State-level public health programs and activities require supportive surveillance systems to accurately determine the nature/extent of risk factors, establish prevalence baselines, and establish trends over time. Given the inherent costs, time resources, and complex nature of such systems there is increasing reluctance on part of legislatures to mandate compliance. Even with legislative authorization, full participation in mandated systems often remains elusive. When Michigan's mandated hospital injury surveillance legislation (with 60% compliance) expired without legislative renewal, the Michigan Department of Community Health replaced it with a voluntary, representative sample hospital emergency department injury/intimate partner violence surveillance system (MEDCIIN). By using strategic public management and community-based participatory action research approaches over a two-year period, the resulting statewide system has achieved an actual hospital participation rate (>90%) that exceeds most mandated systems. Strategic Public Management utilizes 1) emerging crises or problems perceived by policy makers; 2) implementation planning based on organization position control (rather than specific individuals); 3) alternative inducements for participating managers; 4) greater attention to results, less focus on structure; 5) encouragement of entrepreneurial behavior; 6) focused use of potential and symbolic governmental authority; 7) increased use of "tactical" management; 8) the incorporation of "quick results." Community-Based Research involves active community participation in setting the direction and focus of research; defining study problem(s); conducting the research design; and involving community representatives in the research process. This presentation explains key concepts and application strategies for these approaches, and describes their strengths, limitations, and possible application to other data and surveillance systems.
Learning Objectives: At the end of the session, participants will be able to: 1. Identify the key concepts of Strategic Public Management and Community-Based Participatory Action Research and their application to the design and implementation of a voluntary statewide Emergency Department Surveillance System 2. Understand the lessons learned and strengths and weaknesses of the approaches in the successful recruitment of 23 hospital emergency departments over a twenty-four month period. 3. Identify and understand some of the anticipated advantages and limitations of the approaches when compared to other approaches used to establish surveillance systems.
Keywords: Surveillance, Emergency Department/Room
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Michigan Department of Community Health
Michigan Public Health Institute
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employee of the Michigan Department of Community Health