Tabletop Exercise for Training and Improving Business Continuity Plan Development in Hospital Pharmacies

While tabletop exercises (TTX) are frequently used for disaster preparedness, their value for strengthening hospital pharmacies' (HPs) business continuity plans (BCPs) remains uncertain. This study aimed to assess the impact of a TTX on the quality of HPs' BCPs and on links between BCPs and crisis response training.

Swiss HPs' BCPs were evaluated with a grid scoring 48 items (5-point Likert scale; 1 = "not at all sufficient" to 5 = "excellent"; 3 = minimal satisfactory expectation). Baseline BCP assessments were followed by a TTX simulating a blackout. A hot debriefing immediately after the TTX, followed by a written report from investigators, highlighted areas of improvement in business continuity management. Nine months later, follow-up BCP assessments were followed by a full-scale exercise (FSX) simulating cyberattacks and observed by four assessors. Participants reported satisfaction using questionnaires. The primary outcome was the difference between pre- and post-TTX BCP scores; the secondary outcome was the correlation between follow-up BCP scores and overall FSX responses.

Mean percentage of expected key items included in five HPs' BCPs rose from 47.9% to 54.2% (P < 0.05). Mean overall BCP score increased by 8.6%, from 1.74 ± 0.15 to 1.89 ± 0.16 (P < 0.05). Aspects relating to risk reduction or response improved more than those involving risk readiness or recovery. HPs with better BCP scores responded better to the FSX (R² = 0.78). Participants greatly appreciated both exercises.

HPs' BCPs slightly improved, with a correlation between BCP quality and HPs' ability to deal with crisis. The study highlighted the benefits of strengthening HPs' business continuity preparedness and the usefulness of disaster simulations, including TTX.