Developing Guidance and Training Materials for Conducting Health Surveillance in Emergency Shelters in New Hampshire

BACKGROUND: Conducting health surveillance during a large scale incident or disaster provides essential information on the health of residents and provides situational awareness for emergency management and public health professionals.  During the activation of an emergency shelter, health surveillance monitors the health of the population in the shelters by monitoring for outbreaks, injuries and the need for resources for behavioral health and chronic disease management. In December 2012, the City of Nashua, NH Division of Public Health and Community Services and the New Hampshire Department of Health and Human Services convened a Shelter Surveillance Work Group to develop guidance and protocols for conducting health surveillance in emergency shelters that aligns with the Centers for Disease Control and Prevention’s (CDC) Public health Emergency Preparedness Capability 7, Mass Care, Function 4: Monitor Mass Care Population Health.

METHODS: Starting in December 2012, the Shelter Surveillance Work Group met on a regular basis to research best practices, existing tools and lessons learned from previous disasters to develop guidance that could be disseminated across the state for local towns, cities, health departments, public health regions and volunteer organizations to utilize in emergency shelters. Organizations including the American Red Cross and Homeland Security and Emergency Management participated on the work group. Forms from CDC and guidance from the Association for Professionals in Infection Control and Epidemiology were adapted and used as the foundation for developing the state guidance. Additionally, the guidance includes resources for infection prevention and control in shelters.

RESULTS: In June 2013, the work group finalized and disseminated the guidance statewide including presentations at two conferences for emergency managers, public health professionals and volunteer organizations and multiple presentations to partner organizations. The work group also developed training for medical volunteers that provides an overview of health surveillance and reviews the forms that are used to conduct health surveillance in emergency shelters. Approximately, thirty-five medical volunteers from three out of the thirteen public health regions have been trained as of January 13, 2014.

CONCLUSIONS: New Hampshire serves as an example for how other health departments can develop guidance and implement processes for conducting health surveillance in emergency shelters and implement a training plan for training partner agencies in the state on shelter surveillance. During this session, the development and components of the guidance will be reviewed and tips for working with partner organizations will be discussed.