“Tools are needed to assure timely and appropriate care and to assess the efficacy of these interventions in restoring the health of the affected community and thereby increasing the resilient recovery from an event.”

Implementing The National Health Security Strategy
Part 1 of 5
Written by RADM Craig Vanderwagen, M.D., USPHS (Retired)

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This essay is one in a series exploring the issues that affect the success of the public health practitioner in meeting the needs of the public’s health, and by doing so, increasing the resilience of communities and the Nation.

The series takes as its guiding framework,the National Health Security Strategy (NHSS) developed and released by the US Department of Health and Human Services (HHS) in December 2009. The development and public release of this strategic document was directed by Congress as part of the Pandemic and All Hazards Preparedness Act of December 2006. The document is the product of a wide variety of stakeholder discussions and an examination of the real threat issues confronting the Nation. It is a national document, not just a federal document.

The NHSS has 10 stated strategic goals. This series will not address each of them, but will explore practical applications of tools that will be major elements in the successful achievement of at least four of them (Integrated/Scalable Health Care Systems; Effective Countermeasure Enterprise; Post Incident Recovery; and Situational Awareness) and add materially to the achievement of at least two others (Science, Evaluation, and Quality Assurance Improvements and Timely and Effective Communications). By bringing focus and effort to these practical considerations the public health practitioner can indeed contribute to the implementation and success of the NHSS which is a portion of or overall national security enterprise.

This essay broadly examines the importance of managing the movement of supplies, personnel, and patients in execution of various public health interventions. Following essays will more focusedly consider aspects of this broader field of logistics. While the series utilizes lessons learned in disaster events primarily, it will also suggest the need for effective logistical skill in completing the more routine tasks of public health. It is intended to underscore the importance of planning, the acquisition of the right tools and people, and the necessary attention to the details of the intervention and its requirements. Without these principles fully engaged, the success of the desired intervention will falter.

Public health has traditionally been viewed as a preventive activity aimed at populations rather than individuals. This is the core of public health practice and depends on the gathering and analysis of information about the health status and risk factors affecting health. Based on this application of technical tools and methods, interventions are planned and executed to address those factors which may adversely influence the health of the population of interest.

Logistics in Public Health - Video Transcript

I think public health practitioners don't pay as much attention to this part of our response capability as they should. The national health security strategy, however, has focused us on this because our experience in significant disasters like Katrina and others has revealed that we can't effectively monitor supplies, personnel or patient movement without an effective logistics process. Now there are critical elements to this logistics process that you need to be very conscientious about. First, understand your logistic systems as a strategic asset and in your planning assure that you think about it in a strategic way.

Secondly, you have to think about it as an end to end process that is it's not just a piece in the middle here somewhere. This is part of the whole process of preparedness and response. Thirdly, you need to think about it from the point of view of who are the right collaborative partners to facilitate our ability to get things and people moved in an appropriate way. Without those partners, we won't succeed. We need transportation. We need energy. We need public safety. That's all important. Fourthly, I think you need to be thinking about it from the point of view of how well is our logistics plan designed for mission accomplishment. Without that define for mission accomplishment, it isn't going to work very effectively and lastly, you need to have metrics in place that will help you understand whether you're moving forward effectively to meet that mission accomplishment. With those five factors, we've learned we can do a much better job of protecting the health and well-being of the population we serve.

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