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Lessons About the State and Local Public Health System Response to the 2009 H1N1 Pandemic: A Workshop Summary

Stoto, Michael A. PhD; Nelson, Christopher PhD; Higdon, Melissa A. MPH; Kraemer, John JD, MPH; Hites, Lisle PhD, MS, MEd; Singleton, Christa-Marie MD, MPH

Journal of Public Health Management & Practice: September/October 2013 - Volume 19 - Issue 5 - p 428–435
doi: 10.1097/PHH.0b013e3182751d3e
Original Articles

Objective: Identify lessons about the public health emergency preparedness system from after action report/improvement plans (AAR/IPs) authored by state and local health departments following the 2009 H1N1 influenza pandemic.

Design: Potentially generalizable findings were collected during a workshop attended by representatives from the Centers for Disease Control and Prevention (CDC), state and local public health departments, and other organizations that prepared 2009 H1N1AAR/IPs.

Participants: Workshop participants included state and local health department personnel who had submitted AAR/IPs to the CDC for review.

Measures: Workshop participants were asked to consider the question: What did you hear from other jurisdictions that resonated with your own experience and could be a generalized finding?

Results: Workshop discussions revealed potential lessons concerning: (1) situational awareness during the initial response; (2) resource mobilization and legal authority; (3) the complexity of vaccine distribution and administration; (4) balancing emergency response and routine operations; (5) communication and coordination among the many independent actors in the public health system; and (6) incident management in a long-duration incident.

Conclusions: The response to the 2009 H1N1 influenza pandemic provides an opportunity to learn about the public health system's emergency response capabilities and to identify ways to improve preparedness for future events. Perhaps the most important lessons from the 2009 H1N1 response reveal the complexity of coordinating actions among the many different actors, institutions, sectors, and disciplines involved in the public health system. While the response to the pandemic engendered creative “on the spot” solutions, continued effort is needed to better understand and manage the identified challenges.

The objective of this article was to identify lessons about the public health emergency preparedness system from after action report/improvement plans authored by state and local health departments following the 2009 H1N1 influenza pandemic.

Department of Health Systems Administration, Georgetown University School of Nursing & Health Studies, Washington, District of Columbia (Dr Stoto and Mr Kraemer); RAND Corporation, Santa Monica, California (Dr Nelson); Harvard School of Public Health, Boston, Massachusetts (Ms Higdon); O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, District of Columbia (Mr Kraemer); University of Alabama at Birmingham School of Public Health, University Boulevard, Birmingham (Dr Hites); and Division of State and Local Readiness, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Singleton).

Correspondence: Michael A. Stoto, PhD, Department of Health Systems Administration, Georgetown University School of Nursing & Health Studies, 3700 Reservoir Rd, NW, Room 236, Washington, DC 20057 (stotom@georgetown.edu).

This article was developed with funding support awarded to the Harvard School of Public Health under cooperative agreements with the US Centers for Disease Control and Prevention (CDC) grant number 5P01TP000307-01.

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC.

Disclosure: The authors declare no conflicts of interest.

© 2013 Lippincott Williams & Wilkins, Inc.