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ASSESSMENT OF PUBLIC HEALTH AND HEALTHCARE PREPAREDNESS CAPABILITIES : ANALYZING CORRECTIVE ACTIONS TO IDENTIFY PRIORITIES. Lisa McCormick, DrPH ; Jonathan Wilson, RN, MSN, CHEP; Elena Linn, MPH; W. Terry McLeod, RN, BSN, CHEP; Jim Craig, BS, CPM. All Disasters Begin Locally!.

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ASSESSMENT OF PUBLIC HEALTH AND HEALTHCARE PREPAREDNESS CAPABILITIES: ANALYZING CORRECTIVE ACTIONS TO IDENTIFY PRIORITIES

Lisa McCormick, DrPH; Jonathan Wilson, RN, MSN, CHEP; Elena Linn, MPH; W. Terry McLeod, RN, BSN, CHEP; Jim Craig, BS, CPM

all disasters begin locally
All Disasters Begin Locally!
  • Initial Detection
  • Initial Response
  • Initial Recovery

Local Preparedness Is Essential

linking response systems
Linking Response Systems

First Responders

Fire/EMS

Medical & Mental

Health Services

Law

Enforcement

Public

Health

Emergency Management

capability overlap
Capability Overlap

Healthcare

Emergency Management

Public Health

National Preparedness and Core Capabilities

10 Essential Services of Public Health

PHP and HCP Capabilities

exercises and real life events
Exercises and Real-life events
  • Capabilities are tested via exercises and real-life events
  • Information and data collected in AARs/IPS are used to identify:
    • strengths
    • areas for improvement
    • capability performance
    • corrective actions
current need
Current Need
  • Need exists for a systematic, rigorous process for examining AARs and IPs
  • Method to examine trends and patterns within areas of improvement across capabilities in order to ensure:
    • Lesson learned are not ignored
    • Lessons learned are incorporated into future planning
    • Mistakes are not repeated
introduction to the cap corrective a ction prioritization process
Introduction to the CAP (corrective action prioritization) process
  • Purpose: creation of a tool that captures themes within corrective actions overtime
    • Depicts trends in areas of improvement
    • Allows for comparisons (event vs. exercises, exercise type vs. exercise type, year to year)
    • Identifies systemic problem areas that occur over time
  • Goal: enhance preparedness and response by prioritizing resources & strengthening capabilities

Note: This analysis does NOT look at strengths resulting from exercises/events. It is a way to look at reoccurring themes in areas for improvements.

slide10
Data
  • Data was collected from 12 MSDH after-action reports (AARs) from 2010 to 2013
    • 3 Events (note: two events flood/tornado 2011 combined into one AAR)
    • 9 Exercises
  • A total of 405 Corrective Actions identified
    • 118 from Events
    • 287 from Exercises
  • Created an Excel database and tool for recording, tracking, and analyzing AAR/IPs and CAs
methods
Methods
  • Reviewed, coded, and assigned by:
    • 1) Capability: PHP Capabilities & HCP capabilities, function (s), task (s), resource element (s)
    • 2) Theme: Macro-Theme, Needed Action, Unit of Improvement/Focal Point, Mezzo-Theme, Micro Theme, and Agency/Function Responsible
  • Capability and themes for CAs were determined by the context of the CA (i.e. what was trying to be accomplished)
  • Filters and pivot charts are used to analyze results and trends
macro theme definition
Macro Theme Definition
  • Staffing: Corrective Actions pertaining to issues regarding staffing (ex. Identifying additional staff, staff assignments, the management of staffing, etc.).
  • Training: Corrective Actions pertaining to the need for additional training (ex. training on roles and responsibilities, policies and procedures, equipment, systems/logistics, ICS, future exercises/drills, etc.).
  • Policies and Procedures: Corrective Actions pertaining to the planning and policies & procedures (ex. operational plans, systems/logistics, equipment, documentation & forms, etc.).
  • External Partners: Corrective Actions pertaining to partnering or communicating with external partners (identifying and developing partnerships/collaborations, MOUs, communication plans, etc.).
  • Internal Partners: Corrective Actions pertaining to communicating, coordinating and partnering with internal partners.
  • Equipment/Resource Need: Corrective Actions pertaining to the need for or standardization of equipment, systems, resources or supplies (ex. communications equipment, documentation & forms, systems/logistics, etc.).
example using themes
Example using Themes
  • CA Description: Provide Additional basic and advanced training opportunities for CORES ESAR-VHP local System Administrators.
conclusion tool for assessments
Conclusion – Tool for Assessments
  • Monitor quality of evaluation process
  • Realization of the utility of corrective actions/reduce stigma associated with identifying corrective actions
  • Database to track capability improvement over time
conclusion tool for prioritization
Conclusion – Tool for Prioritization
  • Assistance in conducting a needs assessment
  • Identify reoccurring & understated areas for improvement
  • Prioritize for future PHEP and HPP work plans
questions

Questions?

Lisa McCormick, DrPH

UAB School of Public Health

lmccormick@uab.edu