Beyond the After-Action Review: Expert Consensus for Military-Civilian Pandemic Planning.

Area of Science:

• Public Health
• Health Systems Management
• Emergency Preparedness

Background:

• The US Military Health System (MHS) requires robust pandemic preparedness strategies.
• Lessons from past events necessitate improvements in health system readiness.
• National and civilian health systems can benefit from MHS preparedness insights.

Purpose of the Study:

• To compile and rate expert-informed recommendations for MHS pandemic preparedness.
• To identify actionable strategies with implications for civilian and national health security.
• To enhance the MHS's ability to respond to future pandemics.

Main Methods:

• A Modified Delphi process involving expert panelists was employed.
• Recommendations were sourced from Department of Defense (DoD) after-action reports and reviews.
• Panelists rated recommendations on importance and feasibility using a Likert scale across four rounds.

Main Results:

• The study began with 102 recommendations, culminating in 25 highly rated items.
• Key domains addressed include support to civil authorities, public health emergency management, personnel, and policy.
• Panel participation included 30 initial interviewees down to 14 final consensus attendees.

Conclusions:

• The 25 prioritized recommendations focus on enhancing MHS pandemic planning.
• Critical areas include civilian-military coordination, telehealth expansion, and supply chain resilience.
• Findings are relevant for improving civilian health systems and national preparedness strategies.