Senior leaders make decisions during disaster with limited knowledge of the impact on morbidity and mortality of populations. Public health emergencies and disasters are considered wicked problems, that is, problems with ambiguous and confounding challenges that often have no clear-cut right or wrong but only better or worse answers. While executive leaders generally desire to lead effectively and improve outcomes, their understanding of best outcomes, public health and disaster decision-making, is lacking. A different approach is required to transfer the knowledge gained in public health and disaster research to assist executive leadership as they are ensconced in the predictable but often rare event. A review of executive decisions during emerging infectious disease outbreaks like the 2009 H1N1 pandemic, Ebola virus disease (EVD), and Middle East respiratory syndrome (MERS) demonstrate the challenges to public health and healthcare providers already facing resource-constrained conditions. Executive decisions in past events failed to provide appropriate guidance to manage the emerging crisis. Poorly-informed decision-makers have recommended personal protective equipment unsupported by science; they have inappropriately implemented 21-day quarantines of asymptomatic healthcare workers exposed to EVD patients, tromping on civil liberties while failing to improve outcomes. This presentation will demonstrate a new simulation-based approach to support executive leadership during crisis. It will outline a program that guides the decision making process based on research and best science, integrated with policy, to improve outcomes during disasters and public health emergencies.