Building National Partnership for Prevention of emerging and Reemerging Infectious Diseases - The Puerto Rico Department of Health (PRDOH) Division of Epidemiology and Investigation (DEI) is applying for Components 1, 2, and 3 under opportunity CDC-RFA-CK-26-0107 for a five year project to address Puerto Rico's ongoing vulnerability to emerging and re-emerging infectious diseases driven by its geographic location, climate, and exposure to natural disasters such as hurricanes and flooding, which disrupt health services and increase transmission risks. Concurrently, the territory's acute care facilities experience a persistent excess burden of Central Line Associated Bloodstream Infections (CLABSIs). This project establishes a coordinated framework to systematically scale up organizational staffing, close frontline competency gaps, improve administrative systems, and deploy data driven interventions to achieve system wide public health resilience. To address these gaps, Component 1 will focus on strengthening organizational capacity by improving staffing, coordination, and administrative systems, while expanding partnerships with healthcare facilities, clinical laboratories, and federal partners. Component 2 will strengthen the Foodborne and Waterborne Disease Surveillance Program by hiring a Public Health Specialist to expand provider outreach, support workforce development, and enhance quality improvement activities. Planned activities include disseminating disease specific clinical guidance, conducting stakeholder engagement and gap assessments to adapt outbreak tools, providing workforce training, and updating response plans. Component 3 will implement the Puerto Rico Healthcare Resilience and CLABSI Prevention Initiative using the National Healthcare Safety Network (NHSN) Targeted Assessment for Prevention (TAP) Strategy to identify high-burden units and evaluate system level factors. This component will disseminate CDC guidance, establish a learning collaborative, deliver Project Firstline-based training to frontline personnel using a progressive multi year cohort framework, and enhance healthcare preparedness through response protocols and tabletop simulation exercises. Continuous program monitoring and evaluation will be integrated into a structured plan across all activities to ensure quality improvement and accountability. The target population encompasses all residents across Puerto Rico's municipalities and health regions, coordinating interventions across acute care hospitals, reference laboratories, the Puerto Rico Public Health Laboratory (PRPHL), environmental health programs, Federally Qualified Health Centers (FQHCs), and Diagnostic and Treatment Centers (CDTs) island-wide. Expected short term outcomes include improved staffing, coordination, communication, utilization of standardized tools, increased dissemination of guidance, and identification of structural factors affecting performance. Intermediate outcomes include more effective public health programming, stronger partnerships, improved outbreak detection and response, and increased adoption of standardized infection control policies and procedures across participating facilities. Long term outcomes will realize a more resilient public health system with enhanced capacity to detect and respond to infectious disease threats, sustained organizational capacity to maintain activities beyond the project period, and a reduced burden of healthcare-associated and community-associated infections across the territory.
