The Fort McMurray Alberta wildfire was one of Canada’s largest natural disasters in history, burning 589,995 hectares of land until being controlled on July 5, 2016. In responding to the fire, Alberta Health Services (AHS) prompted a province-wide coordinated response. Through a combination of pre-emptive strategies and responsive activities, the AHS response has been considered a success. Underlying the successful response is the collective experiences and contextual knowledge of AHS staff members acquired from past events. While the frequency and severity of risks associated with extreme weather and climate change are increasing worldwide, there is a persistent knowledge gap in the evidence-base informing public health emergency preparedness. It is imperative that lessons learned from past events inform future preparedness activities. Learning lessons is a systematic implementation process that can be used to inform future responses and best practices that are transferable to similar situations.

To describe strategies employed and challenges encountered during recovery after the Alberta wildfires.

A single-case study approach was employed to understand the AHS method to “learning lessons,” and the process involved in translating lessons into actionable goals. Semi-structured interviews with senior leaders (n=11) were conducted and internal documents were obtained.

The analysis revealed a strategic learning process, including debriefs, staff surveys, interviews, and member validity checking. The implementation process used to translate the lessons identified included a project management framework, evaluation techniques, and the utilization of tacit and explicit knowledge. Key challenges for implementation involve clarification of processes, leadership commitment, resource and time constraints, staff turn-over, and measuring outcomes.

Translating the lessons from the Alberta wildfires is crucial for enhancing preparedness, and exploratory research in this area can contribute to building a program of research in evaluation during disaster recovery.

In 2008, the Medical Officer of Health at Alberta Health Services (Edmonton, Canada) was notified that, in some practice settings, a syringe was used to administer medication through the side port of an intravenous circuit and then the syringe, with residual drug, was used to administer medication to other patients in the same manner. This practice has been implicated in several outbreaks of bloodborne infection in hospital and clinic settings.

A risk assessment model was developed to predict the risk of a patient contracting a bloodborne viral infection from the practice. The risk of transmission was defined as the product of 5 factors: (1) the population prevalence of a specific bloodborne pathogen, (2) the probability of finding a viral bloodborne pathogen in an intravenous circuit, (3) the rate of syringe reuse, (4) the probability of causing disease given a bloodborne pathogen exposure, and (5) the susceptibility of the exposed person.

The risk was modeled first with consistent use of the proximal port of the intravenous circuit. The risk of transmission of hepatitis B virus was approximately 12–53 transmission events per 1,000,000 exposure events for a range of practice probabilities (ie, frequency of the risk practice) from 20% to 80%, respectively. The risk of transmission of hepatitis C virus was approximately 1.0–4.3 transmission events per 1,000,000 exposure events for the same practice probability range, and the risk of transmission of human immunodeficiency virus was approximately 0.03–0.15 transmission events per 1,000,000 exposure events for the same practice probability range. The use of the distal port was associated with a 10-fold decrease in the risk.

Practitioners must practice safe, aseptic injection techniques. The model presented here can be used to estimate the risk of disease transmission in situations where reuse has occurred and can serve as a framework for informing public health action.