Brief updates on NCPERRC research
In 2010 each research project conducted a study requesting input from North Carolina health department staff and others. As of October 1, the data collection phases of each project are complete. Now the research teams are in the process of analyzing the information collected. Here is a brief report on the work in progress.
Research project: Accreditation and Public Health Systems
Study: Preparedness Capacity Survey in North Carolina and matched comparison group from other states
Team: University of Arkansas for Medical Sciences, University of North Carolina at Chapel Hill and state and national partners
Goal: To measure local health department resources and capacities relevant to their ability to prepare for and respond to public health emergencies from an all-hazards perspective comparing North Carolina LHDs to a matched comparison group of LHDs from around the country
Method: 60-question online survey
Partners participating: 98% of all North Carolina (NC) LHDs (preparedness coordinator, health director and environmental health specialist) and 61% of LHDs in other states (as of 10/5/2010)
Preliminary results: For NC LHDs, the findings show evidence of a broad and robust set of capacities for planning, detecting and responding to public health incidents and emergencies. However, there is also evidence of significant local variability in some areas such as use of surveillance systems, emergency communications plans, volunteer registry and an all-hazards approach to planning.
Next steps: The team is currently working on: (1) analyzing the preparedness capacities comparing accredited, soon to be accredited and non-accredited NC LHDs; (2) analyzing the results of NC LHDs to a matched comparison group of LHDs from around the country; (3) preparing custom reports for all participating LHDs showing their capacities compared to LHDs from their region, the state and the matched comparison health departments; and (4) widely disseminating the overall results in research brief, presentations and journal articles.
Research project: Public Health Surveillance Systems
Study: North Carolina Electronic Disease Surveillance System (NCEDSS) evaluation
Team: University of North Carolina at Chapel Hill – School of Medicine and Gillings School of Global Public Health, Centers for Disease Control and Prevention Field Epidemiology Officer and state partners
Goal: To assess and make recommendations to improve electronic disease surveillance in North Carolina; this year's focus is on the North Carolina Electronic Disease Surveillance System (NC EDSS)
Method: In-depth in-person interviews with the NC EDSS lead and CD nurse staff at local health departments and with NC DPH users
Partners participating: 30 NC LHDs were invited to participate and 28 have completed interviews; interviews are also planned with NC DPH users
Preliminary results: The team is currently analyzing the collected information, but the preliminary findings show that there is a wide range of local procedures for NC EDSS use. Many users are making effective and efficient use of the system, and many praise NC EDSS for facilitating rapid access to laboratory results. However, not all users are making use of NC EDSS' full capacity. The information collected in this study will be used to identify best practices for use of NC EDSS from across the state.
Next steps: Over the coming months the team will be working on describing how LHDs have integrated NC EDSS into their work processes for disease surveillance and case management and what common bottlenecks they face in using the system. In addition, the team is working on defining the resources needed to use NC EDSS and identifying ways to efficiently manage the NC EDSS workload. Furthermore, the team is generating a list of recommended systems changes to improve the effective and efficient use of NC EDSS.
Research project: Regionalization of Public Health Preparedness Workforce Infrastructure
Study: Public Health Epidemiology (PHE) Program with 11 PHEs strategically placed at the state's largest hospitals providing services to the majority of North Carolina's 85 LHDs
Team: University of North Carolina at Chapel Hill and state partners
Goal: To describe the structural capacity of the PHE program; the PHE roles and responsibilities; the services PHEs provide to LHDs, NC DPH, and the hospitals in which they are based; and the role played by PHEs in responding to the H1N1 pandemic.
Methods: Data was collected from PHEs via web survey, paper-based assessment, and face-to-face interviews. PHE supervisors and NC DPH staff were interviewed as well. Additional data about services provided to LHDs by PHEs were collected from LHD staff via a Web survey.
Partners participating: A total of 119 lead Communicable Disease and Tuberculosis nurses from 75 LHDs completed in the Web survey. All PHEs participated in the surveys and interviews as did their hospital supervisors. In addition, key staff members at NC DPH were interviewed for this study.
Preliminary results: Preliminary reports have been delivered to NC DPH with information useful for managing and improving the PHE program including a description of the structural capacity (defined as "program inputs" including human, informational, organizational, and fiscal/physical resources) and the PHE roles and responsibilities including the estimated average time for each duty. The results of the Web survey and other interviews were released in October. This study suggests that the PHE program has enhanced (a) communication between hospitals and local public health, (b) the timeliness and completeness of communicable disease reporting, and (c) LHD's efficiency in reporting and investigating communicable disease in the community.
The team is working on the final descriptive reports for NC DPH as well as a manuscript, research briefs (to be posted on the NCPERRC Web site), posters and presentations to share the study findings in North Carolina and nationally.
Research project: Engineering the North Carolina Health Alert Network
Study: Computer Models to Assist with Vaccination Clinic Implementation
Team: North Carolina State University, University of North Carolina at Chapel Hill and the Southern Piedmont Partnership for Public Health (SPPPH)
Goal: To develop computer models for improving mass vaccination clinic implementation in order to find ways to improve resource utilization, the number of community members served, and the service time in future clinics.
Method: Through phone interviews and sharing information about the clinics, the research team and partners are working together to create a mass vaccination clinic computer model to reflect what actually happened in the 2009 H1N1 flu vaccination clinics in the SPPPH counties. The information collected includes what the clinic layout and patient flow looked like, how long each clinic activity took, how many people were involved, what skills were needed, and how long the clinic was in operation.
Partners participating: The SPPPH of the North Carolina Public Health Incubator Collaboratives. For phase 1 of this study, 5 LHDs are participating.
Preliminary results: Results are still pending, but the health departments are looking forward to working with the models in the spring of 2011 to plan future clinics.
Next steps: The team will develop the vaccination clinic configuration computer simulation models using the data captured via interviews. The models will be demonstrated to the LHDs to confirm that they accurately represent how each LHDs clinic operated. The models will include variables that can be changed to evaluate the efficiency of their clinic configuration. These models will also be presented and shared with other health departments in SPPPH.