feedback, paperwork, and any equipment that must be returned. Adjourn and thank you
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