186367 Competing cultures in public health disaster preparedness and response: Military versus collaborative organizational models

Tuesday, October 28, 2008: 9:30 AM

David M. Abramson, PhD MPH , National Center for Disaster Preparedness, Columbia University, New York, NY
Nancy VanDevanter, DrPH, RN , New York University College of Nursing, New York, NY
Joyce Moon-Howard, MPH, Dr PH , Department of Sociomedical Sciences, Columbia University, New York, NY
Perri Leviss, MPM , Consultant, Barrington, RI
Peggy Honore', DHA , US Department of Health and Human Services, OPHS, Rockville, MD
Since 2002, public health agencies have received over $5 billion in emergency preparedness funds. Moreover, the National Response Plan has institutionalized the Incident Command Structure as a governance framework and delineated an expansive series of roles that public health will be expected to play in the course of a disaster. This emerging role for public health has led to state, regional, and local public health restructuring; to shifting priorities; and to the emergence of a new type of public health workforce, one proficient in emergency response structures and services. The consequences of this federal mandate have been manifest in both emergency and non-emergency settings. Based upon analyses of interviews conducted with over 50 state and local public health officials in Louisiana and Mississippi as part of a Robert Wood Johnson Foundation-funded Katrina Oral History Project, we identified two competing cultures. One may be characterized as the vertically-oriented “military” model, in which authority is centralized and tasks distributed in linear fashion. The second and more prevalent is the traditional horizontally-focused “collaborative” model, in which public health officials serve a convening function and problem-solving is valued over task assignment. During the disaster response and recovery work associated with Hurricane Katrina organizational conflicts between these cultures arose periodically, threatening the efficient and effective delivery of public health services. We will examine the nature and consequences of these competing organizational models, and consider potential policies and strategies for bridging the two models.

Learning Objectives:
1. Participants will be able to articulate the two dominant organizational models of preparedness in public health agencies 2. Participants will analyze the differences between the models, and be able to describe an organizational model for bridging the two forms

Keywords: Local Public Health Agencies, Organizational Change

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As co-investigator, I have been involved in the data collection and analysis of this study
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.