title: Linking public health agencies and hospitals for improved emergency preparedness: North Carolina's public health epidemiologist program.
abstract: BACKGROUND
  In 2003, 11 public health epidemiologists were placed in North Carolina's largest hospitals to enhance communication between public health agencies and healthcare systems for improved emergency preparedness. We describe the specific services public health epidemiologists provide to local health departments, the North Carolina Division of Public Health, and the hospitals in which they are based, and assess the value of these services to stakeholders.
  
  
  METHODS
  We surveyed and/or interviewed public health epidemiologists, communicable disease nurses based at local health departments, North Carolina Division of Public Health staff, and public health epidemiologists' hospital supervisors to 1) elicit the services provided by public health epidemiologists in daily practice and during emergencies and 2) examine the value of these services. Interviews were transcribed and imported into ATLAS.ti for coding and analysis. Descriptive analyses were performed on quantitative survey data.
  
  
  RESULTS
  Public health epidemiologists conduct syndromic surveillance of community-acquired infections and potential bioterrorism events, assist local health departments and the North Carolina Division of Public Health with public health investigations, educate clinicians on diseases of public health importance, and enhance communication between hospitals and public health agencies. Stakeholders place on a high value on the unique services provided by public health epidemiologists.
  
  
  CONCLUSIONS
  Public health epidemiologists effectively link public health agencies and hospitals to enhance syndromic surveillance, communicable disease management, and public health emergency preparedness and response. This comprehensive description of the program and its value to stakeholders, both in routine daily practice and in responding to a major public health emergency, can inform other states that may wish to establish a similar program as part of their larger public health emergency preparedness and response system.
authors.affiliation: North Carolina Preparedness and Emergency Response Research Center, North Carolina Institute for Public Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
authors.forename: Milissa
authors.initials: M
authors.lastname: Markiewicz
authors.forename: Christine A
authors.initials: CA
authors.lastname: Bevc
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hegle
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Horney
authors.forename: Megan
authors.initials: M
authors.lastname: Davies
authors.forename: Pia D M
authors.initials: PD
authors.lastname: MacDonald
mesh_terms: D003140:Communicable Disease Control; D019033:Delivery of Health Care, Integrated; D004636:Emergency Service, Hospital; D058872:Epidemics / Q000517:prevention & control*; D004812:Epidemiologic Methods; D006739:Hospital Administration; D006801:Humans; D009111:Local Government; D009657:North Carolina; D011159:Population Surveillance; D015397:Program Evaluation; D011635:Public Health Administration; D011637:Public Health Nursing; D011795:Surveys and Questionnaires