Edward P. Ehlinger, MD, MSPH Director and Chief Health Officer Boynton Health Service, University of Minnesota Big 10+2 Universities H1N1 Lessons Learned Online Sharing Conference University of Illinois Indiana University University of Iowa University of Michigan Michigan State University University of Minnesota Northwestern University The Ohio State University Pennsylvania State University Purdue University University of Wisconsin
Transcript
Edward P. Ehlinger, MD, MSPH Director and Chief Health Officer
Boynton Health Service, University of Minnesota
Big 10+2 Universities H1N1 Lessons Learned Online Sharing
Conference
University of Illinois
Indiana University
University of Iowa
University of Michigan
Michigan State University
University of Minnesota
Northwestern University
The Ohio State University
Pennsylvania State University
Purdue University
University of Wisconsin
University of Chicago
University of Minnesota Project Team
Dave Bender, CIDRAPPaul Bernhardt, School of Public HealthJill DeBoer, CIDRAP and Academic Health
CenterEd Ehlinger, Boynton Health ServiceKathleen Kimball-Baker, CIDRAPAmy Becker LaFrance, CIDRAPElizabeth McClure, Academic Health CenterJoan Rambeck, Academic Health CenterTechnical and other staff, volunteers
Association of State and Territorial Health Officials
Lisa C. Barrios, ScM, DrPHChief, Research Application Branch.
CDC Division of Adolescent and School Health,Lead, 2009 H1N1 Flu Community Measures Guidance,
Technical Assistance and Communications Group
Marsha L. Vanderford, PhD Chief, Risk Communication Branch, CDC DEO/OPHPR
Director, Emergency Communication System
Agenda for Online Sharing Conference May 18, 2010
Snapshots from interviews (all areas)Preview of practices available online
Health services Reports from the field (U of Ill, PSU)
Vaccine distribution Reports from the field (IU, OSU, PU)
On-line pollingDialogue with CDC partners
Federal guidance documents Outreach to higher education
Challenges/issues needing further attention
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Snapshots from Interviews
Incident ManagementResidence HallsHealth ServicesCommunicationsVaccine DistributionTeaching PoliciesHuman ResourcesCollaboration with Local and State Public
HealthIssues Needing Further Attention
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Incident Management
Importance of NIMS structure and trainingPlanning and response group with broad
representation A variety of successful approaches were used
Importance of strong leadership and integration of health/public health personnel
Planning and decision-makingVarious successful methods used to convene
and communicate among response team members
Extended response time
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Incident Management: Sample Practices
Successful experience with Virtual EOC (University of Wisconsin)
Successful experience with Health DOC (University of Minnesota)
Early concerns about summer campsMismatch between plans and H1N1 realityMany institutions had limited to no options to
relocate students due to housing capacityThose who implemented isolation housing
reported mixed results Standard approach: “If you have symptoms,
go home. If you can’t leave, self-isolate.” “We really dodged a bullet here.”
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Residence Halls
Important role for dining services partners Online meal ordering systems Meal delivery
Important role for student leaders Resident Advisors Community Advisors Health Advocates
Some reached out to fraternities and sororities
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Residence Halls: Sample Practices
Alternate housing plan for international students (Michigan State University)
Student involvement in development of H1N1 housing plan (University of Chicago)
Online census and health survey (University of Minnesota)
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Health Services
Modified health service operations
Building entrance changes Trained greeters Triage protocols Some suspended standard
clinic operations for a time
Importance of phone-based information and triage (nurse lines)
Most reported being “busy but not overwhelmed”
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Health Services: Sample Practices
Online screening system for those with symptoms and those exposed (Northwestern University)
Flu nurse protocol (Purdue University)
Direct parent contact (University of Illinois)
Direct patient follow-up (Pennsylvania State University)
Infection control internship (Pennsylvania State University)
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Communications: The Big Themes
Coordinating messages was crucial Unified approach to vetting communications,
importance of speaking “one message with one voice”
Streamlining information also helped Heavy reliance on email communications and
consolidated online information. Align all websites. Update information daily.
Finding multiple modes/media was beneficial Approaches include signage, residence hall
kiosks, tweet chats/podcasts with health experts, and many more.
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Communications: The Big Themes
Great media interest in higher education experiences and responses
Concerns about message fatigue over timeOverall, communication efforts were a
success “Our Housing Department had more complaints
about bedbugs than H1N1.”
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www.giantmicrobes.comwww.tapirback.com
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Communications: Sample Practices
Student chapter of the American Red Cross created brochures on H1N1 that were distributed with hand sanitizer to city bus riders. They reached 5,000 people in two days.(Purdue University)
Rapid ‘triage’ of non-clinical questions e-mailed to a central “M-Hub.” Messages were forwarded to the right people for quick replies. (University of Wisconsin-Madison)
From University of Michigan’s campaign http://www.vpcomm.umich.edu/flu/pdf/cover_coug
h.pdf
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Vaccine Distribution
Vaccine access and quantities available were a challenge
Complications of nasal and injectable product differences and availability
Mixture of mass walk-in clinics and scheduled appointment systems successfully used.
Many successes and lessons learned
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Vaccine Distribution: Sample Practices
Online appointment systems (Indiana University, Michigan State University, University of Minnesota)
Automated phone registration (Ohio State University)
Mass clinic operations (Purdue University, University of Minnesota)
Effective student assistance models (Pennsylvania State University, University 0f Iowa, University of Chicago)
Use of Medical Reserve Corps (University of Minnesota)
Effective FluMist protocol (University of Minnesota)
Effective use of incentives (University of Illinois)
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Teaching Policies
Spring 2009: Concerns about travel abroad programs in Mexico
Fall goal: Effective self-isolation for students and faculty with symptoms
Nearly all of us have an existing absence note policy which needed suspension
Reviewed alternate methods for completing courses should social distancing measures be implemented
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Teaching Policies: Sample Practices
Faculty webinar (Michigan State University)
Weekly classroom attendance monitoring through use of a convenience sample of classes (Pennsylvania State University)
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Human Resources
Great deal of communication to employees
Questions and concerns emerged about sick
and vacation leave policies
Some enacted new HR policies
Some developed guidance documents
Business continuity plans revisited Who are the essential employees during a
pandemic?
2020
Human Resources: Sample Practices
Guidance documents (University of Illinois, Ohio State University)
Pandemic influenza policy (University of Minnesota)
Essential function staff designations (Purdue University)
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Collaboration with Health Departments
Great collaborations reported across the board with local health departments
Two-way partnerships Good information sharing Vaccine sharing
Some variability on direct relationships with state health departments
Vaccine distribution was the biggest area of conflict
Important partnerships with hospitals, medical centers, local emergency managers, and CBOs.
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Collaboration: Sample Practices
Memorandum of understanding with local public health (Purdue University)
Open letter to Athletic Directors from State Epidemiologist (University of Minnesota)
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Challenges: Snapshots from Interviews
Vaccine access and distribution Residence hallsPlan activation triggersStockpiling suppliesProviding education when social distancing
is recommended Universities as communitiesNeed to establish an effective partnership
with local and state health department
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Challenges: Snapshots from Interviews
Other Use of antivirals Designation of essential personnel and
operational continuity plans Compensation policies Need for alternate methods to reach parents Media coverage Need for improvement redesign of plans based
on this experience Response price tag
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Key Themes from CDC IHE Needs Assessment, Spring 2010
Lisa C. Barrios, ScM, DrPH
2009 H1N1 was overblown; pandemic fatigueNeed clarity on “increased severity”Need more information/special outreach for:
Rural and international students Non-faculty staff (e.g., cafeteria workers) Addressing parent concerns
Concerned with “increase social distancing” and “stay home when sick” recommendations
No formal policy change: students encouraged to stay home when sick; faculty encouraged to relax attendance requirements
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Your Turn: What Should CDC Know About Communications?
Marsha L. Vanderford, PhD,
Do you agree or disagree with the themes from the needs assessment?
What information was missing from the CDC guidance? Did you make any policy changes because of H1N1? What information/tools would you need to change policy or
practice? Did your university make use of any social media channels to
communicate with students? If so, what were they? Text messages? Tweets? Blogs? Facebook?
What communications activities did you find most effective? What communications activities did you consider ineffective? Where did you find the information you communicated to others? What impact, if any, did this have on your school policies?
What changed? Why?
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Overarching Themes
Colleges and universities were significantly impacted by H1N1 – nearly all campus operations were affected.
Uncertainties early on were a challenge – required preparation for all possibilities.
H1N1 response required an unprecedented level of community organizing over an extended period of time.
Multi-discipline response teams worked well.Importance of student leadership and
participation.
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Publication of report for all Big 10 + 2 InstitutionsSummary report for ASTHO and its membersCIDRAP’s Promising Practices web site expansion
WWW.CIDRAPPRACTICES.ORGYou can now access an archived version of the Lessons
Learned Conference. Later this summer specific university practices will be available.
