Cdc's Emergency Response Clearance Process: An inside Look

Background:  When public health emergencies occur, people need fast information that is current, accurate, and accessible. A vital task of the Centers for Disease Control and Prevention (CDC) is supporting a review and approval process that ensures all CDC recommendations and publications are of the highest quality, technically accurate, and tailored to the intended audience. CDC’s Joint Information Center (JIC), a 24/7 emergency preparedness and response unit, coordinates and manages the emergency response clearance process, tracks input from numerous reviewers, and manages workload demands to make sure all information is cleared before being released publicly.

Program background:  Emergency response clearance is the process of rapidly obtaining review and approval by the appropriate CDC subject matter experts and decision makers before an informational product is released to the public. The specifics of the clearance process for any type of document should be appropriate for the informational product under review and should balance the concerns of audience needs, scientific accuracy, and speed. To accomplish this mission, CDC’s JIC uses a set of practices that have been revised and refined through numerous emergency responses and that have consistently led to gains in efficiency. Electronic clearance systems, standard operating procedures, workflow diagrams, clearance request forms, clearance forecasting reports, and fact sheets that provide instructions for submitting documents for clearance are examples of products the JIC uses to coordinate and manage emergency response clearance. Evaluation plans are currently being developed and pilot tested. To support the emergency response clearance process, the JIC works with stakeholders across CDC to leverage the expertise of the agency’s clearance community.

Evaluation Methods and Results:  Evaluation of the clearance process is in the formative stage.  To date, the JIC has been able to develop and pilot analyses of how long documents take to be cleared during responses and identify groups that may need additional resources to handle their clearance workloads.  Future evaluation activities will include expanded implementation of time to clear analyses and the development of additional metrics that could be used to measure the quality of products.

Conclusions:  During public health emergencies, implementing an efficient emergency clearance process that ensures the rapid dissemination of high quality information products to all target audiences is in both the agency’s and the public’s best interest. Agencies must balance the need for rapid dissemination of information that is scientifically accurate with ensuring materials are clearly written in a way that can be understood and used by clinicians, health departments, and for targeted audiences who hope to mitigate a public health outbreak or disaster. CDC’s emergency response clearance process bridges the divide between the content being produced and the target populations who need it most.

Implications for research and/or practice:  CDC is working to develop and test methods for evaluating the emergency response clearance process. Critical variables include how quickly products are approved, the scientific accuracy of products, and the appropriateness of audience tailoring. Future analyses will routinely track how quickly products are cleared and how well they meet the scientific and communication goals of the clearance process.