Strong communication systems for knowledge exchange are required to prevent, respond to and mitigate the effects of emerging public health incidents (EPHIs). The objective of this paper is to examine how “tacit knowledge” – implicit knowledge used to guide everyday practice – is employed in professional relationships and communication processes between public health and acute care settings. A qualitative study design was used to explore the experiences of key informants from public health and acute care settings in Ontario, Canada, to examine how specific dimensions of tacit knowledge are employed in communications about EPHIs. Twenty-six in-depth interviews were conducted from 2014 to 2015. The results describe the way in which participants employ discretion and knowledge of local context, and rely on relationships built on trust and credibility, to facilitate decision-making and communication during EPHIs. Given the uncertainty characterizing most EPHIs, communicators rely a great deal on their informal knowledge and networks which allow them to remain flexible and respond quickly to changing situations. The results reveal that communication about public health guidance during emergencies is a complex and active process that draws from past experiences of the individuals involved, and is shaped by the requirements of local circumstances. The broader implications of these findings for building resilient and responsive health systems are considered. In particular, for rethinking the authority of standardized forms of evidence in public health decision-making, and the importance of knowledge which is grounded in the uniqueness of specific local contexts.

为了防止，应对和减轻新出现的公共卫生事件（EPHI）的影响，需要强大的知识交流通信系统。本文的目的是研究“隐性知识”（用于指导日常实践的隐性知识）如何用于公共卫生与急性护理环境之间的专业关系和沟通过程。使用定性研究设计来探索加拿大安大略省公共卫生和急性护理机构中关键信息提供者的经验，以检查在有关EPHI的交流中如何利用隐性知识的特定维度。2014年至2015年进行了26次深度访谈。结果描述了参与者运用判断力和对当地情况的了解，以及依赖建立在信任和信誉上的关系的方式，在EPHI期间促进决策和沟通。考虑到大多数EPHI的不确定性，传播者在很大程度上依赖于他们的非正式知识和网络，这使他们能够保持灵活性并能对变化的情况迅速做出反应。结果表明，在紧急情况下，有关公共卫生指导的交流是一个复杂而活跃的过程，它取材于相关个人的过去经验，并且受当地情况的影响。考虑了这些发现对建立适应性强和反应迅速的卫生系统的广泛影响。尤其是对于重新考虑标准化证据形式在公共卫生决策中的权威性以及基于本地特定情况的知识的重要性。