Keywords

ambulatory urgent care, clinical decision support systems, disease notification, pertussis, public health practice

 

Authors

  1. Staes, Catherine J. BSN, MPH, PhD
  2. Gesteland, Per H. MS, MD
  3. Allison, Mandy MD
  4. Mottice, Susan PhD
  5. Rubin, Michael MD
  6. Shakib, Julie H. DO, MPH
  7. Boulton, Rachelle MSPH
  8. Wuthrich, Amyanne MS
  9. Carter, Marjorie E. MPH
  10. Leecaster, Molly PhD
  11. Samore, Matthew H. MD
  12. Byington, Carrie L. MD

Abstract

Objectives: We assessed urgent care providers' knowledge about public health reporting, guidelines, and actions for the prevention and control of pertussis; attitudes about public health reporting and population-based data; and perception of reporting practices in their clinic.

 

Methods: We identified the 106 providers (95% are physicians) employed in 28 urgent care clinics owned by Intermountain Healthcare located throughout Utah and Southern Idaho. We performed a descriptive, cross-sectional survey and assessed providers' knowledge, attitudes, beliefs, and behaviors associated with population-based data and public health mandates and recommendations. The online survey was completed between November 1, 2007, and February 29, 2008.

 

Results: Among 63 practicing urgent care providers (60% response rate), 19 percent knew that clinically diagnosed pertussis was reportable, and only half (52%) the providers correctly responded about current pertussis vaccination recommendations. Most (35%-78%) providers did not know the prevention and control measures performed by public health practitioners after reporting occurs, including contact tracing, testing, treatment, and prophylaxis. Half (48%) the providers did not know that health department personnel can prescribe antibiotics for contacts of a reported case, and only 22 percent knew that health department personnel may perform diagnostic testing on contacts. Attitudes about reporting are variable, and reporting responsibility is diffused.

 

Conclusion: To improve our ability to meet public health goals, systems need to be designed that engage urgent care providers in the public health process, improve their knowledge and attitude about reporting, and facilitate the flow of information between urgent care and public health settings.