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    Preparing for the Next Public Health Emergency

    Since the start of the COVID-19 pandemic, MEHP Online faculty have been engaged with questions of ethics and policy in the face of a public health emergency. Now increasingly, they are turning their attention to lessons learned to improve health care safety and resiliency going forward. 

    In an August 2022 commentary in NEJM Catalyst, Lee Fleisher and his colleagues from the US Center for Medicare and Medicaid Services (CMS) share the results of a mixed-methods study to learn about the experiences of hospitals, critical access hospitals, and nursing homes during the pandemic. They identify seven key levers to consider in preparing for future public health emergencies:  

    • Leadership, culture, and governance 

    • Communications systems 

    • Data reporting 

    • Training and testing 

    • Staff resilience 

    • Infection prevention and control expertise

    • Local planning and coordination 

    Acknowledging that preparedness must be a joint effort among federal, state, and local governments, as well as public and private organizations, they discuss how their findings have exposed the fragility of the American health care system, and how future needs might better be met. 

    Earlier, in a February perspective in NEJM, Dr. Fleisher and colleagues laid out some specific measures to improve the resiliency of health care safety standards in future public health emergencies. There has been “substantial deterioration on multiple patient-safety metrics since the beginning of the pandemic,” they observe, and we must “reevaluate whether the health care system has sufficiently invested in ensuring a deeply embedded safety culture and maintaining an unflagging commitment to safety.”  

    They propose that CMS and the Centers for Disease Control and Prevention (CDC) partner with leaders across the health care ecosystem to expand the collection and use of data on safety indicators to institute “a thorough system of safety that reaches from the boardroom to the front lines and that can be maintained during times of crisis.” 

    Finally, a team including Kevin Volpp examines the role of health technology in mitigating COVID spread. COVID-19 contact tracing apps from Google and Apple, they write, saw low adoption, with approximately 1 in 14 people downloading them in states where they are available. Barriers to use included “issues with app functionality, such as installation errors, battery drainage, inaccuracies in tracking location, and perceptions that the app was useless as people were not receiving notifications about exposures.” And for similar apps to have an impact in the future, they write, designers must focus on ease of use and clearer communication about what the apps doing to protect their users. 

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