CD Surveillance Evaluation Provider Survey

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CD Surveillance Evaluation Provider Survey

• Preliminary Results
• Dan Rubado

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Background

• Presented survey to ID Advisory Council
• Sent out survey link via email to
• Outreach Team providers listserv
• Clark County Medical Society listserv
• ID Advisory Council listserv
• Convenience sample captured whoever was
  motivated and took the time to respond

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Overview

• Ran from Dec. 18th Feb. 5th
• 66 responses
• 67 of respondents were physicians
• Convenience sample
• Limitation probably over-representation of more
  proactive, pro-public health providers

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Responses
Received no responses since Jan. 14th
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Job Titles

• Q1 - Please indicate what your position is at
  your office

67 Physicians
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Job Experience

• Q2 - How long have you worked in this capacity in
  Clark County?

60 with 4 or more years of experience
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Organization Type

• Q3 - Please indicate what type of organization
  you work for

55 work in private group practice 25 work
within a health system
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Organization Type
Organization types where different providers
practice
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Notifiable Conditions List

• Q4 - In the past year, were you provided with a
  list of notifiable conditions to report to CCPH?

Only 60 of respondents provided notifiable
conditions list
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Notifiable Conditions List
Health systems less frequently received NC list
than group practices Not significant (p0.21)
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Notifiable Conditions List
Physicians less frequently have the NC list Not
significant (p0.221)
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Notifiable Condition Time Frames

• Q5 - Are you familiar with the different time
  frames for reporting specific notifiable
  conditions to CCPH?

Only 50 claim familiarity with reporting time
frames
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Notifiable Condition Time Frames
Nurses appear more familiar with time frames than
physicians Difference not significant (p0.60)
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Notifiable Condition Time Frames
The proportion of providers familiar with
reporting time frames is similar across years of
job experience (p0.664)
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Notifiable Condition Time Frames

• Respondents who received the NC list were 4.2
  (95 CI 1.5, 12.2) times more likely to be
  familiar with the time frames than otherwise
• Association is significant (p0.012)

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Public Health Alerts

• Q6 - In the past year, did you receive any health
  alerts, advisories, or updates from CCPH
  regarding significant communicable disease
  threats?

88 received disease information from CCPH
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Disease Reporting

• Q7 - Do you know how to report notifiable
  conditions?

71 know how to report NCs to CCPH
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Disease Reporting
Experienced providers were more likely to know
how to report Differences not significant
(p0.31)
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Disease Reporting
Position does not affect providers reporting
knowledge Differences not significant (p0.26)
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Disease Reporting

• Respondents who received the NC list were 8.8
  (95 CI 2.4, 32.4) times more likely to know how
  to report conditions
• Association is highly significant (p0.001)

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Reporting Line

• Q8 - Do you have the phone number for the 24-hour
  disease reporting line at CCPH?

Only 52 actually have the phone number
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Reporting Line
Nurses are more likely to know the reporting
number than physicians Difference is marginally
significant (p0.07)
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Reporting Line
Health systems are least likely to know the
reporting number
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Reporting Line

• Respondents who received the NC list were 11.3
  (95 CI 3.3, 39.4) times more likely to know the
  CCPH reporting line number
• Association is very highly significant (plt0.001)

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Reporting Protocols

• Q9 - Does your organization have specific
  protocols for reporting notifiable conditions to
  CCPH?

Only 42 have a protocol for reporting that they
know of
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Reporting Protocols
Physicians are less likely than nurses to know
whether they have a reporting protocol Difference
is significant (p0.041)
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Reporting Protocols
Hospital and health system practitioners are more
likely to report having a protocol than those in
group practice Significant trend (p0.039) phi
(corr)0.474
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Reporting System Rating

• Q10 - How user-friendly is the CCPH notifiable
  condition reporting system?

63 Dont know possibly represents widespread
unfamiliarity with system
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Reporting System Rating
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Reporting System Rating
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Barriers to Reporting

• Q11 - Which factor do you find to be the largest
  barrier to timely reporting of notifiable
  conditions?

Of those identifying a barrier, 57 rely heavily
on labs for reporting 19 dont have the time
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Barriers to Reporting
Lab reporting relied on across all organization
types
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Barriers to Reporting
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Cases Identified

• Q12 - In the past year, did you see any
  laboratory confirmed or clinically compatible
  cases of the following conditions at your
  organization?

Meningitis
Chlamydia
E. Coli
Pertussis
Salmonella
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Cases Identified
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Reporting Frequency

• Q13 - In general, when you diagnose the following
  conditions, how often do you report them to CCPH?

Chlamydia
Meningitis
E. Coli
Pertussis
Salmonella
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Reporting Frequency
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Reporting Timeliness

• Q14 - During the past year, how long after
  identifying a case of the following diseases did
  it usually take before you reported it to CCPH?

Chlamydia
Meningitis
E. Coli
Pertussis
Salmonella
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Reporting Timeliness
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Attitudes Toward Reporting

• Q15 - In your view, how important is it to report
  each of the following conditions to CCPH?

Chlamydia
Meningitis
E. Coli
Pertussis
Salmonella
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Attitudes Toward Reporting
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Attitudes Toward Public Health Investigation

• Q16 - In your view, how important is it that CCPH
  conduct contact and outbreak investigations for
  each of the following conditions?

Chlamydia
Meningitis
E. Coli
Pertussis
Salmonella
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Attitudes Toward Public Health Investigation
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Comments

• Q17 - Please add any concerns or recommendations
  you may have regarding notifiable condition
  reporting and communicable disease surveillance
  in Clark County.
• I think CCPH does a GREAT job of notifying us of
  anything going on in the community or surrounding
  comminuties--warning us of what to look for and
  who to contact. I rarely feel at a loss regarding
  a public health question and have to go looking
  or calling for help--usually the answers have
  come to me before I have time to ask.

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Comments

• Multiple calls from CCHD for follow up
  information can be very time consuming
• Add short-cut to phone system
• ...not practical to report all suspected cases
  without lab confirmation, which they cannot
  afford. Additionally, if Pertussis is suspected,
  they have already had symptoms for ?3 weeks...
  keeping them off work and school for one week
  seems illogical...

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Comments

• I've called the hotline number on the mousepad
  and told I need to call a different number, this
  is frustrating
• question the benefit of reporting minor animal
  bites of adults by his/her own pet
• What is the importance of reporting animal bites
  from pets?

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Comments

• ID Advisory Council Member
• Phone numbers and webpages change and wall
  posters get out of date or lost.  This is one
  aspect of notifying the county/state that is the
  most frustrating and time-consuming for me.  
  Finding the correct phone number is probably the
  most difficult part of reporting for a busy
  primary care provider.
• ...what about having the automated lab reports
  include a flag when notifiable pathogen is
  identified!!!  That may boost provider reporting.

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Feedback

• Which results are the most significant for CD
  surveillance?
• Which results are most important for provider
  outreach?
• What further analysis should be done?
• What unanswered questions should be addressed?

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Feedback

• How should these results be reported back to the
  providers?
• How should these results be presented to the
  Region IV Surveillance Coalition?