1. Preparedness Measurement at CDC Stephanie Dopson, MSW, MPH, ScD
Preparedness Measurement at CDC Stephanie Dopson, MSW, MPH, ScD. Candidate Influenza Coordination Unit, Centers for Disease Control and Prevention
Conduct descriptive assessment of current CDC measures of public health emergency response and their alignment to agency goals and national/federal objectives
Validate framework for public health emergency preparedness and response measurement efforts
Determine gaps, and based on the identified gaps, new measures can be drafted
Link between state, local and agency measurement not clearly articulated
Development of preparedness measures within CDC has been approached top-down instead of bottom-up (at the program level)
More objectives and action items than outputs and outcomes
Development of measures has been focused on budget activities rather than programs and systems
Lack of measures in key public health preparedness priority areas including epidemiology and community preparedness
Opportunities to develop cross-cutting measures
Points of contact may not have full visibility on all measures being developed in their Center
Project analysis based on wording of measures instead of how the measure is calculated
Competing priorities, H1N1, restructuring within one year timeframe at CDC
Measurement is a complex issue
Differing interpretations across CDC of what constitutes public health preparedness
The Department of Homeland Security has overall authority for emergency response activities as laid out in the National Response Framework (NRF). Defines the structure of how we respond.
The Department of Health and Human Services under the NRF has responsibility for public health and medical services (Emergency Support Function 8.
The Centers for Disease Control and Prevention executes public health response activities.
The Pandemic and All Hazards Preparedness Act (PAHPA) of focuses on public health and medical response.
Reviewed national guidance documents that lay out and prioritize public health preparedness activities
Cross-referenced results against CDC’s 5 functional goal objective areas
1) Health Monitoring and Surveillance 2)Epidemiology and Other Assessment Sciences 3) Public Health Laboratory Science and Service 4) Response and Recovery Operations 5) Public Health System Support)
Gathered preparedness measures across CDC
Assessed measures for alignments and gaps
Process 2%
Diane Caves
Anita McLees
Stephanie Dopson
Felicia Suit
LaBrina Jones
Todd Talbert
Julie Madden
David Withum
Output 24%
Not a measure 50%
Outcome
24%
N=114
As of 12/2009
Collected:
Wording of measures
Implementation status
Driver (e.g. PART, GPRA, balanced scorecard)
Center / Division (who developed / managed the measure)
Analyzed:
Public health function/capability
Measure type (process, output, outcome, not a measure)
Health Monitoring and Surveillance
Epidemiology and Other Assessment Sciences
Public Health Laboratory Science and Service
Response and Recovery Operations
Public Health System Support
Health Monitoring
Public Health
System Support
28%
and Surveillance
10%
Epidemiology 2%
Public Health
Laboratory Science
16%
Response and
Recovery
43%
Stephanie Dopson,
n=114
As of 9/2009
Lack of clarity as to who has responsibility for cross-cutting preparedness measurement, lack of review, lack of regular updating
No systematic data collection system to capture the data for measures
Measure language in many instances needed clarification
Outcomes of measures have not been well defined
Those who are expected to develop and report measures are not necessarily the ones with the knowledge, experience and training in performance measurement
Complexity of public health preparedness systems at the federal and state level
Capabilities versus public health impact
All hazards versus scenario specific
Programs evolve more quickly than measures
Lack of performance measurement / evaluation backgrounds
Homeland Security Presidential Directives (HSPD-21)
Pandemic and All Hazards Preparedness Act (PAHPA) 2006
In Memory and Honor of Friend and CDC Colleague Diane Caves
National Response Framework
National Health Security Strategy
Target Capabilities
U.S Department for Health and Human Services
Centers for Disease Control and Prevention