Public Health Communication with Frontline Clinicians During the First Wave of the 2009 Influenza Pandemic
Public Health Communication with Frontline Clinicians During the First Wave of the 2009 Influenza Pandemic
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DOI：
10.1097/phh.0b013e3181ee9b29
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发表时间：
2011-01-01
影响因子：
3.3
通讯作者：
Byington, Carrie L.
中科院分区：
文献类型：
--
作者：
Staes, Catherine J.;Wuthrich, Amyanne;Byington, Carrie L.
内容：在突发公共卫生事件期间，办公室一线临床医生是疾病检测、治疗和控制的重要合作伙伴。公共卫生当局和一线临床医生之间的沟通至关重要，但公共卫生机构，医学会和医疗保健提供组织都呼吁改善。目的：描述2009年甲型H1N1流感第一波大流行期间公共卫生和一线临床医生之间的沟通过程;评估临床医生对公共卫生指南的使用和知识;评估临床医生对突发公共卫生事件期间沟通的看法和偏好。设计和方法：在第一波大流行期间，我们进行了一项流程分析，并调查了犹他州509名办公室初级保健提供者。设置和参与者：来自犹他州参与应急响应的主要机构的公共卫生和医疗保健领导人以及遍布犹他州的办公室初级保健提供者。主要结局指标：沟通过程和信息流，电子邮件的分布，至少每周访问关键网站的临床医生的比例，临床医生对最近的指导和对电子邮件负载的看法，主要信息来源，以及临床医生反馈的定性结果的知识。结果：流程分析揭示了冗余的活动和消息传递。141名受访者（28%）从各种来源获得信息：68%的人从州公共卫生机构获得信息;几乎100%的人从医疗保健机构获得信息。只有三分之一的人经常访问州公共卫生或机构网站（至少每周一次）以获得最新的指导。在第一波中，临床医生对指导的了解没有改变;但是，在指导改变后，正确的知识降低。临床医生感到不堪重负的电子邮件量，更喜欢一个单一的机构电子邮件的临床指导，并建议新的信息是简洁和明确的识别。结论：公共卫生、医疗保健组织和临床医生之间的沟通是多余的和压倒性的，考虑到临床医生的偏好和机构沟通渠道，可以加强沟通。
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 e-mails, proportion of clinicians who accessed key Web sites at least weekly, clinicians' knowledge about recent guidance and perception about e-mail 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 health care organizations. Only one-third visited a state public health or institutional Web site 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 e-mail volume, preferred a single institutional e-mail for clinical guidance, and suggested that new information be concise and clearly identified. Conclusion: Communication between public health, health care organizations and clinicians was redundant and overwhelming and can be enhanced considering clinician preferences and institutional communication channels.