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Chiang SC, Fisher HH, Bridwell ME, Trigoso SM, Rasulnia BB, Kuwabara SA. Applying the Ready, Willing, and Able Framework to Assess Agency Public Health Emergency Preparedness: The CDC Perspective. Health Secur 2020; 18:75-82. [PMID: 32324076 DOI: 10.1089/hs.2019.0090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Public health emergencies in the United States have been complex, frequent, and increasingly costly in the past decade, at times overwhelming government agencies that are primarily resourced for routine, nonemergency health functions. Emergencies are not always predictable, and adequate resources are not always available to prepare staff in advance for emergency response roles and to mobilize them quickly when a new threat emerges. Additionally, real-world data that connect preparedness levels to response outcomes may be difficult to obtain, further limiting continuous quality improvement efforts by public health officials. In this article, we apply the Ready, Willing, and Able (RWA) framework to identify areas for improvement related to organizational and staff readiness, willingness, and ability to respond during a public health emergency. We share emergency response deployment, training, and personnel data collected as part of emergency response activations (2008 to 2018) at the Centers for Disease Control and Prevention to illustrate how the framework may be applied at government agencies to improve response processes and effectiveness. Additionally, we propose potential metrics aligned with the framework constructs that may help emergency managers consistently assess agency preparedness and, over time, be incorporated into broader standardized measurement methods. We conclude that the RWA framework is a practical tool that can complement other preparedness approaches currently in use at government public health agencies.
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Affiliation(s)
- Shawn C Chiang
- Shawn C. Chiang, MPH, is a Predoctoral Research Fellow, Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA. At the time this work was conducted, he was an Evaluation Fellow, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Holly H. Fisher, PhD, is Evaluation Lead, Risk Management and Operational Integrity; Silvia M. Trigoso, MPH, is a Program Manager, Incident Manager Training and Development Program; Bobby B. Rasulnia, PhD, is Deputy Director, Risk Management and Operational Integrity; and Sachiko A. Kuwabara, PhD, is Director, Risk Management and Operational Integrity; all in the Division of Emergency Operations, Center for Preparedness and Response, CDC, Atlanta, GA. Matthew E. Bridwell, MPH, is Deputy Branch Chief, Division of Global HIV and TB, Center for Global Health, CDC, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Holly H Fisher
- Shawn C. Chiang, MPH, is a Predoctoral Research Fellow, Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA. At the time this work was conducted, he was an Evaluation Fellow, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Holly H. Fisher, PhD, is Evaluation Lead, Risk Management and Operational Integrity; Silvia M. Trigoso, MPH, is a Program Manager, Incident Manager Training and Development Program; Bobby B. Rasulnia, PhD, is Deputy Director, Risk Management and Operational Integrity; and Sachiko A. Kuwabara, PhD, is Director, Risk Management and Operational Integrity; all in the Division of Emergency Operations, Center for Preparedness and Response, CDC, Atlanta, GA. Matthew E. Bridwell, MPH, is Deputy Branch Chief, Division of Global HIV and TB, Center for Global Health, CDC, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Matthew E Bridwell
- Shawn C. Chiang, MPH, is a Predoctoral Research Fellow, Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA. At the time this work was conducted, he was an Evaluation Fellow, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Holly H. Fisher, PhD, is Evaluation Lead, Risk Management and Operational Integrity; Silvia M. Trigoso, MPH, is a Program Manager, Incident Manager Training and Development Program; Bobby B. Rasulnia, PhD, is Deputy Director, Risk Management and Operational Integrity; and Sachiko A. Kuwabara, PhD, is Director, Risk Management and Operational Integrity; all in the Division of Emergency Operations, Center for Preparedness and Response, CDC, Atlanta, GA. Matthew E. Bridwell, MPH, is Deputy Branch Chief, Division of Global HIV and TB, Center for Global Health, CDC, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Silvia M Trigoso
- Shawn C. Chiang, MPH, is a Predoctoral Research Fellow, Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA. At the time this work was conducted, he was an Evaluation Fellow, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Holly H. Fisher, PhD, is Evaluation Lead, Risk Management and Operational Integrity; Silvia M. Trigoso, MPH, is a Program Manager, Incident Manager Training and Development Program; Bobby B. Rasulnia, PhD, is Deputy Director, Risk Management and Operational Integrity; and Sachiko A. Kuwabara, PhD, is Director, Risk Management and Operational Integrity; all in the Division of Emergency Operations, Center for Preparedness and Response, CDC, Atlanta, GA. Matthew E. Bridwell, MPH, is Deputy Branch Chief, Division of Global HIV and TB, Center for Global Health, CDC, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Bobby B Rasulnia
- Shawn C. Chiang, MPH, is a Predoctoral Research Fellow, Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA. At the time this work was conducted, he was an Evaluation Fellow, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Holly H. Fisher, PhD, is Evaluation Lead, Risk Management and Operational Integrity; Silvia M. Trigoso, MPH, is a Program Manager, Incident Manager Training and Development Program; Bobby B. Rasulnia, PhD, is Deputy Director, Risk Management and Operational Integrity; and Sachiko A. Kuwabara, PhD, is Director, Risk Management and Operational Integrity; all in the Division of Emergency Operations, Center for Preparedness and Response, CDC, Atlanta, GA. Matthew E. Bridwell, MPH, is Deputy Branch Chief, Division of Global HIV and TB, Center for Global Health, CDC, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Sachiko A Kuwabara
- Shawn C. Chiang, MPH, is a Predoctoral Research Fellow, Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA. At the time this work was conducted, he was an Evaluation Fellow, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Holly H. Fisher, PhD, is Evaluation Lead, Risk Management and Operational Integrity; Silvia M. Trigoso, MPH, is a Program Manager, Incident Manager Training and Development Program; Bobby B. Rasulnia, PhD, is Deputy Director, Risk Management and Operational Integrity; and Sachiko A. Kuwabara, PhD, is Director, Risk Management and Operational Integrity; all in the Division of Emergency Operations, Center for Preparedness and Response, CDC, Atlanta, GA. Matthew E. Bridwell, MPH, is Deputy Branch Chief, Division of Global HIV and TB, Center for Global Health, CDC, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
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Tomizuka T, Kanatani Y, Kawahara K. Insufficient preparedness of primary care practices for pandemic influenza and the effect of a preparedness plan in Japan: a prefecture-wide cross-sectional study. BMC FAMILY PRACTICE 2013; 14:174. [PMID: 24252688 PMCID: PMC3840630 DOI: 10.1186/1471-2296-14-174] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 11/18/2013] [Indexed: 11/10/2022]
Abstract
Background Cases of emerging infectious diseases, including H5N1 influenza, H7N9 influenza, and Middle East Respiratory Syndrome, have been reported in recent years, and the threat of pandemic outbreaks persists. In Japan, primary care is the frontline against emerging infectious diseases in communities. Although the importance of pandemic preparedness in primary care has been highlighted previously, few studies have thus far investigated the preparedness among primary care practices (PCPs) or differences in the preparedness of different institutional settings. We examined PCP preparedness and response to the 2009 influenza pandemic in Japan, and explored the role of a pandemic preparedness plan during the pandemic. Methods We used a survey questionnaire to assess how well individual PCPs in Okinawa, Japan, were prepared for the 2009 influenza pandemic. The questionnaire was mailed to all eligible PCPs (N = 465) in Okinawa, regardless of their institutional setting. In addition, we assessed the differences in the preparedness of clinics and hospitals and determined whether the national preparedness plan affected individual preparedness and response. Data were analyzed using descriptive and logistic regression analyses. Results A total of 174 (37.4%) PCPs responded to our survey. In general, high-level personal protective equipment (PPE) such as N95 masks (45.4%), gowns (30.5%), and eye protection (21.3%) was stocked at a low rate. Clinic-based PCPs were significantly less prepared than hospital-based PCPs to provide N95 masks (OR 0.34), gowns (OR 0.15), and eye protection (OR 0.18). In addition, only 32.8% of PCPs adopted an adequate business continuity plan (BCP). After controlling for institutional setting, reading the national preparedness plan was significantly associated with establishment of a BCP (OR 5.86), and with knowledge of how to transfer a swab specimen to a local medical laboratory (OR 5.60). Conclusions With regard to PPE availability, PCPs (especially clinic-based PCPs) were not adequately prepared for the influenza pandemic. Awareness of the national pandemic preparedness plan is likely to promote prefecture-wide implementation of BCPs and surveillance activity.
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Affiliation(s)
- Taro Tomizuka
- Department of Health Policy Science, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan.
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