Building on the recommendations and guidance in the 2012 Institute of Medicine (IOM) report Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response, the IOM Forum on Medical and Public Health Preparedness for Catastrophic Events sponsored an interactive workshop session at the National Association of County and City Health Officials (NACCHO) Public Health Preparedness Summit, held March 12-15, 2013, in Atlanta, Georgia. The goals of the session were to provide practitioners with practical guidance and encourage participants to strategize their efforts and leverage work already being done around the country. Specifically, presentation and discussion objectives were to2

  • Introduce the key principles of public engagement
  • Provide practical guidance on how to plan and implement a public engagement activity
  • Provide attendees with sample tools to facilitate planning
  • Introduce and simulate different methods of engagement exercises

The workshop examined theories and practices of public engagement, explored challenges and lessons learned, and included sample public engagement exercises. The workshop was organized in two parts. First, invited panelists provided background on crisis standards of care (CSC) and public engagement and discussed specific examples of recent public engagement exercises and lessons learned in their communities. In the second part, attendees participated in two simulated, interactive public engagement exercises using two different methods. These abbreviated exercises were intended to give attendees a better sense of the engagement process and a sampling of tools available to them for working with their own communities.

Public engagement is a useful approach for obtaining public input about pending policy decisions that require difficult choices among competing values (IOM, 2012a). Although average citizens may lack the expertise to comment on technical issues (e.g., the use of Sequential Organ Failure Assessment scores to allocate ventilators), they are very capable of deliberating on the values underlying public policy decisions (e.g., whether to withhold or withdraw life-preserving care, such as ventilators, in crisis situations where resources become scarce). Some of the benefits of public engagement are that it can help inform members of the community, include their input in disaster planning to increase legitimacy and acceptance, and reveal public misunderstandings, biases, and areas of deep disagreement. Policy makers can then work to address these matters during the development of disaster plans and during the plan dissemination phase by having community members at the table in the beginning stages of the process.

About This Summary

The report that follows summarizes the presentations by the expert panelists and the open panel discussions that took place during the workshop. Beginning by framing and defining public engagement outreach during the planning stages, it moves to describing the specific case studies speakers presented during the workshop. These include Seattle and King County, Washington; Harris County, Texas; the State of Michigan; and an example from the IOM and the Centers for Disease Control and Prevention (CDC). Following these case studies, challenges and lessons learned are discussed, and finally a description of the two simulated public engagement exercises performed during the workshop: a community conversation simulation and a Q-sort activity based on a severe influenza pandemic scenario. A list of references, the statement of task, the workshop agenda, and biographical sketches of the panelists are available in the appendixes.



The role of the ad hoc planning committee of the Institute of Medicine (IOM) Forum on Medical and Public Health Preparedness for Catastrophic Events was limited to developing this session (i.e., workshop) for the National Association of County and City Health Officials Summit. This summary has been prepared by the rapporteurs as a factual overview of the presentations and discussions at the session. Statements, recommendations, and opinions expressed are those of individual presenters and participants, and are not necessarily endorsed or verified by the IOM or the Forum, and they should not be construed as reflecting any group consensus.


The complete statement of task can be found in Appendix B.