A heightened sense of urgency influenced flu season planning for 2020-21 across California. This was certainly the case in Los Angeles County – center of the state’s coronavirus surges since spring 2020. The specter of an influenza epidemic appearing on top of a COVID-19 pandemic meant that failure to plan was not an option. Over a span of months, existing connections between Los Angeles area hospital managers and County public health personnel matured into a coordinated approach.

Participants in the L.A. Hospitals Coordinated Flu Effort are unanimous 
that a bigger accomplishment should be recognized. The coordinated flu effort is a model not only for future flu season responses in L.A. County – but for hospital-public agency collaboration in a range of areas. These include future influenza response campaigns in L.A. County and neighboring counties, the critical COVID-19 immunization campaign now unfolding and many more public health campaigns and population health strategies.

The California Hospital Association (CHA), the Hospital Association of Southern California (HASC) and Communities Lifting Communities (CLC) 
have also played important roles in developing communication tools as well as the statewide, “FightFluTogether” public awareness campaign and supporting communications to ensure consistent messaging across participating organizations. 

Components of the Collaborative

Several elements came together in the first part of 2020 to make the Los Angeles-area flu immunization campaign a true collaborative effort. These included the following.

• Los Angeles Department of Public Health received one-time funding for developing communications tools that can be used this year and beyond.
• HASC brought the statewide FightFluTogether.org campaign to
  the collaborative, joined regular teleconferences, made key connections and involved its strategic communications team and CLC community health initiative with the effort.
• Sharing lessons learned and strategies proven to boost participation by groups with traditionally lower immunization rates.
• A community health partnership of West Los Angeles organizations including Cedars-Sinai, Kaiser Permanente, Providence St. Joseph, and UCLA Health reached out to Martin Luther King, Jr. Community Hospital, Adventist Health White Memorial, and L.A. County Department of Public Health to launch a wider, regional collaborative.

Carolyn Buenaflor of Cedars-Sinai recalled some thoughts that accompanied the effort’s launch in April 2020.

“The public health-hospital collaborative was dipping its toes, somewhat hesitantly, into the flu effort,” Buenaflor, associate director, community health improvement at Cedars, recalled. “We needed to focus on specific goals unique to the group and we narrowed it down to three: unified and consistent messaging regarding importance of getting the flu shot, coordinating flu outreach to provide flu vaccines to vulnerable populations, and sharing of best practices and lessons learned as we navigate flu outreach in a pandemic.”

Another important milestone was the integration of L.A. Dept. of Public Health immunization outreach with hospital efforts. The two had long worked separate paths, several participants agreed.

“I think DPH had some assumptions about the way hospitals work,” said Mary Anne Chern, president of Adventist Health White Memorial’s Charitable Foundation. “It’s good for them to participate in problem-solving with the staff who have boots on the ground.”

White Memorial nurses conduct flu shot clinics 
for people experiencing homelessness and have identified practical steps that earn trust, Chern said. 

The seven-plus months the collaborative has met and exchanged ideas has broken down barriers that existed previously, said Aizita Magaña, director of planning and public partnerships for L.A. County Department of Public Health’s Vaccine Preventable Disease Control group.

“Hospitals and County public health are now working together to leverage relationships and not competing,” she said.

Magaña emphasized the effort’s precedent-setting work, calling it “critical and historic.”

“The collaborative has given us a new foundation to engage partners on their current capacity, needs and resources – and this will significantly inform the coming COVID-19 immunization 
effort,” Magaña said. “Having relationships 
and communication through the collaborative with key representatives makes immunization implementation strategies more effective. We hope to learn and share more in the months ahead.”

Lessons Learned

Most gains noted by project collaborators 
derive from better communication. These best practices fall into two categories – more effective communication between project partners, and more strategic, informed messaging for the public.

Examples of important communications lessons learned include the following.