Synopsis of a public health emergency preparedness critical incident registry.

As called for in the National Health Security Strategy, health departments currently use a number of "after action report" formats to collect data from actual public health emergency responses. The 2009 H1N1 pandemic revealed significant weaknesses in the use of these approaches, especially the absence both of reflective root-cause analyses and of a framework to describe performance in terms of public health emergency preparedness capabilities. To address these deficiencies and to develop an effective approach to learning from actual public health emergencies, we sought to understand how the concept and operations of a "critical incident registry," common in health care and other industries, could be adapted to meet the National Health Security Strategy objectives.