Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.
J Public Health (Oxf). 2011 Sep;33(3):361-8. doi: 10.1093/pubmed/fdq092. Epub 2010 Nov 8.
Effective management of modern public health emergencies requires the coordinated efforts of multiple agencies representing various disciplines. Organizational culture differences between public health (PH) and emergency management (EM) entities may hinder inter-agency collaboration. We examine how PH and EM differ in their approach to PH law and how such differences affect their collaboration towards PH preparedness.
We conducted 144 semi-structured interviews with local and state PH and EM officials between April 2008 and November 2009. Thematic qualitative analysis in ATLAS.ti was used to extract characteristics of each agency's approach to PH legal preparedness.
Two conflicting approaches to the law emerge. The PH approach is characterized by perceived uncertainty regarding legal authority over preparedness planning tasks; expectation for guidance on interpretation of existing laws; and concern about individual and organizational liability. The EM approach reveals perception of broad legal authority; flexible interpretation of existing laws; and ethical concerns over infringement of individual freedoms and privacy.
Distinct interpretations of preparedness law impede effective collaboration for PH preparedness. Clarification of legal authority mandates, designation within laws of scope of preparedness activities and guidance on interpretation of current federal and state laws are needed.
有效管理现代公共卫生突发事件需要多个机构的协调努力，这些机构代表着不同的学科。公共卫生（PH）和应急管理（EM）实体之间的组织文化差异可能会阻碍机构间的合作。我们研究了 PH 和 EM 在处理 PH 法律方面的差异，以及这些差异如何影响他们在 PH 准备方面的合作。
我们在 2008 年 4 月至 2009 年 11 月期间对当地和州 PH 和 EM 官员进行了 144 次半结构化访谈。使用 ATLAS.ti 进行主题定性分析，以提取每个机构对 PH 法律准备情况的方法的特征。
出现了两种相互冲突的法律方法。PH 方法的特点是对准备规划任务的法律权限存在不确定性；对现有法律解释的指导的期望；以及对个人和组织责任的关注。EM 方法揭示了对广泛法律权限的看法；对现有法律的灵活解释；以及对侵犯个人自由和隐私的道德关注。
对准备法律的不同解释阻碍了 PH 准备的有效合作。需要明确法律授权的要求，在法律中指定准备活动的范围，并就当前联邦和州法律的解释提供指导。
