Harris County Pandemic Influenza Engagement Projects & IOM/CDC Nurse Triage Line Public Engagement Project

Size: px

Start display at page:

Download "Harris County Pandemic Influenza Engagement Projects & IOM/CDC Nurse Triage Line Public Engagement Project"

Chastity Wade
5 years ago
Views:

1 Harris County Pandemic Influenza Engagement Projects & IOM/CDC Nurse Triage Line Public Engagement Project Umair A. Shah, MD, MPH NACCHO PHP Summit March 14, 2013

Harris County, Texas Third most populous county in

miles (size of Rhode Island) Geographically,

2 Harris County, Texas Third most populous county in the nation with population of 4.1 million Daytime population estimated to be 5-6 million Spread over 1,700+ sq. miles (size of Rhode Island) Geographically, politically, and demographically diverse HCPHES serves as the county health department for Harris County

3 HCPHES Mass Care/Mass Fatality Planning: Public & Partner Engagement Projects May - July ) To obtain citizen and stakeholder input on the draft plan for prioritizing vaccines, antivirals, and ventilators in the event of an influenza pandemic. [8 public + 1 stakeholder sessions] 2) To convene partners for pandemic influenza preparedness planning with the goal of reviewing current plans in place, gaps in planning, and strategies for overcoming identified gaps. [2 ½ day workshop]

4 Leveraging Internal/External Resources rce: with update Website: Public Health - Seattle/King County, 2009

5 Public Engagement - Locations

= diversity of opinion Reaching populations often left out of decision-making All-day meetings

6 Public Engagement - Recruitment Project Recruitment Goals 8 public sessions throughout county (+ 1 stakeholder session) 50 participants/session= 400 participants Diversity of participation = diversity of opinion Reaching populations often left out of decision-making All-day meetings breakfast, lunch, $75 stipend offered From sign to finish complete all sessions within two months!!

7 Public Recruitment Video - HCPHES

8 Public Engagement - Recruitment

9 REPRESENTATION Public Engagement - Recruitment

11 Public Engagement Scenario-Based

12 Public Engagement Discourse

13 Public Engagement - Polling

14 Public Engagement - Discourse

15 HCPHES PROJECT - SUCCESS? 1. The process was generally successful in attracting citizens to participate in nine in-person public engagement meetings held across the county. 2. The process was successful in attracting participants from diverse backgrounds and perspectives. 3. The process was successful in improving the knowledge of participants so they could engage in informed discussions about national vaccine policy. 4. The evaluation revealed that citizens changed their perspectives and opinions as a result of the deliberative process. 5. The process was perceived to be of high quality by citizens and stakeholders.

18 Partner Workshop Location July 2011

HCPHES Partner Workshop Sectors Examples of Sectors Represented Public Health 9-1-1 and other call

Care/Skilled-Care/Assisted Living Centers/Hospice Mortuary/Forensics Pharmacies/Pharmacists Emergency

Care Clinics Ambulatory Surgery Centers Urgent Care Centers Veterinarians Business/Private Interests

19 HCPHES Partner Workshop Sectors Examples of Sectors Represented Public Health and other call centers Fire Law Enforcement Emergency Medical Services (EMS)/Ambulance Long-Term Care/Skilled-Care/Assisted Living Centers/Hospice Mortuary/Forensics Pharmacies/Pharmacists Emergency Management (EM) Private Physicians/Clinicians Medical Society Non-Governmental Organizations Primary Care Clinics Ambulatory Surgery Centers Urgent Care Centers Veterinarians Business/Private Interests Nursing Laboratory Home Health Additional areas of government Hospitals including emergency departments and administration

20 Recruitment video - partner

21 HCPHES Partner Workshop Sectors 1) Sectors 2) Cross-sectors

22 HCPHES Partner Workshop Gaps & Building a System Developing steering committee for mass care/mass fatality planning

23 HCPHES Project Information: _Engagement_Evaluation.pdf

24 Public Engagement Forging a Way Forward NURSE TRIAGE LINE PROJECT

25 IOM Antivirals Public Engagements: Purpose To allow the Centers for Disease Control & Prevention (CDC) to receive input from a diverse cross-section of the public on the issue of acceptability of Nurse Triage Lines and other possible strategies to assist in the distribution and dispensing of antiviral drugs during a flu pandemic 25

26 IOM Antivirals Public Engagements: Basics Community Conversations in geographically and demographically diverse locations with general public participants who reflect the diversity of their communities Series of 4-hour sessions with a total of 232 participants: 1. Frontier Rural: Fort Benton, MT (Feb. 9) 2. Midsize Urban: Chattanooga, TN (Feb. 16) 3. Large Metropolitan: Los Angeles, CA (Mar. 2) IOM planning committee designed method and tools with collaboration with local public health and advocacy organizations on participant recruitment and logistics 26

27 IOM Planning Committee Membership Arthur Kellermann (co-chair), The RAND Corporation Lisa Koonin (co-chair), Centers for Disease Control and Prevention Alex Adams, National Association of Chain Drug Stores Roger Bernier, University of Georgia James S. Blumenstock, Association of State and Territorial Health Officials Greg Bogdan, Rocky Mountain Poison Center Susan Cooper, State of Tennessee Jack Herrmann, National Association of County and City Health Officials Ruth Lynfield, Minnesota Department of Health Suzet McKinney, Tauri Group Judy Meehan, National Healthy Mothers, Healthy Babies Coalition Elena Rios, National Hispanic Health Foundation Carol Rutenberg, Telephone Triage Consulting, Inc. Umair A. Shah, Harris County Public Health and Environmental Services 27

28 Framing the Issue: In a Flu Pandemic: Getting Life-Saving Medicines to the Public In a severe pandemic, possible roadblocks Many people sick at the same time Crowded hospitals, doctor s offices and clinics Long waits to see a healthcare provider for a prescription Sick, contagious people in waiting rooms and other public places People don t know where to turn for information In response, possible new strategies To provide quicker access to antiviral drugs To get medical advice to sick people and the worried well 28

29 Strategies For Consideration 1. Nurse Triage Lines 2. Collaborative Practice Agreements 3. Text Message System 4. Friend and Neighbor Pick Up and Delivery 5. Pandemic Flu Website 29

30 Method and Tools Surveys and scenarios designed to elicit 1. Participants thoughts about the 5 strategies: What are their pros and cons? Do they seem fair? Would they be acceptable if antivirals were in short supply? 2. Participants own ideas about how to get antivirals to the public during a flu pandemic 30

31 Agenda: Main Features 1. Audience Response System (ARS) pre-survey 2. CDC expert presentation on flu pandemics, antivirals, and proposed distribution & dispensing strategies 3. Two roundtable scenario discussions a. A severe flu pandemic causing long waits to see a healthcare provider for a prescription b. As pandemic continues, antivirals become scarce 4. ARS post-survey 31

32 Number of Participants Age Racial/Ethnic Characteristics of Three Sites Fort Benton, MT Chattanooga, TN Los Angeles, CA Older 100% White (7% Hutterite) Young adult-middle age 41% African American, 4% Hispanic Middle age > 90% African American, Hispanic Educational Level 84% some college 80% some college 55% some college Health Insurance Coverage 93% 83% 58% Nearest Pharmacy 32% > 25 miles 92% < 5 miles 98% < 5 miles Have called any medical hotline Have called a poison control center 62% 64% 42% 27% 10% 9% 32 32

33 High-Level Takeaways 1. Widespread acceptance of concept that there should be alternative ways for people to access antiviral drugs during a flu pandemic 2. Broad acceptance of all proposed strategies, including Nurse Triage Lines and Collaborative Practice Agreements 3. Few significant regional differences across the three sessions 33

34 The Devil Is In the Details... Some concerns expressed about: Capacity of hotlines (need to avoid cold-lines ) Competency (medical, cultural, etc.) of staff Streamlining of access Locus of control (national vs. local) Gaming the system if antivirals in short supply Other themes: Scarcity scenarios may require different strategies Transparency and communication as essential to trust, acceptance 34

35 Final Takeaways 1. Widespread acceptance of NTLs & CPAs Caveats: concerns increase when children, scarcity at issue 2. Conversations mainly increased acceptance of proposed strategies 3. Participant evaluation reflected consistent, broad agreement The information presented was trustworthy & helped them understand the challenges of getting antivirals to the public in a pandemic The scenario discussions were productive allowing them to express their views and hear the opinions of others By the post-survey, they had a better understanding of the issues They would recommend that family and friends participate in a similar session if offered the chance 35

36 Public Engagement: Over-arching Takeaway Message Public engagement is worth the effort it should be embraced, not feared! 36

37 To download the report, please visit: 12/Public-Engagement-on- Facilitating-Access-to-Antiviral- Medications.aspx Umair A. Shah, MD, MPH Deputy Director, Harris County Public Health & Environmental Services ph:

Flu on Call TM : Improving Access to Medical Care in a Severe Influenza Pandemic: Centers Play a Vital Role

Flu on Call TM : Improving Access to Medical Care in a Severe Influenza Pandemic: 2 1 1 Centers Play a Vital Role Lisa Koonin, DrPH, MN, MPH Centers for Disease Control June 3, 2014 1 Potential Problems