A word on the scope of this toolkit

As stated in the introduction section, this toolkit is intended to be used after a healthcare facility or health department has made the decision to conduct a patient notification. Guidance on how to determine if a patient notification is warranted will not be covered in this document. Centers for Disease Control and Prevention (CDC) has developed a qualitative assessment of lapses in infection control to better inform patient notification and testing decisions. This approach relies on collaboration among stakeholders including infection control experts and public health officials to assess the risk a particular infection control lapse or scenario might have posed to patients. Please see the resources below for additional information on factors to consider when determining the need for a patient notification. If additional assistance is needed, please contact CDC at

Resources for Determining the Need for a Patient Notification

Patel PR, Srinivasan A, Perz JF. Developing a broader approach to management of infection control breaches in health care settingsexternal icon. AJIC 2008;36:685-690.

Dudzinski DM, Hébert PC, Foglia MB, Gallagher TH. The Disclosure Dilemma — Large-Scale Adverse Eventsexternal icon. N Engl J Med 2010; 363:978-986.

VHA Handbook 1004.08: Disclosure of Adverse Events to Patients.external icon

Once the decision to notify has been made, it must be determined whether the healthcare facility or the health department will be leading the notification. In a recent study (Schneider et al, J Patient Saf 2013:9;8-12external icon), patients expressed a preference for the notification to come from the healthcare facility. However, this is not always feasible and in certain circumstances it may be preferable for the outreach to come from the health department. These circumstances may include notifications involving smaller facilities that do not have the resources to manage a notification event or notifications involving providers who are not fully cooperative or capable of objectively and effectively managing the process themselves. Regardless of who is leading the notification, both the health department and the healthcare facility should work together to assure consistent messaging and to make the process as easy as possible for affected patients. Included in this toolkit are examples of notification materials that originated from healthcare facilities and health departments.


The CDC would like to acknowledge the thoughtful comments and feedback on toolkit contents that were provided by individuals from the following organizations:

  • APIC – Long Island
  • Association of State and Territorial Health Officials
  • Gastroenterology Consultants
  • HONOReform Foundation
  • Jefferson County Health Department
  • Justin’s Hope
  • Montgomery County Health Department
  • National Association of County and City Health Officials
  • Nevada State Health Division
  • New York City Department of Health and Mental Hygiene
  • New York State Department of Health
  • New York State Nurses Association
  • NYS Chapter of American Congress of Obstetricians and Gynecologists
  • Premier healthcare alliance
  • Pulse, New York
  • Southern Nevada Health District