Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT 84112, USA.
J Public Health Manag Pract. 2011 Jan-Feb;17(1):36-44. doi: 10.1097/PHH.0b013e3181ee9b29.
During public health emergencies, office-based frontline clinicians are critical partners in the detection, treatment, and control of disease. Communication between public health authorities and frontline clinicians is critical, yet public health agencies, medical societies, and healthcare delivery organizations have all called for improvements.
Describe communication processes between public health and frontline clinicians during the first wave of the 2009 novel influenza A(H1N1) pandemic; assess clinicians' use of and knowledge about public health guidance; and assess clinicians' perceptions and preferences about communication during a public health emergency.
During the first wave of the pandemic, we performed a process analysis and surveyed 509 office-based primary care providers in Utah.
Public health and healthcare leaders from major agencies involved in emergency response in Utah and office-based primary care providers located throughout Utah.
MAIN OUTCOME MEASURE(S): Communication process and information flow, distribution of e-mails, proportion of clinicians who accessed key Web sites at least weekly, clinicians' knowledge about recent guidance and perception about e-mail load, primary information sources, and qualitative findings from clinician feedback.
The process analysis revealed redundant activities and messaging. The 141 survey respondents (28%) received information from a variety of sources: 68% received information from state public health; almost 100% received information from health care organizations. Only one-third visited a state public health or institutional Web site frequently enough (at least weekly) to obtain updated guidance. Clinicians were knowledgeable about guidance that did not change during the first wave; however, correct knowledge was lower after guidance changed. Clinicians felt overwhelmed by e-mail volume, preferred a single institutional e-mail for clinical guidance, and suggested that new information be concise and clearly identified.
: Communication between public health, health care organizations and clinicians was redundant and overwhelming and can be enhanced considering clinician preferences and institutional communication channels.
在公共卫生突发事件期间，以办公室为基础的一线临床医生是疾病检测、治疗和控制的关键合作伙伴。公共卫生部门与一线临床医生之间的沟通至关重要，但公共卫生机构、医学协会和医疗保健提供组织都呼吁加以改进。
描述 2009 年新型甲型 H1N1 流感大流行第一波期间公共卫生与一线临床医生之间的沟通流程；评估临床医生对公共卫生指导的使用情况和了解程度；评估临床医生在公共卫生紧急情况下对沟通的看法和偏好。
在大流行的第一波期间，我们进行了一个流程分析，并对犹他州的 509 名以办公室为基础的初级保健提供者进行了调查。
犹他州参与应急反应的主要机构的公共卫生和医疗保健领导人以及遍布犹他州的以办公室为基础的初级保健提供者。
沟通流程和信息流、电子邮件的分发情况、至少每周访问关键网站的临床医生比例、临床医生对近期指导意见的了解程度以及对电子邮件负担的看法、主要信息来源以及临床医生反馈的定性发现。
流程分析显示存在重复的活动和信息传递。141 名应答者（28%）从各种来源获得信息：68%从州公共卫生部门获得信息；几乎 100%从医疗保健组织获得信息。只有三分之一的人经常访问州公共卫生或机构网站（至少每周一次）以获取最新的指导意见。临床医生对第一波期间未发生变化的指导意见有一定了解；然而，在指导意见发生变化后，正确的知识就较低。临床医生感到电子邮件数量过大，他们更喜欢使用单一的机构电子邮件来提供临床指导，并建议新信息要简明扼要且清晰标识。
公共卫生、医疗保健组织和临床医生之间的沟通既重复又让人应接不暇，可以考虑临床医生的偏好和机构沟通渠道加以改进。
