Applying the Ready, Willing, and Able Framework to Assess Agency Public Health Emergency Preparedness: The CDC
Shawn C Chiang1, Holly H Fisher1, Matthew E Bridwell1
1Shawn C. Chiang, MPH, is a Predoctoral Research Fellow, Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA. At the time this work was conducted, he was an Evaluation Fellow, Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Holly H. Fisher, PhD, is Evaluation Lead, Risk Management and Operational Integrity; Silvia M. Trigoso, MPH, is a Program Manager, Incident Manager Training and Development Program; Bobby B. Rasulnia, PhD, is Deputy Director, Risk Management and Operational Integrity; and Sachiko A. Kuwabara, PhD, is Director, Risk Management and Operational Integrity; all in the Division of Emergency Operations, Center for Preparedness and Response, CDC, Atlanta, GA. Matthew E. Bridwell, MPH, is Deputy Branch Chief, Division of Global HIV and TB, Center for Global Health, CDC, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
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Public health emergencies in the United States have been complex, frequent, and increasingly costly in the past decade, at times overwhelming government agencies that are primarily resourced for routine, nonemergency health functions. Emergencies are not always predictable, and adequate resources are not always available to prepare staff in advance for emergency response roles and to mobilize them quickly when a new threat emerges. Additionally, real-world data that connect preparedness levels to response outcomes may be difficult to obtain, further limiting continuous quality improvement efforts by public health officials. In this article, we apply the Ready, Willing, and Able (RWA) framework to identify areas for improvement related to organizational and staff readiness, willingness, and ability to respond during a public health emergency. We share emergency response deployment, training, and personnel data collected as part of emergency response activations (2008 to 2018) at the Centers for Disease Control and Prevention to illustrate how the framework may be applied at government agencies to improve response processes and effectiveness. Additionally, we propose potential metrics aligned with the framework constructs that may help emergency managers consistently assess agency preparedness and, over time, be incorporated into broader standardized measurement methods. We conclude that the RWA framework is a practical tool that can complement other preparedness approaches currently in use at government public health agencies.
