Preparing for Terrorism: Tools for Evaluating the Metropolitan Medical Response System Program

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The Metropolitan Medical Response System (MMRS) program of the U. S. Department of Health and Human Services (DHHS) provides funds to major U. S. cities to help them develop plans for coping with the health and medical consequences of a terrorist attack with chemical, biological, or radiological (CBR) agents. DHHS asked the Institute of Medicine (IOM) to assist in assessing the effectiveness of the MMRS program by developing appropriate evaluation methods, tools, and processes to assess both its own management of the program and local preparedness in the cities that have participated in the program. This book provides the managers of the MMRS program and others concerned about local capabilities to cope with CBR terrorism with three evaluation tools and a three-part assessment method. The tools are a questionnaire survey eliciting feedback about the management of the MMRS program, a table of preparedness indicators for 23 essential response capabilities, and a set of three scenarios and related questions for group discussion. The assessment method described integrates document inspection, a site visit by a team of expert peer reviewers, and observations at community exercises and drills.

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Editorial Reviews

From The Critics
The committee was established in the autumn of 2000 to study the feasibility of expanding the Metropolitan Medical Strike Team model established in Washington, DC and neighboring counties into a national program to respond to a mass-casualty terrorism incident. The attacks of September 2001 accelerated their effort and moved it from more theoretical to more concrete realms. The report is not indexed. Annotation c. Book News, Inc., Portland, OR
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Product Details

  • ISBN-13: 9780309084284
  • Publisher: National Academies Press
  • Publication date: 5/2/2003
  • Pages: 332
  • Product dimensions: 5.80 (w) x 9.00 (h) x 0.70 (d)

Table of Contents

Executive Summary 1
1 Introduction 17
Chemical, Biological, and Radiological Terrorism 18
The MMRS Program 23
Charge to the Committee 26
Methods of the Present IOM Study 28
Organization of This Report 30
2 Community Emergency Management and Available Federal Assistance 31
Emergency Management Terminology 32
Emergency Management in the United States 34
Local Emergency Management 36
State Assistance 40
The Federal Emergency Response Plan 42
The National Contingency Plan 47
The Federal Radiological Emergency Response Plan 48
Terrorism-Specific Federal Support Teams 48
Conclusion 50
3 Federal Efforts to Increase State and Local Preparedness for Terrorism 52
ODP Programs 53
FBI Programs 57
CDC Programs 58
FEMA Programs 60
4 Metropolitan Medical Response System Program Contracts 66
Functional Areas Covered 67
Products Demanded 68
Contract Deliverable Evaluation Instrument 74
5 Measurement and Data Collection in Evaluation 75
Evaluations of Various Types 76
Management Functions of Evaluations in the MMRS Program Context 78
Summative and Formative Uses of Various Evaluation Types 81
Why an Adequate Written Plan Is Not Sufficient Assurance of Preparedness 82
Evaluation Measurement for Low-Frequency, High-Stakes Events 85
Evaluation Measurements: Performance Measures and Proxies 86
Criteria for Selection of Evaluation Methods 87
6 Preparedness Indicators 91
Existing Standards 92
Existing Assessment Tools 94
Performance Measures Versus Preparedness Indicators 97
7 Feedback to Office of Emergency Preparedness on Program Management 100
OEP Help to MMRS Program Contractors 102
Survey for MMRS Program Contractors 105
8 Feedback to Office of Emergency Preparedness on Program Success 113
Essential Response Capabilities 115
Preparedness Indicators for Evaluation of Written Submissions, On-Site Inspection, and Observed Exercises 118
Preparedness Criteria 118
Exercises and Drills 159
Site Visits and Peer Evaluators 160
Scenario-Driven Group Interactions 161
Summary 162
9 Closing Remarks 164
Strategic Uses of Evaluation Data: Implementing the "Layering Strategy" 166
Committee Critique and Suggestions for Program Amendments 169
References 171
A: Committee and Staff Biographies 177
B Selected Information About Federal Chemical, Biological, Radiological, Nuclear Consequence Management Response Teams 187
C Metropolitan Medical Response System Program Cities 198
D 2000 MMRS Contract Deliverable Evaluation Instrument 200
E Preparedness Indicators for Metropolitan Medical Response System Program Contract Deliverables 219
F Scenarios and Discussion Materials for Use on Site Visits 252
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