Case Analysis Help
3. A brief review of the facts in the case and analysis of important issues –
I. Facts
a. Key players, their organizations, and their roles in the incident
The key players in the whole process of preventing H1N1, developing a vaccine, making sure that the vaccine is delivered effectively and reaches the public on time are as follows:
Phil Bredesen, who as the Governor of Tennessee, was the one who asked Cooper regarding her thoughts on how should the H1N1 should be countered and what should the public be informed about. Phil Bredesen also spoke to the media and state what should be the role of media in all this, to report the correct stories and accurate facts and not to mislead anyone.
Susan Cooper who as the State Health Commissioner was side by side the governor in highlighting the role of media regarding the issue, she was also the one who stated that the next public emergency is of significance instead of reconstructing infrastructure.
Tim Jones who was the state epidemiologist, David Kirschke, who as the Deputy state Epidemiologist and Kelly Moore who was the Medical Director for the state’s immunization programs. Moore, as mentioned above was also the pioneer of the distribution model, taken from Texas distribution model.
b. The threat – H1N1
H1N1 is basically a type of flu which is categorized as virus and is a common form of flu. This kind of flu has the potential to kill people, and in the year 2009, month of July, Tennessee saw a 48 year old person’s death because of this flow.
c. The vaccine
When the vaccine was developed, Tennessee decided on giving those vaccines to those distributors who pre-registered and were interested in distributing the vaccines. When the British suspended the Chiron Corporations Manufacturing License, who was manufacturing H1N1 vaccines, then the federal authorities of Tennessee tried to find new suppliers and managed to find 6 million doses of vaccines. The state preferred to give those vaccines to those women who were pregnant, the employee who were working in the health care sector as they were more likely to be affected from the flu, those people who were living six year old kids and were responsible for their well-being and those people who were most likely to be affected from the virus.
d. Final outcome
The outcome was that the demand for vaccines went down, but in the state of Knox County, the demand for Flumixt vaccine. Moreover, as employees were the priority for taking vaccines because they were most likely to be affected, they refused to take it. Most importantly, there was a gradual decline in demand for vaccine observed.
II. Analysis
- a. Initial response
When World Health organization announced that the flu is H1N1, that is swine flu and it is a serious virus, which is when CDC came into action and issued guidelines for people to protect them from the flu. The initial response of Tennessee was that it gave its health officials critical information regarding the flu, so that they can develop strategies in order to effectively counter the virus. The health officials were treating this as an emergency case because it also appeared in Mexico, Texas and California. After the outbreak, health officials conducted a press conference in which they informed people that the virus is most likely to affect more people, and that they are willing to keep an open relationship with the press, giving any information that they have on the matter and they would also be willing to take any calls in order to answer questions of people. The health officials also stated that in case they didn’t knew anything, they would say so.
b. Arrival of H1N1
a. 2nd wave
The first death which Tennessee witnessed was of a 48 year old person, after which the frequency of people being affected form flu went down. The previously SHOC also closed and the health officials conducted meeting on every Friday morning in order to discuss the situation of H1N1, whether there are chances that it will strike again or not. The flu was no more a constant fear among people, which was mostly because there was vaccine available to eliminate it.
- b. Arrival and distribution of the vaccine
Vaccines arriving and being made available for the public did not in any assured that people are safe from swine flu, which is because the vaccines did not make people immune to the swine flu. It was also noted that there were delays in arrivals of vaccines through shipments and this resulted in delays regarding distribution of the vaccines.
- c. Continuation of preparedness
After the frequency of swine flu patients started to go down, the health professionals started to be less focused on the flu problem, as they met only once a week to discuss the swine flu problem and whether there is a possibility of it being hazardous again. Even though health professionals should have taken measures to assure that necessary steps have been taken to make sure that such a crisis can be effectively managed in the future. The public was also misinformed regarding the current status of the swine flu, which showed that the state was not preparing for anything similar in the future.
4. Recommendations or alternative courses of action presented in a detached and analytical way for the decision maker to consider –
A. Proper Planning
a. Have a team in place that has the experience to handle high level emergency situations and decisions. When the flu first strikes, the state did not had any proper medication for the flu, neither did it have an effective communication system with the public. Throughout the case study, there has been a sense of confusion found in parents, regarding whether they have to send their children to school or not. This confusion is because there is lack of proper communication between health officials and the public. Moreover, when the vaccines arrived, the state did not properly plan as to how the vaccines were supposed to be distributed. This led to more problems.
b. research and plan ahead for future events
Now that the state of Tennessee has witnessed what it is like to be affected by swine flu, they should prepare for future events. Basically, what state needs to do is form a crisis management cell in which people are trained to deal with such problems. This way, whenever there is a crisis, regardless of the situation, the people of crisis management cell would know how to counter them which would minimize damage.
c. effective communication between all offices
The state health professionals, federal and regional were all working separately before it was proposed that if all the health professional forces joined hands, then it would be easier to counter this problem. This is what happened in the case study, due to which forming a model for effective distribution was made possible. However, even though the state held a press conference, it would have been more effective if one or two of the health professionals were on radio, and available for questions that the general public might want to ask. No such direct communication took place between the general public and the health professionals.
d. have guidelines and protocols in place
The initial step was to form guidelines and protocols for the public and the health care professionals by the CDC. This was a good step; however, such steps should have been made available in schools and the general public throughways of effective communication. It was also important that the CDC should have developed guidelines which had simple language and would have been appropriate for children studying in schools.
e. training should be made available to all staff
Training and development is a process through which staff can be trained on how to counter these situations and how to handle emergency scenarios. Training can be given through role playing activities or a fire drill, which makes people realize more about how to act in particular situations.
B. Learn from Previous Experiences
a. conduct research regarding prior mistakes made
The mistakes which the health professionals made regarding distribution of vaccines and communication with the general public should be studied, in order to eliminate chances of any such thing happening in the future. The health professionals and the state must write down proper guidelines of how to respond to such situations. Prior mistakes should not be ignored.
b. Determine how those situations could have been rectified
Situation like communicating with the general public could have been rectified if health professionals had appointed people who are good at communication skills and have the ability of making people calm in emergency situations. For example, the mayor of the state could have come forward and informed people about the current situation, what is most likely to happen in the future, what the health professionals are doing to make things better and what the general public should expect from them.
c. learn from past and current experiences from both the state of Tennessee as well as other states
The United States of America should take into consideration the factors which led to the mismanagement of these situations. For example, how Tennessee managed its flu problem, how it ineffectively kept the media and the general public in the loop and the time it took Tennessee to form an efficient distribution system. The most disappointing aspect was that before the flu incident, the health professionals of Tennessee did not have proper and complete contact information of the distributors found in the state, and even after the crisis striked, it took health professionals of Tennessee a lot of time to form an effective distribution model. Such aspects are disappointing and should be avoided in the future. Moreover, the state must appoint professional people who have the ability to communicate with people and inform them about the situation and how they can protect themselves from it effectively.
d. use this knowledge when making plans for the future
Considering the future, following are some of the plans which might be effective for management crisis:
1) Media is a strong tool in spreading information to the masses and must not be underestimated. The state, which ever problem they think is going to impact the public; they should inform them using different media tools. For example, if the state wanted to inform the public regarding what steps would be taking in closing school and the precautions they should take in order to protect themselves and their children, then this could have been communicated through newspapers and television. Moreover, the state should inform the general public about the places which they should avoid and the places where the public is safe. The general public should also be informed the ways through which they can safeguard their children.
2) Distributors of prescription drugs must be registered beforehand so when there is a need for them to take active part in distributing important medicines for curing diseases, they should be well prepared and the health professionals would know the distributors they can use in order to make sure that vaccines are available for the common public.
C. Utilize Available Resources
a. use available resources and agencies such as TEMA
The Tennessee Emergency Management Agency played a major role in every emergency the state faced, however, throughout the case study; the role of TEMA is not significant. The major part played in the whole scenario was by health professionals and even the media seemed weak in front of them. Moreover, the health professionals were more effective in handling the crisis situation as compared to any other agency.
b. have set guidelines in place on when and how these resources should be used
Every agency has a role to play in crisis management and such roles must be fully defined. For example, the Centre for Disease Control were the first ones to react to the situation, because they knew their responsibility and also how they should carry out such responsibilities. Moreover, the state, the health care professionals and the media should be equally responsible for their duties. Media should know how they are supposed to perform their duty of informing the general public about the crisis which has taken place and the state should be responsible for making sure that the right precautionary measure are being taken to ensure the safety of the general public.
c. open communication between state health officials and agencies
Open communication here means that the federal government, the government of the state and the health care professionals, working for the private and public sector must communicate effectively with each other, in order to decide how crisis like the swine flu should be dealt with, the steps which should be taken to ensure that the concerns of the public are being solved. Integrated agencies of a country in a situation of crisis are more effective as compared to those agencies that work separately when in the country is in crisis.
