A

n emergency response organization differs substantially from our usual public health organization for day-to-day business. However, as the spring 2009 H1N1 (also referred to as swine flu) outbreak highlighted, usual public health processes are fundamental for effectively responding to a public health emergency. The key challenge we will face in the fall and winter of 2009 is not the planning for an H1N1 outbreak but the establishment of clear criteria for the public health workforce to determine priorities in their jurisdictions.

The federal government grants for emergency preparedness to states and local jurisdictions include a program element that requires a Homeland Security Exercise Evaluation. A key aspect of this requirement is an improvement plan based on learning from required exercises of the preparedness plans. However, a 20-page after-action report may not be helpful in real-time decision making. The challenge is to make these reports actionable and nimble. Using quality improvement (QI) methods and tools alongside our situation status reports as actual information and data unfolds can be an invaluable way to determine next steps in our response cycle.

 …