1. CIFOR Toolkit: An Overview of Focus Area 3 – Communication
New York Integrated Center of Food Safety Center of Excellence – August 23, 2016
Madhu Anand, DrPH
Bureau of Communicable Disease Control
New York State Department of Health

2. Background
This is the fourth webinar in a series of monthly webinars from the New York Integrated Center of Food Safety Center of Excellence (NYCoE)
Session will cover CIFOR Toolkit Focus Area 3: Communications
Upcoming monthly sessions will work through the entire CIFOR Toolkit, Focus Areas 4-11

3. Background
Additional sessions will focus on emerging issues in food safety including culture‐independent diagnostic testing, antimicrobial resistance, and advanced molecular detection/whole genome sequencing
All webinars will be recorded and available through the NYSDOH Learning Management System (LMS) at:
Slide decks/recordings for all webinars will post to the NYCoE website:

4. Objectives Describe how to use the CIFOR Toolkit (Worksheets)
Explain Focus Area 3: Communications
Review Goals
Review “Keys to Success” and Recommendations
Contact Lists
Communication Practices
Making Changes
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5. How to Use the CIFOR Toolkit
Determine Priority Focus Areas
For each Focus Area (1-11) deemed as high priority, complete the corresponding worksheet regarding efforts to improve foodborne disease outbreak response in your agency/jurisdiction
Complete the Worksheet as a Team (Workgroup)
Epidemiology, Laboratory, Environmental Health and other agencies
Describe your jurisdiction’s current activities/procedures for the Focus Area
Refer to written protocols/procedures and materials related to ongoing efforts in capacity development or quality improvement
Indicate any activities that, if modified, could improve your jurisdiction’s response to foodborne disease outbreaks

6. How to Use the CIFOR Toolkit
Prioritize CIFOR Recommendations to Address Needed Improvements
Based on needs identified in your jurisdiction, review the CIFOR recommendations related to the Focus Area of interest
Rate the priority for implementing each recommendation based on its likely impact on foodborne outbreak response in your jurisdiction
Some recommendations may already be in place at your agency, or not relevant to your agency, and can be marked as such
Identify activities and procedures in need of improvement

7. Focus Area 3 Title: Communications
Goal of the Focus Area: Agency/jurisdiction lays groundwork for good communication with key individuals, both internal and external to the agency, before an outbreak occurs

8. Toolkit Tracks and Focus Areas
In developing the Toolkit, outbreak response activities have been divided into four major “tracks,”
corresponding to the four main chapters of the CIFOR Guidelines
Planning and Preparation brings the right expertise to the investigation, communicating quickly with all organizations that should be involved, and rapidly sharing investigation findings can accomplish the goal.

9. Keys to Success
Activities, relationships, and resources that are critical to achieving success in a Focus Area
Contact Lists
Communication Practices
Making Changes
Determining whether your jurisdiction has a particular key to success in place can be subjective; use your best judgement in deciding whether an activity is partially or fully in place
Applying metrics and measures can help you identify the success of your program or investigation process

10. Contact Lists 2 Keys to Success
Agency/jurisdiction identifies key individuals and organizations related to outbreak response before an outbreak occurs including members of the outbreak response team, officials inside the agency, contacts at external agencies (i.e. other local, state, and federal agencies),and the media
Agency/jurisdiction establishes and frequently updates contact lists for key individuals and organizations

11. Recommendations: Contact Lists
Prepare contact information (including after-hours information) for:
People in the agency who should be contacted in the event of an outbreak, including backups
Contact people in external agencies (e.g., other local, state and federal agencies)
Important food industry contacts, including trade associations
Information to include:
Phone numbers (primary, alternate, cellular, 24 hour contact, home)
Pager numbers
Fax number
Address

12. Recommendations: Contact Lists
Ensure that all contact lists are updated twice yearly and, when feasible, made available to all stakeholders on both electronic and hard copy formats
Distribute a list of your agency’s contacts to other agencies, and obtain a list of their contacts. Provide the contact list in electronic and hard copy formats
Develop a group electronic distribution list for rapidly sharing information with those who should be contacted in the event of an outbreak

13. Communication Practices
3 Keys to Success
Agency/jurisdiction has procedures for communicating with key individuals and organizations
Agency/jurisdiction has staff trained in communicating with the media and risk communication
Agency/jurisdiction identifies a person(s) responsible for external communication on behalf of the agency/jurisdiction during each outbreak response

14. Recommendations: Communication Practices
Internal
Ensure the members of the outbreak response team know each other before an outbreak occurs
Establish and use routine procedures for communicating among outbreak response team members and their units and agencies before an outbreak occurs
Define a formal communication process for agencies of the outbreak response team for use during outbreaks. Options include daily phone calls and routine alerts

15. Recommendations: Communication Practices
Internal (Prior)
Decide who will be notified when an outbreak is suspected on the basis of roles, including any changes in notification according to the nature of the outbreak (e.g. pathogen type, involvement of commercial product) and timing (weekends and holidays versus weekdays)
Determine whether and how confidential information (e.g. from forms and questionnaires) can be shared within the outbreak response team before an outbreak occurs
Serves as a form of quality assurance
Can be a point of discussion during an after action report

16. Recommendations: Communication Practices
Internal (During)
During an outbreak response, maintain close communication and coordination among outbreak response team members (Epi, Lab, EH)
During an outbreak response, identify persons who will be responsible for external communication on behalf of their organizational unit and for the outbreak response team
During an outbreak response, communicate actions taken and new outbreak information to all members in the outbreak response team. Make sure public information officer is routinely updated to ensure appropriate messaging to the public and media
During an outbreak response, arrange for the outbreak response team to meet daily to update the entire team in a timely manner

17. Recommendations: Communication Practices
External (Prior)
Develop standardized processes (including notification triggers and timelines) for sharing information with other local, state, and federal agencies, including who will notify the next level of public health, environmental health, or food regulatory agencies. Commit to notifying collaborating agencies as soon as possible in the outbreak investigation process.
Identify an agency lead on interactions with other agencies, ideally the lead investigator. Establish procedures for coordinating communication with these entities to provide consistent messaging and accurate information flow.

18. Recommendations: Communication Practices
External (Prior)
Foster working relationships with other agencies, holding joint meetings and planning sessions before an outbreak occurs
Establish processes for participating in multiagency, multijurisdictional conference calls and train staff in conference call etiquette
Determine whether and how confidential information can be shared with other local, state and federal agencies
Identify and regularly communicate with agencies or organizations that receive possible foodborne illness complaints (e.g. Agriculture agencies, facility licensing agencies, poison control centers) and ensure that they have current contact information for your staff

19. Recommendations: Communication Practices
External (During and After)
Rapidly post subtyping results to PulseNet and report newly detected clusters to PulseNet and Fodoborne Outbreak Listserves
Document every outbreak investigation using a standard form to facilitate inclusion in state and national outbreak databases
NORS
Summary Report
Background
Methods
Results
Conclusion
Recommendation
Epi-Curve with timeline

20. Recommendations: Communication Practices
Public
Establish standard channels of communication with the public before an outbreak occurs and use those same channels each time a public health issues arises about which the public may seek information
Identify an agency lead on interactions with the public, ideally someone trained in communication. Establish procedures for coordination communication with the public to provide consistent messaging and accurate information flow.
Create templates for communication with the public (e.g. fact sheets), focusing on the most common foodborne diseases before an outbreak occurs
Refer to CIFOR clearinghouse for templates

21. Recommendations: Communication Practices
Public
Establish relationships with consumer groups that might be helpful in disseminating information about foodborne disease outbreaks and prevention messages
Periodically issue foodborne disease prevention messages or press releases to ensure that the public knows with whom to communicate and from where information ill come during an outbreak
Since the public obtains news from multiple sources, us all available sources to disseminate information (e.g. the Internet, television, radio, newspapers, and social media
If there is a void, public may fill sought information with unreliable sources

22. Recommendations: Communication Practices
Public
Create and test web-based tools for communication with the public (e.g., blast s, survey instruments)
Adopt a standard format for reporting risk information to the public. Decide in advance how to communicate the naming of implicated establishments based on local legal guidelines and whether risk of transmission is ongoing
Adopt a standard scripts for reporting complex procedural or technical information to the public

23. Recommendations: Communication Practices
Public
In communicating with the public during an outbreak provide technical practical measures that the public can take to decrease risk for illness (e.g., avoidance of known high-risk foods or special instructions for their preparation), as well as basic food-safety messaged and information about how to contact public health authorities to report suspected related illnesses
Test messages to the public with representatives of the target population before releasing them

24. Recommendations: Communication Practices
Public
Guide staff on how to respond to and communicate with upset members of the public
Make copies of summary reports from each outbreak response available to members of the public who request them.

25. Recommendations: Communication Practices
Media
Identify an agency lead on media interactions, ideally someone trained as a public information officer
Obtain media training for primary agency spokespersons

26. Recommendations: Communication Practices
Media
Establish standard channels of communication with the media (e.g.; website, telephone number), and use those same channels each time a public health issues arises about which the public might seek information. Identify primary contact persons from major local media outlets. Know routine deadlines and time frames for reporting news through major local media outlets (e.g. the deadline for having news from a press release appear in the evening paper)
Periodically hold a media education event to teach new media professionals in the community’s media market about public health and response to foodborne disease outbreaks

27. Making Changes 2 Keys to Success
Agency/jurisdiction conducts a debriefing among investigators following each outbreak response and refines outbreak response planning based on lessons learned
Agency/jurisdiction has performance indicators related to communication and routinely evaluates its performance in this Focus Area

28. Recommendations: Making Changes
Conduct a debriefing following each outbreak response with all members of the outbreak response team to identify lessons learned
Complexity and how formal depends on size of event
Formal
Identify contributing factors and environmental antecedents
Measures to prevent additional outbreaks
Identify long-term and structural control measures, and plan for implementation
Assess effectiveness and difficulties in implementing outbreak control measures
Assess whether further scientific studies should be conducted
Clarify resource needs, structural changes, or training needs for future
Identify factors that compromised the investigation and seek solutions
Identify necessary changes to current investigation and control guidelines and development of new guidelines or protocols as required
Discuss legal issues that may have arisen

29. Recommendations: Making Changes
Prepare summary reports for all outbreaks consistent with the size and complexity of the response. Use the reports as a continuous quality improvement opportunity
NORS
Annual summaries
Make copies of summary reports available to all members of the outbreak response team and their units and agencies and persons responsible for implementing control measures

30. Helpful Tips for Using the Toolkit
Don’t get distracted by the volume
Be clear on the process
Keep moving – don’t get caught up in too much detail
Focus on a few realistic changes
End with specific action plans
Include time frames and responsible persons
Appoint a facilitator and a recorder for each discussion
Emphasis on realistic changes than can actually occur. Facilitator and recorder can be within the group or from an outside party. Also doesn’t all have to be done at once, but gradually over the span of months, year, etc.

31. Why Should My State Use the Toolkit?
Improve foodborne outbreak investigation and response
Enhance partnerships with agencies/partners in foodborne outbreak investigations
Identify areas needing improvement that may have otherwise gone unrecognized
Comment on what other states are doing or have done – Examples from the field section. Ask if any states on the call would like to share an experience? Maybe mention the use in NY so far – needs assessment via Survey Monkey and setting up regional trainings, to then extend to counties?

32. Where to Find the CIFOR Products
Online at:
Paper copies are also available from CSTE
Contact Dhara Shah at
Examples of CIFOR product use by other states:

33. Next Scheduled NY CoE CIFOR Webinars
Wednesday, September 28, 2-3 PM
Focus Area 4: Complaint Systems
Course announcement and link to register is posted on the NY CoE website, as well as, the DOH Learning Management System (LMS):

34. Resources Comments or questions for NY CoE can be directed to:
Paula Huth, NY CoE Program Coordinator or
Integrated Food Safety CoE Websites:
NY CoE:
CDC: