When COVID-19 swept through U.S. emergency departments in 2020, frontline clinicians improvised at a speed the formal evidence infrastructure was not built to match. Some hospitals quickly identified and adopted promising care innovations; others lagged, hampered by poor communication, siloed institutions, and a chaotic information environment where unvetted guidance competed with rigorous science. The result was an uneven national response and a cautionary blueprint for what must change before the next crisis hits.
Now, following a four-year study funded by the National Institute of Allergy and Infectious Diseases (NIAID), researchers at the RAND Corporation have published a six-part series of actionable guides designed to help emergency medicine stakeholders do better. Released in February 2026, the series covers six distinct professional groups, each with a tailored set of strategies to improve the diffusion of clinical care innovations during public health emergencies (PHEs).
What the Guides Recommend
State and Local Public Health Officials
Public health agencies bridge fragmented health systems, translate national guidance into local context, and connect organizations that rarely share information voluntarily. The guide urges officials to establish regular communication touchpoints with peer agencies and local health care systems before a crisis—building the relationships and infrastructure that can be quickly activated when a PHE hits. Cultivating direct relationships with local ED clinicians is equally important, enabling public health agencies to share locally relevant intelligence on patient misconceptions and circulating misinformation that national guidance cannot anticipate.
During a PHE, the guide highlights data-sharing as a distinctive opportunity for state and local agencies. By aggregating care innovation data from local health systems into shared registries or platforms, public health agencies can support real-time learning across organizations that would otherwise be reluctant to report publicly—reducing the legal and reputational risks that typically inhibit transparency and giving frontline clinicians the locally tailored resources they need to navigate a rapidly shifting information environment.
ED and Health System Leaders
Health system leaders set the conditions under which innovations can spread or stall. The guide stresses building communication networks at local, regional, and national levels before a PHE, and designating a dedicated internal team to continuously vet emerging evidence and maintain living clinical guidance that staff can trust. Implementation support materials—order sets, decision trees, protocols, and visual aids—are highlighted as practical tools that lower adoption barriers for frontline clinicians under pressure.
Real-time dashboards tracking patient volumes, staffing, resources, and care quality give both leaders and clinicians the situational awareness needed to anticipate which innovations should be adopted, scaled, or discontinued.
Frontline Clinicians
Frontline clinicians are often the first to encounter new care challenges during a PHE and are among the most trusted sources of information for both patients and peers. The guide emphasizes preparation: building interprofessional information-sharing networks across disciplines and service lines, getting involved in professional governance, and identifying trustworthy digital media sources (including podcasts, blogs, and social media accounts within the FOAMed movement) before a crisis makes rapid vetting difficult.
During a PHE, clinicians are advised to actively engage with peer and leadership communication channels rather than waiting for guidance to reach them, and to track and report outcomes from newly adopted practices to support better organizational decisionmaking.
Influential ED Clinicians on Digital Media
Emergency clinicians with significant followings on podcasts, blogs, and social media played an outsized role in spreading—and sometimes distorting—information during COVID-19. The guide opens with accountability: these clinicians are urged to disclose credentials, affiliations, and conflicts of interest publicly, and to build relationships with professional societies, journals, and other vetted sources so their platforms amplify evidence-based information rather than compete with it.
During a PHE, influential clinicians are well-positioned to share early anecdotal experiences from hard-hit settings, but must clearly communicate uncertainty, local context, and the expectation that guidance will evolve. The guide also calls on them to produce multimedia “how-to” content—demonstrations, step-by-step instructions, and worked examples—that helps peers implement new care practices in ways that written journal articles rarely can, and to create content that equips other clinicians to have constructive, evidence-informed conversations with patients.
Leaders of Professional Societies
Professional societies convene experts, set standards, and reach large clinical audiences across institutional boundaries—making them critical nodes in any innovation diffusion network. The guide calls on society leaders to build a standing coalition across ED-related organizations that meets regularly and can scale up rapidly when a threat emerges. Societies are also encouraged to offer communications training before a PHE, so clinicians are better prepared to explain complex, rapidly changing medical information to patients and the public with clarity and appropriate context.
During a PHE, the guide emphasizes live interactive forums where clinicians can engage directly with experts and peers across disciplines. Societies should maintain “living guidance” documents that are transparently versioned and aligned across organizations wherever possible, and provide clinicians with practical bedside resources—scripts, talking points, and training modules—to support evidence-informed patient conversations in real time.
Journal and Preprint Editors
The scientific publishing system was not designed for the tempo of a pandemic. The guide calls on journal editors to develop accelerated editorial pathways—backed by dedicated reviewers and emergency funding—for PHE-relevant clinical research, and on preprint servers to establish minimum quality standards for high-stakes treatment content rather than screening only for plagiarism or offensive material. Editors are also encouraged to solicit implementation support materials—slides, decision tools, demonstration videos—that help clinicians actually adopt innovations, not just evaluate them.
Two additional strategies stand out. First, building tools that help authors generate lay summaries, visual abstracts, and other short-form content can extend the reach of published findings to clinicians who are unlikely to read full journal articles during a surge. Second, enabling and promoting structured commenting on articles and preprints—with credential verification—could allow clinical experts to flag errors and facilitate focused dialogue before low-quality science influences practice at scale.
The Research Behind the Series
RAND researchers drew on focus groups at five hospital-based EDs, interviews with key innovators and disseminators from the COVID-19 pandemic, a nationwide survey of more than 1,600 physicians and nurses, and analysis of archived online discourse about ED care innovations spanning two years. Strategies were refined through an in-person expert convening and subsequent review by an expert panel that included representatives from the American College of Emergency Physicians and the Emergency Nurses Association.
As biosecurity threats including pandemic influenza, novel pathogens, and antimicrobial resistance remain persistent concerns, the capacity of emergency health systems to rapidly and equitably adopt evidence-based innovations is critical.
Sources and Further Reading:
5 Things Emergency Department and Health System Leaders Can Do
6 Things Frontline Emergency Department Clinicians Can Do
5 Things Influential Emergency Department Clinicians on Digital Media Can Do
7 Things Leaders of Professional Societies Can Do