Public health communication with frontline clinicians during the first wave of the 2009 influenza pandemic.
BACKGROUND
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.


OBJECTIVE
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.


METHODS
During the first wave of the pandemic, we performed a process analysis and surveyed 509 office-based primary care providers in Utah.


METHODS
Public health and healthcare leaders from major agencies involved in emergency response in Utah and office-based primary care providers located throughout Utah.


METHODS
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.


CONCLUSIONS
: Communication between public health, health care organizations and clinicians was redundant and overwhelming and can be enhanced considering clinician preferences and institutional communication channels.
Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT 84112, USA. Catherine.Staes@hsc.utah.edu
Catherine J
CJ
Staes
Amyanne
A
Wuthrich
Per
P
Gesteland
Mandy A
MA
Allison
Molly
M
Leecaster
Julie H
JH
Shakib
Marjorie E
ME
Carter
Brittany M
BM
Mallin
Susan
S
Mottice
Robert
R
Rolfs
Andrew T
AT
Pavia
Brent
B
Wallace
Adi V
AV
Gundlapalli
Matthew
M
Samore
Carrie L
CL
Byington
D000328:Adult; D002648:Child; D034742:Electronic Mail / Q000706:statistics & numerical data; D004630:Emergencies; D005260:Female; D006287:Health Planning Guidelines; D006306:Health Surveys; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control*; D033183:Interdisciplinary Communication; D008297:Male; D008490:Medical Informatics / Q000458:organization & administration*; D008503:Medical Staff / Q000523:psychology / Q000706:statistics & numerical data; D017146:Models, Organizational; D058873:Pandemics / Q000517:prevention & control*; D019095:Point-of-Care Systems; D011247:Pregnancy; D011635:Public Health Administration; D018570:Risk Assessment; D014589:Utah / Q000453:epidemiology