MPOX 2022: Strategic Management During a Public Health Emergency

<p dir="ltr">In the United States (U.S.), public health emergencies (PHEs) can be declared by the Secretary of the Department of Health and Human Services (DHHS) any time there is a disease, disorder or event that poses a significant risk to the public at large. In the context of a PHE, the challenge of strategic management is enhanced as all levels of the public health sector are forced to respond in a fast-paced, dynamic environment with shifting partner considerations. Strategic management considers the organizational ability to align internal capability with external demands and the “fitness” of the organization to learn and adapt. Mpox (formerly monkeypox) is the most recent infectious disease PHE. There is a research opportunity, using a case study design, to describe the key characteristics of the DHHS mpox response, to identify facilitators and barriers to strategic management, and to develop leadership-based recommendations for future PHEs.</p><p dir="ltr">Theories and concepts that align with strategic planning and strategic management from researchers Mintzberg, Moore, Bryson, Beer and others are utilized to frame this case study. A proposed theory of change, taking into account some of the basic tenets of strategic management theory, outlines the steps that can be transformative in strategic preparation and execution of a PHE response. This theory of change necessarily begins with the upstream reframing of mission, vision, and mandates to better address the structural drivers of downstream health inequity.</p><p dir="ltr">This case study utilizes a multi-methods approach. While quantitative data can help to delineate some federal organizational capacity elements, strategic management performance in this practice setting is best characterized using qualitative data. The data for this study were collected through a phased approach, starting with a survey of DHHS employees and followed by semi-structured in-depth interviews of key informants from DHHS and external partner organizations. It is important to note for the record that the timing of data collection coincided with the change in Presidential administration in January 2025, which brought with it a series of Executive Orders as well as significant policy changes and staffing reductions at DHHS. As a result, research participant recruitment plans were modified in response to these unforeseen barriers in order to collect sufficient data for analysis.</p><p dir="ltr">Data analysis and integration were conducted at the methods level (building type) and appropriately considers both qualitative and quantitative data sets. This research project uses methodological triangulation and a data summary matrix to compare key construct measures from across different sources in order to answer the research questions of interest.</p><p dir="ltr">This case study has generated data on DHHS strategic management during the 2022 mpox PHE, helping to document how internal/external alignment improved over the course of the PHE and providing recommendations that take advantage of identified facilitators while mitigating the identified barriers. The recommendations are captured across four thematic areas: Strategic Planning, Leadership, Resource Allocation, and Health Equity. This effort is intended to inform DHHS on future PHE responses as well as provide baseline data for future research opportunities.</p>

Author dc:creator

• Rob Palmer (22544645)

• Mpox
• Public health emergency preparedness and response
• strategic management

Statement dc:rights

• In Copyright

DOI dc:identifier

https://doi.org/10.25417/uic.30629144.v1

OAI identifier oai:identifier

oai:figshare.com:article/30629144