Preventing Institutional Knowledge Loss at Health Department Viral Hepatitis Programs

The stressors of the COVID-19 pandemic, combined with the turbulent funding landscape and federal priority shifts in public health have created a wave of uncertainty amongst our public health jurisdictions. A 2023 Government Accountability Office (GAO) gap analysis and needs assessment found that most jurisdictions reported gaps in staffing and high turnover due to lengthy hiring processes and low salary offerings, funding, and a lack of qualified applicants. In addition, jurisdictions experience a high turnover rate likely because of high workload, burnout and jurisdictional processes that limit job growth. A study from Harvard T/H/ Chan School of Public Health indicated that between 2017 and 2021 nearly half of public health staff separated from their positions, and a 2024 study from University of Minnesota School of Public Health indicated that approximately 31% of the public health workforce reported considering leaving their positions at some time in the future. With each resignation of a public health staff member, jurisdictions run the risk of losing valued institutional and historic knowledge from seasoned public health leaders. 

Much of the current public health workforce is new to the field as noted in the 2024 Public Health Workforce Interests and Needs Survey (PHWINS), but still experiencing burnout (70% surveyed were experiencing at least one symptom of burnout). Additionally, viral hepatitis programs in health departments are increasing their capacity and having to rapidly onboard new staff. These findings indicate a newer public health workforce, as well as the growing need for comprehensive training as more seasoned public health staff and leaders transition from their positions or approach retirement. 

These challenges prompted the development of Institutional Memory Loss tools to help combat historic knowledge loss in the event of retirement, position loss, or job transitioning of individuals who carry comprehensive knowledge of viral hepatitis programs. The document is designed to use in tandem with the Program Tracking Spreadsheet as a complementary instrument to capture programmatic details that are not easily tracked in a spreadsheet. The document provides guided prompts for viral hepatitis leaders to complete that will:

• Aid in the transfer of institutional knowledge;
• Support onboarding of new staff;
• Foster mentorship within existing viral hepatitis programs, and;
• Provide a functional document for leaders to utilize in times of transition within a program.

The structure and nature of this document is at the discretion of the team completing this work.
While specific details like contacts, funding lists, and full-time employees (FTE)s are more easily captured in a spreadsheet tracking environment, we acknowledge that the institutional knowledge that comes with long term leadership can be more nuanced, and potentially less simple to transfer via tracker. The questions and prompts included in this document were informed by feedback provided by former and current viral hepatitis jurisdictional staff, when polled on what they did in their transitions, and what they wish they may have had when entering into new, similar public health positions.

This document is meant to be tailored to each jurisdiction’s needs. Structure and format changes are welcome.  It is important to note that some of these prompts are designed for thoughtful legacy planning, and reflection and are not meant to be included in a jurisdictional document. Please use your discretion as to what should be documented.