Transcript Slide 1
Introduction to NC Epi Teams Presentation Overview • What is an Epi Team? • Who belongs to an Epi Team? • What are the responsibilities of an Epi Team? • How does an Epi Team function? • What are some examples of Epi Team investigations? Learning Objectives • List the roles on a local health department Epi Team • Describe the four (4) primary responsibilities of an Epi Team • Give an example of a successful NC Epi Team investigation What is an Epi Team? • Multi-disciplinary public health team • “The purpose of an Epi Team is to prevent, respond to, and recover from disease outbreaks and other public health threats identified in the community.” Epi Team Roles • • • • • • • Team Leader Epidemiologist Microbiologist Environmental Health Specialist Interviewer(s) Clinician Media Spokesperson Team Leader • Description – Experience in outbreak investigation and epidemiology – Leader may be different for different outbreaks – Role can be filled by: • County health director • Public health nurse • Epidemiologist • Environmental health specialist Team Leader • Responsibilities – Convenes Epi Team – Provides oversight for investigation – Assigns tasks to other team members – Serves as contact with other agencies – Conducts regular meetings – Facilitates outbreak interventions – Reports outbreaks Epidemiologist • Description – Expertise in field epidemiology methods – Experience developing case definitions and questionnaires Epidemiologist • Responsibilities – Tracks surveillance data – Creates case definitions – Maintains line listing of cases – Trains team members on case finding and follow-up – Provides daily reports on case finding and case counts – Ensures data quality Clinician • Description – Training in medicine, nursing – Knowledge of disease prevention and treatment – Experience in health education Clinician • Responsibilities – Consults regarding disease signs and symptoms, transmission, incubation period, and treatment – Administers vaccines and prophylaxis – Collects clinical specimens – Educates cases and contacts – Visits health care providers – Monitors contacts for symptoms Environmental Health Specialist • Description – Experience with environmental field investigations – Knowledge of food and water safety regulations – Knowledge of environmental sampling Environmental Health Specialist • Responsibilities – Monitors environmental surveillance data – Conducts field investigations and traceback investigations – Collects environmental samples – Provides guidance on food and water safety regulations and engineering – Implements facility-related control measures Public Information Officer • Description – Experience developing media messages – Knowledge of risk and crisis communication Public Information Officer • Responsibilities – Reviews provider and public alerts, fact sheets, and reporting reminders – Prepares/reviews press releases – Responds to media inquires – Ensures availability of appropriate educational materials Laboratorian • Description – Expertise in laboratory testing – Knowledge of proper specimen collection and transport procedures Laboratorian • Responsibilities – Provides information on proper collection and transport of clinical specimens – Coordinates submission of specimens to State Laboratory of Public Health Administrator • Description – Knowledge of local health department policies and procedures – Experience handling staff expenses Administrator • Responsibilities – Distributes meeting agendas – Records minutes and keeps records of meetings – Tracks staff expenses (overtime, travel reimbursement) – Assures after hours building and cell phone access IT Specialist • Description – Knowledge of local health department computer system – Experience with database development and management IT Specialist • Responsibilities – Assists in database development, modification, and maintenance – Provides technical support – Assists with data entry – Equips team with necessary equipment Responsibilities of an Epi Team • Coordinate disease surveillance activities • Conduct epidemiologic investigations • Gather and analyze information from investigation • Implement public health control measures • Educate the public Coordinate Disease Surveillance • Monitor routine surveillance data • Compare expected to observed numbers and rates • Investigate reports from healthcare providers • Confirm or refute rumors of outbreaks Conduct Epidemiologic Investigations • • • • • Define cases Find cases Collect data Analyze data Report findings Gather and Analyze Information Implement Public Health Control Measures • Decide upon appropriate control measures • Work with community partners to implement control measures • Communicate necessity of control measures to affected groups Educate the Public • Assist hospitals or other healthcare facilities with outbreak management • Provide guidance to agencies dealing with outbreaks – Institutional settings (e.g. long-term care facilities, correctional facilities) How Does an Epi Team Function? • • • • • Communication Logistics Incident Command Structure Coordination with PHRST and DPH Resources Epi Team Contact Information • Maintain database of all team members – Name, specialty, best way to contact – Phone Numbers (work, home, cell) – Pager Number – Email Address – Emergency Contact • Distribute to all team members • Update regularly Internal Communication • Information flows in both directions – Leader should update Epi Team via meetings, conference calls, or email – Members provide regular updates to team leader • Acts as tool for measuring progress • Enables leader to provide feedback and direction to team members Document Investigation Progress • Keeps team members up to date • Provides material for communication with external partners • Can be used final report Maintain Daily Log • All steps taken in the investigation • Decisions made and rationale • Contacts: name, position, contact information • Meeting Documentation – Minutes – Follow up actions and those responsible • Photographs External Communication • Provide regular updates to external partners – NC Division of Public Health – Public Health Regional Surveillance Team – Local stakeholders – hospitals, healthcare providers, other government leaders/agencies, community organizations – General public • Maintain routine communication Epi Team Logistics Incident Command Structure How To Work in A Team • Know what is expected – Team member responsibilities – Team member expertise – Resources available for tasks • Know your role • Know who is in charge Delegation • Team leader will delegate tasks to appropriate team members • Other team members may also need to delegate tasks when overwhelmed • Assign an alternate team leader as a back-up Stress Triggers • Long hours, lack of rest • Personal health and safety concerns • Local sensitivities • Unexpected or traumatic event • Legal concerns • Intense pressure to investigate quickly • Interaction with multiple agencies • Security concerns Stress Management Strategies: – Enough sleep, good nutrition – Strategic pauses – Using humor – Talking to someone – Visualization – Self-talk – Massage – Debriefing After-action Discussions and Reports / Evaluation • Identifies what worked • Identifies what did not work • Creates a record • Can be used as a reference Resources for Investigation • Personnel • Equipment • Physical space NC Epi Team Investigation • DESCRIBE A SUCCESSFUL INVESTIGATION OF ONE OF NC’S EPI TEAMS – INCLUDE MISTAKES AND LESSONS LEARNED NC Epi Team Investigation 2 • DESCRIBE A SUCCESSFUL INVESTIGATION OF ONE OF NC’S EPI TEAMS – INCLUDE MISTAKES AND LESSONS LEARNED Conclusion • Working as a team requires: – A wide range of expertise – Clear communication – A rapid but careful and systematic approach in dealing with outbreaks References • Butler JC, Cohen ML, Friedman CR, Scripp RM, Watz CG. Collaboration between public health and law enforcement: new paradigms and partnerships for bioterrorism planning and response. Emerg Infect Dis 2002;8(10):1152-6. • Frace RM, Jahre JA. Policy for managing a community infectious disease outbreak. Infect Control Hosp Epidemiol 1991;12(6):346-7. • Sobel J, Griffin PM, Slutsker l, Swerdlow DL, Tauxe RV. Investigation of multistate foodborne disease outbreaks. Public Health Rep 2002;117(1):8-19.