Commonly used procedures to measure public-health emergency preparedness are inefficient,
Christopher Nelson, a senior political scientist at the RAND Corp. who presented findings
of a RAND expert panel on preparedness measures.
Written assessments or surveys to health departments, for example, are relatively
inexpensive but have a limited ability to capture operational capabilities, he said. And,
they also suffer from self-report bias, he said. Exercises and drills are also limited
as evaluation tools because the drill too often focuses on whether it was donenot how
well it was performed, he said.
Emergency preparedness needs to be addressed on a more incremental scale, Nelson said.
A promising alternative would be to conduct smaller-scale assessments that are embedded in
routine activities, such as testing mass-dispensing procedures at annual flu clinics, he
said. The key is to not test everything all at once, but rather do separate testing of the
training of staff, operating warehouses and dispensing of medication. Focus on individual
returns, then train (all of these components) together, he said.
In addition, there needs to be a better definition of a public-health emergency, which
would provide a foundation for a better measurement of preparedness, Nelson said. Such a
definition should include all hazards that pose a public-health threat, not just terrorism
activities, and should be defined by public-health consequences, not causes, he said. --
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