Developing a measure of local agency adaptation to emergencies: a metric

Local public health agencies often must respond to health-related emergencies or disasters, while continuing to fulfill all public health functions for which they are funded. This article reports the development and initial pilot test of a method for measuring the nature and degree of a public health agency's response to such an emergency or disaster. How the instrument was developed as well as the initial results from the pilot study of four local public health systems (LPHSs) are presented and discussed. The instrument measured the extent to which each function and division of each of the four LPHSs were affected and provided a metric that could be used across LPHSs to indicate the burden experienced by each due to the emergency. Results obtained from the pilot study indicate that size and complexity of an LPHS was not predictive of its ability to respond to the emergency. These results support the use of the framework and associated measurement procedures to provide valuable information to managers responsible for such LPHSs. Such information should provide a foundation for comparing variations in performance and outcomes to various types of emergencies that vary in their severity and focus.