Integrating a framework for conducting public health systems research into statewide operations-based exercises to improve emergency preparednessReport as inadecuate

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BMC Public Health

, 12:680

Health policies, systems and management in high-income countries


BackgroundDue to the uncommon nature of large-scale disasters and emergencies, public health practitioners often turn to simulated emergencies, known as -exercises-, for preparedness assessment and improvement. Under the right conditions, exercises can also be used to conduct original public health systems research. This paper describes the integration of a research framework into a statewide operations-based exercise program in California as a systems-based approach for studying public health emergency preparedness and response.

MethodsWe developed a research framework based on the premise that operations-based exercises conducted by medical and public health agencies can be described using epidemiologic concepts. Using this framework, we conducted a survey of key local and regional medical and health agencies throughout California following the 2010 Statewide Medical and Health Exercise. The survey evaluated: 1 the emergency preparedness capabilities activated and functions performed in response to the emergency scenario, and 2 the major challenges to inter-organizational communications and information management.

ResultsThirty-five local health departments LHDs, 24 local emergency medical services EMS agencies, 121 hospitals, and 5 Regional Disaster Medical and Health Coordinators-Specialists RDMHC responded to our survey, representing 57%, 77%, 26% and 83%, respectively, of target agencies in California. We found two sets of response capabilities were activated during the 2010 Statewide Exercise: a set of core capabilities that were common across all agencies, and a set of agency-specific capabilities that were more common among certain agency types. With respect to one response capability in particular, inter-organizational information sharing, we found that the majority of respondents’ comments were related to the complete or partial failure of communications equipment or systems.

ConclusionsUsing the 2010 Statewide Exercise in California as an opportunity to develop our research framework, we characterized several aspects of the public health and medical system’s response to a standardized emergency scenario. From a research perspective, this study provides a potential new framework for conducting exercise-based research. From a practitioner’s perspective, our results provide a starting point for preparedness professionals’ dialogue about expected and actual organizational roles, responsibilities, and resource capacities within the public health system. Additionally, the identification of specific challenges to inter-organizational communications and information management offer specific areas for intervention.

KeywordsActivities Capabilities Emergency response Exercises Functions Information sharing Inter-organizational communications Preparedness Systems research AbbreviationsCHACalifornia Hospital Association

EMSEmergency medical services

IEDImprovised explosive device

LHDsLocal health departments

RDMHCRegional Disaster Medical and Health Coordinator-Specialist.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2458-12-680 contains supplementary material, which is available to authorized users.

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Author: Jennifer C Hunter - Jane E Yang - Michael Petrie - Tomás J Aragón


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