Role of Exercises and Drills in the Evaluation of Public Health in Emergency Response

2006 ◽  
Vol 21 (3) ◽  
pp. 173-182 ◽  
Author(s):  
Kristine M. Gebbie ◽  
Joan Valas ◽  
Jacqueline Merrill ◽  
Stephen Morse
Keyword(s):  
Public Health ◽  
Emergency Response ◽  
Emergency Preparedness ◽  
Health Agency ◽  
Delphi Panel ◽  
Emergency Plan ◽  
Local Public Health ◽  
The Public ◽  
Delphi Round ◽  
Over Time

AbstractIntroduction:Public health agencies have been participating in emergency preparedness exercises for many years. A poorly designed or executed exercise, or an unevaluated or inadequately evaluated plan, may do more harm than good if it leads to a false sense of security, and results in poor performance during an actual emergency. At the time this project began, there were no specific standards for the public health aspects of exercises and drills, and no defined criteria for the evaluation of agency performance in public health.Objective:The objective of this study was to develop defined criteria for the evaluation of agency performance.Method:A Delphi panel of 26 experts in the field participated in developing criteria to assist in the evaluation of emergency exercise performance, and facilitate measuring improvement over time. Candidate criteria were based on the usual parts of an emergency plan and three other frameworks used elsewhere in public health or emergency response.Results:The response rate from the expert panel for Delphi Round I was 74%, and for Delphi Round II was 55%. This final menu included 46 public health-agency level criteria grouped into nine categories for use in evaluating an emergency drill or exercise at the local public health level.Conclusion:Use of the public health-specific criteria developed through this process will allow for specific assessment and planning for measurable improvement in a health agency over time.

scholarly journals Applying a Behavioral Model Framework for Disaster Recovery Research in Local Public Health Agencies: A Conceptual Approach

2015 ◽  
Vol 9 (4) ◽  
pp. 403-408 ◽  
Author(s):  
Lauren Walsh ◽  
Stephanie Garrity ◽  
Lainie Rutkow ◽  
Carol B. Thompson ◽  
Kandra Strauss-Riggs ◽  
...  
Keyword(s):  
Public Health ◽  
Educational Intervention ◽  
Emergency Preparedness ◽  
Disaster Recovery ◽  
Recovery Period ◽  
Health Agency ◽  
Behavioral Model ◽  
Conceptual Approach ◽  
Model Framework ◽  
Local Public Health

AbstractThe local public health agency (LPHA) workforce is at the center of the public health emergency preparedness system and is integral to locally driven disaster recovery efforts. Throughout the disaster recovery period, LPHAs have a primary responsibility for community health and are responsible for a large number of health services. In the face of decreasing preparedness funding and increasing frequency and severity of disasters, LPHAs continue to provide essential disaster life cycle services to their communities. However, little is known about the confidence that LPHA workers have in performing disaster recovery-related duties. To date, there is no widely used instrument to measure LPHA workers’ sense of efficacy, nor is there an educational intervention designed specifically to bolster disaster recovery-phase efficacy perceptions. Here, we describe the important role of the LPHA workforce in disaster recovery and the operational- and efficacy-related research gaps inherent in today’s disaster recovery practices. We then propose a behavioral framework that can be used to examine LPHA workers’ disaster recovery perceptions and suggest a research agenda to enhance LPHA workforce disaster recovery efficacy through an evidence-informed educational intervention. (Disaster Med Public Health Preparedness. 2015;9:403–408)

scholarly journals Canadian healthcare readiness for public health emergencies

2017 ◽  
Vol 86 (1) ◽  
pp. 29-31
Author(s):  
Cory Lefebvre ◽  
Adam Beswick ◽  
Lauren Crosby ◽  
Eric Mitchell
Keyword(s):  
Public Health ◽  
Infection Control ◽  
Emergency Preparedness ◽  
Health Care Services ◽  
Health Agency ◽  
Public Health Emergency ◽  
Effective Prevention ◽  
The Public ◽  
Public Health Emergencies ◽  
Care Services

Following the 2003 SARS (Severe Acute Respiratory Syndrome) outbreak in Toronto, there remains a concern that Canada’s healthcare systems are inadequately equipped to respond to a future public health emergency. Public health emergencies, defined as an emergency need for health care services to respond to a disaster, significant or catastrophic event, are economically costly. Effective prevention and responses to future emergencies would prevent economic costs like those from the 2003 SARS outbreak. An analysis from Hawryluck et al. of the SARS response identified major gaps: incomplete infection control, lack of system-wide communications, and no system-wide coordination leading to isolated, inefficient responses. More than a decade later, improvements have been made but there are areas in the infection control protocol that still require changes. More training is required for Emergency Medical Services (EMS) personnel to effectively handle emergency scenes and to improve multiple agency coordination. Local hospitals need to improve their surge capacity, administrative emergency preparedness infrastructure, and personnel training. The creation of the Public Health Agency of Canada (PHAC) in 2004 responded to concerns about the capacity of Canada’s healthcare system to respond effectively to public health threats. At the provincial level, the Emergency Management Branch (EMB) works effectively similar to and in coordination with PHAC. The needs for improvement should question if Canada will be able to handle the next public health emergency that rolls through its door.

scholarly journals The Economic, Institutional, and Political Determinants of Public Health Delivery System Structures

2012 ◽  
Vol 127 (2) ◽  
pp. 208-215 ◽  
Author(s):  
Richard C. Ingram ◽  
F. Douglas Scutchfield ◽  
Glen P. Mays ◽  
Michelyn W. Bhandari
Keyword(s):  
Public Health ◽  
Delivery System ◽  
Health Agency ◽  
Policy Makers ◽  
Local Public Health ◽  
Public Health Agencies ◽  
Health Delivery ◽  
Health Agencies ◽  
Health Delivery System ◽  
Over Time

Objectives. A typology of local public health systems was recently introduced, and a large degree of structural transformation over time was discovered in the systems analyzed. We present a qualitative exploration of the factors that determine variation and change in the seven structural configurations that comprise the local public health delivery system typology. Methods. We applied a 10-item semistructured telephone interview protocol to representatives from the local health agency in two randomly selected systems from each configuration—one that had maintained configuration over time and one that had changed configuration over time. We assessed the interviews for patterns of variation between the configurations. Results. Four key determinants of structural change emerged: availability of financial resources, interorganizational relationships, public health agency organization, and political relationships. Systems that had changed were more likely to experience strengthened partnerships between public health agencies and other community organizations and enjoy support from policy makers, while stable systems were more likely to be characterized by strong partnerships between public health agencies and other governmental bodies and less supportive relationships with policy makers. Conclusions. This research provides information regarding the determinants of system change, and may help public health leaders to better prepare for the impacts of change in the areas discussed. It may also help those who are seeking to implement change to determine the contextual factors that need to be in place before change can happen, or how best to implement change in the face of contextual factors that are beyond their control.

scholarly journals Central-line–Associated Bloodstream Infections Among Adult Intensive Care Unit Patients in Canadian Hospitals, 2011–2018

2020 ◽  
Vol 41 (S1) ◽  
pp. s464-s465
Author(s):  
Wallis Rudnick ◽  
Lynn Johnston ◽  
Jocelyn A. Srigley ◽  
Jun Chen Collet ◽  
Jeannette Comeau ◽  
...  
Keyword(s):  
Public Health ◽  
Intensive Care ◽  
Health Agency ◽  
Bloodstream Infections ◽  
Central Line ◽  
Public Health Agency ◽  
Fisher Exact Test ◽  
The Public ◽  
Annual Range ◽  
Over Time

Background: Nosocomial central-line–associated bloodstream infections (CLABSIs) are an important cause of morbidity and mortality in hospitalized patients. CLABSI surveillance establishes rates for internal and external comparison, identifies risk factors, and allows assessment of interventions. Objectives: To determine the frequency of CLABSIs among adult patients admitted to intensive care units (ICUs) in CNISP hospitals and evaluate trends over time. Methods: CNISP is a collaborative effort of the Canadian Hospital Epidemiology Committee, the Association of Medical Microbiologists and Infectious Disease Canada and the Public Health Agency of Canada. Since 1995, CNISP has conducted hospital-based sentinel surveillance of healthcare-associated infections. Overall, 55 CNISP hospitals participated in ≥1 year of CLABSI surveillance. Adult ICUs are categorized as mixed ICUs or cardiovascular (CV) surgery ICUs. Data were collected using standardized definitions and collection forms. Line-day denominators for each participating ICU were collected. Negative-binomial regression was used to test for linear trends, with robust standard errors to account for clustering by hospital. We used the Fisher exact test to compare binary variables. Results: Each year, 28–42 adult ICUs participated in surveillance (27–37 mixed, 6–8 CV surgery). In both mixed ICUs and CV-ICUs, rates remained relatively stable between 2011 and 2018 (Fig. 1). In mixed ICUs, CLABSI rates were 1.0 per 1,000 line days in 2011, and 1.0 per 1,000 line days in 2018 (test for linear trend, P = .66). In CV-ICUs, CLABSI rates were 1.1 per 1,000 line days in 2011 and 0.8 per 1,000 line days in 2018 (P = .19). Case age and gender distributions were consistent across the surveillance period. The 30-day all-cause mortality rate was 29% in 2011 and in 2018 (annual range, 29%–35%). Between 2011 and 2018, the percentage of isolated microorganisms that were coagulase-negative staphylococci (CONS) decreased from 31% to 18% (P = .004). The percentage of other gram-positive organisms increased from 32% to 37% (P = .34); Bacillus increased from 0% to 4% of isolates and methicillin-susceptible Staphylococcus aureus from 2% to 6%). The gram-negative organisms increased from 21% to 27% (P = .19). Yeast represented 16% in 2011 and 18% in 2018; however, the percentage of yeast that were Candida albicans decreased over time (58% of yeast in 2011 and 30% in 2018; P = .04). Between 2011 and 2018, the most commonly identified species of microorganism in each year were CONS (18% in 2018) and Enterococcus spp (18% in 2018). Conclusions: Ongoing CLABSI surveillance has shown stable rates of CLABSI in adult ICUs from 2011 to 2018. The causative microorganisms have changed, with CONS decreasing from 31% to 18%.Funding: CNISP is funded by the Public Health Agency of Canada.Disclosures: Allison McGeer reports funds to her for studies, for which she is the principal investigator, from Pfizer and Merck, as well as consulting fees from Sanofi-Pasteur, Sunovion, GSK, Pfizer, and Cidara.

scholarly journals At-a-glance - Emergency department surveillance of thermal burns and scalds, electronic Canadian Hospitals Injury Reporting and Prevention Program, 2013

2017 ◽  
Vol 37 (1) ◽  
pp. 30-31 ◽  
Author(s):  
Jennifer Crain ◽  
Steven McFaull ◽  
Deepa Rao ◽  
Minh Do ◽  
Wendy Thompson
Keyword(s):  
Public Health ◽  
Emergency Department ◽  
Prevention Program ◽  
Surveillance System ◽  
Health Agency ◽  
Hot Water ◽  
The Public ◽  
Hospitalization Rates ◽  
Injury Reporting ◽  
Over Time

Introduction Although fatality and hospitalization rates for burns in Canada have declined over time, less serious cases still commonly present to the emergency department (ED). Methods The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) is an injury and poisoning surveillance system administered by the Public Health Agency of Canada, operating in emergency departments of 17 hospitals. Results Overall, cases reported in 2013 were scalds and contact burns from hot objects. The leading direct causes of scalds were hot beverages and hot water. The leading causes of contact burns were stoves/ovens and fireplaces/accessories. While the overall proportion of burns was highest among females, males comprised a higher proportion of burns from all mechanisms except scalds.

Ready, Willing, and Able: A Framework for Improving the Public Health Emergency Preparedness System

2010 ◽  
Vol 4 (2) ◽  
pp. 161-168 ◽  
Author(s):  
O. Lee McCabe ◽  
Daniel J. Barnett ◽  
Henry G. Taylor ◽  
Jonathan M. Links
Keyword(s):  
Public Health ◽  
Emergency Response ◽  
Emergency Preparedness ◽  
Public Health Emergency ◽  
High Quality ◽  
The Public ◽  
Public Health Emergencies ◽  
Public Health Emergency Preparedness ◽  
Comprehensive Framework ◽  
Necessary And Sufficient

ABSTRACTEvery society is exposed periodically to catastrophes and public health emergencies that are broad in scale. Too often, these experiences reveal major deficits in the quality of emergency response. A critical barrier to achieving preparedness for high-quality, system-based emergency response is the absence of a universal framework and common language to guide the pursuit of that goal. We describe a simple but comprehensive framework to encourage a focused conversation to improve preparedness for the benefit of individuals, families, organizations, communities, and society as a whole. We propose that constructs associated with the well-known expression “ready, willing, and able” represent necessary and sufficient elements for a standardized approach to ensure high-quality emergency response across the disparate entities that make up the public health emergency preparedness system. The “ready, willing, and able” constructs are described and specific applications are offered to illustrate the broad applicability and heuristic value of the model. Finally, prospective steps are outlined for initiating and advancing a dialogue that may directly lead to or inform already existing efforts to develop quality standards, measures, guidance, and (potentially) a national accreditation program.(Disaster Med Public Health Preparedness. 2010;4:161-168)

Developmental Disorders in Canada

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Sarah Palmeter
Keyword(s):  
Public Health ◽  
Developmental Disorders ◽  
Health Agency ◽  
The Public ◽  
Age Of Diagnosis ◽  
High Level ◽  
Project Objectives ◽  
Disability Severity ◽  
Occupational Function ◽  
Improve Health

In the completion of my practicum at the Public Health Agency of Canada (PHAC) this summer, I worked to develop a surveillance knowledge product to support the national surveillance of developmental disorders. This project used Statistics Canada’s 2017 Canadian Survey on Disability to investigate the burden of developmental disorders in Canada. Developmental disorders are conditions with onset in the developmental period. They are associated with developmental deficits and impairments of personal, social, academic, and occupational function. The project objectives are to estimate the prevalence of developmental disorders in Canadians 15 years of age or older, overall and by age and sex, as well as report on the age of diagnosis, disability severity, and disability co-occurrence in those with developmental disorders. The majority of the analysis has been completed and preliminary results completed, which cannot be released prior to PHAC publication. Although not highly prevalent, developmental disorders are associated with a high level of disability in young Canadians. Early detection and interventions have been shown to improve health and social outcomes among affected individuals. Understanding the burden of developmental disorders in Canada is essential to the development of public health policies and services.

The Public Health Crisis Survival Guide

2018 ◽  
Author(s):  
Joshua M. Sharfstein
Keyword(s):  
Public Health ◽  
Police Officers ◽  
Health Agency ◽  
Health Improvement ◽  
Strong Response ◽  
Popular Imagination ◽  
Health Crisis ◽  
The Public ◽  
Public Health Crisis ◽  
Critical Skills

Firefighters fight fires. Police officers race to crime scenes, sirens blaring. And health officials? Health officials respond to crises. There are infectious disease crises, budget crises, environmental health crises, human resources crises—and many more. At such critical moments, what happens next really matters. A strong response can generate greater credibility and authority for a health agency and its leadership, while a bungled response can lead to humiliation and even resignation. Health officials must be able to manage and communicate effectively as emotions run high, communities become engaged, politicians lean in, and journalists circle. In popular imagination, leaders intuitively rise to the challenge of a crisis: Either they have what it takes or they do not. In fact, preparation is invaluable, and critical skills can be learned and practiced. Students and health officials alike can prepare not only to avoid catastrophe during crises, but to take advantage of new opportunities for health improvement. The Public Health Crisis Survival Guide provides historical perspective, managerial insight, and strategic guidance to help health officials at all levels not just survive but thrive in the most challenging of times.

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