The 10 facilities sent 37 employees to the CDP's Hospital Emergency Response Training for Mass Casualty Incidents (HERT) course and the HERT Train-the-Trainer course. The HERT course is designed to prepare hospitals to conduct safe and effective emergency medical response to a mass casualty incident, while the train-the-trainer course allowed the graduates to deliver CDP training programs in their home jurisdiction and maintain a capable response team. The CDP continues to provide technical oversight and administrative assistance to the program.

The hospitals have since trained an additional 88 healthcare employees and established two Regional Decontamination Rapid Response Teams reflecting CDP training. In 2012, the northeast region outfitted two decontamination (decon) response trailers. These trailers are strategically located at separate facilities for rapid deployment to requesting regional hospitals.

"We've also developed notification procedures and a response team activation policy," said Brenda Greene, regional hospital coordinator for northeast Tennessee. "Hospital planners revisited or developed decontamination procedures and policies, resulting from the CDP course. The hospitals in our region not only feel better prepared, but are better prepared to respond to a [chemical, biological, radiological, nuclear, or explosive] incident."

The HERT course requires hospital employees—anyone on staff—to become familiar with decontamination procedures. These procedures not only protect the employees and patients, but also prevent a hospital from the cross-contamination that occurs when disaster survivors enter a hospital before decontamination. This capability is required by the Joint Commission on the Accreditation of Health Care Organizations (JCAHO) that requires health care facilities to be prepared in the event contaminated patients arrive at the hospital.

"Prior to the HERT course we identified the need to have trained members for decon response, to protect our staff, protect the facility, and treat patients who have been contaminated," said Greene. "Since returning from Anniston, and following our training here locally, we have noticed interest from other employees requesting to become part of the response process."

The regional facilities also discovered a need to standardize training within their system. Based on new operating procedures, training standards, and modified decontamination plans, more than 120 healthcare employees, representing 10 hospitals, are trained in lifesaving decontamination procedures, and have the capability to integrate with other teams, trained to the same standards.

"Attending CDP training, representing multiple facilities, increased the awareness of hospitals willing to work together throughout many communities," said Greene. "The training also heightened awareness to upper management who saw a purpose and results. Support for the courses and the acquisition of new equipment is a true benefit."

"The CDP routinely works with leadership and training managers, representing local jurisdictions and organizations, to help them identify training that meets a need or assists to correct a deficiency," said Rick Dickson, associate director of Training and Education, at the CDP. "Training that meets requirements and improves operations and capabilities is the end result we hope all CDP training produces."

The CDP training focuses on incident management, mass casualty response, and emergency response to a catastrophic natural disaster or terrorist act. Healthcare courses are provided at the Noble Training Facility (NTF). The former U.S. Army hospital was converted into a training site for health and medical education in disasters and mass casualty events. It serves as the only hospital in the U.S. dedicated solely to training. CDP training for state, local, and tribal responders is fully funded by the Federal Emergency Management Agency (FEMA), a component of the U.S. Department of Homeland Security.