Barriers to Reporting Communicable Diseases Among Infection Preventionists in Maricopa County, Arizona, 2013

BACKGROUND:   Maricopa County Department of Public Health (MCDPH), Office of Epidemiology evaluates their communicable disease surveillance system annually as part of deliverables for the Public Health Emergency Preparedness (PHEP) cooperative agreement with the Centers for Disease Control (CDC).  For 2012-2013 fiscal year, MCDPH designed a survey to assess potential barriers in notifying public health of reportable diseases in healthcare facilities.  Infection Preventionists (IPs) in local hospitals were asked to complete the survey to identify key barriers, improve upon them and thereby improve the communicable disease reporting system in Maricopa County.

METHODS:   MCDPH designed and conducted a survey that consisted of 33 questions.  There were 5 open-text and 28 multiple-choice questions.  Of the 28 multiple-choice questions, 9 asked for a rating on a specific topic using the provided scale.  The survey was administered to IPs via Survey Monkey, an online survey service.  Reminder emails were sent three times over three weeks in order to increase response rate. Responses for each question were counted and graphed using Microsoft Excel.  The number of responses and their correlating percentages were included in the graphs.  Responses to free-text questions were either listed in a separate section or coded, depending on the nature of the question. 

RESULTS:   The survey was administered in June 2013.  Forty-nine healthcare facilities were contacted and 39 facilities completed the survey.  Some healthcare facilities had more than one IP complete the survey.  Sixty-five IPs received the survey and 46 completed it.  This is an individual response rate of 71%.  Fifty-nine percent of the respondents had work experience for 5 or more years.  Almost three quarters of them had received training on reporting communicable diseases (74%) and their familiarity with the Arizona Administrative code and reporting timeframes were high (96% and 91%, respectively).  One area of concern was awareness on reporting suspect cases.  Fifty-eight percent of the IPs replied that they report suspect cases all the time or most of the time and 11% replied that they did not know that suspect cases were reportable.  Thirty-nine percent replied that physicians do not report suspect cases. 

CONCLUSIONS:   Reaching out to disease reporting partners is essential to ensure complete and accurate reporting to a surveillance system.  This survey identified that knowledge of reporting requirements in regards to suspect cases is an area for improvement amongst our partners.  MCDPH plans to implement a protocol to systematically reach out to partners that are not meeting reporting requirements.