Public Health Communication with Frontline Clinicians During the First Wave of the 2009 Influenza Pandemic

Abstract

Context-During public health emergencies, office-based frontline clinicians are critical partners in the detection, treatment, and control of disease. Communication between public health authorities and frontline clinicians is critical, yet public health agencies, medical societies, and healthcare delivery organizations have all called for improvements.Objectives-Describe communication processes between public health and frontline clinicians during the first wave of the 2009 novel influenza A (H1N1) pandemic; assess clinicians' use of and knowledge about public health guidance; and assess clinicians' perceptions and preferences about communication during a public health emergency.Design and Methods-During the first wave of the pandemic, we performed a process analysis and surveyed 509 office-based primary care providers in Utah.Setting and Participants-Public health and healthcare leaders from major agencies involved in emergency response in Utah and office-based primary care providers located throughout Utah.Main Outcome Measure(s)-Communication process and information flow, distribution of emails, proportion of clinicians that accessed key websites at least weekly, clinicians' knowledge about recent guidance and perception about email load, primary information sources, and qualitative findings from clinician feedback.Results-The process analysis revealed redundant activities and messaging. The 141 survey respondents (28%) received information from a variety of sources: 68% received information from state public health; almost 100% received information from healthcare organizations. Only 1/3 visited a state public health or institutional website frequently enough (at least weekly) to obtain updated guidance. Clinicians were knowledgeable about guidance that did not change during the first wave; however, correct knowledge was lower after guidance changed. Clinicians felt overwhelmed by email volume, preferred a single institutional email for clinical guidance, and suggested new information be concise and clearly identified.Conclusion-Communication between public health, healthcare organizations, and clinicians was redundant, overwhelming, and can be enhanced considering clinician preferences and institutional communication channels. MESH termsinterdisciplinary communication; disease outbreaks; influenza; public health practice

Public health communications and alert fatigue

“…Similar issues were recently documented by a process analysis and survey conducted with primary care providers in Utah following the first wave of the 2009 influenza pandemic. A majority of providers stated that: 1) they received an overwhelming amount of email from public health authorities as well as health care organizations and 2) they desired less frequent, more concise and locally relevant emergency communications during a public health emergency [20]. Despite recognition of these problems, little is known about the potential for HCP alert fatigue from public health communications.…”

Strengthening Partnerships Along the Informatics Innovation Stages and Spaces: Research and Practice Collaboration in Utah

“…Prior to establishing the RMC, many of the key players who would need to respond to this type of public health events did not know one another. As the H1N1 outbreak evolved, researchers from the center were able to rapidly and systematically evaluate real communication in the field and identify problems with duplication of effort and communication overload (20). After the first wave of the outbreak, a new communication strategy was developed in large part due to the ongoing partnership among the major stakeholders, many of whom were represented in the RMC partnership (Figure 7).…”

Examining the Differences in Format and Characteristics of Zoonotic Virus Surveillance Data on State Agency Websites

“…Only 54% considered state agency websites their main resource of online investigation of public health data [6]. In another study, Staes et al [7] found that only 35% of clinicians during the 2009 influenza A H1N1 epidemic accessed state agency websites at least once a week while 50% never accessed them at all. In contrast, over half of the participants visited the CDC’s influenza website (53%) at least once a week [7].…”