LEONARD J. MARCUS, Ph.D. LEONARD J. MARCUS, Ph.D.

Harvard Center for Public Health PreparednessHarvard Center for Public Health PreparednessNational Preparedness Leadership InitiativeNational Preparedness Leadership Initiative

Program for Health Care Negotiation and Conflict ResolutionProgram for Health Care Negotiation and Conflict Resolution

PartnershipsPartnerships betweenbetweenPublic agencies and academia:Public agencies and academia:

Building CONNECTIVITY Building CONNECTIVITY To advance PREPAREDNESSTo advance PREPAREDNESS

AchievingAchievingNationalNational

PreparednessPreparednessNational Governors Association Center for Best PracticesNational Governors Association Center for Best Practices

Academic centers for Academic centers for Pubic health preparednessPubic health preparedness

Located within schools of public health,Located within schools of public health,the national network of the national network of

22 Academic Centers for Public Health 22 Academic Centers for Public Health PreparednessPreparedness

is a workforce development initiative is a workforce development initiative designed to ensure designed to ensure

that frontline public health and health care that frontline public health and health care workersworkers

are prepared to respond to any biological, are prepared to respond to any biological, chemical, chemical,

radiological or nuclear threats or radiological or nuclear threats or emergencies,emergencies,

as well as infectious disease outbreaks and as well as infectious disease outbreaks and natural disasters.natural disasters.

Centers for Disease Control and PreventionCenters for Disease Control and PreventionAssociation of Schools of Public HealthAssociation of Schools of Public Health

Academic centers for Academic centers for Pubic health preparednessPubic health preparedness

ASTHOASTHO NACCHONACCHO

Partnership for Advancing Public Health Practice and Preparedness Partnership for Advancing Public Health Practice and Preparedness

Columbia University Mailman School of Public Health Center for Public Health  Emory University, Rollins School of Public Health

Harvard School of Public Health Johns Hopkins Bloomberg School of Public Health

Saint Louis University School of Public Health

Tulane University School of Public Health and and University of Alabama at Birmingham School of Public Health*

University at Albany SUNY School of Public Health University of California at Berkeley School of Public Health

University of California at Los Angeles School of Public Health University of Illinois at Chicago School of Public Health

Academic centers for Academic centers for Pubic health preparednessPubic health preparedness

SCHOOLSSCHOOLS

University of Iowa: Center for Public Health Practice University of Medicine and Dentistry of New Jersey School of Public HealthUniversity of Medicine and Dentistry of New Jersey School of Public Health

University of Michigan School of Public Health University of Minnesota School of Public Health 

University of North Carolina Chapel Hill School of Public Health University of Oklahoma College of Public Health University of Oklahoma College of Public Health

University of Pittsburgh Graduate School of Public Health and University of Pittsburgh Graduate School of Public Health and Ohio State University School of Public Health* Ohio State University School of Public Health*

University of South Carolina, The Norman J. Arnold School of Public Health University of South Carolina, The Norman J. Arnold School of Public Health University of South Florida College of Public Health University of South Florida College of Public Health

University of Texas School of Public Health University of Texas School of Public Health University of Washington School of Public Health and Community MedicineUniversity of Washington School of Public Health and Community Medicine

Academic centers for Academic centers for Pubic health preparednessPubic health preparedness

SCHOOLSSCHOOLS

Academic centers for Academic centers for Pubic health preparednessPubic health preparedness

PURPOSES and ACTIVITIESPURPOSES and ACTIVITIES

1.1. Support state and local public health agencies in achieving Support state and local public health agencies in achieving preparedness by assessing their needs and providing preparedness by assessing their needs and providing technical assistance.technical assistance.

2.2. Develop and deliver competency-based training in BT preparedness.Develop and deliver competency-based training in BT preparedness.

3.3. Ensure best practices.Ensure best practices.

4.4. Evaluate trainings thereby ensuring cost-effectiveness andEvaluate trainings thereby ensuring cost-effectiveness andminimizing duplication.minimizing duplication.5.5. Expand access to training for public health professionals Expand access to training for public health professionals

across the Nation.across the Nation.6.6. Evaluate the success of these tailored trainings in meetingEvaluate the success of these tailored trainings in meeting

national goals for preparedness.national goals for preparedness.

Connectivity:Connectivity:

THE DILEMMA OF THE THE DILEMMA OF THE CUBECUBE

Peep holePeep hole

AA

Peep holePeep hole

BB Peep hole APeep hole A

Peep hole BPeep hole B

Negotiation &Negotiation &Conflict resolutionConflict resolution

For For public health preparednesspublic health preparedness

a a bioterrorist incidentbioterrorist incident

““CONNECTIVITY”CONNECTIVITY”A A seamless webseamless web of of

people,people, organizations,organizations, resources,resources, & & information information

that can bestthat can best

catch,catch, contain,contain, andand control control

What is necessaryWhat is necessaryTo achieve connectivity?To achieve connectivity?

a a bioterrorist incidentbioterrorist incident

““CONNECTIVITY”CONNECTIVITY”A A seamless webseamless web of of

people,people, organizations,organizations, resources,resources, & & information information

that can bestthat can best

catch,catch, contain,contain, andand control control

LinkagesLinkages

AssetsAssetsOperationsOperations

DecisionsDecisions

What are the greatestWhat are the greatestObstacles Obstacles

to connectivity?to connectivity?

LinkagesLinkages

AssetsAssetsOperationsOperations

DecisionsDecisions

not in placenot in place

not readynot readyimpededimpeded

LouLousysy

Symptoms ofSymptoms ofconflictconflict

connectivityconnectivity

HighHigh

LowLow

MiddleMiddle

Differential Levels of ConnectivityDifferential Levels of Connectivity

Integrated systemsIntegrated systems

Parallel systemsParallel systems

Competitive systemsCompetitive systems

connectivityconnectivity

IntegratedIntegrated

CompetitiveCompetitive

ParallelParallel

DecisionsDecisions

Decision-making occursDecision-making occurstogether on most topicstogether on most topics

Decision-making occurs on Decision-making occurs on specific topicsspecific topics

Separate decision making Separate decision making

connectivityconnectivity

IntegratedIntegrated

CompetitiveCompetitive

ParallelParallel

Emergency PreparednessEmergency Preparedness

Key systems, people, resources, &Key systems, people, resources, &information closely linkedinformation closely linked

The job gets done with limitedThe job gets done with limited efficiency & effectivenessefficiency & effectiveness

System components unlinked withSystem components unlinked withoverlaps and gapsoverlaps and gaps

collaborationcollaboration

““Whole Image Negotiation”Whole Image Negotiation”

Interdependence - Fit - CollaborationInterdependence - Fit - Collaboration

Imagination- Time dimensionsImagination- Time dimensions

Interest based - Mutual benefitsInterest based - Mutual benefits

““W.I.N.”W.I.N.”

conceptual Framework conceptual Framework forfor

PROBLEM SOLVINGPROBLEM SOLVING

MULTI-DIMENSIONALMULTI-DIMENSIONALPROBLEM SOLVINGPROBLEM SOLVING

Uni-dimensionalUni-dimensionalproblem solvingproblem solving

““Me for Me”Me for Me”

Two-dimensionalTwo-dimensionalproblem solvingproblem solving

““Me against You”Me against You”

““Us together”Us together”

ClassicClassicadversarial adversarial

conflictconflict

CollaborationCollaboration

connectivityconnectivity

HighHigh

LowLow

MiddleMiddle

Differential Levels of ConnectivityDifferential Levels of Connectivity

Integrated systemsIntegrated systems

Parallel systemsParallel systems

Competitive systemsCompetitive systems

Leadership

Interest-based negotiationInterest-based negotiation

Multi-dimensional P.S.Multi-dimensional P.S.

Walk in the WoodsWalk in the Woods

Positional bargainingPositional bargaining

Uni, Two-dimensional PSUni, Two-dimensional PS

Power plays & Power plays & dominance dominance

ValuesValuesModelsModels

MethodsMethods

PerformancePerformance

PerformancePerformance

??

??

connectivityconnectivity

HighHigh

LowLow

MiddleMiddle

Improving System PerformanceImproving System Performance

PerformancePerformance

PerformancePerformance

??

??

YOURYOURJOBJOB

YOURYOURJOBJOB

YOURYOURJOBJOB

YOURYOURJOBJOB

SystemPerformance

Everyone doing their job very wellEveryone doing their job very wellEveryone connecting their effortsEveryone connecting their efforts

connectivityconnectivity

IntegratedIntegrated

CompetitiveCompetitive

ParallelParallel

Give Yourself and Your System Give Yourself and Your System a Connectivity “Grade”a Connectivity “Grade”

AA

BB

CC

DD

FF

What canWhat canyou doyou do

to to improve yourimprove your

grade?grade?

??

??

??

??

??

BARRIERS TO BARRIERS TO NEGOTIATING NEGOTIATING

Collaborative strategiesCollaborative strategies

Which door do you choose?Which door do you choose?

Perceptions of risks?Perceptions of risks?Perceptions of rewards?Perceptions of rewards?

Decision analysis: Decision analysis: what criteria influence your decisions?what criteria influence your decisions?

AA BBDoorDoor

AADoorDoor

BB

Pay $Pay $$$$$

Get $$Get $$$$

BARRIERS TO BARRIERS TO NEGOTIATING collaboration:NEGOTIATING collaboration:

PreparednessPreparedness

Which door do you choose?Which door do you choose?

Risks of Terrorism?Risks of Terrorism?The Rewards of Funding?The Rewards of Funding?

Decision analysis: Decision analysis: what criteria influence your decisions?what criteria influence your decisions?

AA BBDoorDoor

AADoorDoor

BB

Pay $Pay $$$$$

Get $$Get $$$$

THE ALIGNED and connectedTHE ALIGNED and connectedSeamless webSeamless web

ConsistencyConsistency DirectionDirection

InternalInternal ExternalExternal

StrategyStrategy - LeadershipLeadership- ProductivityProductivity

responsibilityresponsibility

Each person and each entity Each person and each entity that is part of the that is part of the

bioterrorism preparedness effort…bioterrorism preparedness effort…

……has the responsibility to promote efforts tohas the responsibility to promote efforts tobuild collaboration,build collaboration,

manage differences (conflicts),manage differences (conflicts),and work toward resolving them.and work toward resolving them.

To create a strong web of To create a strong web of surveillance, Detection, and responsesurveillance, Detection, and response

CONNECTIVITYCONNECTIVITY

Thank youThank you

PartnershipsPartnerships betweenbetweenPublic agencies and academia:Public agencies and academia:

Building CONNECTIVITY Building CONNECTIVITY To advance PREPAREDNESSTo advance PREPAREDNESS

Leonard J. Marcus, Ph.D.Leonard J. Marcus, Ph.D.

For more information:

Leonard J. Marcus, Ph.D.Leonard J. Marcus, Ph.D.

Harvard Center Harvard Center for Public Health Preparednessfor Public Health Preparedness

677 Huntington Avenue677 Huntington AvenueBoston, MA 02115Boston, MA 02115

617-496-0867617-496-0867

To contact Dr. Marcus by e-mail:To contact Dr. Marcus by e-mail:ljmarcus@hsph.harvard.eduljmarcus@hsph.harvard.edu