CSTE Annual Conference June 5, 2012 Lauren Rosenberg, MPA CSTE

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State trainings to improve outbreak response using the CIFOR Guidelines for Foodborne Disease Outbreak Response CSTE Annual Conference June 5, 2012 Lauren Rosenberg, MPA CSTE

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State trainings to improve outbreak response using the CIFOR Guidelines for Foodborne Disease Outbreak Response. CSTE Annual Conference June 5, 2012 Lauren Rosenberg, MPA CSTE. Council to Improve Foodborne Outbreak Response (CIFOR). AFDO. ASTHO. USDA/ FSIS. APHL. NEHA. NASPHV. CDC. - PowerPoint PPT Presentation

Transcript of CSTE Annual Conference June 5, 2012 Lauren Rosenberg, MPA CSTE

Page 1: CSTE Annual Conference June 5, 2012 Lauren Rosenberg, MPA CSTE

State trainings to improve outbreak

response using the CIFOR Guidelines for Foodborne Disease Outbreak Response

CSTE Annual ConferenceJune 5, 2012

Lauren Rosenberg, MPACSTE

Page 2: CSTE Annual Conference June 5, 2012 Lauren Rosenberg, MPA CSTE

CDC

ASTHO

APHL

AFDO

CSTE

FDA NACCHO

NEHA

USDA/FSIS

NASDA

Council to Improve Foodborne Outbreak Response (CIFOR)

NASPHV

Page 3: CSTE Annual Conference June 5, 2012 Lauren Rosenberg, MPA CSTE

• Comprehensive, consensus-based guidelines

• Developed by a workgroup with representatives from state, local, and federal level as well as all disciplines

• Based on existing guidelines and practices

• Released in 2009

CIFOR Guidelines Development

Page 4: CSTE Annual Conference June 5, 2012 Lauren Rosenberg, MPA CSTE

CIFOR Guidelines Product• Description of major functions in outbreak

response• Specific practices to improve outbreak response• Performance indicators to determine effectiveness

of activities• Comprehensive but not stand-alone• Does not provide instructions for implementing any

particular recommendation

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CIFOR Guidelines Toolkit

• Better understand their current outbreak response activities

• Become more familiar with the CIFOR Guidelines and recommended practices

• Identify appropriate activities to improve performance

• Make plans to implement those activities

A process and supporting materials to help agencies and jurisdictions:

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CIFOR Toolkit Goals• To identify CIFOR recommendations most

appropriate for your agency or jurisdiction• To prioritize those recommendations to not

overwhelm resources• To designate a lead person to take responsibility

for implementing each recommendation• To agree on an action plan and timeline to

increase the likelihood that changes will occur

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Toolkit Tracks and Focus Areas Planning and Preparation

Surveillance and Outbreak Detection

Investigation of Clusters and Outbreaks

Control Measures · Control of

source at implicated facility

· Food recall· Control of

secondary spread

· Relationships· Necessary

resources · Communications

· Notification/complaint systems

· Pathogen-specific surveillance

· Initial steps· Epidemiology investigation· Environmental health

investigation· Laboratory investigation

Page 8: CSTE Annual Conference June 5, 2012 Lauren Rosenberg, MPA CSTE

CIFOR Toolkit StepsPreparation: select participants, assemble supporting documents, prioritize Focus Areas

Then:1. Describe current activities/procedures in

each Focus Area and identify areas for improvement

2. Prioritize CIFOR recommendations that address these targets

3. Outline steps to implement high priority CIFOR recommendations

Page 9: CSTE Annual Conference June 5, 2012 Lauren Rosenberg, MPA CSTE

Worksheets

Page 10: CSTE Annual Conference June 5, 2012 Lauren Rosenberg, MPA CSTE

Implementation: State-based trainings

• CSTE funded trainings in 22 sites• 17 states:

AK, AR, CT, DE, FL, IA, ID, IL, KS, KY, ME, MI, NV, ND, PA, WA, WV

• 2 county-based areas:Knox County (TN), Cuyahoga County (OH)

• 3 urban areas:Los Angeles, Philadelphia, Milwaukee

Page 11: CSTE Annual Conference June 5, 2012 Lauren Rosenberg, MPA CSTE

Implementation: State-based trainings

• Each site conducted a multidisciplinary training using the Toolkit to identify recommendations from the Guidelines to implement

• Evaluation form and summary report required upon completion of training

• Trainings took place starting Spring 2011

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34%

22%

15%

12%

6%

5%5%

Implementation of the CIFOR Guidelines: State-based trainings participants

Environmental health specialist (361)

Epidemiologist (229)

Public health nurse (157)

Other (131)

Public health laboratorian (62)

Director of health (54)

Regulator (57)

State-based trainings: 1,052 Participants

Page 13: CSTE Annual Conference June 5, 2012 Lauren Rosenberg, MPA CSTE

State-based trainings:Type of training

• All trainings:o Used the Guidelines & Toolkito Introduced participants to Guidelines & Toolkito Had a dedicated facilitator & recordero Evaluated the Toolkit

• Types of trainings varied:o 1-day training (AK, CT, ID, IL, KS, KY, Knox County, Los

Angeles County, ME, Milwaukee, ND, Philadelphia)o Multiple-day training (FL, IA, MI, NV)o Regional trainings (AR, Cuyahoga County, DE, PA, WA,

WV)

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State-based trainings: Focus areas completed

• Sites completed between 3 and 12 focus areas• Most commonly completed focus areas:

o 1 – Relationships o 2 – Communicationso 7 – Epidemiology investigationso 3 – Necessary resourceso 6 – Initial steps

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State-based trainings: Common themes

• Many sites reported similar improvements to be made:o Better communicationo Better coordinationo More trainingo More post-outbreak debriefs/ after-action reportso Use standardized investigation/interview/other

formso Utilize written protocols (create if necessary)

Page 16: CSTE Annual Conference June 5, 2012 Lauren Rosenberg, MPA CSTE

State-based trainings: Common themes

• Many sites reported similar Guidelines recommendations to be implemented:o Chapter 3 – Planning & Preparation

3.1 – Agency roles 3.2.3.3 – Agency-specific response protocol & other resources 3.2.3.4 – Training for the team 3.6.2.2 – Communication among the agencies & units of the

outbreak control teamo Chapter 5 – Investigation of Clusters & Outbreaks

5.1.2.5 – Standardized data collection forms 5.2.5 – Coordinate investigation activities

o Chapter 6 – Control Measures 6.6 – Debriefing

Page 17: CSTE Annual Conference June 5, 2012 Lauren Rosenberg, MPA CSTE

State-based trainings: What was learned

• “We consider ourselves to be ahead of the curve, but staff roles need to be better defined in an outbreak investigation.”

• “Utilizing the Toolkit to guide a review of current practices was very valuable. We learned that we are doing a lot of things right but also learned that standardization of foodborne outbreak detection & response practices statewide would be helpful & could be improved.”

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State-based trainings: What was learned (continued)

• “Enabling all of the jurisdictions to send representatives from multiple disciplines allowed for excellent networking opportunities & face-to-face discussions. All participants learned a lot… local health jurisdictions have developed various strategies to enhance outbreak response.”

• “Having the opportunity to get together & talk about current practices & needed improvements was very helpful.”

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State-based trainings: Next steps

• Follow-up with sites that conducted trainingso Progress on identified action itemso Impact of training on outbreak response

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The CIFOR Toolkit is now available at:www.cifor.us

www.cste.org CSTE Exhibit Hall booth

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Thank you!