County Department of Public Health: Organizing for Emergency Preparedness and Response

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1. Identify the structural dilemmas found in the case. Explain specifically how and why the examples you provide fit the structural dilemma(s). When reading through the case study titled the County Department of Public Health: Organizing for Emergency Preparedness and Response, there was a concern that the division, as organized, would not be able to effectively respond to a chemical, physical, or biological emergency. It was these anxieties that prompted Dr. William Brown to call a critical meeting to address and to make sweeping changes to the Division of Epidemiology and Biodefense Preparedness and Response. Several structural dilemmas that were identified while reading this case study were Vertical Coordination, Lateral Coordination, Differentiation, Gaps, Overlaps, Overload, and finally a Lack of Clarity. There was a lack of vertical coordination versus a very much lateral coordination. There were no formal processes in place at the Division of Epidemiology and Biodefense Preparedness and Response which in turn led to massive non-communication of vital information that should have been shared between the divisions. There were several examples of a lateral coordination going on within the Public Health Department, when it could have been more effective had there been more vertical coordination taking place. Vertical coordination is demonstrated by the higher levels of the organization putting in place and enforcing rules and policies and planning and control systems (Bolman & Deal, 2008, p.54). Overload was best illustrated in the newly created division of the Division of Epidemiology and Biodefense Preparedness and Response (EPI/BDPR). Lillian Armstrong, who was a co-director of the EPI/BDPR division, said that her unit had a definite shortage of personnel, making their job very stressful and not accomplishing all the goals or necessary procedures to

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