An 18-month, independentlyevaluated regional pilot.
The pilot exists to answer one question: can a shared readiness framework be implemented, measured reliably, retained over time, and accepted by the institutions that would have to live with it?
Six functional roles, one founding region.
A founding region should include an urban or suburban law enforcement agency, fire/rescue, EMS, a receiving hospital or trauma center, a dispatch and communications partner, and an academy or simulation facility. A rural partner should be included where transport times and staffing permit a meaningful comparison.
Law enforcement
Threat suppression, warm-zone escort, command integration.
Fire / Rescue
Rescue task force, extraction, casualty collection points.
EMS
Treatment, triage, transport decisions, NEMSIS documentation.
Trauma center
Receiving expectations, alert thresholds, handoff standard.
Dispatch / Comms
Notification, common terminology, resource tracking, timestamps.
Academy / Simulation
Facilities, instructors, scenario control, scoring capacity.
Target scale: 3–6 institutions · Cohort sized to local capacity · Rural comparator where feasible
On numbers that do not yet exist
Participant counts, costs, and site totals must be derived from written commitments and a costed budget. Until partners sign, the honest figures are ranges and the honest status is "proposed."
Seven phases, each behind a stage gate.
Work
Secure governance, medical direction, MOUs, evaluator, baseline protocols, data-use agreements.
Stage-gate evidence required to proceed
Signed agreements; named leads; approved evaluation protocol.
Work
Build the Common Readiness Crosswalk, scenario package, data dictionary, instructor rubric.
Stage-gate evidence required to proceed
Clinical and operational review complete; version 1.0 released.
Work
Collect baseline skills and multi-agency exercise data; certify the initial instructor cadre locally.
Stage-gate evidence required to proceed
Baseline report; inter-rater check; instructor observation records.
Work
Deliver role-based cohorts and joint simulations; run after-action and corrective-action cycles.
Stage-gate evidence required to proceed
Training records; scored exercises; corrective-action register.
Work
Repeat measurements at three and six months; assess retention and protocol drift.
Stage-gate evidence required to proceed
Retention report; site comparisons; data-quality audit.
Work
Run the capstone multi-agency exercise and independent analysis.
Stage-gate evidence required to proceed
Prespecified outcome analysis; limitations; stakeholder interviews.
Work
Publish the independent evaluation and make the go/no-go decision on replication.
Stage-gate evidence required to proceed
Shareable report; revised toolkit; documented expansion decision.
Nine proposed measures. All proposed, not validated.
Each has an operational definition and a validation plan — establishing their reliability is itself part of the pilot's work.
All proposed measures remain subject to local clinical approval, feasibility testing, legal review, and reliability analysis.
What a partner institution is actually agreeing to.
Participation is bounded and reversible. A partner agrees to name an operational lead, contribute staff time for training and exercises, permit scored observation under agreed rules, and review outputs before publication.
A partner does not surrender command authority, does not adopt clinical content its medical director has not approved, and does not release patient-identifiable data. Any institution may withdraw without penalty, and the pilot is designed so that withdrawal of one partner does not invalidate the others' data.