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
- 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
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
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
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