BackgroundPublic health officials and journalists play a crucial role in disseminating information regarding natural disasters, terrorism and other human-initiated disasters. However, research suggests that journalists are unprepared to cover terrorism and many types of natural disasters, in part because of lack sufficient expertise in science and medicine and training. The objective of this research was to identify solutions to problems facing journalists and public health public information officer (PIOs) of communicating with the public during natural and human-initiated disasters.MethodsTo assist in identifying the most pressing problems regarding media response to health-related risks such as terrorism and large-scale natural disasters, 26 expert advisors were convened, including leaders representing journalists and public information officers, state health officials, experts in terrorism and emergency preparedness, and experts in health, risk, and science communication. The advisory group participated in pre-arranged interviews and were asked to identify and review bioterrorism educational resources provided to journalist. All advisory group members were then invited to attend a day long meeting January 29, 2004 to review the findings and reach consensus.ResultsThe most pressing problems were found to be a lack of coordination between PIO's and journalists, lack of resources for appropriately evaluating information and disseminating it efficiently, and a difference in perception of PIO's and journalist towards each others role during emergency situations. The advisory board developed a list of 15 recommendations that may enhance communication plans betweens PIO's, journalist and the public. The solutions were meant to be feasible in terms of costs and practical in terms of the professional and organizational realities in which journalists and PIO's work.ConclusionIt is clear that PIO's and journalists play crucial roles in shaping public response to terrorism and other disasters. The findings from this formative research suggest that perspectives and organizational processes often limit effective communication between these groups; though practical solutions such as participation of journalists in drills, scenario exercises, sharing of informational resources, and raising awareness at professional trade meetings may enhance the timely dissemination of accurate and appropriate information.

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The RDT literature is limited to studies of hospitals, nursing homes, and medical practices. There is little consensus on how to measure or operationalize the environment in these studies. No previous studies have measured the environment for other health care settings such as ambulatory surgery centers, public health departments, or assisted living facilities.

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This paper discusses the foundations of the normative model of strategic management and reports the results of empirical research that examined the validity of the model from the perspective of practising planners. It was concluded, on the basis of the responses, that the normative model of strategic management is an accurate representation of what planners believe to be the steps in the process at both the corporate and business-levels. While the steps were all included, there was significant variation among the relative importance of the various steps.

Market factors play an important role in the diffusion of EHRs in small medical practices. Policy makers interested in furthering the adoption of EHRs must consider strategies that would enhance the confidence of users as well as provide financial support in areas with the highest concentration of small medical practices and Medicare beneficiaries. Health care leaders should be cognizant of the market forces that enable or constrain the adoption of EHR among their practices and those of their competitors.

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