HLTH 6771 Week 10 Terrorism Readiness Evaluation Example

Is the County Ready for a Mass-Casualty Terrorism Incident? A Readiness Evaluation Against Published Criteria

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Walden University

HLTH 6771: Terrorism: A Systematic Approach for Emergency Preparedness

Instructor Name

Month Day, Year

Is the County Ready for a Mass-Casualty Terrorism Incident? A Readiness Evaluation Against Published Criteria

The System and the Criteria

This evaluation judges one preparedness system, the composite metropolitan county's capacity to respond to a mass-casualty terrorism incident at a large public venue, against published criteria. Five criteria are used, each drawn from national guidance. First, whether the core capabilities the national preparedness goal defines for this scenario are owned, resourced and maintained (U.S. Department of Homeland Security, 2015). Second, whether the county's plans assign duties with documented resources. Third, whether information sharing and coordination follow documented processes, as incident management guidance expects (Federal Emergency Management Agency, 2017). Fourth, whether exercise findings become completed corrective actions (Federal Emergency Management Agency, 2020). Fifth, whether the county meets the capability target it set for itself under national assessment guidance (Federal Emergency Management Agency, 2018). The evidence is the documentary record reviewed in earlier weeks, gathered into one judgment here.

Criterion 1: Capabilities Owned and Resourced

Of four capabilities central to this scenario, operational coordination is fully owned, resourced and maintained. Public information and warning is owned and resourced for routine alerts but thin for a long event. Information sharing reaches the sheriff's office but stops there, with no one assigned to carry it further. The health and medical capability is well maintained through a hospital coalition but has no owner for patient distribution decisions. Finding: partly met; two of four capabilities have gaps in ownership at critical functions, and one more is thin for long events.

Criterion 2: Duties Matched by Resources

The terrorism incident annex is well organized but assigns several duties without documented resources or authority: after-hours public warning, mass-casualty supplies, authority to direct patient distribution, a family reunification site and onward sharing of threat information. Finding: not met for five of the annex's critical duties. Each of the five involves either a partner the county cannot direct or a resource the county has not budgeted, which is the same pattern that appears under the other criteria.

Criterion 3: Documented Coordination

The information chain from the state fusion center to local law enforcement is documented. The links from law enforcement to health and emergency management, and from the health department back to the fusion center, are not. Coordination among hospitals is documented for training and bed reporting but not for distribution decisions. Finding: partly met; the documented links serve law enforcement, while the links serving the medical and public consequences of an attack depend on informal practice.

Criterion 4: Exercises Leading to Corrective Action

The county's full-scale stadium exercise produced 9 corrective actions, of which 4 were complete 18 months later, 3 were past due and 2 had not started. Two substantive findings never became corrective actions. Finding: partly met; the county exercises regularly but carries through mainly the simpler actions that one agency can finish alone. Accounts of the 2013 Boston response tied its medical success partly to repeated joint drills beforehand (Biddinger et al., 2013), which is why incomplete follow-through matters.

Criterion 5: Meeting the County's Own Target

For its highest-concern attack scenario, the county committed to moving two hundred badly hurt people into care within four hours, then judged itself able to deliver only about 60% of that. Finding: not met by the county's own assessment, with the shortfall traced in that review to limited ambulances, surgical coverage and surge beds.

How Much Weight a Documentary Evaluation Can Bear

Every finding above rests on documents: the county's assessment, plans, agreements, budgets and exercise records. Documents are the right evidence for a readiness evaluation in one respect: a function that is not written down cannot be verified in advance, trained for consistently or protected from staff turnover. In another respect they understate readiness, because experienced people often fill gaps the documents leave. The verdict that follows is therefore about documented readiness. It is the standard national guidance uses, since assessments, plans and improvement plans are all documents, but it should be read as a statement about what the county can show, not a prediction of every outcome in a real incident.

A second limit is that the county's own target and its 60% rating are self-assessments. They reflect planners' judgment rather than a tested measure. They are still the most direct evidence available, because the county set the target and rated itself against it under a national process designed to surface gaps honestly.

The Verdict

Table 1 summarizes the findings.

Table 1

Readiness Findings by Criterion (Composite County)

No criterion is fully met except operational coordination within the first. The pattern of gaps is consistent across criteria: functions that cross organizational lines are the least documented and least resourced.

What the Verdict Means

The county is not ready, by its own published standards, for a mass-casualty terrorism incident of the scale it has itself identified as a top concern. That finding should not be softened: the county's own assessment, plans and exercise records show it. Nor should it be overstated. The county has a working command and coordination structure, regular exercises, a functioning hospital coalition and a documented link to the state fusion center. A real incident would likely be managed, but key functions, getting patients to the right hospitals, warning everyone affected, passing threat warnings to the health officer and emergency manager and supplying a large casualty load, would depend on improvisation by people working beyond their written roles. The gaps share a cause: functions that cross organizational lines lack an owner, an agreement or a budget. That cause, more than any single gap, is what a recommendation must address. A list of separate fixes, one per gap, would leave the next cross-organizational function unowned as well.

References

Biddinger, P. D., Baggish, A., Harrington, L., d'Hemecourt, P., Hooley, J., Jones, J., Kue, R., Troyanos, C., & Dyer, K. S. (2013). Be prepared: The Boston Marathon and mass-casualty events. New England Journal of Medicine, 368(21), 1958-1960. https://doi.org/10.1056/NEJMp1305480

Federal Emergency Management Agency. (2017). National Incident Management System (3rd ed.).

Federal Emergency Management Agency. (2018). Threat and hazard identification and risk assessment (THIRA) and stakeholder preparedness review (SPR) guide: Comprehensive Preparedness Guide (CPG) 201 (3rd ed.).

Federal Emergency Management Agency. (2020). Homeland Security Exercise and Evaluation Program (HSEEP).

U.S. Department of Homeland Security. (2015). National preparedness goal (2nd ed.).