Equipping residential aged care facilities for acute respiratory illness: The Western Sydney experience of improving outbreak management.

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Acute respiratory illnesses have a disproportionate impact on older people, and especially those living in residential aged care facilities where transmission risks are heightened. Additionally, staff in these facilities have been working under challenging conditions, often ill-equipped in terms of both training and resources to successfully manage the outbreaks of these illnesses. This paper examines the actions of an Australian public health unit to improve influenza outbreak management in residential aged care facilities and critiques the outcomes through a contemporary lens. A naturalistic case study using critical thematic analysis was used to study the Western Sydney Public Health Unit's work with the residential aged care facilities under their jurisdiction in the management of influenza outbreaks during 2014-2019. Key to the Public Health Unit's approach to improving outbreak management in residential aged care facilities was their sustained engagement with aged care stakeholders, activities to build outbreak management capacity in this setting, and an investment in research to inform ongoing action. This engagement was mutually beneficial, as the Public Health Unit and residential aged care facilities became more attuned to each other's needs and challenges. Supporting facility staff in difficult situations resulted in a timelier public health response and improved outbreak management. In Australia, Public Health Units are important partners in the cumulative development of outbreak management capacity and responsiveness in the residential aged care setting; particularly considering the challenges posed by novel pathogens and in establishing an evidence base for best practice and future preparedness.