title: The challenge of measuring emergency preparedness: integrating component metrics to build system-level measures for strategic national stockpile operations.
abstract: OBJECTIVE
  Although significant progress has been made in measuring public health emergency preparedness, system-level performance measures are lacking. This report examines a potential approach to such measures for Strategic National Stockpile (SNS) operations.
  
  
  METHODS
  We adapted an engineering analytic technique used to assess the reliability of technological systems-failure mode and effects analysis-to assess preparedness. That technique, which includes systematic mapping of the response system and identification of possible breakdowns that affect performance, provides a path to use data from existing SNS assessment tools to estimate likely future performance of the system overall.
  
  
  RESULTS
  Systems models of SNS operations were constructed and failure mode analyses were performed for each component. Linking data from existing assessments, including the technical assistance review and functional drills, to reliability assessment was demonstrated using publicly available information. The use of failure mode and effects estimates to assess overall response system reliability was demonstrated with a simple simulation example.
  
  
  CONCLUSIONS
  Reliability analysis appears an attractive way to integrate information from the substantial investment in detailed assessments for stockpile delivery and dispensing to provide a view of likely future response performance.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Jackson
authors.forename: Kay Sullivan
authors.initials: KS
authors.lastname: Faith
mesh_terms: D004189:Disaster Planning; D006801:Humans; D017146:Models, Organizational; D004364:Pharmaceutical Preparations / Q000600:supply & distribution*; D015980:Public Health Practice / Q000592:standards*; D015203:Reproducibility of Results; D062205:Strategic Stockpile; D014481:United States
chemical_list: D004364:Pharmaceutical Preparations