Public Health Preparedness

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Public Health Preparedness Leadership

• Louis Rowitz, PhD
• Director
• Mid-America Regional Public Health Leadership
  Institute

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• We cannot live in a post-September 11, 2001
  world with a pre-September 11, 2001 mind.
• --adapted from Angela Thirkell, 1933

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• TRADITIONAL AND CRISIS LEADERSHIP
• WHAT ARE THE
• DIFFERENCES?
  

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DEFINITION OF CRISIS

• A CRISIS IS CHARACTERIZED BY A HIGH DEGREE OF
  INSTABILITY AND CARRIES THE POTENTIAL FOR
  EXTREMELY NEGATIVE RESULTS THAT CAN ENDANGER THE
  LIVES OF PEOPLE IN A COMMUNITY.
• (ADAPTED FROM KLANN)

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TYPES OF CRISES

• NATURAL DISASTER
• ACT OF WAR
• TOXIC CHEMICAL RELEASE
• HAZARDOUS MATERIAL SPILL
• CRASH OR DERAILMENT
• STRIKE OR BOYCOTT
• TERRORIST ACT
• FINANCIAL CATASTROPHE

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BE PREPARED

• The New Public Health
• Marching Song

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ANALYTIC
CONCEPTUAL
STRUCTURAL
SOCIAL
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• SYSTEMS THINKING AND
• COMPLEXITY

Do you understand your community?
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The Iceberg
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System
Crisis
Complexity Issues
Recovery
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(No Transcript)
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Community Assets Map
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Exercise on Forces for Change
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CRITICAL ISSUE

• HOW DO I
• KEEP MY
• FAMILY SAFE?

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TIPPING POINT AWARENESS
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Public Health ComplexityIssues Leadership
Demands
Strategic Challenges
P.H.
The Tipping Point
Societal Trends
Community Context
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Public Health Response
Societal Pressure
Community Crisis and Priorities
Strategic Challenges
National Agenda
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Societal Pressures
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Dimensions of Culture (Hofstede, 1997)

• Power Distance
• Collectivism vs. Individualism
• Femininity vs. Masculinity
• Uncertainty Avoidance

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Power distance is the extent to which the less
powerful members of institutions and
organizations within a country expect or accept
that power is distributed unequally.
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Individualism pertains to societies in which the
ties between individuals are loose everyone is
expected to look after himself or herself and his
or her immediate familyCollectivism as its
opposite pertains to societies in which people
from birth onwards are integrated into strong,
cohesive in-groups, which throughout peoples
lifetimes continue to protect them in exchange
for unquestioning loyalty.
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Masculinity-femininity as a dimension of societal
culture
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Uncertainty of avoidance is the extent to which
the members of a culture feel threatened by
uncertain or unknown situations
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STRATEGIC CHALLENGES
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NATIONAL AGENDA
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Adaptation to Change

• The Resilience Factor

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The Structure of ChangeConner
Synergy
Nature
Culture
Process
Resilience
Commitment
Roles
Resistance
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Leadership Styles and Environment Match
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(No Transcript)
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The Value of Structured Flexibility
Do you understand the procedure?
Learn It!
Is there a need to make and exception?
Follow the Procedure
Use your best Judgment, communicate your actions
to the appropriate person as soon as possible,
and be prepared to explain what was done and why.
Is there time to get approval/input from others?
Check with the appropriate person to get advice
or approval to proceed.
If permission is denied, follow the procedure as
directed. If desired, advocate for changing the
procedure in the future.
Record your learnings so we dont do it again the
same way.
Go Ahead! Did it work?
Record your learnings so we know why it wont
apply elsewhere.
Would it work in other situations?
Record your learnings for possible incorporation
in updated procedures.
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NATIONAL AGENDA

• PUBLIC HEALTH CERTIFICATIONS
• HEALTH ALERT NETWORK
• PUBLIC HEALTH LEADERSHIP
• ESSENTIAL PUBLIC HEALTH SERVICES
• WORKFORCE DEVELOPMENT

• PUBLIC HEALTH INFRASTRUCTURE
• NATIONAL PERFORMACE STANDARDS
• PUBLIC HEALTH INFORMATICS
• MAPP
• EVIDENCE-BASED PUBLIC HEALTH
• HOMELAND SECURITY

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Transitions (Bridges)
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Social Capital Theory

• Those resources including trust, norms and
  associational networks inherent to social
  relations which facilitate collective action.

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New Leadership Pyramid
Performance
Capacity
Building
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ECOLOGICAL LEADERSHIP

• ECOLOGICAL LEADERS ARE COMMITTED TO THE
  DEVELOPMENT OF THEIR LEADERSHIP SKILLS AND
  COMPETENCIES THROUGHOUT THEIR PROFESSIONAL
  CAREERS WHILE AT THE SAME TIME BEING COMMITTED TO
  THE APPROPRIATE APPLICATION OF THESE SKILLS IN
  THEIR COMMUNITIES CHANGING HEALTH PRIORITIES.

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THE DELICATE BALANCE

• ECOLOGICAL LEADERS IS ABLE TO BALANCETHE NEEDS OF
  DAY-TO-DAY PRACTICE OF PUBLIC HEALTH IN HIS/HER
  ORGANIZATION AND COMMUNITY WITH THE SPECIAL
  SKILLS AND APPLICATIONS NECESSARY TO ADDRESS
  PUBLIC HEALTH EMERGENCIES

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• Leadership and Preparedness
• in Crisis Situations

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BIOTERRORISMCompetencies for Leaders

• DESCRIBE the chain of command and management
  system
• COMMUNICATE public health information/roles/capaci
  ties/legal authority accurately to all emergency
  response partners
• MAINTAIN regular communication with emergency
  response partners

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Competencies for Leaders (Continued)

• ASSURE that the agency has a written updated plan
• ASSURE that the agency regularly practices all
  parts of emergency response
• EVALUATE every emergency response drill
• ASSURE that knowledge and skills are transmitted
  to others

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WHOS IN CHARGE?
INCIDENT COMMAND SYSTEM
BIOTERRORISM OR DISASTER EVENT
COLLABORATION
COLLABORATION
NO COLLABORATION
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NEW PARTNERSHIPS

• Emergency Management System
• Police Department
• Fire Department
• Emergency Medical System
• Community Health Centers
• FBI
• Local Public Health Department
• Homeland Security

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NEW MODELS OF COLLABORATION

• Shared Work
• Maintain Organizational Identities
• Synergy

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CHANGING WAYS TO WORK

• CORE
• SPECIALISTS
• GENERAL WORKERS
• COMMUNITY RESIDENTS

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MEASURES OF SUCCESSIN COLLABORATIVE LEADERSHIP

• COMMUNICATION
• ASSESSMENT
• CONFLICT MANAGEMENT
• DEVELOPMENT OF TRUST
• DECISION-MAKING
• ADDRESSING SAFETY CONCERNS

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DEFINITION OF EMOTIONAL INTELLIGENCE

• THE ABILITY TO USE YOUR EMOTIONS IN A POSITIVE
  AND CONSTRUCTIVE WAY IN YOUR RELATIONSHIP WITH
  OTHERS

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A Framework of Emotional Competenciesp. 28
Cherniss and Goleman
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Leadership Style, EI and Organizational
Effectiveness
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PEOPLE SMART STRATEGIES

• Flexibility in communication
• Personal stress management
• Help others who express pessimism about the
  future
• Show respect for others
• Manage work rage

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Exercise on Emotional Intelligence
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Relationship betweenRisk Communication and
Crisis Communication
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RISK COMMUNICATION SKILLS

• High Concern-High Stress Situations
• Trust Determination and Building Trust
• Strategies for stressed people who do not listen
• Skills for dealing with negative statements
  (Covello)
• 1 N 3 P
• One negative Three Positive
• Risk perception by the public and skills for
  dealing with it

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CRISIS COMMUNICATION

• COMMUNITIES MUST FORM A FLEXIBLE AND QUICKLY
  ACTIVATED CRISIS COMMUNICATION TEAM TO IMPLEMENT
  A COMMUNICATION PLAN AS A PART OF THE TOTAL
  RESPONSE EFFORT

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SEVEN STEP COMMUNICATIONS RESPONSE PLAN

• ACTIVATE THE CCT
• GATHER AND VERIFY INFORMATION
• ASSESS THE GRAVITY OF THE CRISIS
• IDENTIFY KEY STAKEHOLDERS
• IMPLEMENT A COMMUNICATIONS STRATEGY
• DEVELOP EXTERNAL MATERIALS
• INFORM PARTNERS,STAKEHOLDERS, AND MEDIA

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INFORMATION TECHNOLOGY How to use data
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KNOWLEDGE OF THE LAW

• POLICE POWERS
• PERSONAL RIGHTS
• CONFIDENTIALITY--HIPAA

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FORENSICEPIDEMIOLOGY
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New Leadership Skills for New Times
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Major Crisis Leadership Lessons(Mitroff)

• Prepare for at least one crisis in each crisis
  family
• It is not sufficient to prepare for crisis that
  are normal in community
• Prepare for the simultaneous occurrence of
  multiple crisis
• The purpose of definition are to guide, not
  predict

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Major Crisis Leadership Lessons(Mitroff)
continued

• Every Type of Crisis can happen to every
  organization
• No Type of Crisis should be taken literally
• Tampering is the most generic form or type of
  crisis
• No Crisis ever happens as one plans for it
• Traditional risk analysis is both dangerous and
  misleading

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Major Crisis Leadership Lessons(Mitroff)
continued

• Every crisis is capable of being both cause and
  the effect of any other crisis
• Crisis Leadership is systemic
• Perform a systemic crisis audit of your agency
  and community
• Crisis leaders not only recognize the validity of
  all types of crisis, but they also see the
  interconnections between them

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COMMUNITIES SHOULD MAKE PLANS NOW FOR DEALING
WITH ANY RECURRENCES. THE MOST PROMISING WAY TO
DEAL WITH A POSSIBLE RECURRENCE IS TO SUM IT UP
IN A SINGLE WORD PREPAREDNESS AND NOW IS THE
TIME TO PREPARE.
RUPERT BLUE CIVILIAN
SURGEON
GENERAL, 1919
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Leadership will involve working at all levels
of the system