Structuring the Puzzle: Protocol Use in Disease Outbreak Investigations

Abstract

Disease outbreaks affect millions of Americans every year and have potentially large health and financial costs. State and local health departments in conjunction with the CDC have the responsibility for investigating and managing disease outbreaks. Individual states define dozens of diseases as reportable. To manage the scope and diversity of these diseases public health agencies rely on the use of protocols. Protocols can be effective tools for improving performance and reducing errors. However, there are limitations with the use of protocols in natural systems such as disease investigations. Our study included 41 semi-structured interviews with public health disease outbreak investigators. This paper discusses some of the benefits and limitations related to the use of protocols in disease outbreak investigations. We also suggest areas where Human Factors Engineering can support public health disease investigations.