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Introduction to NC Epi Teams

Introduction to NC Epi Teams. Presentation Overview. What is an Epi Team? Who belongs to an Epi Team? What are the responsibilities of an Epi Team? How does an Epi Team function? What are some examples of Epi Team investigations?. Learning Objectives.

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Introduction to NC Epi Teams

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  1. Introduction to NC Epi Teams

  2. Presentation Overview • What is an Epi Team? • Who belongs to an Epi Team? • What are the responsibilities of an Epi Team? • How does an Epi Team function? • What are some examples of Epi Team investigations?

  3. Learning Objectives • List the roles on a local health department Epi Team • Describe the four (4) primary responsibilities of an Epi Team • Give an example of a successful NC Epi Team investigation

  4. What is an Epi Team? • Multi-disciplinary public health team • “The purpose of an Epi Team is to prevent, respond to, and recover from disease outbreaks and other public health threats identified in the community.”

  5. Epi Team Roles • Team Leader • Epidemiologist • Microbiologist • Environmental Health Specialist • Interviewer(s) • Clinician • Media Spokesperson

  6. Team Leader • Description • Experience in outbreak investigation and epidemiology • Leader may be different for different outbreaks • Role can be filled by: • County health director • Public health nurse • Epidemiologist • Environmental health specialist

  7. Team Leader • Responsibilities • Convenes Epi Team • Provides oversight for investigation • Assigns tasks to other team members • Serves as contact with other agencies • Conducts regular meetings • Facilitates outbreak interventions • Reports outbreaks

  8. Epidemiologist • Description • Expertise in field epidemiology methods • Experience developing case definitions and questionnaires

  9. Epidemiologist • Responsibilities • Tracks surveillance data • Creates case definitions • Maintains line listing of cases • Trains team members on case finding and follow-up • Provides daily reports on case finding and case counts • Ensures data quality

  10. Clinician • Description • Training in medicine, nursing • Knowledge of disease prevention and treatment • Experience in health education

  11. Clinician • Responsibilities • Consults regarding disease signs and symptoms, transmission, incubation period, and treatment • Administers vaccines and prophylaxis • Collects clinical specimens • Educates cases and contacts • Visits health care providers • Monitors contacts for symptoms

  12. Environmental Health Specialist • Description • Experience with environmental field investigations • Knowledge of food and water safety regulations • Knowledge of environmental sampling

  13. Environmental Health Specialist • Responsibilities • Monitors environmental surveillance data • Conducts field investigations and traceback investigations • Collects environmental samples • Provides guidance on food and water safety regulations and engineering • Implements facility-related control measures

  14. Public Information Officer • Description • Experience developing media messages • Knowledge of risk and crisis communication

  15. Public Information Officer • Responsibilities • Reviews provider and public alerts, fact sheets, and reporting reminders • Prepares/reviews press releases • Responds to media inquires • Ensures availability of appropriate educational materials

  16. Laboratorian • Description • Expertise in laboratory testing • Knowledge of proper specimen collection and transport procedures

  17. Laboratorian • Responsibilities • Provides information on proper collection and transport of clinical specimens • Coordinates submission of specimens to State Laboratory of Public Health

  18. Administrator • Description • Knowledge of local health department policies and procedures • Experience handling staff expenses

  19. Administrator • Responsibilities • Distributes meeting agendas • Records minutes and keeps records of meetings • Tracks staff expenses (overtime, travel reimbursement) • Assures after hours building and cell phone access

  20. IT Specialist • Description • Knowledge of local health department computer system • Experience with database development and management

  21. IT Specialist • Responsibilities • Assists in database development, modification, and maintenance • Provides technical support • Assists with data entry • Equips team with necessary equipment

  22. Responsibilities of an Epi Team • Coordinate disease surveillance activities • Conduct epidemiologic investigations • Gather and analyze information from investigation • Implement public health control measures • Educate the public

  23. Coordinate Disease Surveillance • Monitor routine surveillance data • Compare expected to observed numbers and rates • Investigate reports from healthcare providers • Confirm or refute rumors of outbreaks

  24. Conduct Epidemiologic Investigations • Define cases • Find cases • Collect data • Analyze data • Report findings

  25. Gather and Analyze Information

  26. Implement Public Health Control Measures • Decide upon appropriate control measures • Work with community partners to implement control measures • Communicate necessity of control measures to affected groups

  27. Educate the Public • Assist hospitals or other healthcare facilities with outbreak management • Provide guidance to agencies dealing with outbreaks • Institutional settings (e.g. long-term care facilities, correctional facilities)

  28. How Does an Epi Team Function? • Communication • Logistics • Incident Command Structure • Coordination with PHRST and DPH • Resources

  29. Epi Team Contact Information • Maintain database of all team members • Name, specialty, best way to contact • Phone Numbers (work, home, cell) • Pager Number • Email Address • Emergency Contact • Distribute to all team members • Update regularly

  30. Internal Communication • Information flows in both directions • Leader should update Epi Team via meetings, conference calls, or email • Members provide regular updates to team leader • Acts as tool for measuring progress • Enables leader to provide feedback and direction to team members

  31. Document Investigation Progress • Keeps team members up to date • Provides material for communication with external partners • Can be used final report

  32. Maintain Daily Log • All steps taken in the investigation • Decisions made and rationale • Contacts: name, position, contact information • Meeting Documentation • Minutes • Follow up actions and those responsible • Photographs

  33. External Communication • Provide regular updates to external partners • NC Division of Public Health • Public Health Regional Surveillance Team • Local stakeholders – hospitals, healthcare providers, other government leaders/agencies, community organizations • General public • Maintain routine communication

  34. Epi Team Logistics

  35. Incident Command Structure

  36. How To Work in A Team • Know what is expected • Team member responsibilities • Team member expertise • Resources available for tasks • Know your role • Know who is in charge

  37. Delegation • Team leader will delegate tasks to appropriate team members • Other team members may also need to delegate tasks when overwhelmed • Assign an alternate team leader as a back-up

  38. Long hours, lack of rest Personal health and safety concerns Local sensitivities Unexpected or traumatic event Legal concerns Intense pressure to investigate quickly Interaction with multiple agencies Security concerns Stress Triggers

  39. Stress Management Strategies: • Enough sleep, good nutrition • Strategic pauses • Using humor • Talking to someone • Visualization • Self-talk • Massage • Debriefing

  40. After-action Discussions and Reports / Evaluation • Identifies what worked • Identifies what did not work • Creates a record • Can be used as a reference

  41. Resources for Investigation • Personnel • Equipment • Physical space

  42. NC Epi Team Investigation • DESCRIBE A SUCCESSFUL INVESTIGATION OF ONE OF NC’S EPI TEAMS – INCLUDE MISTAKES AND LESSONS LEARNED

  43. NC Epi Team Investigation 2 • DESCRIBE A SUCCESSFUL INVESTIGATION OF ONE OF NC’S EPI TEAMS – INCLUDE MISTAKES AND LESSONS LEARNED

  44. Conclusion • Working as a team requires: • A wide range of expertise • Clear communication • A rapid but careful and systematic approach in dealing with outbreaks

  45. References • Butler JC, Cohen ML, Friedman CR, Scripp RM, Watz CG. Collaboration between public health and law enforcement: new paradigms and partnerships for bioterrorism planning and response. Emerg Infect Dis 2002;8(10):1152-6. • Frace RM, Jahre JA. Policy for managing a community infectious disease outbreak. Infect Control Hosp Epidemiol 1991;12(6):346-7. • Sobel J, Griffin PM, Slutsker l, Swerdlow DL, Tauxe RV. Investigation of multistate foodborne disease outbreaks. Public Health Rep 2002;117(1):8-19.

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