Engaging the Public
in Critical Disaster
Theresa Wizemann, Megan Reeve, and Bruce Altevogt,
Forum on Medical and Public Health Preparedness for
Board on Health Sciences Policy
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
THE NATIONAL ACADEMIES PRESS • 500 Fifth Street, NW • Washington, DC 20001
NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
This activity was supported by contracts between the National Academy of Sciences and the American College of Emergency Physicians; American Hospital Association; Association of State and Territorial Health Officials; Centers for Disease Control and Prevention (Contract No. 200-2011-38807, TO #19); Department of Defense (Contract No. HT0011-11-P-0186), Department of Defense, Uniformed Services University of the Health Sciences (Contract No. HT9404-12-1-0022); Department of Health and Human Services’ National Institutes of Health: National Institute of Allergy and Infectious Diseases, National Institute of Environmental Sciences, National Library of Medicine (Contract No. HHSN26300007 [Under Base 1#HHSN263201200074I]); Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (Contract No. HHSO100201000021P); Department of Homeland Security’s Federal Emergency Management Agency (Contract No. HSFE20-13-P-0212); Department of Homeland Security, Office of Health Affairs (Contract No. HSHQDC-13-J-00384 [Under Base 1 # HSHQDC-11-D-00009]); Department of Transportation’s National Highway Traffic Safety Administration (Contract No. DTNH22-10-H-00287); Department of Veterans Affairs (Contract No. 101-G09041); Emergency Nurses Association; Food and Drug Administration (Contract No. HHSF22301027T [Under Base Contract DHHS-8598]); Infectious Disease Society of America; Martin, Blanck & Associates; Mayo Clinic; Merck Sharp & Dohme Corp. (Contract No. 2391); National Association of Chain Drug Stores; National Association of County and City Health Officials; National Association of Emergency Medical Technicians; Pharmaceutical Research and Manufacturers of America; Target Corporation; Trauma Center Association of America; and United Health Foundation. The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for the activity.
International Standard Book Number-13: 978-0-309-28891-0
International Standard Book Number-10: 0-309-28891-6
Additional copies of this workshop summary are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.
For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu.
Copyright 2013 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
Cover Image: Harris County Public Health and Environmental Services (2011). HCPHES Pandemic Influenza Projects.
Suggested citation: IOM (Institute of Medicine). 2013. Engaging the public in critical disaster planning and decision making: Workshop summary. Washington, DC: The National Academies Press.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council.
WORKSHOP PLANNING COMMITTEE 1
MEREDITH LI-VOLLMER, Seattle and King County Public Health, Seattle, WA
LINDA SCOTT, Healthcare Preparedness Program, Lansing, MI
UMAIR SHAH, Division of Disease Control and Clinical Prevention, Harris County Public Health and Environmental Services, Houston, TX
BRUCE M. ALTEVOGT, Project Director
MEGAN REEVE, Associate Program Officer
ALEX REPACE, Senior Program Assistant
1 Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
FORUM ON MEDICAL
AND PUBLIC HEALTH PREPAREDNESS FOR
CATASTROPHIC EVENTS 1
ROBERT P. KADLEC (Co-Chair ), RPK Consulting, LLC, Alexandria, VA
LYNNE R. KIDDER (Co-Chair ), Consultant, Boulder, CO
ALEX J. ADAMS, National Association of Chain Drug Stores, Alexandria, VA
ROY L. ALSON, American College of Emergency Physicians, Winston-Salem, NC
WYNDOLYN BELL, UnitedHealthcare, Atlanta, GA
DAVID BIBO, The White House, Washington, DC
KATHRYN BRINSFIELD, Office of Health Affairs, Department of Homeland Security, Washington, DC
CAPT. D. W. CHEN, Office of the Assistant Secretary of Defense for Health Affairs, Department of Defense, Washington, DC
SUSAN COOPER, Regional Medical Center, Memphis, TN
BROOKE COURTNEY, Office of Counterterrorism and Emerging Threats, U.S. Food and Drug Administration, Washington, DC
BRUCE EVANS, National Association of Emergency Medical Technicians, Upper Pine River Fire Protection District, Bayfield, CO
JULIE L. GERBERDING, Merck Vaccines, Merck & Co., Inc., West Point, PA
LEWIS R. GOLDFRANK, New York University School of Medicine, New York
DAN HANFLING, INOVA Health System, Falls Church, VA
JACK HERRMANN, National Association of County and City Health Officials, Washington, DC
JAMES J. JAMES, American Medical Association, Chicago, IL
PAUL E. JARRIS, Association of State and Territorial Health Officials, Arlington, VA
LISA G. KAPLOWITZ, Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human Services, Washington, DC
ALI S. KHAN, Centers for Disease Control and Prevention, Atlanta, GA
1 Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
MICHAEL G. KURILLA, National Institute of Allergy and Infectious Diseases, Washington, DC
JAYNE LUX, National Business Group on Health, Washington, DC
LINDA MACINTYRE, American Red Cross, San Rafael, CA
SUZET MCKINNEY, Chicago Department of Public Health, IL
NICOLE MCKOIN, Target Corporation, Minneapolis, MN
MARGARET M. MCMAHON, Emergency Nurses Association, Williamstown, NJ
AUBREY K. MILLER, National Institute of Environmental Health Sciences, Bethesda, MD
MATTHEW MINSON, Texas A&M University, College Station
ERIN MULLEN, Pharmaceutical Research and Manufacturers of America, Washington, DC
JOHN OSBORN, Mayo Clinic, Rochester, MN
ANDREW T. PAVIA, Infectious Disease Society of America, Salt Lake City, UT
STEVEN J. PHILLIPS, National Library of Medicine, Bethesda, MD
LEWIS J. RADONOVICH, Department of Veterans Affairs, Washington, DC
KENNETH SCHOR, Uniformed Services University of the Health Sciences, Bethesda, MD
ROSLYNE SCHULMAN, American Hospital Association, Washington, DC
RICHARD SERINO, Federal Emergency Management Agency, Department of Homeland Security, Washington, DC
ERIC S. TONER, Center for Biosecurity of the University of Pittsburgh Medical Center, Baltimore, MD
MARGARET VANAMRINGE, The Joint Commission, Washington, DC
CRAIG VANDERWAGEN, Martin Blanck & Associates, Alexandria, VA
JENNIFER WARD, Trauma Center Association of America, Las Cruces, NM
JOHN WIESMAN, Washington State Department of Health, Tumwater, WA
GAMUNU WIJETUNGE, National Highway Traffic Safety Administration, Washington, DC
This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:
SUSAN COOPER, Regional Medical Center at Memphis
KRISTINE M. GEBBIE, Flinders University of South Australia
DEBRA KREISBERG, University of Colorado
STEVEN A. MEESE, Ohio Department of Health
Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by HERMINIA PALACIO, Robert Wood Johnson Foundation. Appointed by the Institute of Medicine, she was responsible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this workshop summary rests entirely with the rapporteurs and the institution.
Expanding Practical Experience
THEORY TO PRACTICE: PLANNING AND IMPLEMENTING PUBLIC ENGAGEMENT ACTIVITIES
Seattle and King County, Washington
Providing Alternative Strategies for Increasing Access to Antiviral Medications and Treatment Advice
CHALLENGES AND LESSONS LEARNED
Regulatory Considerations: Public Engagement and the Common Rule
The Value of Outside Expertise and Sharing Best Practices
PUBLIC ENGAGEMENT SAMPLE EXERCISES
Community Conversation Simulation
Boxes, Figures, and Tables
2 Major Structural Elements of Each Public Engagement Workshop
3 Sample Introductory Exercise to Establish Baseline Opinions (Abbreviated)
1 Spectrum of public engagement
2 Q-sort board for ranking opinion statements printed on cards
3 Example of a Q-sort board completed during the simulated public engagement exercise at the workshop
1 Methods for Learning About the Meeting
2 Race/Ethnicity for Harris County Adults, Citizens, and Stakeholders
3 Income for Harris County Adults, Citizens, and Stakeholders
|ARS||audience response system|
|CDC||Centers for Disease Control and Prevention|
|CSC||crisis standards of care|
|EMS||emergency medical services|
|HCPHES||Harris County Public Health and Environmental Services|
|IOM||Institute of Medicine|
|IRB||institutional review board|
|NACCHO||National Association of County and City Health Officials|
|NTL||nurse triage line|
|VPAT||Vulnerable Populations Action Team|