Southwest Center for Public Health Preparedness

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Southwest Center for Public Health Preparedness

• Review and Practice Evaluation

David L. Johnson, PhD, Director College of Public
Health, University of Oklahoma February 26, 2004
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2004 Review and Practice Evaluation

• Part A Introduction

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Southwest Center for Public Health Preparedness

• Mission
• Provide education and training to help prepare
  the public health workforce and others for
  response to terrorism, emerging infectious
  diseases, and other public health disasters

http//www.swcphp.ouhsc.edu/
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SWCPHP Specific Objectives

• Accurately assess competencies in core public
  health skills and bioterrorism preparedness
• Design, develop and deliver education and
  training to enhance agency preparedness to
  respond to bioterrorism events
• Perform best practices evaluations related to
  emerging public health issues
• Assist in sustaining and enhancing the public
  health workforce

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Metrics for Success

• Effectiveness
• Efficiency
• Productivity
• Accountability

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Effectiveness

• Tailored to the audience
• Relevance course content tailored to the
  specific audience through needs assessment
• Credibility utilize local subject matter experts
  (SMEs) when possible and appropriate
• Value relate the material to everyday practice
  needs and overall disaster preparedness as well
  as bioterrorism preparedness credential with
  continuing education credit (CME, etc.)
• Competency-based training
• Focus on both core public health competencies and
  bioterrorism preparedness competencies
• Match the competencies to the functional role
• Enhance and evaluate organizational as well as
  individual competencies

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Efficiency

• Avoid redundancy and waste
• Close coordination with CDC Focus Area G and HRSA
  Hospital Bioterrorism Preparedness Program
  training efforts
• Contract with SMEs to minimize overhead
• Leverage resources
• Partner whenever possible to expand audience
  access and leverage funding
• Utilize Train-the-Trainer approach where
  appropriate

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High Productivity

• Broad variety of training modalities
• Seminars, workshops, short courses, drills
  exercises, graduate courses degree programs
• On-site in-person training
• Synchronous distance education (graduate courses)
• Streaming video
• DVD / CD-ROM-based (in development)
• Aggressive schedule of offerings (see pg. 28, 1
  qtr FY04 report)
• Intensive and continuous course development
  effort
• Wide variety of topics and audiences
• Broad geographic coverage
• Originally Oklahoma and New Mexico
• North Texas (Tarrant County) via NACCHOs Project
  Public Health Ready
• Colorado added in FY 2004 geographic expansion

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Accountability

• To trainees
• Critiques obtained for every training course
• Continuous quality improvement process
• To our partners and client organizations
• Advisory Board of practice partners and clients
• Quarterly review and coordination meetings
• To CDC ASPH
• Monthly conference calls, quarterly reports,
  annual meetings
• To Congress

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2004 Review and Practice Evaluation

• Part B Evaluation Criteria

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2004 Review and Practice Evaluation

• Part B-I
• Leadership and Strategic Planning

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Public Health Education and Training
Infrastructure BEFORE the SWCPHP

• No formal individual needs assessment process
• Few preparedness training opportunities
• Infrequent drills and exercises
• No Certificate program in core public health
• Only discipline-specific MPH programs
  (biostatistics, epidemiology, health promotion,
  etc.)
• No access to graduate public health education
  outside two major metropolitan areas
• No distance education (DE)

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Public Health Education and Training
Infrastructure AFTER the SWCPHP

• Objective needs assessment
• Broad spectrum of training opportunities
• Drills and exercises keyed to the Response Plan
• Aggressive and expanding Distance Education
  program
• New graduate public health education curricula
  tailored to health agency personnel
• New specialty MPH in Terrorism Preparedness

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2004 Review and Practice Evaluation

• Part B-II
• Customer and Market Focus

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Products and Clients

• Products
• Short courses, seminars, workshops, drills
  exercises
• Graduate coursework leading to a Master of Public
  Health (MPH) degree in Preparedness and Terrorism
• Clients
• Public Health Leaders Managers, Professionals,
  and Support Staff (80)
• First Responders, Educators, Media, First
  Receivers (ER, EMS, etc.), others (20)
• Multiple Levels
• Senior Leaders and Managers
• Practice Professionals
• Support Personnel

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SWCPHP Core Partners

• College of Public Health
• New curricula tailored to public health agency
  personnel
• Course scheduling to accommodate working students
• Active involvement of the Dean, Chairs, and
  senior faculty
• Distance Education infrastructure investment
• Oklahoma State Department of Health
• Tuition support
• Employees allowed time off to attend classes
• Advancement incentives tied to advanced education
• Active involvement of the Commissioner and senior
  leaders
• Distance Education infrastructure investment

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SWCPHP Core Partners (cont.)

• Tulsa City-County and Oklahoma City-County Health
  Departments
• Objective needs assessment methods development
• Training methods development
• Quantitative evaluation methods development

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Additional Partners

• New Mexico Department of Health
• Oklahoma Department of Mental Health and
  Substance Abuse Services
• Oklahoma City Area Indian Health Service
• Oklahoma City Area Inter-Tribal Health Board
• Indian Health Resource Center of Tulsa
• Albuquerque Area Indian Health Board
• Oklahoma Department of Environmental Quality
• Oklahoma Department of Emergency Management

• Oklahoma State Medical Association
• Oklahoma Hospital Association
• University of Oklahoma at Tulsa
• University of North Texas
• Los Alamos National Laboratory
• Tulsa AHEC
• University of New Mexico
• Central Colorado Area Health Education Centers
  (AHECs)

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Partnerships Resulting from SWCPHP Efforts

• NACCHO - Public Health Ready Project
• Working closely with Tulsa City-County Health
  Department and Tarrant County (Texas) Health
  Department, as well as the Cherokee Nation to
  assess preparedness for bioterrorism and
  emergency response
• Memorial Institute for the Prevention of
  Terrorism (MIPT)
• University of Texas School of Public Health,
  Academic Center for Public Health Preparedness

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New Partnerships (cont.)

• HRSA - Bioterrorism Hospital Preparedness Program
• Best practices evaluation and technical
  assistance related to expedient engineering
  techniques for patient isolation in bioterrorism
  and epidemic disease response
• Working with the MIPT and UTSPH to develop
  integrated first responder / public health
  preparedness training

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Graduate Public Health Education Maintaining the
Public Health Workforce

• Active collaboration between the University of
  Oklahoma College of Public Health, Oklahoma State
  Department of Health, and the Southwest Center
  for Public Health Preparedness
• Tailor public health curricula to health agency
  needs
• Improve access to graduate public health
  education
• Stimulate current health department employees to
  pursue formal public health education
• Promote interest among non-employee students to
  seek public health agency careers

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A Collaborative Effort

• College of Public Health
• New curricula tailored to public health agency
  personnel
• Course scheduling to accommodate working students
• Active involvement of the Dean, Chairs, and
  senior faculty
• Distance Education infrastructure investment
• Oklahoma State Department of Health
• Tuition support
• Employees allowed time off to attend classes
• Advancement incentives tied to advanced education
• Active involvement of the Commissioner and senior
  leaders
• Distance Education infrastructure investment
• Southwest Center for Public Health Preparedness
• Develop curricula and courses in Preparedness
  topics
• Provide technical support to preparedness
  instructors

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New Product Graduate Certificate in Public Health

• Specifically tailored to public health agency
  personnel
• 18 semester hours
• Core didactic public health education in
  biostatistics, epidemiology, health promotion,
  health administration policy, and environmental
  health
• Integrated public health practice course via case
  studies and problem based learning involving
  bioterrorism scenario

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New Product MPH in Public Health Practice

• 44 semester hours, of which 18 are from the
  Certificate program
• Broad-based preparation in all core areas
• 9 hours of electives to allow additional focus
• Particularly suited to public health agency
  leaders and managers

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New Product MPH in Preparedness and Terrorism

• Specifically designed for public health
  preparedness and response planners
• 44 semester hours,
• Broad-based preparation in all core areas
• Focus on preparedness for bioterrorism, emerging
  infectious diseases, and other public health
  disasters

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New Graduate Courses Developed for the MPH in
Preparedness and Terrorism
CPH 7113 Current Topics in Preparedness CPH 7223
Policy and Legal Aspects of Terrorism CPH
7433 Mental Health and Psychological Aspects
of Terrorism CPH 7533 Emergency Risk
Communications CPH 7940 Field Practice in Public
Health Preparedness
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2004 Review and Practice Evaluation

• Part B-III
• Information and Analysis

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Productivity Statistics for 5 Quarters (Oct
2002-Dec 2003)

• Continuing Education
• 3,300 persons trained (700/qtr average)
• 57 training events (10/qtr average)
• 21,200 person-hours of training (4000/qtr
  average)

Average cost 37/hour or 296/day
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SWCPHP Y1 Q1 Training
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SWCPHP Y1 Q2 Training
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SWCPHP Y1 Q3 Training
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SWCPHP Y1 Q4 Training
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SWCPHP Y2 Q1 Training
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Productivity Statistics for 5 Quarters (Oct
2002-Dec 2003) (cont.)

• Graduate Education
• 43 health department professionals trained
• 596 semester hours of coursework
• 8,940 classroom hours

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Public Health Employee Education Gains Achieved
to Date

• 43 OSDH students currently enrolled
• 25 expected to complete the Certificate by Dec
  2004
• Broad and balanced representation
• Oklahoma City OSDH employees (22 students)
• HIV/STD Service Injury Prevention
• Immunization Special Services
• Financial Management Child Abuse Prevention
• Emergency Medical Service Nursing Service
• Maternal and Child Health Laboratory Service
• Family Health Administration Internal Audit Unit
• Community Health Administration Tobacco Use
  Prevention
• Acute Disease Epidemiology
• County health department employees (17 students
  representing 12 departments)
• Other (4 students formerly with OSDH)

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Areas of Special Expertise

• Objective scenario-based evaluation
• Disaster mental health aspects of public health
  preparedness
• Policy and legal aspects of terrorism
  preparedness
• Water supply security
• Technical assistance in expedient engineering
  methods for hospital and health department
  isolation surge capacity
• Cultural issues in working with Native American
  and Hispanic populations

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Objective Evaluation

• SWCPHP staff have been active in developing and
  validating objective techniques for preparedness
  evaluation
• Current projects
• NACCHO Project Public Health Ready assessment,
  training, and evaluation support to the Tarrant
  County, TX Public Health Department and Tulsa
  City-County Health Department
• Several publications submitted or in preparation,
  participation in panel discussions at national
  ASPH/CDC and NACCHO meetings

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Disaster Mental Health

• SWCPHP staff are nationally active in disaster
  mental health preparedness efforts, particularly
  regarding the protection of children
• Current activities
• P-FLASH and K-FLASH mental health practitioner
  training (direct and as Train-the-Trainer)
  courses on-going
• Disaster mental health planning for school
  administrators, counselors, and nurses in
  development
• Best practices survey of state mental health
  disaster plans in progress
• Developing graduate course in disaster mental
  health

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Policy and Legal Assets

• SWCPHP staff and practice partners with combined
  public health and law backgrounds
• Peter Budetti, MD,JD Betty Pfefferbaum, MD, JD
• Madeline Robertson, MD,JD Les Beitsch, MD JD
• Ken Levit, JD Gary Cox, JD
• David L. Boren, JD President, University of
  Oklahoma and former Chair, United States Senate
  Intelligence Committee

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Current Public Health Law and Policy Related
Activities

• Developing model public health policy and
  preparedness workshop format and curriculum
• Pilot workshop scheduled for April 2004 in
  partnership with the Oklahoma Public Health
  Association

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Water Supply Security

• SWCPHP staff and partners are providing both
  preparedness planning and hands-on emergency
  response training in drinking water supply
  security
• Active partnership with Los Alamos National
  Laboratory trainers
• Current projects
• Water treatment plant operator preparedness
• Chlorine release emergency response
• Chapter on water security for new bioterrorism
  text in final draft by SWCPHP personnel

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Isolation Surge Capacity

• SWCPHP staff are leading a national effort to
  evaluate expedient engineering methods for
  isolating potentially infectious patients in
  hospitals and health department during natural or
  bioterrorism-related outbreaks
• Current projects
• Preliminary evaluation of free-standing HEPA
  filtration units and HEPA-filtered
  exhaust-ventilated patient enclosures (completed)
• Detailed case study evaluation of real-world
  applications of various system designs, and
  development of a guidelines document in
  partnership with the HRSA Hospital Bioterrorism
  Preparedness effort

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Cultural Issues

• SWCPHP staff are working with Oklahoma tribes,
  New Mexico tribes and pueblos, and regional
  Latino populations
• Current projects
• Disaster crisis communications development under
  the CDC Pre-Event Message Development project
• NACCHO Project Public Health Ready Cherokee
  Nation
• Indian Health Service Incident Command System
  training (approximately 50 of all IHS hospitals,
  health centers, and field clinics fall within the
  SWCPHP support area)

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2004 Review and Practice Evaluation

• Part B-IV
• Systems Development

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Education and Training Delivery Methodologies

• Traditional in-class delivery
• Synchronous video teleconferencing
• Asynchronous streaming
• Digital capture for Internet streaming or CD-ROM
  distribution
• Hard-copy materials

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Large Geographic Support Region

• SWCPHP supports three states
• 300,000 square miles
• 10,000,000 population
• 9,200-member public health workforce (excluding
  Indian Health Service and Tribes)
• Geography is a driver for innovation and an
  enhanced distance education infrastructure
• Collaboration between OSDH and SWCPHP has made
  possible significant expansion in DE capabilities

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Distance Education Initiative

• State-of-the-art synchronous video teleconference
  delivery statewide, with interstate compatibility
• Evening and weekend course scheduling, video
  capture, and on-line streaming to accommodate
  working students
• DE infrastructure funding provided by OSDH and
  COPH
• 220,844 OSDH
• 175,000 COPH

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Oklahoma State Department of HealthH.323
Videoconference Sites
OSDH H.323 Videoconference Sites
OCCHD
OSDH
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College and university H.323 hub sites in Oklahoma
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2004 Review and Practice Evaluation

• Part B-V
• Business Focus

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The Bottom Line Public Health Preparedness has
been significantly enhanced during the Centers
first year

• Opportunities for Best Practices advances in
  demonstrating public health preparedness
• Objective rather than subjective assessment and
  evaluation
• Organizational as well as individual preparedness
  evaluation, on the NACCO model
• Training and evaluation keyed to the
  organizations Emergency Response Plan
• Integrated scenario-based evaluation/training/re-e
  valuation

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Funding Leveraged in Support of SWCPHP Goals

• COPH, OSDH distance education initiative
• Synchronous DE infrastructure
• Asynchronous (Internet web site)
• CD-ROM based materials
• OSDH tuition assistance
• MIPT integrated first responder / public health
  training
• In cooperation with UTHSC A-CPHP
• CDC Pre-Event Message Development

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Involvement of Partners in Planning,
Implementation, or Communication

• Advisory Board
• Curriculum Development Committee
• Assessment and evaluation methods development
• Lecturers in Grand Rounds, short courses, and
  graduate courses
• COPH Liaison Office at OSDH

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Human Resources Management

• Mix of on-staff, contractor, and partner subject
  matter experts, with a total of 4 administrative
  staff for CO, NM, OK
• In-state facilitation by our contractual partners
  in New Mexico and Colorado
• Utilize LOCAL subject matter experts whenever
  possible
• University contractor facilitates CME
  credentialing

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Types of Competency-Based Training and Education

• Grand Rounds
• Seminars
• Workshops
• Short courses
• Tabletop exercises
• Problem-based learning and case studies
• Hands-on field exercises
• Conferences
• Graduate public health coursework

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2004 Review and Practice Evaluation

• Part C
• Summary

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Summary

• Working closely with our partners
• Highly productive and cost-effective
• Leveraging funds via partnerships
• Sustaining and enhancing the workforce by
  enhancing access to formal public health
  education
• Developing special expertise in a number of
  nationally relevant areas

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Southwest Center for Public Health Preparedness

• Discussion