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<p><strong>You Are Here:</strong> <span class="crumb_link"><a href="/" class="crumb_link">AHRQ Archive Home</a> > <a href="/prep/" class="crumb_link">Public Health Preparedness Archive</a> > Chapter 5 </span></p>
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<td height="30px"><h2><span class="title">Adapting Community Call Centers for Crisis Support</span></h2></td>
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<td><div id="centerContent"><p><strong>Public Health Emergency Preparedness</strong></p> <div class="headnote">
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<p>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.</p>
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<p>This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: <a href="https://info.ahrq.gov/">https://info.ahrq.gov</a>. Let us know the nature of the problem, the Web address of what you want, and your contact information. </p>
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<p>Please go to <a href="https://www.ahrq.gov/">www.ahrq.gov</a> for current information.</p></div>
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<h2>Chapter 5. Recommendations </h2>
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<p>In reviewing disaster scenarios for expected community needs, it becomes
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clear that we must help the public make informed decisions and care for themselves
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during severe health events. It is only with such strategies that we can
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hope to alleviate many potential demands on health care delivery systems
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and to accommodate those most in need. Assisting community health call centers
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to develop certain response capabilities is a part of that overall strategy.
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By employing the scenario-specific models and tools in this report, health
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call centers can increase their ability to support the following areas:</p>
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<ul>
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<li>Health information.</li>
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<li>Disease surveillance.</li>
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<li>Triage/decision support.</li>
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<li>Quarantine and isolation support/monitoring.</li>
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<li>Outpatient drug information/adverse event reporting.</li>
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<li>Mental health support/referral.</li>
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</ul>
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<p>As this report has illustrated, four of the Department of Homeland Security
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National Planning Scenarios afford the best opportunity to involve
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most of the potential response capabilities for community health
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call centers: </p>
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<ul>
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<li>Biological attack—aerosol anthrax.</li>
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<li>Biological disease outbreak—pandemic influenza.</li>
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<li>Biological attack—plague.</li>
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<li>Biological attack—food contamination.</li>
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</ul>
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<p>This does not imply that health call centers could not play an important
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role in responses to other scenarios; rather, that developing tools related
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to the response needs of these four biological scenarios affords the greatest
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potential for success.</p>
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<p>Poison control centers, nurse advice lines, drug information centers, health
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agency hotlines and local/State/Federal public health agencies were chosen
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as target audiences for the proposed scenario-specific models and applications
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because they are familiar with basic physiological responses to particular
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health threats due to the knowledge and skills gained in their area of health
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care. The professionals employed by such centers have experience in assessing
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patient status, problem-solving, and working with symptomatic patients over
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the phone. </p>
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<p>During any health emergency, these centers could continue to provide
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regular services while expanding services to provide information and support
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related to the event. Much of the expansion of services could be handled
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with nonclinical staff. In this way, these centers could help with surge
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capacity and informing the public about health issues so that they can make
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informed decisions and care for themselves.</p>
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<p>It seems wise to build on the expertise, credibility, and infrastructure
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of community health call centers when planning for emergency responses. Expanding
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their capabilities to inform, educate, and assist the public with their health
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concerns can free the health care delivery system to most effectively use
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their limited resources to provide care to those most in need. This approach
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can especially aid in handling those at low risk for injury or illness, who
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may have valid fears and concerns that, without a mechanism to get information,
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could lead them to overtaxed hospitals and health departments.</p>
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<p>This does not guarantee compliance with official recommendations, but it
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should help the public to understand the risks or consequences of their choices.
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However, call centers that are embedded in the community and familiar to
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the public should be well received when providing support during a health
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emergency.</p>
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<p>Call centers attempting to provide the community services described here
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should do so in cooperation with the public health authority that, by statute,
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is responsible for coordinating health and medical services in response to
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public health and medical care needs following a major disaster or emergency,
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or during a developing potential medical situation. This coordination with
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the public health authority will help to ensure consistency with other response
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measures.</p>
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<p>The model and tools proposed in this report should be used as part of a comprehensive
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public information strategy that includes the use of:</p>
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<ul>
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<li>Mass media to provide the public with information on preventive measures,
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home care management, and the appropriate time to seek health care services. </li>
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<li>Community health call centers to reinforce mass messaging and to provide
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additional and more tailored information to individuals with questions
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and concerns, as well as to review these issues for their value as potential
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mass media messages.</li>
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<li>Community health call centers to assist with outpatient (home care)
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monitoring and support, thereby helping to extend the reach of public
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health and health care systems into households.</li>
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<li>Information collected by the call centers for situational awareness
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and disease outbreak management and control. </li>
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</ul>
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<p>In an emergency, the public may view hospitals as "safe havens"—places
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to go for food, shelter, protection, and medical attention. However, particularly
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in the event of a transmissible infectious disease in which hospitalized
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patients represent the sickest patients in the community, the concept of
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hospitals as "safe havens" may not be applicable. It may become
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more advantageous to manage and support the public in their homes with the
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assistance of health call centers. Community response planners will need
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to reinforce the concept of the home as a "safe haven" in their
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risk communication strategies and develop measures to support this concept
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in all aspects of their planning efforts. The possibility that some rudimentary
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degree of medical care will need to be delivered in the home setting should
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be included in public preparedness and education campaigns. </p>
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<h3><a name="Integration" id="Integration"></a>Integration With Current Programs
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and Initiatives </h3>
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<p>The concept of using community health call centers, the proposed model,
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and the IR applications fits well within programs and initiatives at the
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State and Federal levels. Such response resources can easily fit within the
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National Incident Management System (NIMS) that provides a consistent nationwide
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template to enable all government, private-sector, and nongovernmental organizations
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to work together during domestic incidents. </p>
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<p>By working within the NIMS framework and coordinating with local authorities,
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health call centers can ensure that the public receives accurate, coordinated
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information, helping to decrease panic and calls to emergency management.
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In the same manner, call centers can participate in ongoing operations, such
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as quarantine and isolation management or Strategic National Stockpile support,
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as part of the multi-agency coordination system, a combination of facilities,
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equipment, personnel, procedures, and communications integrated into a common
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framework for coordinating and supporting incident management.</p>
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<p>Federal and State Governments have set forth several requirements to be
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prepared for a disaster, including pandemic influenza. In Homeland Security
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Presidential Directive 8: National Preparedness, there are 36 essential capabilities
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on the Target Capabilities List (TCL) that various levels of government should
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develop and maintain.<sup><a href="call5.htm#ref31">31</a></sup> </p>
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<p>Among those TCLs is the requirement to strengthen medical surge and mass prophylaxis
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capabilities. Included in the National Preparedness Goal is supporting medical target
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capabilities for medical surge, such as isolation and
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quarantine.<sup><a href="call5.htm#ref32">32</a></sup> The
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proposed model and IR applications provide support for these efforts by allowing
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residents to identify and locate their point of dispensing (POD) location for mass
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prophylaxis and providing a mechanism to track and monitor patients in isolation
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and quarantine in order to assist public health agencies.</p>
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<p>The State of Colorado, like many others, has a quarantine and isolation
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component in its pandemic influenza plan. The Pandemic Influenza Annex to
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the Colorado Department of Public Health and Environment Internal Emergency
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Response Implementation Plan gives the authority to isolate or quarantine
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persons, groups of people, or buildings in Colorado, and at the recommendation
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of the Governor's Expert Emergency Epidemic Response Committee, to
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limit or close public gatherings and restrict the movement of people.</p>
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<p>Containment
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strategies range from those affecting individuals (e.g., isolation of patients)
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to measures that affect groups or entire communities (e.g., monitoring of
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contacts, cancellation of public gatherings). Guided by the current epidemiological
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data, State and local public health officials will implement the most appropriate
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of these measures to maximize the impact on influenza transmission and to
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minimize the impact on individual freedom of movement. The HELP program is
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included in the plan as a means to gather surveillance data for situational
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awareness and to support efforts to monitor those individuals placed in isolation
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or quarantine. Using the proposed IR applications will aid in providing this
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response capability.</p>
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<h3><a name="Communication" id="Communication"></a>Public Health Communications
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and Education </h3>
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<p>The National Association of County and City Health Officials has some timely
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recommendations to prepare for pandemic influenza. First is to engage the
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community and bring all stakeholders together in a way that makes sense.
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An essential piece to preparing any community for a public health emergency
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is involving stakeholders in the planning. Community members need to be heard,
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and if they feel that their views are not only being considered but also
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incorporated into the planning process, they will be more likely to support
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whatever plan is created. Second is to empower people to do their own planning.
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Third is to establish excellent lines of communication, the key to education
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about and awareness of any public health issue. These recommendations support
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the concept of health call centers and their use of IR technology to communicate
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with the public:</p>
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<blockquote>
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<p>"Dissemination and sharing of timely and accurate information with
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the health care community, the media, and the general public will be one
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of the most important facets of the pandemic response. Advising the public
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in actions they can take to minimize their risk of exposure or actions
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to take if they have been exposed, will reduce the spread of the pandemic
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and may also serve to reduce panic and unnecessary demands on vital services."<sup><a href="call5.htm#ref33">33</a></sup></p>
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</blockquote>
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<p>The National Governors Association also stresses the importance of public
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communications in order to build a trusted relationship with the response
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community and enhance the public's understanding of pandemic influenza.
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Responses to pandemic influenza must provide for effective communication
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to the public to minimize negative behaviors, accentuate positive actions,
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and limit the psychosocial and psychological impact of imposing public health
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measures that include movement restrictions. These messages should be developed
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and trained and trusted messengers should be selected now.<sup><a href="call5.htm#ref34">34</a></sup> For this reason,
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established and community-embedded health call centers are a good fit to
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partner with public health agencies to provide such communications.</p>
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<p>A major goal of public health education messages is to ensure that the public
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has the knowledge to protect itself. Prevention and infection control are
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the first line of defense, but there are other education topics as well.
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Dispelling rumors keeps the public properly informed and less prone to panic
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because of misinformation. Public health authorities have the responsibility
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to explain the rationale behind disease control measures, to explain why
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these measures are necessary, and to ensure that information is current and
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that messages do not contradict one another.<sup><a href="call5.htm#ref35">35</a></sup> Health call centers
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can partner with public health agencies to relay such information to the
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public in a consistent, accurate, and up-to-date manner.</p>
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<p>In "Components of Effective Disaster Public Education and Information,"
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(December 2005) a working group of the Emergency Management Accreditation Program emphasizes
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the correlation between effective public education and coordinated, effective
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disaster response and recovery outcomes. The report outlines steps for creating
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comprehensive and understandable public education messages so that residents
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can be better informed and better prepared. The report notes that, "Federal
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and State Governments must support local capabilities to provide effective
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public education and information through continuity of authority, emphasis,
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message, and language, as local and State public education and information
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have a direct impact on successful outcomes in a
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disaster."<sup><a href="call5.htm#ref36">36</a></sup> It is
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such local capabilities that health call centers have to offer the governments
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and communities they serve.</p>
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<p>Blendon et al. reported that most Americans favor the use of quarantine
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as a weapon against contagious diseases like SARS and pandemic influenza
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but are far less comfortable with strict enforcement and monitoring measures.
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While 76 percent of Americans surveyed said that they favor quarantining
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those potentially exposed to serious contagious diseases, only 42 percent
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supported a compulsory quarantine under which those who refused to comply
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could be arrested. However, 75 percent of those surveyed would favor periodic
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telephone calls to monitor those in
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quarantine.<sup><a href="call5.htm#ref24">24</a></sup> This
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suggests that a quarantine strategy using a health call center and a tool such
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as the QI Monitoring Application would be favorable to most Americans and likely
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to experience good compliance.</p>
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<p>The HELP model, which has become established in the community and is used
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on a daily basis, can be a resource for times of disaster, giving people
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the risk-based messages that include how to care for themselves and their
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families in order to mitigate a threat. The various call flows are designed
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to give reassurance as well as direction and information on the appropriate
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response measures. Such information can substantially change the behavior
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of the caller.</p>
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<p>Our report on the Denver Health NurseLine demonstrated that
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70 percent of patients complied with nurse advice line recommendations, though
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the same percentage had a different plan for their health care prior to
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calling.<sup><a href="call5.htm#ref10">10</a></sup> Patients
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who called were already aware of a need for information and were receptive
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to changing their behavior based on the information they received. It is
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not unlikely that the same behavioral changes would be seen in an emergency
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situation with persons contacting a health call center and perhaps even those
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receiving information via an IR system.</p>
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<h3><a name="SpecialNeeds" id="SpecialNeeds"></a>Special Needs Populations</h3>
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<p>Special needs populations will need customized forms of contact during an
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emergency. The proposed IR applications take into consideration some special
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needs communities, in particular the Spanish-speaking population. By developing
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most of the IR applications to accommodate both English and Spanish, a majority
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of callers will have the option to use such strategies to get information
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on the disaster. Depending on a community's demographics, it may want
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to offer additional language options for callers. </p>
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<p>Planners will need to determine
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if there will be sufficient demand to have announcements recorded in a particular
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language or to have those callers speak with a staff person using a translation
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service. The vision impaired will also likely find it easy to retrieve information
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via their telephone rather than from printed materials or the Internet. Many
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call centers have relied on TTY/TDD technology to communicate with the hearing
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impaired, though text messaging and e-mail communications are becoming more
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prevalent. The IR applications do not support TTY/TDD, and those callers
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would need to interact with a staff person to get information. The use of
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toll-free numbers should enable those without a phone in their home, a cell
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phone, or without even their own residence to call from any public phone
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at no cost.</p>
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<h3><a name="Volunteer" id="Volunteer"></a>Volunteer Use in Call Centers</h3>
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<p>Volunteers can assist health call centers in responding to public inquiry.
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The volunteers would need to have a vested interested in the community and
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be able to think on their feet, work under pressure, and answer the questions.
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To find these individuals, a call center can look to established volunteer
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groups, church organizations, or recognized nongovernment organizations like
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the Salvation Army or the American Red Cross. Planners who choose to use
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health care workers to staff a call center may want to look for volunteers
|
|
through the Health Resources Services Administration (HRSA) Emergency Systems
|
|
for Advance Registration of Volunteer Health Professionals program that each
|
|
State is developing. An important caveat made by HRSA is that these individuals
|
|
will need to identify themselves to callers as volunteers helping the
|
|
State.<sup><a href="call5.htm#ref37">37</a></sup></p>
|
|
<p>When using volunteers in a call center, it is best to be aware of the legal
|
|
implications of volunteer use in a disaster situation. Good Samaritan statutes
|
|
are laws enacted by various States that protect health care providers and
|
|
other rescuers from being sued when they are giving emergency help to a victim.
|
|
The rescuer has to use reasonable, prudent guidelines for care during the
|
|
response. Under such laws, the assistance must be voluntary, the person receiving
|
|
the help must not object to being helped, and the rescuer's actions must be a
|
|
good-faith effort to help.<sup><a href="call5.htm#ref38">38</a></sup></p>
|
|
<p>The Federal Volunteer Protection Act provides that no volunteer of a nonprofit
|
|
organization or governmental entity shall be liable for harm caused by an
|
|
act or omission of the volunteer on behalf of the organization or entity
|
|
if the volunteer meets certain requirements.<sup><a href="call5.htm#ref39">39</a></sup> It is very important to note
|
|
that this Federal law preempts State laws to the extent that such laws are
|
|
inconsistent, except that it does not preempt any State law that provides
|
|
additional protection from liability relating to volunteers or to any category
|
|
of volunteers in the performance of services for a nonprofit organization
|
|
or government entity. Health call centers that use volunteers should contact
|
|
their legal counsel to ensure that their use is in compliance with applicable
|
|
laws, that volunteers are covered under their liability insurance for such
|
|
use, and that volunteers are properly trained for such activities.</p>
|
|
<h3><a name="Partners" id="Partners"></a>Public Information Partnerships</h3>
|
|
<p>Public information partnerships between health call centers and public health
|
|
agencies prove that together they can meet the expected needs of communities
|
|
during health emergencies including: improving information support and surge
|
|
capacity, expanding surveillance signals, and collecting data for situational
|
|
awareness. These partnerships help meet the new demands on public health
|
|
agencies, increasing their response capabilities and access outside of the
|
|
9:00 a.m. to 5:00 p.m. work day, handling rapidly evolving information while
|
|
maintaining control, and enabling members of the public to care for
|
|
themselves and their families by supplying the information to help them make
|
|
decisions. </p>
|
|
<p>The need for such partnerships will remain constant or potentially increase,
|
|
since public health events will continue to occur. These events will require
|
|
effective, structured, and coordinated systems for providing public information
|
|
and support as part of the response. The HELP model has been proven to be
|
|
a cost-effective, efficient, reliable, and adaptable component of Colorado's
|
|
readiness response model for any public health emergency. The HELP model
|
|
offers the promise for similar response capabilities for other community
|
|
health call centers working in partnership with their public health agencies.
|
|
These community resources will likely have robust infrastructure to serve
|
|
as strong platforms that can incorporate the proposed tools and adapt them
|
|
as needed.</p>
|
|
<h3>Model Utility and Adaptability</h3>
|
|
<p>This model and the IR applications were applied locally and statewide, but
|
|
they could potentially be adapted for interstate and Federal use. There may
|
|
be legal risk implications for clinical personnel using decision support
|
|
and triage strategies across State lines. The National Council of State Boards
|
|
of Nursing (www.ncsbn.org) is working to secure mutual recognition of nurse
|
|
licensure across States that may help with this issue. However,
|
|
a larger issue concerns the coordination of messages across various levels
|
|
of government to ensure consistency and public trust. It may be difficult
|
|
for public health and safety agencies across all levels of government to
|
|
agree on specific strategies and develop unified messages. It may be easier
|
|
to develop response resources such as the HELP model and IR applications
|
|
on a statewide or smaller scale to avoid the difficulties in regional and
|
|
national coordination. Planners at various levels of government should consider
|
|
this challenge in their planned application of such resources.</p>
|
|
<p>The model and applications that we have developed are largely informational in nature
|
|
and can be delivered easily with trained nonclinicians or can be automated.
|
|
However, the applications should all be employed with sufficient back-up
|
|
support such as the HELP platform so that users can always get the proper
|
|
assistance. </p>
|
|
<p>In our experience, it has been valuable to have systems and processes that
|
|
can be adjusted to the changing needs of emerging public health events.
|
|
This has included the ability to:</p>
|
|
<ul>
|
|
<li>Rapidly change FAQ content and public health messages. </li>
|
|
<li>Handle surge responses through a variety of mechanisms<ul>
|
|
<li>Using recordings/announcements</li>
|
|
<li>Using an interactive response system with interactive response applications</li>
|
|
<li>Partnering with media to deliver information</li>
|
|
<li>Having trained ancillary staff.</li></ul>
|
|
</li>
|
|
<li>Learn from experiences.</li>
|
|
</ul>
|
|
<p>Some of the lessons learned from more than 3 years of operating the HELP
|
|
program include:</p>
|
|
<ul>
|
|
<li>Call volume is driven by the event and media attention—anticipate
|
|
call volume surges related to morning, afternoon, and evening news broadcasts.</li>
|
|
<li>Media organizations are willing to assist with disseminating information,
|
|
including hotline numbers regularly displayed in television news crawlers.</li>
|
|
<li>Adaptation to include the latest local and State health department
|
|
messages is necessary to meet both public health and public needs.</li>
|
|
<li>Surveillance, though not an intended purpose of the program, became
|
|
an important function due to the utility of structured data collection
|
|
(situational awareness) and the ability to identify emerging issues (sentinel
|
|
event detection).</li>
|
|
</ul>
|
|
<p>Operating a public informational resource requires the ongoing need to adapt,
|
|
reassess, and improve. There always will be further challenges to address:</p>
|
|
<ul>
|
|
<li>Testing the IR applications in various community groups (non-English
|
|
speakers, seniors) and determining if there are any issues with their
|
|
use.</li>
|
|
<li>Improving public messages and FAQ information content.</li>
|
|
<li>Determining other information and tools for meeting the needs of health
|
|
emergency events.</li>
|
|
</ul>
|
|
<hr />
|
|
<p class="size2"><a href="index.html#contents">Return to Contents</a></p>
|
|
<h2><a name="References" id="References"></a>References</h2>
|
|
|
|
<p class="size2"><a name="ref01" id="ref01"></a><sup>1</sup> Krause G, Blackmore C, Wiersma S, et al. Mass vaccination campaign following community outbreak of meningococcal disease. <em>Emerg Infect Dis</em> 2002;8:1398-1403.</p>
|
|
|
|
<p class="size2"><a name="ref02" id="ref02"></a><sup>2</sup> Svoboda T, Henry B, Shulman L, et al. Public health measures to control the spread of the severe acute respiratory syndrome during the outbreak in Toronto. <em>N Engl J Med</em> 2004;350:2352-2361.</p>
|
|
|
|
<p class="size2"><a name="ref03" id="ref03"></a><sup>3</sup> Tan CG, Sandhu HS, Crawford DC, et al. Surveillance for anthrax cases associated with contaminated letters, New Jersey, Delaware, and Pennsylvania, 2001. <em>Emerg Infect Dis</em> 2002;8:1073-1077.</p>
|
|
|
|
<p class="size2"><a name="ref04" id="ref04"></a><sup>4</sup> Covello VT, Peters R, Wojtecki J, et al. Risk communication, the West Nile virus epidemic, and bioterrorism: responding to the communication challenges posed by the intentional or unintentional release of a pathogen in an urban setting. <em>J Urban Health</em> 2001;78:382-391.</p>
|
|
<p class="size2"><a name="ref05" id="ref05"></a><sup>5</sup> Bogdan GM, Scherger DL, Brady S,
|
|
et al. Health emergency assistance line and triage hub (HEALTH) model. (Prepared
|
|
by Denver Health—Rocky Mountain Poison and Drug Center under Contract
|
|
No. 290-0014). Rockville, MD: Agency for Healthcare Research and Quality,
|
|
January 2005. AHRQ Publication No. 05-0040. Available at:
|
|
<a href="/research/health">https://www.ahrq.gov/research/health</a>.</p>
|
|
<p class="size2"><a name="ref06" id="ref06"></a><sup>6</sup> Renn O. Perception of
|
|
risks. <em>Toxicol Lett</em> 2004;149:405-413.</p>
|
|
<p class="size2"><a name="ref07" id="ref07"></a><sup>7</sup> Lasker RD. Redefining readiness:
|
|
terrorism planning through the eyes of the public. New York, NY: The New York
|
|
Academy of Medicine, 2004. Available at:
|
|
http://www.redefiningreadiness.net/pdf/RedefiningReadinessStudy.pdf.</p>
|
|
<p class="size2"><a name="ref08" id="ref08"></a><sup>8</sup> Blendon RJ, Benson JM, Weldon KJ,
|
|
et al. Harvard School of Public Health Project on the Public and Biological
|
|
Security: Pandemic Influenza Survey September 28—October 5, 2006.
|
|
Available at: www.hsph.harvard.edu/panflu/IOM_Avian_flu.ppt. </p>
|
|
<p class="size2"><a name="ref09" id="ref09"></a><sup>9</sup> Lai MW, Klein-Schwartz W, Rodgers
|
|
GC, et al. 2005 Annual Report of the American Association of Poison Control
|
|
Centers' national poisoning and exposure database. <em>Clin Toxicol</em> 2006;44:803-932.
|
|
Available at: http://www.aapcc.org/2005.htm.</p>
|
|
<p class="size2"><a name="ref10" id="ref10"></a><sup>10</sup> Bogdan GM, Green JL, Swanson D,
|
|
et al. Evaluating patient compliance with nurse advice line recommendations
|
|
and the impact on healthcare costs. <em>Am J Manag Care</em> 2004;10:534-542.</p>
|
|
<p class="size2"><a name="ref11" id="ref11"></a><sup>11</sup> Phillips SJ, Knebel A, eds. Mass
|
|
medical care with scarce resources: a community planning guide. (Prepared
|
|
by Health Systems Research, Inc., under contract No. 290-04-0010). Rockville,
|
|
MD: Agency for Healthcare Research and Quality, 2006. AHRQ Publication No.
|
|
07-001. Available at: <a href="/research/mce/">https://www.ahrq.gov/research/mce/</a>. </p>
|
|
<p class="size2"><a name="ref12" id="ref12"></a><sup>12</sup> National Incident
|
|
Management System.Department of Homeland Security publication. Version March 1, 2004.
|
|
Available at:
|
|
<a href="http://www.fema.gov/pdf/emergency/nims/nims_doc_full.pdf.">http://www.fema.gov/pdf/emergency/nims/nims_doc_full.pdf.</a>. Accessed April 17, 2008.</p>
|
|
<p class="size2"><a name="ref13" id="ref13"></a><sup>13</sup> Cooperative Agreement
|
|
Guidance for Public Health Emergency Preparedness Public Health. Centers for Disease Control
|
|
and Prevention. Available at: <a href="http://www.bt.cdc.gov/planning/coopagreement/">http://www.bt.cdc.gov/planning/coopagreement/</a>.</p>
|
|
<p class="size2"><a name="ref14" id="ref14"></a><sup>14</sup> National Planning
|
|
Scenarios: Created for Use in National, Federal, State and Local Homeland Security
|
|
Preparedness Activities. Version 20.1 Draft. April 2005.</p>
|
|
<p class="size2"><a name="ref15" id="ref15"></a><sup>15</sup> Web site. California Department of Health Services, Immunization Branch. Flu. Available at: <a href="http://www.dhs.ca.gov/ps/dcdc/izgroup/diseasesbrowse/flu.htm">http://www.dhs.ca.gov/ps/dcdc/izgroup/diseasesbrowse/flu.htm</a>.<a href="/exitdisclaimer.htm"><img src="/images/exitdisclaimer.gif" alt="Exit Disclaimer" border="0" align="middle" /></a> Accessed November, 2005.</p>
|
|
|
|
<p class="size2"><a name="ref16" id="ref16"></a><sup>16</sup> Web site. Minnesota Department of Health. Influenza (Flu). Available at: <a href="http://www.health.state.mn.us/divs/idepc/diseases/flu/">http://www.health.state.mn.us/divs/idepc/diseases/flu/</a>.<a href="/exitdisclaimer.htm"><img src="/images/exitdisclaimer.gif" alt="Exit Disclaimer" border="0" align="middle" /></a> Accessed November 2005.</p>
|
|
|
|
<p class="size2"><a name="ref17" id="ref17"></a><sup>17</sup> Web site. Georgia Department of Human Resources, Division of Public Health. Immunization Section. Flu Season 2005-2006. Available at: <a href="http://health.state.ga.us/programs/immunization/flu.asp">http://health.state.ga.us/programs/immunization/flu.asp</a>.<a href="/exitdisclaimer.htm"><img src="/images/exitdisclaimer.gif" alt="Exit Disclaimer" border="0" align="middle" /></a> Accessed November 2005.</p>
|
|
|
|
<p class="size2"><a name="ref18" id="ref18"></a><sup>18</sup> Web site. Commonwealth of Massachusetts, Department of Public Health. Seasonal Flu: Information for the Public.</p>
|
|
|
|
<p class="size2"><a name="ref19" id="ref19"></a><sup>19</sup> Web site. San Diego County Immunization Initiative. Flu Update: Winter 2005-2006. Available at: http://www.immunization-sd.org/parents/eng/index.html. Accessed November 2005.</p>
|
|
|
|
<p class="size2"><a name="ref20" id="ref20"></a><sup>20</sup> Web site. Oregon State Public Health. Acute and Communicable Disease Prevention. Influenza: Flu Vaccine Information. Available at: <a href="http://oregon.gov/DHS/ph/acd/flu/fluvax.shtml">http://oregon.gov/DHS/ph/acd/flu/fluvax.shtml</a>.<a href="/exitdisclaimer.htm"><img src="/images/exitdisclaimer.gif" alt="Exit Disclaimer" border="0" align="middle" /></a> Accessed November 2005.</p>
|
|
|
|
<p class="size2"><a name="ref21" id="ref21"></a><sup>21</sup> Cartter ML,
|
|
Melchreit R, Mshar P, et al. Brief Report: Vaccination coverage among callers
|
|
to a State influenza hotline—Connecticut, 2004-05 influenza season.
|
|
<em>MMWR</em> 2005;54(08):199-200.</p>
|
|
<p class="size2"><a name="ref22" id="ref22"></a><sup>22</sup> Kuhles D.
|
|
Videophone monitoring of SARS patients in voluntary home isolation. National
|
|
Association of City & County Health Officials (NACCHO) Model Practices Database
|
|
2005. Available at: http://archive.naccho.org/modelPractices/Result.asp?PracticeID=114. </p>
|
|
<p class="size2"><a name="ref23" id="ref23"></a><sup>23</sup> Lee ML, Chen CJ,
|
|
Su IJ, et al. Use of quarantine to prevent transmission of severe acute respiratory
|
|
syndrome—Taiwan, 2003. <em>MMWR</em> 2003;52 (29):680-683.</p>
|
|
<p class="size2"><a name="ref24" id="ref24"></a><sup>24</sup> Blendon RJ, DesRoches
|
|
CM, Cetron MS, et al. Attitudes toward the use of quarantine in a public health emergency
|
|
in four countries. <em>Health Aff</em> 2006;25:w15-25.</p>
|
|
<p class="size2"><a name="ref25" id="ref25"></a><sup>25</sup> Bronstein AC, Seroka
|
|
AM, Wruk KM, et al. Application of poison center TESS data for toxicosurveillance: the
|
|
concept of the surveillance technician—10% automation and 90% perspiration. <em>J
|
|
Toxicol-Clin Toxicol</em> 2004;42:787-788.</p>
|
|
<p class="size2"><a name="ref26" id="ref26"></a><sup>26</sup> McClung MW, Swanson DD,
|
|
Bogdan GM, et al. Using respiratory-related calls to a nurse advice line to predict
|
|
pediatric upper respiratory infection-related healthcare utilization. <em>AMIA
|
|
Annu Symp Proc</em> 2003;929.</p>
|
|
<p class="size2"><a name="ref27" id="ref27"></a><sup>27</sup> Krenzelok EP. Poison
|
|
information centers save lives…and money!<em> Przegl Lek</em> 2001;58:175-176.</p>
|
|
<p class="size2"><a name="ref28" id="ref28"></a><sup>28</sup> Bogdan GM, Seroka AM,
|
|
Swanson D, et al. Providing health information during disease outbreaks. <em>J Toxicol-Clin
|
|
Toxicol</em> 2004;42:817.</p>
|
|
<p class="size2"><a name="ref29" id="ref29"></a><sup>29</sup> Web site. Division of
|
|
Global Migration and Quarantine: Quarantine Stations. Centers for Disease Control and
|
|
Prevention. Available at: <a href="http://www.cdc.gov/ncidod/dq/quarantine_stations.htm">http://www.cdc.gov/ncidod/dq/quarantine_stations.htm</a>. Last updated April 9, 2007.
|
|
Accessed April 2007.</p>
|
|
<p class="size2"><a name="ref30" id="ref30"></a><sup>30</sup> Kansas Department of
|
|
Health and Environment Public Education Line phone bank operator training powerpoint.
|
|
To obtain a copy contact: Mike Cameron, Risk Communications Specialist, KDHE Office
|
|
of Communications, mcamero1@kdhe.state.ks.us or 785-368-8053.</p>
|
|
<p class="size2"><a name="ref31" id="ref31"></a><sup>31</sup> National preparedness
|
|
guidance, Homeland Security Presidential directive 8: national preparedness. Department
|
|
of Homeland Security, April 27, 2005. Available at:
|
|
<a href="http://www.ojp.usdoj.gov/odp/docs/NationalPreparednessGuidance.pdf"> http://www.ojp.usdoj.gov/odp/docs/NationalPreparednessGuidance.pdf</a> [<a href="/pdfhelp.htm">PDF Help</a>].</p>
|
|
<p class="size2"><a name="ref32" id="ref32"></a><sup>32</sup> Interim national
|
|
preparedness goal, Homeland Security Presidential directive 8: national preparedness.
|
|
Department of Homeland Security, March 31, 2005. Available at:
|
|
<a href="http://www.ojp.usdoj.gov/odp/docs/InterimNationalPreparednessGoal_03-31-05_1.pdf"> http://www.ojp.usdoj.gov/odp/docs/InterimNationalPreparednessGoal_03-31-05_1.pdf</a> [<a href="/pdfhelp.htm">PDF Help</a>].</p>
|
|
<p class="size2"><a name="ref33" id="ref33"></a><sup>33</sup> Centers for Disease
|
|
Control and Prevention. Local health department guide to pandemic influenza
|
|
planning, version 1.0. (Prepared by National Association of County and City
|
|
Health Officials under Cooperative Agreement No. U50/CCU 302718). CDC, 2006 Available at:
|
|
http://www.naccho.org/topics/infectious/influenza/documents/NACCHOPanFluGuideforLHDsII.pdf.</p>
|
|
<p class="size2"><a name="ref34" id="ref34"></a><sup>34</sup> Preparing for a
|
|
pandemic influenza: a primer for governors and senior State officials. National Governor's
|
|
Association Center for Best Practices, 2006. Available at:
|
|
http://www.nga.org/Files/pdf/0607PANDEMICPRIMER.PDF.</p>
|
|
<p class="size2"><a name="ref35" id="ref35"></a><sup>35</sup> Web site. University of Michigan
|
|
Medical School, Center for the History of Medicine. The 1918-1920 influenza
|
|
pandemic escape community digital document archive. Available at:
|
|
http://www.med.umich.edu/medschool/chm/influenza/index.htm.</p>
|
|
<p class="size2"><a name="ref36" id="ref36"></a><sup>36</sup> Components of effective disaster
|
|
public education and information working group report, December 2005 (interim
|
|
document) The Emergency Management Accreditation Program (EMAP). Available
|
|
at: http://www.emaponline.org/?232.</p>
|
|
<p class="size2"><a name="ref37" id="ref37"></a><sup>37</sup> Health Resources
|
|
Services Administration. Emergency system for advance registration of volunteer
|
|
health professionals: interim technical and policy guidelines, standards, and
|
|
definitions, version 2 June 2005. Available at:
|
|
<a href="http://www.hrsa.gov/esarvhp/guidelines/default.htm">http://www.hrsa.gov/esarvhp/guidelines/default.htm</a>.</p>
|
|
<p class="size2"><a name="ref38" id="ref38"></a><sup>38</sup> Good Samaritan,
|
|
Charitable Care Statutes, and Specific Provisions Related to Disaster Relief Efforts.
|
|
American Medical Association. 2005.
|
|
http://www.ama-assn.org/ama1/pub/upload/mm/395/goodsamaritansurvey.doc. </p>
|
|
<p class="size2"><a name="ref39" id="ref39"></a><sup>39</sup> Federal Volunteer Protection Act
|
|
of 1997 from The National Archives and Records Administration GPO Access
|
|
Web site. Available at: <a href="http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=105_cong_public_laws&docid=f:publ19.105.pdf">http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=105_cong_public_laws&docid=f:publ19.105.pdf</a> [<a href="/pdfhelp.htm">PDF Help</a>].</p>
|
|
<p class="size2"><a href="index.html#contents">Return to Contents</a><br />
|
|
<a href="callapp1.htm">Proceed to Next Section</a></p>
|
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<div class="footnote">
|
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<p> The information on this page is archived and provided for reference purposes only.</p></div>
|
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<p> </p>
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<div id="banner_Footeraddress"><p>Agency for Healthcare Research and Quality <img src="/images/bottom_dot.gif" alt="" /> 5600 Fishers Lane Rockville, MD 20857 <img src="/images/bottom_dot.gif" alt="" /> Telephone: (301) 427-1364</p></div>
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