Disaster Strikes!
Environmental Health Responds:
Stories from the Field
Environmental Health Emergency Preparedness Training
Twin Cities Metro Advanced Practice Center
And
Minnesota Department of Health
March 16, 2009
Twin Cities Metro APC
Disaster Denial Paradigm
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It isn’t going to happen.
If it happens, it will not be as they said it
would be.
If it happens, and it is as bad as they said,
it will not happen to me.
If it happens and it is as bad as they said,
and it happens to me, then someone has
planned for it and is coming to help.
Twin Cities Metro APC
Welcome to a Different Kind of Training
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Interviewed EHP across
the country
Learned how they dealt
with actual disasters
and emergencies
They shared valuable
tips, techniques and
lessons learned
Experience is a
powerful teacher
Twin Cities Metro APC
Environmental Health Competencies
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Focused on 8 EH Core Competencies
(defined by the American Public Health
Association and the National Center for
Environmental Health at CDC)
There are a total of 14 EH
Competencies
Key to disaster & emergency
preparedness, response, & recovery
Twin Cities Metro APC
Environmental Health Competencies
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Organizational Knowledge & Behavior
Collaboration
Information Gathering
Data Analysis
Problem Solving
Reporting, Documentation, and Record
Keeping
Communication
Education
Twin Cities Metro APC
Competency Definition
A cluster of related knowledge, skills, and
attitudes that affect a major part of one’s
job, that correlates with performance on
the job, that can be measured against
some accepted standards, and that can be
improved via training and development.
Source: Environmental Health Competency Project:
Recommendations for Core Competencies for Local
Environmental Health Practitioners 2001
Twin Cities Metro APC
Emergency and Disaster Definitions
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Disaster overwhelms the affected
community and requires outside
assistance
Emergency is not a disaster in itself,
but an event requiring immediate
response
The role of an EHP in responding to a
disaster or an emergency is
essentially the same
Twin Cities Metro APC
How the Module Works
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Introduction followed
by 8 lessons
Each lesson focuses on
one core competency
Complete one or more
lessons in a session
No required specific
order
Lesson Format
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Twin Cities Metro APC
Competency Overview
Field-based Stories
Lessons Learned
Resources
Quiz Questions
Print this Lesson
Applying the Competencies
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Competencies
brought to life
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Stories illustrate
specific action
steps
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Taken by EHP
during actual
events
Twin Cities Metro APC
Event Descriptions
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Anhydrous
Ammonia Spill
Diazinon Spill
Pesticide
Warehouse Fire
Hurricane Katrina
Mercury Release
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Twin Cities Metro APC
Chlorine Leak
Earthquakes
Floods
Landfill Odor
TOPOFF Exercise
Tornadoes
Icon Graphics
Twin Cities Metro APC
Training Module Perspective
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Be consistent with
NIMS
Provide guidance for
Environmental Health
Professionals
Based on actual field
experience
Provide Useful &
Practical Information
Twin Cities Metro APC
Organizational Knowledge & Behavior
What does it Mean?
The capacity to function effectively
within the culture of the organization
and to be an effective team player.
Twin Cities Metro APC
Organizational Knowledge & Behavior
Why is it Important?
To strengthen
the EH team’s
performance
during a disaster
Twin Cities Metro APC
Organizational Knowledge & Behavior
What is the EHP Role?
¾
¾
Understand ICS
and how
environmental
health and your
emergency
response plan work
within ICS
Read/understand
the procedures in
your emergency
response plan
Twin Cities Metro APC
Organizational Knowledge & Behavior
What is the EHP Role? (Cont.)
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¾
Help keep your
team safe during a
disaster
Help ensure your
team is always
prepared to respond
Twin Cities Metro APC
Organizational Knowledge & Behavior
ICS Organizational Chart
Twin Cities Metro APC
Organizational Knowledge & Behavior
How do you build Organizational Knowledge?
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Ensure your staff is trained in ICS
Meet with your jurisdiction’s Dir. Of Emergency Mgt.
to discuss & review roles for environmental health
within ICS
Know how your jurisdiction’s emergency plan works,
your roles within it, and how it ties into ICS
Twin Cities Metro APC
Organizational Knowledge & Behavior
Keep Your Team Safe!
¾
Understand your role and the limitations of
your training & equipment
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Anticipate potential hazards that you or your
staff may encounter
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Obtain and provide PPE for your team, based
on potential health hazards expected
Twin Cities Metro APC
Organizational Knowledge & Behavior
Keep Your Team Safe! (Continued)
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¾
¾
Twin Cities Metro APC
Provide initial and
annual training on
the use of PPE
Make sure your
team members
take mental-health
breaks
Use a buddy
system
Organizational Knowledge & Behavior
Keep Your Team Safe! (Continued)
¾
¾
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Wear easily
identifiable
uniforms
Prepare field
equipment kits for
a quick response
Ensure team
members carry up
to date info
Twin Cities Metro APC
Organizational Knowledge & Behavior
Lessons Learned
¾
Determine how your skills & assets can aid
the response
¾
Develop an EH emergency response plan
¾
Ensure staff are trained to carry it out
Twin Cities Metro APC
Organizational Knowledge & Behavior
Lessons Learned (Continued)
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Take action to minimize
fatigue
¾
Enforce time limits for
assistance
¾
Limit the number of
response hours worked
Twin Cities Metro APC
Collaboration
What does it Mean?
The capacity to form partnerships
and alliances with other individuals
and organizations in order to
enhance performance on the job.
Twin Cities Metro APC
Collaboration
Why is it Important?
A multidisciplinary team of knowledgeable
and experienced experts working together
is essential for effective and timely
response and recovery
Twin Cities Metro APC
Collaboration
What is the EHP Role?
Planning Stage
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ID other disaster and emergency
responders
Build relationships with other
responders & work together on
disaster/emergency planning
Cross-train with other responders
Determine other resources that may
help during a disaster/emergency
Twin Cities Metro APC
Collaboration
What is the EHP Role? (Continued)
Response & Recovery Stages
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Collaborate with all involved parties
such as local, state, federal, businesses
and remediation contractors
Twin Cities Metro APC
Collaboration
Identify Partners
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Fire & Police
Public Utilities
Medical Community
Restaurant Assoc.
Private Businesses
Federal Agencies
State Agencies
Local Agencies
Colleges
Twin Cities Metro APC
Collaboration
Build Relationships
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Make appointments
& talk to partners
now
Make relationshipbuilding part of
your routine
Join emergency
mgt committees to
work with other
responders
Twin Cities Metro APC
Collaboration
Become Familiar with Tools
¾
Develop Mutual-aid Agreements to prevent
duplication and misunderstandings
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Know when to invoke Mutual-aid Agreements
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Be familiar with any existing Memorandums of
Understanding
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Understand how the Emergency Management
Assistance Compact works
Twin Cities Metro APC
Collaboration
Be Proactive in Your Community
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Make appointments to meet with medical
& hospital staff
Make appointments to meet with local
planning & building officials
Make appointments to meet with volunteer
agencies
Twin Cities Metro APC
Collaboration
Understanding and Communicating your Role
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Be firm in your
convictions
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ID internal &
external disaster
response training
needs
Twin Cities Metro APC
Collaboration
Understanding and Communicating your Role (Cont.)
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Work with members on your own team as often & as
thoroughly as possible
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Work with private contractors when necessary
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Work with first responders to ID needs, assets &
opportunities
Twin Cities Metro APC
Collaboration
Understanding and Communicating your Role (Cont.)
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Involve key stakeholders in planning for disaster,
and emergency response & recovery
Be prepared to work with new partners as new
issues arise
Twin Cities Metro APC
Collaboration
Lessons Learned
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Make collaboration a high priority during
planning, response & recovery stages
Always work within Incident Command
System
Twin Cities Metro APC
Information Gathering
What does it Mean?
The capacity to identify sources and
compile relevant and appropriate
information when needed, and the
knowledge of where to go to obtain
the information.
Twin Cities Metro APC
Information Gathering
Why is it Important?
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Assessing risk and damage is critical to the
health & safety of victims and responders
The assessment begins with information
gathering
Twin Cities Metro APC
Information Gathering
What is the EHP Role?
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Continuous effort
due to changing
circumstances
Think outside the
box
Be creative
Work alone or with
partners
Twin Cities Metro APC
Information Gathering
Getting Started
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What information do you need?
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Where will you find the information?
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How will you gather the information?
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What will you do with the information
once you find it?
Twin Cities Metro APC
Information Gathering
Ask Questions to Assess:
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Your ability to
respond
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The current state
of response efforts
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Current incident
related conditions
Twin Cities Metro APC
Information Gathering
Techniques
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Conduct initial overview inspections of
affected area(s)
Keep a running list of inspected area(s) &
collected information
Develop a checklist to ensure consistent
assessment of key factors
Twin Cities Metro APC
Information Gathering
Techniques (Cont.)
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Use technological tools to facilitate assessments
Use binoculars and cameras to conduct
assessments from a safe distance
Work with other professionals when necessary
Twin Cities Metro APC
Information Gathering
Techniques (Cont.)
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Conduct individual interviews to assess impact on
current health
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Use technological tools to facilitate interviews
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Use telephone hotlines
Twin Cities Metro APC
Information Gathering
Sources
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Obtain information from partners at EOC and IC
meetings
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Read & listen to news media reports
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Partner with other relief agencies
Twin Cities Metro APC
Information Gathering
Sources (Cont.)
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Partner with state & federal experts
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Contact local colleges for assistance
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Develop a streamlined process for
collecting & exchanging information
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Compile a list of information sources
Twin Cities Metro APC
Information Gathering
Lessons Learned
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Remember to take notes
Keep copies of records for future reference
Watch for/adjust to unusual or unexpected
hazards while collecting information
Twin Cities Metro APC
Reporting, Documentation & Record-Keeping
What does it mean?
The capacity to produce reports to
document actions, keep records,
and inform appropriate parties.
Twin Cities Metro APC
Reporting, Documentation & Record-Keeping
Why is it Important?
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Prevent duplication of effort
Serve as communication tools
Necessary for financial reimbursement
Helpful for future preparedness activities
Twin Cities Metro APC
Reporting, Documentation & Record-Keeping
What is the EHP Role?
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Produce reports to
document actions
Document expenses for
reimbursement
Keep records for legal
proceedings
Keep and use records
as learning tools
Twin Cities Metro APC
Reporting, Documentation & Record-Keeping
Documenting Information
¾
Actual disaster will dictate
documentation method
¾
Critical to record and
preserve information
¾
Use handwritten notes,
photographs or electronic
devices
Twin Cities Metro APC
Reporting, Documentation & Record-Keeping
Developing a System
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Make sure your reports are accurate
enough to prevent duplication of effort
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Become familiar with FEMA Applicant
Handbook
Twin Cities Metro APC
Reporting, Documentation & Record-Keeping
Developing a System (Cont.)
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Keep your reporting process simple and easy to use
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Use your normal, everyday recording methods
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Check with your legal advisor about record-keeping
requirements prior to a disaster
¾
Review and critique your system
Twin Cities Metro APC
Reporting, Documentation & Record-Keeping
Lessons Learned
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Consider developing a redundant
record keeping system for your
office
Assign a person responsible for
data entry
Become familiar with FEMA
record-keeping requirements
Twin Cities Metro APC
Data Analysis
What does it Mean?
The capacity to analyze data,
recognize meaningful test
results, interpret results, and
present the results in an
appropriate way to different
types of audiences.
Twin Cities Metro APC
Data Analysis
Why is it Important?
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To determine priorities &
next steps
To evaluate effectiveness
of your response
To accurately assess the
impact on environmental
health
To eliminate guesswork
and validate the necessity
of your actions
Twin Cities Metro APC
Data Analysis
What is the EHP Role?
¾
Perform a variety of analyses
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Use a variety of resources to analyze data
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Use results from your analyses to develop
accurate reports
Twin Cities Metro APC
Data Analysis
Getting the most from your Data
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You are accountable for the health and
safety of the public
If you need help analyzing data, request
the resources you need
Make your data requirements known early
If a sampling protocol is being developed,
get involved
Remember: analyzing poor quality data
may be worse than not having any data
Twin Cities Metro APC
Data Analysis
Using & Accessing Information
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Develop an easy to use
system for making data
accessible
Use a variety of resources
to analyze data
Use credible databases
Twin Cities Metro APC
Data Analysis
Using & Accessing Information (Cont.)
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Develop an
inventory of
resources by
hazard category
Identify internal &
external experts
Analyze data to
determine
appropriate EH
protection
measures
Twin Cities Metro APC
Data Analysis
Lesson Learned
¾
Be open to exploring other factors
(such as weather patterns, cultural
practices and vulnerable
populations) that may affect your
response
Twin Cities Metro APC
Problem Solving
What does it Mean?
The capacity to develop insight into
and appropriate solutions to
environmental health problems.
Twin Cities Metro APC
Problem Solving
Why is it Important?
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Your expertise &
experience make
you uniquely
qualified to ID and
solve problems
Your proactive
involvement is
critical to keeping
the public safe and
healthy
Twin Cities Metro APC
Problem Solving
What is the EHP Role?
¾
ID current & potential
problems
¾
Propose solutions and
actions
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Prioritize actions
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Prevent future
problems
Twin Cities Metro APC
Problem Solving
Identifying Problems
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Food Protection
Wastewater
Hazardous Waste
Mgt
Noise
Housing
Occupational
Safety
Swimming Pools
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Twin Cities Metro APC
Potable Water
Solid Waste Mgt
Air Quality
Radiation
Vectors
Hazardous
Materials
Emergency
Preparedness
Problem Solving
Decision Making with Incomplete Information
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In a chaotic situation,
you can receive limited
or inaccurate information
Understand your
threshold for making
decisions with minimal or
no data
When you lack sufficient
data, use common sense
Twin Cities Metro APC
Problem Solving
Propose Solutions and Actions
¾
The process will be
driven by criteria such
as:
‰ Protection of public
health
‰ Available
resources
‰ Affordability
Twin Cities Metro APC
Problem Solving
Propose Solutions and Actions (Cont.)
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Legal
authority/constraints
Effect on vulnerable
or at-risk
populations
Political support
Twin Cities Metro APC
Problem Solving
Prioritize Your Actions or Strategies
¾
Generally, EH
priorities are set
according to the
greatest health risks
¾
IC may set priorities
based on scientific,
political or other
factors
Twin Cities Metro APC
Problem Solving
Strategies
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Learn & understand brainstorming techniques
Use existing emergency response plans with
predetermined priorities
Set realistic priorities according to your needs
Twin Cities Metro APC
Problem Solving
Strategies (Cont.)
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Assess risk in setting
priorities for reopening
businesses &
reoccupying homes
Be proactive in
preventing future
hazards
Expand or shift existing
services to meet needs
Twin Cities Metro APC
Problem Solving
Strategies (Cont.)
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Emphasize prevention
measures
Know your limitations
Bring in other
resources to prevent
problems
Twin Cities Metro APC
Problem Solving
Lessons Learned
¾
Correct protocols can not
always be followed
immediately, can be
followed later on
¾
Enlist experienced
people for jobs that
require technical
expertise
Twin Cities Metro APC
Communication
What does it Mean?
The capacity to effectively
communicate risk and exchange
information with colleagues, other
practitioners, clients, policy-makers,
interest groups, media, and the public
through public speaking, print and
electronic media, and interpersonal
relations.
Twin Cities Metro APC
Communication
Why is it important?
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Frequent communication is
essential to successful
disaster/emergency
response and recovery
Responders must share
assessments, discoveries,
challenges and actions
Public must be regularly
informed
Twin Cities Metro APC
Communication
What is the EHP Role?
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Routinely communicate
with team members
Communicate regularly
with responders
Communicate with public in
a variety of ways
Acquire reliable
communication equipment
Twin Cities Metro APC
Communication
7 Rules of Risk Communication
1.
Accept & involve the
public as your partner
2.
Plan carefully &
evaluate your efforts
3.
Listen to the public’s
specific concerns
4.
Be honest, frank and
open
Twin Cities Metro APC
Communication
7 rules of Risk Communication (Cont.)
5.
Work with other
credible sources
6.
Meet the needs of
the media
7.
Speak clearly &
with compassion
Twin Cities Metro APC
Communication
Methods
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Town Meetings
Print & electronic communications
Meetings
Telephone hotlines
Media: TV, radio, newspaper
Twin Cities Metro APC
Communication
Tips & Techniques
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Establish a single
point of contact
and check-in
procedure
Develop a
redundant
communication
system at a distant
location
Twin Cities Metro APC
Communication
Tips & Techniques (Cont.)
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Attend or ask to
attend status-briefing
meetings
Capitalize on
opportunities to share
information with wide
range of responders
Understand your role
giving instructions &
advice during
response activities
Twin Cities Metro APC
Communication
Tips & Techniques (Cont.)
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Take advantage of hightech communication tools
(if available)
Become proficient in
ways to communicate
quickly to the public
Acquire equipment to
communicate directly
with key responders
Twin Cities Metro APC
Communication
Tips & Techniques (Cont.)
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Ensure the
accuracy of your
messages
Use simple tools for
immediate
messaging
Develop good
listening skills
Twin Cities Metro APC
Communication
Tips & Techniques (Cont.)
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Be prepared to provide
emotional support
Be cognizant of
cultural, educational
and regional
differences
Develop skills for
dealing with mentalhealth issues
Twin Cities Metro APC
Communication
Tips & Techniques (Cont.)
¾
Test your communication system when
you arrive on site
Twin Cities Metro APC
Communication
Lessons Learned
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Ensure messages
released to public
are consistent &
correct
Consider the
emotional stress of
the people you are
trying to help
Twin Cities Metro APC
Education
What does it Mean?
The capacity to use the environmental
health practitioner’s front-line role to
effectively educate the public on
environmental health issues and the
public health rationale for
recommendations.
Twin Cities Metro APC
Education
Why is it Important?
¾
Disasters/emergencies
cause a wide range of
hazards
¾
EHPs must educate
people about these
hazards to ensure their
health & safety
Twin Cities Metro APC
Education
What is the EHP Role?
¾
Prepare generic
educational materials
¾
Deliver educational
messages effectively
¾
Use a variety of methods
& materials to educate
the public
Twin Cities Metro APC
Education
Prepare Educational Materials
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Boil water notices
Well disinfection
instructions
Power outages
Floods
Food safety
Shelter-in-place
Twin Cities Metro APC
Education
Present Effective Messages
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Use clear,
understandable
language
¾
Be optimistic & factual
¾
Talk slowly and calmly
¾
Avoid using acronyms
¾
Share essential
information
Twin Cities Metro APC
Education
Delivering the Message-Town Meetings
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Conduct informational meetings at critical
times
Involve outside experts in community
meetings
Twin Cities Metro APC
Education
Delivering the Message-Incorporate Education
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Incorporate education during interviews
Twin Cities Metro APC
Education
Delivering the Message-Print Materials
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Identify potential distribution locations for
educational materials
Compile examples of existing fact sheets
Twin Cities Metro APC
Education
Delivering the Message-Media
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Work with your PIO to
ensure your message
reaches a wide audience
Develop a positive
working relationship
with the media
Twin Cities Metro APC
Education
Delivering the Message-Hotlines
¾
Use phone hotlines to disseminate critical
information
Twin Cities Metro APC
Education
Delivering the Message-Local Government
¾
Involve local government officials in your
educational efforts
Twin Cities Metro APC
Education
Lesson Learned
¾
Store information sheets at an alternate
location from your office
Twin Cities Metro APC
In Every Lesson There Are:
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Think about it exercises
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Quiz questions
Twin Cities Metro APC
Resources
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Links to Specific
Documents
Sample Field
Equipment Kit Lists
Sample Field
Assessment Form
Sample Facility
Survey Checklist
Fact Sheets
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¾
Twin Cities Metro APC
Links to Specific
Websites
Sample Mutual-aid
Agreements
Sample Disaster
Survey Form
Sample Door
Hangers
Training Module Summary
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Interviewed 22 EHP
Ten Incidents
Highlight their collective
disaster experience
Relate their experiences to
the EH Core Competencies
There is no linear, step by
step formula for success
Creativity, flexibility &
teamwork are essential
Twin Cities Metro APC
By Doing a Great Job,
The reputation of EH will not end up Here
Twin Cities Metro APC
Remember
Experience is a powerful teacher,
especially in the realm of disasters and
emergencies.
Twin Cities Metro APC
Finally
Being here is one small step for the
Twin Cities Metro APC/NACCHO and
one giant leap for environmental health
and emergency preparedness!
Twin Cities Metro APC