Planning & Preparation

Chapter Summary

Preparations made ahead of a healthcare-associated infection (HAI) or antimicrobial-resistant (AR) pathogen outbreak lay the groundwork for actions taken during the outbreak response. 

In Chapter 3, Planning & Preparation, we lay out the roles, resources, processes, and relationships that should be in place prior to initiating an outbreak response. Example activities include developing the capacity to rapidly collect and analyze large amounts of information, taking rapid action to stop transmission, and communicating effectively with stakeholders.

Background information on agencies and partners that may be involved in an outbreak response is provided, and their respective roles and responsibilities are described, including considerations for a coordinating agency and the composition of outbreak response teams. 

Other topics include planning and preparation for resource identification and record management, communication considerations, understanding legal authorities, and preparation for escalation, recovery, and follow-up, including potential implementation of an incident command system.

As advances occur in outbreak protocols, this guidance document will be updated. Previous changes can be tracked below:

• 2nd Edition – Published June 2024
• 1st Edition – Published October 2022 
• URLs in this document are valid as of April 29, 2024.

1. Centers for Disease Control and Prevention (CDC). Public Health Professionals Gateway: HealthDepartment Governance. https://www.cdc.gov/publichealthgateway/sitesgovernance/index.html
2. Centers for Disease Control and Prevention (CDC). State Based HAI Prevention Activities. https://www.cdc.gov/hai/state-based/index.html
3. Franklin SM, Crist MB, Perkins KM, Perz JF. Outbreak response capacity assessments and improvements among public health department health care-associated infection programs— United States, 2015-2017. J Public Health Manag Pract. 2020;2022; 28(2):116-125. DOI: 10.1097/PHH.0000000000001148
4. Centers for Disease Control and Prevention (CDC). Epidemic Intelligence Service: Urgent Assistance (Epi-Aids). https://www.cdc.gov/eis/request-services/epiaids.html
5. U.S. Food & Drug Administration. Information Sharing. https://www.fda.gov/federal-state-localtribal-and-territorial-officials/communications-outreach/information-sharing
6. Holt JD, Ghosh SN, Black JR. Legal Considerations. In: Rasmussen SA, Goodman RA, eds. The CDC Field Epidemiology Manual. US Department of Health and Human Services Centers for Disease Control and Prevention (CDC); 2018:chap 13. https://www.cdc.gov/eis/field-epimanual/chapters/Legal.html
7. California Hospital Association. Emergency Preparedness: Drills and Exercises. https://www.calhospitalprepare.org/exercises
8. Centers for Disease Control and Prevention (CDC). Healthcare-associated infections (HAIs): Infection Control Assessment Tools. https://www.cdc.gov/hai/prevent/infection-controlassessment-tools.html
9. Centers for Disease Control and Prevention (CDC). Quick Observation Tools (QUOTs) for Infection Prevention. https://www.cdc.gov/infectioncontrol/tools/quots.html
10. Heymann DL, ed. Control of Communicable Diseases Manual. 20th ed. APHA Press; 2015.
11. Centers for Medicare and Medicaid Services (CMS). Emergency Preparedness Rule. https://www.cms.gov/Medicare/Provider-Enrollment-andCertification/SurveyCertEmergPrep/Emergency-Prep-Rule.html
12. Christensen BE, Fagan RP. Healthcare Settings. In: Rasmussen SA, Goodman RA, eds. The CDC Field Epidemiology Manual. US Department of Health and Human Services Centers for Disease Control and Prevention (CDC); 2018:chap 18. https://www.cdc.gov/eis/field-epimanual/chapters/Healthcare-Settings.html
13. Centers for Disease Control and Prevention (CDC). Outpatient Settings Policy Options for Improving Infection Prevention. October 2015. https://www.cdc.gov/hai/pdfs/prevent/Outpatient-Settings-Policy-Options.pdf
14. US Department of Health & Human Services(HHS). Public Health. 45 CFR 164.512(b). https://www.hhs.gov/hipaa/for-professionals/special-topics/public-health/index.html 
15. US Department of Health & Human Services(HHS). Summary of the HIPAA Privacy Rule. https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html