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Adapting Community Call Centers for Crisis Support

Public Health Emergency Preparedness

This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.

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Chapter 5. Recommendations

In reviewing disaster scenarios for expected community needs, it becomes clear that we must help the public make informed decisions and care for themselves during severe health events. It is only with such strategies that we can hope to alleviate many potential demands on health care delivery systems and to accommodate those most in need. Assisting community health call centers to develop certain response capabilities is a part of that overall strategy. By employing the scenario-specific models and tools in this report, health call centers can increase their ability to support the following areas:

  • Health information.
  • Disease surveillance.
  • Triage/decision support.
  • Quarantine and isolation support/monitoring.
  • Outpatient drug information/adverse event reporting.
  • Mental health support/referral.

As this report has illustrated, four of the Department of Homeland Security National Planning Scenarios afford the best opportunity to involve most of the potential response capabilities for community health call centers:

  • Biological attack—aerosol anthrax.
  • Biological disease outbreak—pandemic influenza.
  • Biological attack—plague.
  • Biological attack—food contamination.

This does not imply that health call centers could not play an important role in responses to other scenarios; rather, that developing tools related to the response needs of these four biological scenarios affords the greatest potential for success.

Poison control centers, nurse advice lines, drug information centers, health agency hotlines and local/State/Federal public health agencies were chosen as target audiences for the proposed scenario-specific models and applications because they are familiar with basic physiological responses to particular health threats due to the knowledge and skills gained in their area of health care. The professionals employed by such centers have experience in assessing patient status, problem-solving, and working with symptomatic patients over the phone.

During any health emergency, these centers could continue to provide regular services while expanding services to provide information and support related to the event. Much of the expansion of services could be handled with nonclinical staff. In this way, these centers could help with surge capacity and informing the public about health issues so that they can make informed decisions and care for themselves.

It seems wise to build on the expertise, credibility, and infrastructure of community health call centers when planning for emergency responses. Expanding their capabilities to inform, educate, and assist the public with their health concerns can free the health care delivery system to most effectively use their limited resources to provide care to those most in need. This approach can especially aid in handling those at low risk for injury or illness, who may have valid fears and concerns that, without a mechanism to get information, could lead them to overtaxed hospitals and health departments.

This does not guarantee compliance with official recommendations, but it should help the public to understand the risks or consequences of their choices. However, call centers that are embedded in the community and familiar to the public should be well received when providing support during a health emergency.

Call centers attempting to provide the community services described here should do so in cooperation with the public health authority that, by statute, is responsible for coordinating health and medical services in response to public health and medical care needs following a major disaster or emergency, or during a developing potential medical situation. This coordination with the public health authority will help to ensure consistency with other response measures.

The model and tools proposed in this report should be used as part of a comprehensive public information strategy that includes the use of:

  • Mass media to provide the public with information on preventive measures, home care management, and the appropriate time to seek health care services.
  • Community health call centers to reinforce mass messaging and to provide additional and more tailored information to individuals with questions and concerns, as well as to review these issues for their value as potential mass media messages.
  • Community health call centers to assist with outpatient (home care) monitoring and support, thereby helping to extend the reach of public health and health care systems into households.
  • Information collected by the call centers for situational awareness and disease outbreak management and control.

In an emergency, the public may view hospitals as