Public health investigation: focus group study of a regional infectious disease exercise.

Background: Local health departments and public health nurses are crucial in surveillance and response during public health emergencies. Simulated exercises are useful to train personnel and test emergency preparedness plans, but these exercises can be inconvenient or unrealistic. To address these drawbacks, "Public Health Investigation" (PHI), a multicounty, electronic infectious disease exercise, was created.

Methods: After the 4-week PHI exercise, 6 separate focus groups and 1 regional focus group were conducted with participating health departments to explore perceptions of whether the format was useful, how to improve future exercises, and how well exercise objectives were met.

Results: Counties reported improvements in all exercise objectives, especially surge capacity and coordination between counties. Small health departments requested state assistance with risk communication. Existing protocols and procedures were reported as helpful. Suggested improvements to the exercise format included a shorter, 3-week exercise, interviews with mock patients, pertinent scene information provided with scene questions, instruction on technology used, and clarifications to the "Rules of the Game."

Conclusions: Participants indicated that the format of the PHI exercise was successful in addressing exercise objectives. Increased regional collaboration may be the greatest strength of an exercise of this format.