Forty healthcare professionals returned to FEMA's Center for Domestic Preparedness (CDP) to train in preparation for a mass-casualty incident that they hope will never come. The employees represented 13 different hospitals in the Northeast Tennessee area and took part in the Healthcare Leadership for Mass Casualty Incidents (HCL) course in Anniston, Ala.

HCL is an exercise-based course designed to assist healthcare professionals in generating appropriate decisions in response to a mass casualty incident.

The returning group previously participated in the Hospital Emergency Response Training for Mass Casualty Incidents (HERT) course in September 2011. HERT prepares facility and agency staffs to conduct safe and effective emergency medical responses.

As a result from much planning and assistance from the CDP HERT training, an additional 88 healthcare employees received training, resulting in the establishment of two Regional Decontamination Rapid Response Teams.

"We come to the CDP and receive our training," said Brenda Greene, the regional hospital coordinator for Northeast Tennessee. "We then go back and train in our area."

The employees attended the HCL course to accomplish several objectives.

"We have had a change in several leadership and key positions within our emergency preparedness system at the hospitals," said Greene. "This was a good opportunity to bring the group together to train as a whole with many of the new people and to refresh with the senior personnel."

Along with training, Greene hopes that the employees training at the CDP will encourage team-building and problem-solving among the employees, as well as networking. The group represents many facets of the emergency medical field including safety managers, security, nurses, placement staff, chaplains, and public health officials.

"A major goal of training this week was the ICE component," added Greene. "It's all about exercises and being prepared. You cannot get a better experience."

The CDP developed the integrated capstone event (ICE) to provide the opportunity for multiple disciplines to work together in a final culminating exercise. The ICE component is a one-of-a-kind event where students from multiple courses "respond" to a single mass-casualty incident and work together to resolve the challenges.

During their CDP training, students have the opportunity to see effective roles and positions in an emergency from multiple perspectives throughout the HCL course.

"It's important to understand where we fit in to the big picture," said Will Fritz, base manager for Wings Air Rescue aeromedical transportation in Northeast Tennessee.

CDP's Noble Training Facility is the only hospital facility in the United States dedicated to training hospital and healthcare professionals in disaster preparedness and response. Noble has state-of-the-art facilities, but one element that each student finds most helpful is the site's ability to push the exercise.

"I think it is good we are seeing all of incident command open up," said David Robinson, OSHA compliance officer for Mountain States Health Alliance. "Most of our events, we do not get to go this far. It's encouraging to see how the roles should be played even though our roles differ at home."

Students are assigned roles during an emergency exercise and given the opportunity to see how multiple departments within a hospital work together to achieve a common goal.

"The emergency operations center (EOC) is very representative of a typical EOC in any county or town in this country," said Fritz. "That is something I would not have been able to experience in my current position without coming to the CDP."

CDP staff work to ensure the students have an accurate exposure to the inner workings of a mass- casualty incident.

"I want all of the students to have a realistic experience and have them think through how they would respond to an incident of this magnitude," said Pat Fugate, a HCL instructor, speaking about the realistic training scenario.

"My objective is to ensure the students understand the relationships within the command structure, that they learn how to relate with each other, how to communicate within the command center and how to make good decisions," added Fugate.

Each of the healthcare employees will be able to apply their CDP training in their current positions, as well as make plans for the future.

"Over the course of my career, I have trained in many different facilities at many different levels -- county, state, federal. I think the CDP instructors' ability to keep the class on a defined timeline and adhere to the course objectives and materials are two elements that are critical in education and training," said Fritz. "I believe that is why, when you leave here, you feel like you've actually learned something."

"The training will be beneficial as we move forward and plan our future exercises," said Greene. "This will be a system for them to build on within their own facility. The students have already pointed out additional training they wish to go over once home."

CDP training is fully funded for tribal, state, and local response personnel. Round-trip air and ground transportation, lodging, and meals are provided at no cost to responders or their agency or jurisdiction. The CDP plays a leading role in preparing state, local and tribal responders to prepare for and respond to manmade events or major accidents involving mass casualties. To learn more about the Center for Domestic Preparedness, visit or call 866-213-9553. Visit the CDP on Facebook, Twitter and LinkedIn