|An Introduction to the National Health Security Preparedness Index Project|
|Geetika Nadkarni, Senior Analyst in Preparedness, ASTHO|
Over the past decade, significant resources have been invested toward developing and strengthening the national health security infrastructure. A number of benchmarks and standards have been created to measure individual target areas that fit within the broad scope of public health preparedness and readiness, including measures from Healthy People 2020, the U.S. Department of Health and Human Services (HHS) Public Health and Healthcare Preparedness Capabilities, Pandemic and All-Hazard Preparedness Act (PAHPA) benchmarks, and Trust for America’s Health Ready or Not? report. However, no overarching index measure currently exists to evaluate the entire composite picture of preparedness.
The general public and elected officials are increasingly calling for ways to determine how well their communities are prepared for public health emergencies and what further steps can be taken to improve their existing programs. There remains a need to quantify the current status of preparedness at the state and local levels, to measure progress, and to estimate the return on investment for preparing and protecting the health security of America.
The Association of State and Territorial Health Officials (ASTHO) and the Centers for Disease Control and Prevention (CDC) have recently collaborated through a cooperative agreement to steward the development of a preparedness measurement instrument, known as the National Health Security Preparedness Index (NHSPI). The mission of the NHSPI is to present an accurate portrayal of public health and health system preparedness that provides relevant, actionable information to drive decision- making and continuous improvement of the nation’s health security. The primary audiences of the Index are policymakers, including Congress and state and local leadership. Specifically, the purpose of the NHSPI is to:
- Assess current investments and inform future funding decisions;
- Identify current public health and health system capabilities, assess gaps, and identify best practices for the purpose of quality improvement;
- Be a one-stop shop for measurement and a single tool resource for states and locals to measure preparedness;
- Provide consistency over time; and
- Demonstrate how well a jurisdiction can be prepared at a certain level of funding.
The NHSPI will combine various criteria with different scales or units of measurement into one composite metric, and ensure that the relative weighting of the various criteria are appropriately reflected in composite score, regardless of the differences in the scale or in the units of measurement. It is anticipated that the NHSPI will take several years to fully incorporate into the spectrum of health security.
For the first project year, the CDC has funded the project to focus on the public health capabilities of preparedness in the development of the Index. In future years, additional components such as healthcare system preparedness, may be added to the model.
The NHSPI project will use the following guiding principles in its design:
- Synthesize current guidance, policies, directives, etc. toward a common measurement;
- Embrace already established relevant and applicable metrics;
- Create new data reports only where gaps exist; and
- Include viewpoints and feedback from the broader preparedness community.
In addition, the NHSPI project team will be sensitive to, and proactively manage, how the indicators should be interpreted and applied.
While ASTHO and the CDC are facilitating the NHSPI’s development, broad representation from the practice and research community is involved in the process. The NHSPI project is led by a Steering Committee empanelled by prominent preparedness leaders who provide guidance, direction, and decision-making to the project.
In addition to leadership from local and state public health agencies representing the National Association of County and City Health Officials (NACCHO) and ASTHO membership, the Steering Committee includes representatives from the Association of Public Health Laboratories, the Council of State and Territorial Epidemiologists, Trust for America’s Health, the Center for Biosecurity of UPMC, the Robert Wood Johnson Foundation, and federal liaisons from the CDC, ASPR, the U.S. Department of Homeland Security, the Department of Defense, and the Federal Emergency Management Agency. Three subject-matter workgroups in the areas of governance, model design, and stakeholder communication, include experts from a wide number of public, academic, and private organizations.
The NHSPI project is in its early stages and will continue to feature ongoing opportunities for the local and state practice community to provide input and feedback on the Index’s development. This includes a soon-to-be-launched website, where individuals will be able to both access information and provide comments on the Index’s progress.
For more information on this project, please contact Geetika Nadkarni, Senior Analyst in Preparedness at ASTHO (firstname.lastname@example.org).