Public health is an essential responder for emergencies: we are mandated first responders for disease outbreaks, family reunification and assistance center operations, emergency sheltering and mass care, and extreme heat or cold events., Yet due to our department's limited capacity and low frequency of regularly occurring incidents. our day-to-day work doesn't give us the opportunity to hone response skills over the years many Minneapolis Health Department staff have shared that they would appreciate the opportunity to have more hands-on experience to feel grounded and prepared for their role in an emergency response. We have had to activate our entire work force three times in the past ten years. Although many responses do not require this full department activation, when they do, we must be ready to implement our responses effectively.
The Minneapolis Health Department serves the most populous city in the state of Minnesota, a 58-square mile urban center undergoing rapid growth and development. Minneapolis grew to 423,990 in most recent estimates, an 11% increase from the 2010 census, and is projected to continue growing as it is the second largest economic center of the Midwest with a large international airport, five Fortune 500 companies, a large health care system, as well as a wide variety of multi-ethnic urban city communities. As of 2010 the city is 64% White, 19% Black or African American, 11% Hispanic or Latino, 6% Asian, 2% American Indian, 6% Other and 4% Multiracial.
Maintaining readiness to respond to emerging threats, natural hazards, and outbreaks is a priority for our department. We have approximately 107 FTEs, half of whom are grant funded positions whose time may not necessarily be devoted to training for emergencies. To ensure we can respond with prepared and confident staff, we developed our Habits program, which we are nominating for the NACCHO Model Practices Award.
The program was a result of the Health Commissioner reading The Power of Habit by Richard Duhigg, which postulates that habits acquired through repetition reduce stress and mistakes. The concept was to provide the Health Department's Incident Management Team with opportunities to learn, practice, and simulate the initial chaotic setup phase of our department's most likely responses, thereby reducing mistakes and increasing staff confidence and competency in those responses. By repeating the same functions for different likely scenarios in exercises, habits can be formed by those individuals assigned to response roles. It also provided a chance to practice leadership and decision making during the initial pandemonium of an event. Leadership and decision making are the critical skills that we have learned are important components for ensuring success.
The program consisted of a series of emergency response exercises conducted in multiple rounds, utilizing different scenarios and types of emergency operations, including Medical Countermeasure Medical Countermeasure Point of Dispensing, Family Assistance Center, and Mass Care Shelter. These operations are all currently designated responsibilities for our department by the City Emergency Operations Plan. For each exercise, staff were assigned to the role on the Incident Management Team that they will play in a real life-emergency. Each person was given a position description and checklist and kit of materials applicable to their role. Everyone then received the exercise scenario and time to run through it, followed by a debrief and walk-through of the situation. Each exercise was run through in three rounds, since the Incident Management Team for any given response includes one primary and two alternate people identified for each role. With each subsequent exercise additional supplies, equipment, and complexity was added to further the skills acquired. In addition, as issues were identified, changes were made in processes and organization to improve flow and efficiency.
In the post exercise evaluations, the staff reported they enjoyed working together to solve the problems and to be a part of the team. Many staff initially expressed anxiety about the exercises, but by the third round many stated they were looking forward to the opportunity again. While we have heard complaints from staff that the preparedness training and exercises take too much time away from their real” work, the evaluations showed that staff found this to be a valuable use of time. Overall, the evaluations showed that staff confidence and skills were increased and our goals met to be more prepared for the next event.