What do infection prevention in dialysis clinics and hurricane response in the Caribbean have in common? More than you might think. This episode explores how culture, leadership, and coordination shape health outcomes, whether in a treatment chair or a disaster zone. First, Shalini Nair, a Senior Analyst of Infection Disease at ASTHO, breaks down the growing concern around dialysis-related infections and what the CDC’s Making Dialysis Safer for Patients Coalition is doing to address it. She shares frontline-informed strategies that health departments and facilities can use right now: building a “see it, say it” culture of safety, using short, role-specific training and real-time coaching, and ensuring visible leadership support that reinforces infection prevention as everyone’s responsibility. Then, the focus shifts to disaster response with Maggie Nilz, Senior Analyst of preparedness at ASTHO and Team Rubicon, a veteran-led humanitarian organization. Nilz reflects on her decade of deployments, from chainsaw operations in U.S. disaster zones to coordinating international health response in Jamaica after a devastating hurricane. She explains how public health leadership, interagency coordination, and pre-disaster data systems are critical when hospitals are damaged, infrastructure is down, and communities still need everyday healthcare.
Key Insights to Improve Infection Prevention in Dialysis Settings | ASTHO
Leading Humanitarian Aid Organization in the US | Team Rubicon
Leadership Power Hour: Your Launchpad for Impact | ASTHO
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This is public Health review.
Morning Edition for Wednesday,
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February 18th, 2026.
I'm John Sheehan with news from
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the.
Association of State.
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And territorial health.
Officials today.
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We'll hear about infection
prevention in dialysis clinics
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and hurricane response in the
Caribbean.
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Our first guest.
Shalini Nair.
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A senior analyst of infectious
disease.
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At asto breaks.
Down the growing concern around
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dialysis related infections and
what the CD CS making dialysis
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safer for patients coalition is
doing to address it.
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Later, Maggie.
Nails, a senior analyst of
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preparedness at ASTO, explains
her involvement with TEAM.
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Rubicon A.
Veteran LED humanitarian
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organization Nils reflects on
her decade of deployments from
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chainsaw operations in US
disaster zones to coordinating
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international health response in
Jamaica after a devastating
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hurricane.
But let's start with Shalini
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Nair.
We wanted to know more about
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dialysis related infections and
prevention efforts.
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So when we think about dialysis
related infections, we're
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referring to infections that
occur as a result of lapses and
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infection control when it comes
to the delivery of dialysis via
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ports and other equipment.
So staph infection control is
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very important when it comes to
protecting patients from
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potentially life threatening
infections like these.
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Got you.
And it's become such a problem
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that the CDC set up this this
coalition to sort of address
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address the issue, taking
feedback from from all kinds of
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participants what what was one
of the most actionable infection
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prevention takeaways.
Yeah.
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So a standout take away that we
heard from our participants was
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that fostering a culture of
safety that's focused around a
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see it, say it approach where
staff and patients are all
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encouraged to speak up about
infection risks in real time.
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This approach really strengthens
shared accountability.
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It supports earlier risk
identification, and it also just
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helps normalize infection
prevention as something that's
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everybody's responsibility,
which makes it a powerful lever
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for having that sustained
improvement.
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And health departments can help
reinforce that through things
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like technical assistance or
just recognizing facilities that
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do this well.
Another piece of feedback was
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staff training.
Were there were there techniques
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or training specifically that
were that were more effective?
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Yeah.
So our frontline staff
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emphasized that short,
interactive and role specific
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training formats.
So things like simulation
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trainings or really just taking
advantage of real time teaching
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moments are most effective,
especially in busy dialysis
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environments.
Staff also said that they really
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value feedback that's
constructive, non punitive and
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non disruptive to patient care,
so delivering it through
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approaches like audits, huddles
or unscheduled observation
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visits that focus more on
reinforcing positive practices
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rather than punishing mistakes.
And the third big take away was
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leadership support.
What does that refer to exactly?
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Yeah.
So when we're talking about
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leadership support, we're
talking about leaders who are
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present and involved in creating
that culture of safety and
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health departments can help
support facility leadership in
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doing that by sharing best
practices, offering leadership
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focused training resources and
promoting accountability
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frameworks that prioritize
infection prevention.
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So providing guidance on
allocating time and resources
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for staff education, recognizing
frontline contributions, and
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training managers, especially on
repeated lapses in infection
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control, can help cultivate
leaders that model safe
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practices and help sustain that
culture of safety.
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And so for health departments
that aren't part of this
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coalition or aren't part of the
CDC's group, how can they take
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steps to either joining it or
learning more?
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We would recommend that they
check out the CD CS website for
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the Making Dialysis Safer for
Patients coalition and there's
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more information there on how to
join.
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But the coalition overall offers
health departments a really
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collaborative platform where
they can access evidence based
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tools, training resources, as
well as engage in peer learning
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opportunities that are focused
on dialysis safety.
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It allows them to stay current
on infection prevention
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strategies, learn directly from
frontline experiences, and also
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strengthen the health department
partnerships with dialysis
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facilities.
So overall, joining the MD's
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coalition supports a more
informed and impactful action to
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improve patient safety.
Shalini Nair is a senior analyst
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of Infectious.
Disease at asto.
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Now let's hear from Maggie Nils,
a senior analyst of
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preparedness.
At ASTO.
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And a member of team.
Rubicon A.
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Veteran LED humanitarian
organization.
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Team Rubicon is a veteran LED
humanitarian response
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organization that responds to
disasters leveraging the skills
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of military veterans and
civilian volunteers.
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They actually started after the
2010 Haiti earthquake with a
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group, a very small group of six
that deployed over there,
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including veterans, paramedics,
EMT's and physicians to provide
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care to the people of Haiti.
And these days they focus on
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everything from immediate
response, things like debris
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removal, emergency logistics,
chainsaw operations, home
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repairs, to long term recovery,
including things like long term
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sustainable home repairs and
rebuilding of homes and
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communities.
And this includes actually
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international deployments as
well.
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Team Rubicon has a World Health
Organization certified emergency
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medical team that'll deploy to
public health emergencies.
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It's amazing.
It's such a heartening story of
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an organization of groups of
veterans just saying, like, we
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know how to do this stuff.
Let's just get out there and do
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it.
Yeah, absolutely.
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I think the flexibility and the
capacity of, you know, veteran
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and 1st responder volunteers to
come together and move quickly
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and efficiently has been an
incredible asset to the
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organization.
And so tell us a little bit
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about your experience with it.
How long have you been part of
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Team Rubicon?
Yeah, So I started volunteering
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with Team Rubicon about 10 years
ago.
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I was right out of college.
I had been working as an EMT in
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rural upstate New York for all
four years of my undergrad and
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really found myself missing the
first responder life and
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camaraderie and community.
And a friend pointed me towards
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Team Rubicon and my first
deployment was to a very, very
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small town responding to a
tornado in rural Missouri.
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And I just, you know,
immediately was, was sucked in
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by the partnership and, and
community within this group and
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the ability to use the skills I
had to give back.
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And over my time, I've served in
a lot of different capacities.
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I've worked as a chainsaw
operator and a chainsaw
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instructor as well.
I now help support the chainsaw
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instructor, train the trainer
curriculum for the organization,
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and then I've supported through
command staff roles and even did
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some epidemiology and public
health work through their COVID
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response efforts as well.
And Maggie, most recently, you
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were sent to help out in Jamaica
in the wake of Hurricane
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Melissa.
Yes, Yeah.
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So I was down there the first
week or so of December, and for
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them I was serving as a liaison
officer, which is a little bit
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of a newer role for me.
Normally I am out in the field
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running a chainsaw or teaching
other people how to run a
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chainsaw, but my role in Jamaica
was to focus on health and
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interagency coordination.
So I was embedded in meetings
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with the Government of Jamaica,
their Ministry of Health and
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Wellness, the Pan American
Health Organization, and several
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UN coordinating bodies to
connect with and partner with
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other organizations in the
health, sheltering and logistics
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sectors.
And my job was to help ensure
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that Team Rubicon's operational
work and specifically their
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emergency medical team was
aligned with jurisdictional
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priorities.
So making sure that our team
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that was there with a field
hospital was coordinated with
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the larger Ministry of Health
and their goals and objectives.
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And I'm doing a lot of work like
making sure that they had the
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right resources that they
needed.
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Ensuring that our physicians and
nurses coming into the country
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had the right licensure and
approval to come in, that we
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were able to bring in
pharmaceuticals so that that
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field hospital could do the work
that it needed to do.
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So all of the the connecting and
contacting and conversations
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that happen to make sure that
teams in the field can be as
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effective as possible.
My gosh, yeah.
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You forget that, you know, even
though an area is devastated,
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like parts of Jamaica were the
response effort, you know,
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especially when that size has to
be really strictly managed.
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Yeah, absolutely.
And I think especially in a case
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like this where it was, you
know, the strongest hurricane
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that, you know, the island has
seen.
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And we're looking at, I think
nearly every hospital except for
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one had significant or or
devastating damage to it.
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And in addition to, you know,
injuries and health and Wellness
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issues that people have post
disaster, you know, these field
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hospitals are also dealing with
day-to-day continuity of care.
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You know, people still have kids
and deal with diabetes and, you
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know, all of the other things
that we deal with on a
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day-to-day life that require
healthcare.
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And so that coordination piece
is so key to making sure that
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all these volunteers coming in
or working together and working
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with the government for what
they need.
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Wow.
What other kinds of needs did
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you see in, in Jamaica?
What, what were some of the big
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rebuilding efforts?
You know, I think a lot was
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focused on while I was there
getting, you know, key critical
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infrastructure pieces up so that
people could start to focus on
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their home life as well.
So things like, you know, making
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sure that hospitals are up and
back online so that people can
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get day-to-day care, getting
schools back up on online.
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You know, families with children
are having to stay at home to
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provide childcare if the schools
aren't open.
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And so if we can get the schools
open, then, you know, parents
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and older parts of the family
unit can focus more on
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rebuilding their home or going
back to work and kind of getting
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the economy back up on its feet.
There was still a lot of work
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being done in terms of like
route clearance and road
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clearance, especially in the the
more mountainous regions on the
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inner, inner parts of the
islands.
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Getting into some of those towns
was still really challenging.
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You know, I think the recovery
efforts have come a long way
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since I was there.
But, yeah, well, I was there.
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We're still focused a lot on
critical infrastructure.
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Of course, that was December.
That was right after it
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happened.
Yep.
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So Maggie, you were, you're a
senior analyst for preparedness
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here at ASTO.
How have your experiences doing
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this kind of volunteer response
work, How is that impacted or
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influenced or or colored your
thinking about your job?
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Yeah, I think for me, continuing
to take the opportunities to
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deploy to the field immediately
post disaster really helps
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continue to ground my
understanding in the the
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continuing evolving needs of
communities post disaster and
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jurisdictions post disaster.
You know, this deployment in
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particular really reinforced how
essential public health
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leadership and coordination are
during disasters.
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And you know, from my ass aside,
my experience working with
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health departments and
surveillance systems and
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emergency preparedness
frameworks really translated
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well into the field.
I was able to go into some of
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these coordination rooms and
have informed conversations
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about how to navigate the needs
of the health sector and how to
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support long term health care
delivery beyond like let's just
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get physicians into the country
phase.
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And then at the same time, I
think being embedded in the
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response really highlighted some
of the real world challenges
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that jurisdictions face after
disasters.
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Things like how do you make
decisions with limited data?
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How do you handle, you know, not
only increased healthcare needs,
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but infrastructure damage,
workforce strains, rapidly
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evolving needs.
And, and for me, that field
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00:12:58,440 --> 00:13:02,120
perspective directly informs my
work at ASTO and helps me ensure
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00:13:02,120 --> 00:13:06,120
that our support to States and
territories is practical and
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flexible and, and grounded in
the response realities.
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You and you've got this first
hand experience of being in, in
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00:13:12,880 --> 00:13:15,640
emergency zones and, you know,
places that have just
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experienced disasters.
And so you do have that, that
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00:13:19,720 --> 00:13:23,120
experience of this is what you
need to be prepared for in
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certain situations.
And of course you can bring that
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00:13:26,600 --> 00:13:29,920
experience and that knowledge to
jurisdictions who maybe haven't
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00:13:29,920 --> 00:13:32,080
thought through everything that
might actually happen.
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00:13:32,640 --> 00:13:34,400
Yeah, absolutely.
And I think, you know, one of
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00:13:34,400 --> 00:13:38,080
the things in particular for me
as a, you know, I have a little
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00:13:38,080 --> 00:13:40,320
bit of an epidemiology
background as well that, you
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00:13:40,320 --> 00:13:44,960
know, so was highlighted is this
importance of data and data
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00:13:44,960 --> 00:13:47,920
infrastructure being set up in
in the preparedness side as
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00:13:47,920 --> 00:13:50,320
opposed to trying to set it up
mid disaster.
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I think it's, you know, we all
of us use numbers now to make
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decisions and when you don't
have them it can be really
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00:13:56,960 --> 00:13:59,800
challenging.
And so for me was such a key
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00:13:59,800 --> 00:14:03,240
take away was thinking about how
do we work with jurisdictions to
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00:14:03,240 --> 00:14:05,960
make sure that they have the
information they need before the
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00:14:05,960 --> 00:14:08,600
disaster hits.
So that way when it does that
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00:14:08,600 --> 00:14:12,640
information flow is still there.
Has your work with ASTO
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00:14:13,080 --> 00:14:16,160
influenced your work with Team
Rubicon?
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00:14:17,120 --> 00:14:21,480
Yeah, absolutely.
I mean, I think in thinking
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00:14:21,480 --> 00:14:25,320
about the work that I do at Asso
in terms of supporting
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00:14:25,320 --> 00:14:27,920
jurisdictions in their own
preparedness frameworks,
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00:14:28,560 --> 00:14:32,080
understanding their surveillance
needs, the things that they
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00:14:32,080 --> 00:14:36,320
think about in terms of surge
capacity, especially in this
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00:14:36,320 --> 00:14:40,240
deployment, really supported my
ability to go into some of these
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00:14:40,240 --> 00:14:42,760
rooms and have these
conversations and think about
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00:14:42,760 --> 00:14:46,280
the ways in which, you know, an
organization like Team Rubicon
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00:14:46,280 --> 00:14:49,920
that is a volunteer based
organization can support surge
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00:14:49,920 --> 00:14:52,640
capacity, can support data
collection.
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00:14:53,400 --> 00:14:56,000
Because I've had some of those
conversations with jurisdictions
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00:14:56,000 --> 00:14:59,280
before about, you know, through
ASTO, about how they're using
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00:14:59,600 --> 00:15:02,760
volunteer organizations and NGOs
to support those needs.
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00:15:03,320 --> 00:15:07,760
And so you've been with the
organization for 10 years now.
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00:15:08,640 --> 00:15:10,840
Are you planning any more
deployments?
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00:15:10,840 --> 00:15:13,160
I suppose it probably depends on
the state of the world.
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00:15:13,520 --> 00:15:19,680
Yeah, I think, I think in my
experience, we're the disaster
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00:15:19,680 --> 00:15:23,240
cycle has changed a little bit.
We used to have really specific
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00:15:23,240 --> 00:15:27,400
seasons and I think we're sort
of in this constantly evolving
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00:15:27,480 --> 00:15:30,240
train of, of natural disasters
now.
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00:15:31,520 --> 00:15:34,120
So while it does depend on, you
know, what strikes and what the
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00:15:34,120 --> 00:15:38,840
needs are, I do plan to continue
to stay supporting Team Rubicon.
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00:15:38,840 --> 00:15:41,920
I think it's been a really
unique opportunity for me to
273
00:15:41,920 --> 00:15:45,080
connect, you know, so many
different aspects of my, my
274
00:15:45,080 --> 00:15:48,920
passions and, and work.
And really, you know, over the
275
00:15:48,920 --> 00:15:51,760
years, volunteering has allowed
me to connect public health with
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00:15:51,760 --> 00:15:55,640
disaster response and even bring
in some new skills like running
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00:15:55,640 --> 00:15:58,320
chainsaws.
And it just really continues to
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00:15:58,320 --> 00:16:00,400
strengthen my skill set and my
perspective.
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00:16:00,400 --> 00:16:03,280
And I always appreciate the
opportunity to give back to
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00:16:03,280 --> 00:16:07,840
these communities.
Maggie Nils is a senior analyst
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00:16:07,840 --> 00:16:09,720
of preparedness at ASTO and a
member.
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00:16:09,720 --> 00:16:12,440
Of Team Rubicon.
A veteran LED humanitarian
283
00:16:12,440 --> 00:16:15,240
organization.
Earlier, we heard from Shalini
284
00:16:15,240 --> 00:16:17,400
Nair, a senior analyst of
Infectious.
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00:16:17,400 --> 00:16:23,800
Disease at asto.
A new Essentials of Leadership
286
00:16:23,800 --> 00:16:27,080
and Management series titled
Leadership Power Hour, Your
287
00:16:27,080 --> 00:16:30,400
Launchpad for Impact equips
public health leaders with
288
00:16:30,400 --> 00:16:33,800
strategic insights and tools
needed to lead with confidence
289
00:16:33,800 --> 00:16:37,200
and drive meaningful change.
Over the course of five
290
00:16:37,200 --> 00:16:39,720
sessions, these insightful.
One hour programs.
291
00:16:39,720 --> 00:16:42,520
Explore key leadership
competencies essential for
292
00:16:42,520 --> 00:16:46,120
driving organizational success.
The leadership Power Hour
293
00:16:46,120 --> 00:16:48,640
prepares supervisors and
managers to become more
294
00:16:48,640 --> 00:16:51,160
effective in their roles within
governmental public health
295
00:16:51,160 --> 00:16:53,880
agencies.
The power hours are designed to
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00:16:53,880 --> 00:16:55,560
improve professional skills as
a.
297
00:16:55,560 --> 00:16:58,720
Leader and include.
Live facilitated online
298
00:16:58,720 --> 00:17:01,800
training, opportunities to
collaborate with peers, and
299
00:17:01,800 --> 00:17:05,880
access to in depth self-paced
learning for more details.
300
00:17:05,880 --> 00:17:08,119
Or to register.
Check out the link in the show.
301
00:17:08,119 --> 00:17:13,319
Notes Leading Change is a new
ASTO workshop designed for
302
00:17:13,319 --> 00:17:15,599
professionals and clinical and
non clinical.
303
00:17:15,599 --> 00:17:18,160
Public health roles the workshop
equips.
304
00:17:18,160 --> 00:17:21,440
Participants with strategies and
skills to navigate change and
305
00:17:21,440 --> 00:17:25,200
uncertainty as individuals, team
members, and organization wide
306
00:17:25,200 --> 00:17:29,040
leaders emphasizing actionable
instruction and resources it
307
00:17:29,040 --> 00:17:31,080
enables.
Leaders to create and implement.
308
00:17:31,080 --> 00:17:35,120
Real world initiatives in their
agencies for 2026 and beyond.
309
00:17:35,920 --> 00:17:39,320
Participants will gain tools to
design targeted initiatives and
310
00:17:39,320 --> 00:17:41,640
foster tangible organizational
change.
311
00:17:42,280 --> 00:17:45,240
This experience prepares them to
drive meaningful impact in their
312
00:17:45,240 --> 00:17:47,600
workplaces.
Find more at the link in the
313
00:17:47,600 --> 00:17:50,920
show notes.
This has been public health.
314
00:17:50,920 --> 00:17:54,040
Review Morning Edition I'm John
Sheehan for the Association of
315
00:17:54,040 --> 00:17:56,040
State and.
Territorial health officials.
00:00:00,640 --> 00:00:03,000
This is public Health review.
Morning Edition for Wednesday,
2
00:00:03,000 --> 00:00:06,640
February 18th, 2026.
I'm John Sheehan with news from
3
00:00:06,640 --> 00:00:07,920
the.
Association of State.
4
00:00:07,920 --> 00:00:10,680
And territorial health.
Officials today.
5
00:00:10,680 --> 00:00:13,560
We'll hear about infection
prevention in dialysis clinics
6
00:00:13,840 --> 00:00:15,800
and hurricane response in the
Caribbean.
7
00:00:16,440 --> 00:00:18,200
Our first guest.
Shalini Nair.
8
00:00:18,440 --> 00:00:20,240
A senior analyst of infectious
disease.
9
00:00:20,240 --> 00:00:23,000
At asto breaks.
Down the growing concern around
10
00:00:23,000 --> 00:00:27,240
dialysis related infections and
what the CD CS making dialysis
11
00:00:27,240 --> 00:00:30,480
safer for patients coalition is
doing to address it.
12
00:00:31,280 --> 00:00:33,680
Later, Maggie.
Nails, a senior analyst of
13
00:00:33,680 --> 00:00:37,200
preparedness at ASTO, explains
her involvement with TEAM.
14
00:00:37,200 --> 00:00:39,680
Rubicon A.
Veteran LED humanitarian
15
00:00:39,680 --> 00:00:43,560
organization Nils reflects on
her decade of deployments from
16
00:00:43,560 --> 00:00:47,080
chainsaw operations in US
disaster zones to coordinating
17
00:00:47,080 --> 00:00:49,960
international health response in
Jamaica after a devastating
18
00:00:49,960 --> 00:00:52,560
hurricane.
But let's start with Shalini
19
00:00:52,560 --> 00:00:54,480
Nair.
We wanted to know more about
20
00:00:54,480 --> 00:00:57,280
dialysis related infections and
prevention efforts.
21
00:00:58,240 --> 00:01:01,720
So when we think about dialysis
related infections, we're
22
00:01:01,720 --> 00:01:06,760
referring to infections that
occur as a result of lapses and
23
00:01:06,760 --> 00:01:10,600
infection control when it comes
to the delivery of dialysis via
24
00:01:10,600 --> 00:01:14,880
ports and other equipment.
So staph infection control is
25
00:01:14,960 --> 00:01:18,240
very important when it comes to
protecting patients from
26
00:01:18,320 --> 00:01:20,760
potentially life threatening
infections like these.
27
00:01:21,560 --> 00:01:23,840
Got you.
And it's become such a problem
28
00:01:23,840 --> 00:01:28,480
that the CDC set up this this
coalition to sort of address
29
00:01:28,800 --> 00:01:31,920
address the issue, taking
feedback from from all kinds of
30
00:01:31,920 --> 00:01:38,840
participants what what was one
of the most actionable infection
31
00:01:38,840 --> 00:01:41,520
prevention takeaways.
Yeah.
32
00:01:41,520 --> 00:01:45,600
So a standout take away that we
heard from our participants was
33
00:01:45,600 --> 00:01:49,120
that fostering a culture of
safety that's focused around a
34
00:01:49,120 --> 00:01:53,560
see it, say it approach where
staff and patients are all
35
00:01:53,560 --> 00:01:57,320
encouraged to speak up about
infection risks in real time.
36
00:01:57,880 --> 00:02:01,120
This approach really strengthens
shared accountability.
37
00:02:01,360 --> 00:02:05,600
It supports earlier risk
identification, and it also just
38
00:02:05,600 --> 00:02:08,800
helps normalize infection
prevention as something that's
39
00:02:08,800 --> 00:02:12,680
everybody's responsibility,
which makes it a powerful lever
40
00:02:12,680 --> 00:02:15,280
for having that sustained
improvement.
41
00:02:15,640 --> 00:02:18,240
And health departments can help
reinforce that through things
42
00:02:18,240 --> 00:02:22,160
like technical assistance or
just recognizing facilities that
43
00:02:22,160 --> 00:02:26,320
do this well.
Another piece of feedback was
44
00:02:26,320 --> 00:02:29,360
staff training.
Were there were there techniques
45
00:02:29,360 --> 00:02:32,600
or training specifically that
were that were more effective?
46
00:02:33,080 --> 00:02:34,560
Yeah.
So our frontline staff
47
00:02:34,680 --> 00:02:39,800
emphasized that short,
interactive and role specific
48
00:02:39,800 --> 00:02:42,600
training formats.
So things like simulation
49
00:02:42,600 --> 00:02:46,480
trainings or really just taking
advantage of real time teaching
50
00:02:46,480 --> 00:02:50,560
moments are most effective,
especially in busy dialysis
51
00:02:50,560 --> 00:02:53,880
environments.
Staff also said that they really
52
00:02:53,880 --> 00:02:58,320
value feedback that's
constructive, non punitive and
53
00:02:58,320 --> 00:03:02,000
non disruptive to patient care,
so delivering it through
54
00:03:02,000 --> 00:03:06,880
approaches like audits, huddles
or unscheduled observation
55
00:03:06,880 --> 00:03:11,480
visits that focus more on
reinforcing positive practices
56
00:03:11,760 --> 00:03:16,040
rather than punishing mistakes.
And the third big take away was
57
00:03:16,040 --> 00:03:18,920
leadership support.
What does that refer to exactly?
58
00:03:19,280 --> 00:03:20,480
Yeah.
So when we're talking about
59
00:03:20,480 --> 00:03:24,200
leadership support, we're
talking about leaders who are
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00:03:24,480 --> 00:03:29,920
present and involved in creating
that culture of safety and
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00:03:29,920 --> 00:03:32,920
health departments can help
support facility leadership in
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00:03:32,920 --> 00:03:37,400
doing that by sharing best
practices, offering leadership
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00:03:37,400 --> 00:03:41,280
focused training resources and
promoting accountability
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00:03:41,280 --> 00:03:44,320
frameworks that prioritize
infection prevention.
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00:03:44,720 --> 00:03:48,280
So providing guidance on
allocating time and resources
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00:03:48,280 --> 00:03:53,400
for staff education, recognizing
frontline contributions, and
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00:03:53,400 --> 00:03:57,800
training managers, especially on
repeated lapses in infection
68
00:03:57,800 --> 00:04:01,840
control, can help cultivate
leaders that model safe
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00:04:01,840 --> 00:04:05,040
practices and help sustain that
culture of safety.
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00:04:05,680 --> 00:04:09,240
And so for health departments
that aren't part of this
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00:04:09,240 --> 00:04:12,720
coalition or aren't part of the
CDC's group, how can they take
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00:04:12,720 --> 00:04:15,640
steps to either joining it or
learning more?
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00:04:16,079 --> 00:04:19,360
We would recommend that they
check out the CD CS website for
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00:04:19,360 --> 00:04:23,200
the Making Dialysis Safer for
Patients coalition and there's
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00:04:23,200 --> 00:04:25,480
more information there on how to
join.
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00:04:25,560 --> 00:04:29,520
But the coalition overall offers
health departments a really
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00:04:29,520 --> 00:04:33,160
collaborative platform where
they can access evidence based
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00:04:33,160 --> 00:04:37,280
tools, training resources, as
well as engage in peer learning
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00:04:37,280 --> 00:04:40,680
opportunities that are focused
on dialysis safety.
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00:04:41,120 --> 00:04:43,920
It allows them to stay current
on infection prevention
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00:04:43,920 --> 00:04:48,160
strategies, learn directly from
frontline experiences, and also
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00:04:48,160 --> 00:04:51,360
strengthen the health department
partnerships with dialysis
83
00:04:51,360 --> 00:04:55,280
facilities.
So overall, joining the MD's
84
00:04:55,280 --> 00:04:59,960
coalition supports a more
informed and impactful action to
85
00:04:59,960 --> 00:05:05,760
improve patient safety.
Shalini Nair is a senior analyst
86
00:05:05,760 --> 00:05:07,480
of Infectious.
Disease at asto.
87
00:05:08,280 --> 00:05:11,080
Now let's hear from Maggie Nils,
a senior analyst of
88
00:05:11,080 --> 00:05:12,320
preparedness.
At ASTO.
89
00:05:12,560 --> 00:05:14,320
And a member of team.
Rubicon A.
90
00:05:14,360 --> 00:05:16,520
Veteran LED humanitarian
organization.
91
00:05:17,920 --> 00:05:21,080
Team Rubicon is a veteran LED
humanitarian response
92
00:05:21,080 --> 00:05:25,440
organization that responds to
disasters leveraging the skills
93
00:05:25,440 --> 00:05:28,120
of military veterans and
civilian volunteers.
94
00:05:28,440 --> 00:05:32,640
They actually started after the
2010 Haiti earthquake with a
95
00:05:32,640 --> 00:05:36,160
group, a very small group of six
that deployed over there,
96
00:05:36,360 --> 00:05:40,280
including veterans, paramedics,
EMT's and physicians to provide
97
00:05:40,280 --> 00:05:44,600
care to the people of Haiti.
And these days they focus on
98
00:05:44,600 --> 00:05:48,000
everything from immediate
response, things like debris
99
00:05:48,000 --> 00:05:52,040
removal, emergency logistics,
chainsaw operations, home
100
00:05:52,040 --> 00:05:58,000
repairs, to long term recovery,
including things like long term
101
00:05:58,000 --> 00:06:00,880
sustainable home repairs and
rebuilding of homes and
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00:06:00,880 --> 00:06:03,080
communities.
And this includes actually
103
00:06:03,080 --> 00:06:04,800
international deployments as
well.
104
00:06:04,800 --> 00:06:08,280
Team Rubicon has a World Health
Organization certified emergency
105
00:06:08,280 --> 00:06:12,000
medical team that'll deploy to
public health emergencies.
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00:06:12,720 --> 00:06:15,760
It's amazing.
It's such a heartening story of
107
00:06:15,760 --> 00:06:19,520
an organization of groups of
veterans just saying, like, we
108
00:06:19,520 --> 00:06:21,800
know how to do this stuff.
Let's just get out there and do
109
00:06:21,800 --> 00:06:23,320
it.
Yeah, absolutely.
110
00:06:23,320 --> 00:06:27,440
I think the flexibility and the
capacity of, you know, veteran
111
00:06:27,440 --> 00:06:30,760
and 1st responder volunteers to
come together and move quickly
112
00:06:30,760 --> 00:06:33,040
and efficiently has been an
incredible asset to the
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00:06:33,040 --> 00:06:35,880
organization.
And so tell us a little bit
114
00:06:35,880 --> 00:06:38,520
about your experience with it.
How long have you been part of
115
00:06:38,520 --> 00:06:40,800
Team Rubicon?
Yeah, So I started volunteering
116
00:06:40,800 --> 00:06:43,040
with Team Rubicon about 10 years
ago.
117
00:06:43,840 --> 00:06:47,040
I was right out of college.
I had been working as an EMT in
118
00:06:47,040 --> 00:06:51,080
rural upstate New York for all
four years of my undergrad and
119
00:06:51,080 --> 00:06:54,920
really found myself missing the
first responder life and
120
00:06:54,920 --> 00:06:58,280
camaraderie and community.
And a friend pointed me towards
121
00:06:58,280 --> 00:07:01,760
Team Rubicon and my first
deployment was to a very, very
122
00:07:01,760 --> 00:07:05,160
small town responding to a
tornado in rural Missouri.
123
00:07:05,560 --> 00:07:08,440
And I just, you know,
immediately was, was sucked in
124
00:07:08,440 --> 00:07:11,480
by the partnership and, and
community within this group and
125
00:07:11,680 --> 00:07:14,240
the ability to use the skills I
had to give back.
126
00:07:14,240 --> 00:07:17,960
And over my time, I've served in
a lot of different capacities.
127
00:07:17,960 --> 00:07:21,560
I've worked as a chainsaw
operator and a chainsaw
128
00:07:21,560 --> 00:07:24,640
instructor as well.
I now help support the chainsaw
129
00:07:24,640 --> 00:07:27,800
instructor, train the trainer
curriculum for the organization,
130
00:07:28,480 --> 00:07:32,080
and then I've supported through
command staff roles and even did
131
00:07:32,080 --> 00:07:35,120
some epidemiology and public
health work through their COVID
132
00:07:35,120 --> 00:07:40,560
response efforts as well.
And Maggie, most recently, you
133
00:07:40,760 --> 00:07:45,840
were sent to help out in Jamaica
in the wake of Hurricane
134
00:07:45,840 --> 00:07:47,960
Melissa.
Yes, Yeah.
135
00:07:47,960 --> 00:07:56,040
So I was down there the first
week or so of December, and for
136
00:07:56,040 --> 00:07:58,600
them I was serving as a liaison
officer, which is a little bit
137
00:07:58,600 --> 00:08:02,320
of a newer role for me.
Normally I am out in the field
138
00:08:02,320 --> 00:08:04,560
running a chainsaw or teaching
other people how to run a
139
00:08:04,560 --> 00:08:10,200
chainsaw, but my role in Jamaica
was to focus on health and
140
00:08:10,200 --> 00:08:14,120
interagency coordination.
So I was embedded in meetings
141
00:08:14,120 --> 00:08:17,200
with the Government of Jamaica,
their Ministry of Health and
142
00:08:17,200 --> 00:08:20,920
Wellness, the Pan American
Health Organization, and several
143
00:08:20,920 --> 00:08:25,800
UN coordinating bodies to
connect with and partner with
144
00:08:25,840 --> 00:08:30,400
other organizations in the
health, sheltering and logistics
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00:08:30,400 --> 00:08:33,000
sectors.
And my job was to help ensure
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that Team Rubicon's operational
work and specifically their
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emergency medical team was
aligned with jurisdictional
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priorities.
So making sure that our team
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that was there with a field
hospital was coordinated with
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the larger Ministry of Health
and their goals and objectives.
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And I'm doing a lot of work like
making sure that they had the
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right resources that they
needed.
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Ensuring that our physicians and
nurses coming into the country
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had the right licensure and
approval to come in, that we
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were able to bring in
pharmaceuticals so that that
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field hospital could do the work
that it needed to do.
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So all of the the connecting and
contacting and conversations
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that happen to make sure that
teams in the field can be as
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effective as possible.
My gosh, yeah.
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You forget that, you know, even
though an area is devastated,
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like parts of Jamaica were the
response effort, you know,
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especially when that size has to
be really strictly managed.
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Yeah, absolutely.
And I think especially in a case
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like this where it was, you
know, the strongest hurricane
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that, you know, the island has
seen.
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And we're looking at, I think
nearly every hospital except for
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one had significant or or
devastating damage to it.
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And in addition to, you know,
injuries and health and Wellness
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issues that people have post
disaster, you know, these field
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hospitals are also dealing with
day-to-day continuity of care.
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You know, people still have kids
and deal with diabetes and, you
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know, all of the other things
that we deal with on a
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day-to-day life that require
healthcare.
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And so that coordination piece
is so key to making sure that
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all these volunteers coming in
or working together and working
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with the government for what
they need.
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Wow.
What other kinds of needs did
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you see in, in Jamaica?
What, what were some of the big
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rebuilding efforts?
You know, I think a lot was
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focused on while I was there
getting, you know, key critical
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infrastructure pieces up so that
people could start to focus on
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their home life as well.
So things like, you know, making
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sure that hospitals are up and
back online so that people can
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get day-to-day care, getting
schools back up on online.
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You know, families with children
are having to stay at home to
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provide childcare if the schools
aren't open.
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And so if we can get the schools
open, then, you know, parents
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and older parts of the family
unit can focus more on
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rebuilding their home or going
back to work and kind of getting
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the economy back up on its feet.
There was still a lot of work
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being done in terms of like
route clearance and road
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clearance, especially in the the
more mountainous regions on the
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inner, inner parts of the
islands.
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Getting into some of those towns
was still really challenging.
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You know, I think the recovery
efforts have come a long way
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since I was there.
But, yeah, well, I was there.
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We're still focused a lot on
critical infrastructure.
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Of course, that was December.
That was right after it
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happened.
Yep.
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So Maggie, you were, you're a
senior analyst for preparedness
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here at ASTO.
How have your experiences doing
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this kind of volunteer response
work, How is that impacted or
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influenced or or colored your
thinking about your job?
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00:11:41,840 --> 00:11:46,000
Yeah, I think for me, continuing
to take the opportunities to
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deploy to the field immediately
post disaster really helps
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00:11:49,760 --> 00:11:54,880
continue to ground my
understanding in the the
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00:11:54,880 --> 00:11:58,080
continuing evolving needs of
communities post disaster and
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jurisdictions post disaster.
You know, this deployment in
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00:12:01,120 --> 00:12:04,640
particular really reinforced how
essential public health
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leadership and coordination are
during disasters.
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And you know, from my ass aside,
my experience working with
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00:12:11,440 --> 00:12:13,640
health departments and
surveillance systems and
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00:12:13,640 --> 00:12:16,440
emergency preparedness
frameworks really translated
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well into the field.
I was able to go into some of
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these coordination rooms and
have informed conversations
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00:12:23,960 --> 00:12:27,920
about how to navigate the needs
of the health sector and how to
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00:12:27,920 --> 00:12:31,960
support long term health care
delivery beyond like let's just
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get physicians into the country
phase.
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00:12:34,720 --> 00:12:37,280
And then at the same time, I
think being embedded in the
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00:12:37,280 --> 00:12:40,200
response really highlighted some
of the real world challenges
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that jurisdictions face after
disasters.
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00:12:42,880 --> 00:12:46,880
Things like how do you make
decisions with limited data?
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How do you handle, you know, not
only increased healthcare needs,
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but infrastructure damage,
workforce strains, rapidly
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evolving needs.
And, and for me, that field
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perspective directly informs my
work at ASTO and helps me ensure
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00:13:02,120 --> 00:13:06,120
that our support to States and
territories is practical and
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00:13:06,120 --> 00:13:09,120
flexible and, and grounded in
the response realities.
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00:13:09,320 --> 00:13:12,880
You and you've got this first
hand experience of being in, in
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emergency zones and, you know,
places that have just
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experienced disasters.
And so you do have that, that
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experience of this is what you
need to be prepared for in
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certain situations.
And of course you can bring that
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00:13:26,600 --> 00:13:29,920
experience and that knowledge to
jurisdictions who maybe haven't
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00:13:29,920 --> 00:13:32,080
thought through everything that
might actually happen.
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00:13:32,640 --> 00:13:34,400
Yeah, absolutely.
And I think, you know, one of
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00:13:34,400 --> 00:13:38,080
the things in particular for me
as a, you know, I have a little
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00:13:38,080 --> 00:13:40,320
bit of an epidemiology
background as well that, you
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00:13:40,320 --> 00:13:44,960
know, so was highlighted is this
importance of data and data
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00:13:44,960 --> 00:13:47,920
infrastructure being set up in
in the preparedness side as
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00:13:47,920 --> 00:13:50,320
opposed to trying to set it up
mid disaster.
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00:13:50,320 --> 00:13:53,920
I think it's, you know, we all
of us use numbers now to make
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00:13:53,920 --> 00:13:56,960
decisions and when you don't
have them it can be really
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00:13:56,960 --> 00:13:59,800
challenging.
And so for me was such a key
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00:13:59,800 --> 00:14:03,240
take away was thinking about how
do we work with jurisdictions to
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00:14:03,240 --> 00:14:05,960
make sure that they have the
information they need before the
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00:14:05,960 --> 00:14:08,600
disaster hits.
So that way when it does that
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00:14:08,600 --> 00:14:12,640
information flow is still there.
Has your work with ASTO
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00:14:13,080 --> 00:14:16,160
influenced your work with Team
Rubicon?
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00:14:17,120 --> 00:14:21,480
Yeah, absolutely.
I mean, I think in thinking
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00:14:21,480 --> 00:14:25,320
about the work that I do at Asso
in terms of supporting
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00:14:25,320 --> 00:14:27,920
jurisdictions in their own
preparedness frameworks,
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00:14:28,560 --> 00:14:32,080
understanding their surveillance
needs, the things that they
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00:14:32,080 --> 00:14:36,320
think about in terms of surge
capacity, especially in this
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00:14:36,320 --> 00:14:40,240
deployment, really supported my
ability to go into some of these
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00:14:40,240 --> 00:14:42,760
rooms and have these
conversations and think about
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00:14:42,760 --> 00:14:46,280
the ways in which, you know, an
organization like Team Rubicon
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00:14:46,280 --> 00:14:49,920
that is a volunteer based
organization can support surge
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00:14:49,920 --> 00:14:52,640
capacity, can support data
collection.
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00:14:53,400 --> 00:14:56,000
Because I've had some of those
conversations with jurisdictions
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00:14:56,000 --> 00:14:59,280
before about, you know, through
ASTO, about how they're using
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00:14:59,600 --> 00:15:02,760
volunteer organizations and NGOs
to support those needs.
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00:15:03,320 --> 00:15:07,760
And so you've been with the
organization for 10 years now.
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00:15:08,640 --> 00:15:10,840
Are you planning any more
deployments?
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00:15:10,840 --> 00:15:13,160
I suppose it probably depends on
the state of the world.
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00:15:13,520 --> 00:15:19,680
Yeah, I think, I think in my
experience, we're the disaster
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00:15:19,680 --> 00:15:23,240
cycle has changed a little bit.
We used to have really specific
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00:15:23,240 --> 00:15:27,400
seasons and I think we're sort
of in this constantly evolving
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00:15:27,480 --> 00:15:30,240
train of, of natural disasters
now.
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00:15:31,520 --> 00:15:34,120
So while it does depend on, you
know, what strikes and what the
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00:15:34,120 --> 00:15:38,840
needs are, I do plan to continue
to stay supporting Team Rubicon.
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00:15:38,840 --> 00:15:41,920
I think it's been a really
unique opportunity for me to
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00:15:41,920 --> 00:15:45,080
connect, you know, so many
different aspects of my, my
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00:15:45,080 --> 00:15:48,920
passions and, and work.
And really, you know, over the
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00:15:48,920 --> 00:15:51,760
years, volunteering has allowed
me to connect public health with
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00:15:51,760 --> 00:15:55,640
disaster response and even bring
in some new skills like running
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00:15:55,640 --> 00:15:58,320
chainsaws.
And it just really continues to
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00:15:58,320 --> 00:16:00,400
strengthen my skill set and my
perspective.
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00:16:00,400 --> 00:16:03,280
And I always appreciate the
opportunity to give back to
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00:16:03,280 --> 00:16:07,840
these communities.
Maggie Nils is a senior analyst
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00:16:07,840 --> 00:16:09,720
of preparedness at ASTO and a
member.
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00:16:09,720 --> 00:16:12,440
Of Team Rubicon.
A veteran LED humanitarian
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00:16:12,440 --> 00:16:15,240
organization.
Earlier, we heard from Shalini
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00:16:15,240 --> 00:16:17,400
Nair, a senior analyst of
Infectious.
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00:16:17,400 --> 00:16:23,800
Disease at asto.
A new Essentials of Leadership
286
00:16:23,800 --> 00:16:27,080
and Management series titled
Leadership Power Hour, Your
287
00:16:27,080 --> 00:16:30,400
Launchpad for Impact equips
public health leaders with
288
00:16:30,400 --> 00:16:33,800
strategic insights and tools
needed to lead with confidence
289
00:16:33,800 --> 00:16:37,200
and drive meaningful change.
Over the course of five
290
00:16:37,200 --> 00:16:39,720
sessions, these insightful.
One hour programs.
291
00:16:39,720 --> 00:16:42,520
Explore key leadership
competencies essential for
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driving organizational success.
The leadership Power Hour
293
00:16:46,120 --> 00:16:48,640
prepares supervisors and
managers to become more
294
00:16:48,640 --> 00:16:51,160
effective in their roles within
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295
00:16:51,160 --> 00:16:53,880
agencies.
The power hours are designed to
296
00:16:53,880 --> 00:16:55,560
improve professional skills as
a.
297
00:16:55,560 --> 00:16:58,720
Leader and include.
Live facilitated online
298
00:16:58,720 --> 00:17:01,800
training, opportunities to
collaborate with peers, and
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learning for more details.
300
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Or to register.
Check out the link in the show.
301
00:17:08,119 --> 00:17:13,319
Notes Leading Change is a new
ASTO workshop designed for
302
00:17:13,319 --> 00:17:15,599
professionals and clinical and
non clinical.
303
00:17:15,599 --> 00:17:18,160
Public health roles the workshop
equips.
304
00:17:18,160 --> 00:17:21,440
Participants with strategies and
skills to navigate change and
305
00:17:21,440 --> 00:17:25,200
uncertainty as individuals, team
members, and organization wide
306
00:17:25,200 --> 00:17:29,040
leaders emphasizing actionable
instruction and resources it
307
00:17:29,040 --> 00:17:31,080
enables.
Leaders to create and implement.
308
00:17:31,080 --> 00:17:35,120
Real world initiatives in their
agencies for 2026 and beyond.
309
00:17:35,920 --> 00:17:39,320
Participants will gain tools to
design targeted initiatives and
310
00:17:39,320 --> 00:17:41,640
foster tangible organizational
change.
311
00:17:42,280 --> 00:17:45,240
This experience prepares them to
drive meaningful impact in their
312
00:17:45,240 --> 00:17:47,600
workplaces.
Find more at the link in the
313
00:17:47,600 --> 00:17:50,920
show notes.
This has been public health.
314
00:17:50,920 --> 00:17:54,040
Review Morning Edition I'm John
Sheehan for the Association of
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00:17:54,040 --> 00:17:56,040
State and.
Territorial health officials.
