Improving Communication in Rabies Exposure Risk Assessment: A Targeted Recommendation

Context

A recent potential rabies exposure event in British Columbia involved coordination between emergency medicine, veterinary medicine, regional public health, and provincial oversight through the BC Centre for Disease Control and Wildlife Land Resource Stewardship.

While the exposure was appropriately classified as negligible risk following multi-level review, the communication experience for the individual involved was fragmented and unclear during the assessment process.

Observed Gap

During the intake and follow-up process, the individual was asked similar questions multiple times by the same intermediary (e.g., intake staff relaying information to multiple medical professionals).

However, the purpose of this repetition was not explained.

From the user perspective, this created:

• Uncertainty about whether information had been received or understood

• Concern that the situation was not being handled cohesively

• Increased stress during a time-sensitive and high-stakes scenario

In reality, the repetition reflected:

• Independent assessment by multiple clinicians

• A structured, redundant decision-making process designed to ensure accuracy

This distinction was not communicated.

Key Insight

There is a mismatch between system function and user perception.

• System reality: Redundant questioning = thorough, multi-layered assessment

• User perception: Redundant questioning = disorganization or lack of coordination

This gap undermines confidence, even when care is appropriate.

Recommendation

Introduce a standardized communication statement during intake and follow-up interactions in potential rabies exposure cases.

Suggested language:

“You may be asked similar questions more than once. This is because your case is being reviewed by multiple medical professionals independently to ensure a thorough and accurate risk assessment.”

Rationale

This low-effort intervention would:

• Improve clarity and transparency during assessment

• Reduce patient stress and uncertainty

• Reinforce confidence in the system’s rigor

• Align user experience with actual system performance

Importantly, this does not require changes to clinical protocols, only to communication practice.

Broader Implications

This issue is likely not unique to rabies exposure scenarios.

Similar communication gaps may exist in other:

• Communicable disease assessments

• Public health intake processes

• Multi-layered clinical decision pathways

Addressing this gap could have system-wide benefits for patient experience without increasing resource burden.

Conclusion

The current rabies exposure response system demonstrates strong clinical and public health coordination. Enhancing communication around the structure of that coordination represents a clear opportunity to improve user experience and trust, particularly in high-stress scenarios.