By Ms. Meghan Treber, MS, ICF, TRACIE Program Director
The mission of the U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR) is to save lives and protect Americans from 21st century health security threats by leading the nation’s medical and public health preparedness for, response to, and recovery from disasters and public health emergencies. To accomplish this mission, ASPR collaborates with healthcare systems; healthcare coalitions; community stakeholders and groups; state, local, tribal, and territorial governments; the private sector; and other partners across the U.S. to improve readiness and response capabilities.
Healthcare system preparedness has evolved significantly over the past decade to accommodate the diverse needs of communities, to be flexible and compliant with various government and private sector requirements, and to effectively respond to various emergencies and disasters. Multiple reports and stakeholder feedback since 2010 led to a call to expand healthcare system preparedness information availability. In response, ASPR designed and launched an innovative program in 2015 to advance and enhance healthcare system preparedness and response across the nation comprised of three domains: 1) Technical Resources (TR); 2) Assistance Center (AC); and 3) Information Exchange (IE). ASPR TRACIE is a comprehensive, one-stop, national knowledge center for healthcare system preparedness which provides technical assistance (TA) and facilitates the efficient and effective exchange of information. As a planning resource and in the dynamic environment of a disaster, ASPR TRACIE simplifies access to resources and experts, serving as a force multiplier through improved information sharing while reducing duplication of effort. ASPR TRACIE continues to be a unique, key federal assistance source for healthcare system preparedness across the U.S., with its resources being applicable to and used by healthcare providers internationally.
Understanding the Healthcare System Preparedness Landscape
ASPR TRACIE was developed through a collaboration between multiple HHS Operating Divisions, other federal government departments/agencies; local, state, tribal, and regional government agencies; national associations; nonprofit organizations; and private sector partners. Early outreach with these stakeholders elicited ideas, comments, and recommendations for ASPR TRACIE’s development process, services, and resources. With this support and input, the ASPR TRACIE program was able to develop and launch a website focused on healthcare system preparedness resources, receive requests for information and technical assistance, and promote peer-to-peer discussion boards through the IE.
The key to achieving ASPR TRACIE’s goals is the assemblage and utilization of a unique cadre of vetted subject matter experts (SMEs) who volunteer their time to the project to curate and review resources, provide input on TA requests, and collaboratively develop new resources when topic gaps are identified. This cadre is composed of more than 1,000 professionals in the fields of healthcare, disaster medicine, public health, and public safety recognized for improving and advancing their field of expertise.
Providing a Forum to Share and Grow Knowledge
ASPR TRACIE’s Technical Resources domain consists of a Resource Library that contains thousands of resources from numerous contributors that can be easily accessed and downloaded and 57 Topic Collections (TCs) showcasing medical and healthcare preparedness plans, tools, and templates curated by ASPR TRACIE staff and vetted by the SME Cadre. Additional pages (e.g., CBRN, Novel Coronavirus, Infectious Disease, Disaster Behavioral Health) highlight resources within topic areas that are of particular interest to our stakeholders.
All ASPR TRACIE content is free and publicly accessible from the home page, Resource Library, TCs, and the AC webpage. ASPR TRACIE also has the ability to quickly disseminate information through our robust listserv, which has a reach of more than 1.5 million healthcare professionals.
The Assistance Center can be accessed by phone, online form, and email and is staffed weekdays between 9:00 a.m.-5:00 p.m. Eastern Time, excluding federal holidays. The AC is managed by experienced ASPR TRACIE staff with knowledge of healthcare and public health preparedness and response. Since 2015, the AC has received over 8,800 TA requests from users in all levels of U.S. government, healthcare, and the private sector. Requests for TA increased by 138% in 2020 over previous monthly averages; nearly 75% of TA requests in 2020 were related to COVID-19.
The ASPR TRACIE team provides TA through written products, toolkits, phone calls, emails, and webinars. TA responses are customized to meet the needs and timeline of the requestor. The team reviews and develops an individualized work plan to provide a comprehensive response to each TA request. The team works with partners and the SME Cadre, as appropriate, to assist with fulfilling TA requests. Figure 1 illustrates the top 10 TA request categories since 2015.
The Information Exchange is comprised of nearly 10,000 members and serves as a unique, near real-time peer-to-peer discussion area that facilitates quick conversations, collaboration, and resource sharing on a wide range of healthcare system preparedness topics.
The ASPR TRACIE program strives for continuous quality improvement and to maintain a high level of customer service satisfaction. Today, the program maintains a 99% overall customer satisfaction rating and 99.5% satisfaction rating for timeliness of TA responses. Figure 2 highlights a few key statistics of the ASPR TRACIE program since 2015.
Identifying and Filling Gaps in Healthcare System Preparedness
To continuously meet stakeholders’ evolving needs, the ASPR TRACIE team regularly determines areas for future work by assessing trends in TA requests, monitoring IE discussions, and noting knowledge gaps identified during conferences, webinars, or meetings. These assessment methods enable the team to consider the best format to develop new, original, user-friendly resources (e.g., tip sheets, tools, templates, webinars) and prioritize next topics. Producing resources in various formats helps to meet diverse stakeholder needs and modes of learning.
The team is both flexible and adaptive to time-sensitive requests. For example, during the COVID-19 response, ASPR TRACIE was quickly able to respond to an influx of TA requests and provided direct assistance to interagency partners by creating new online resource collections, hosting webinars, and reviewing hundreds of resources to include the most up-to-date information on the website. Our COVID-19 Resources page highlights resources identified or developed to address current response and recovery operations to COVID-19. The team created over 100 products in 2020, including new tip sheets and other resources specific to COVID-19 preparedness, response, and recovery, as documented in a Calendar Year 2020 Resources Digest.
The tremendous expansion in the volume of website visitors and TA requests received during the COVID-19 pandemic clearly demonstrates the critical need for the services ASPR TRACIE provides. It also substantiates how healthcare and public health practitioners rely on this federal source as a key component of their daily work. The growing frequency and complexity of TA requests requires more innovative solutions to produce the right information for the right stakeholder at the right time. This includes developing resources that serve as “just-in-time” guides for both planners and responders, more effectively sharing knowledge and efficiently capturing lessons learned from SMEs, while anticipating and addressing the needs of our stakeholders before disaster strikes. For example, our recent Healthcare System Cybersecurity: Readiness & Response Considerations is one of the few available documents that addresses a comprehensive approach to clinical, financial, and system planning for the consequences of information system downtime; and one of our most downloaded documents, the EMS Infectious Disease Playbook, synthesizes multiple sources of information in a single planning document addressing the full spectrum of infectious agents to create a concise reference resource for emergency medical services (EMS) agencies developing their service policies.
About the Author
Ms. Treber has over 25 years of experience in Emergency Public Health and Medical Preparedness and Emergency Management. She started her career as an Emergency Medical Technician and Paramedic working in pre-hospital and hospital settings throughout the National Capital Region and has responded to thousands of calls for emergency service, including the attack on the Pentagon on September 11, 2001, the Amtrak Train Derailment in Kensington, Maryland in July 2002, and Hurricane Isabel in September 2003. She has worked in Federal, State, local, and private sector settings for the last 20 years. She worked for the U.S. Department of Health and Human Services as both an employee and contractor helping to develop national level policy on domestic preparedness and leading operational response planning for managing the public health and medical consequences of disasters and emergencies. Following her federal service, Ms. Treber held numerous senior leadership positions for the Commonwealth of Pennsylvania, including the State Public Health Preparedness Director and Special Assistant to the Governor, for Emergency Preparedness, where she was responsible for ensuring governmental and community resiliency from all hazards emergencies and disasters. Currently, as the Senior Director of Emergency Management, Public Health Preparedness, and Resilience for ICF, she helps clients develop programs and policies, evaluate program effectiveness, engage stakeholders, and develop response plans, training, and exercises to improve our national resilience to disasters and emergencies. Ms. Treber is the Project Director for the ICF team supporting ASPR TRACIE.
Acknowledgements:
The author would like to acknowledge Shayne Brannman, ASPR TRACIE Program Director; Audrey Mazurek, ICF TRACIE Deputy Program Director; Corina Solé Brito, ICF TRACIE Technical Resources and Communications Lead; Bridget Kanawati, ICF TRACIE Assistance Center Lead; Jennifer Nieratko, ICF TRACIE Special Programs Lead; John Hick, MD, Senior Editor; and our project team partners and SMEs.
