EBOLA PREPAREDNESS TOOL FOR EBOLA TREATMENT CENTERS AND ASSESSMENT HOSPITALS PRESENTED BY HOUSTON DEPARTMENT OF HEALTH AND HUMAN SERVICES, OFFICE OF SURVEILLANCE AND PUBLIC HEALTH PREPAREDNESS JULY 17, 2015 Prepared for APIC Houston chapter
Objectives 2 Review the recent Ebola Virus Disease (EVD) outbreak and modes of transmission Understand the CDC s tiered for health care facility designation Describe the purpose and review the steps of the Ebola Readiness Assessment ()
EVD Transmission and Persistence 3 Transmission (direct contact of mucous membranes or broken skin) Blood or body fluids of a person/animal with EVD Contaminated equipment or other objects Ingestion of infectious blood or body fluids Persistence of virus in environment May remain stable for 4 to 5 days in dried blood 1 but only for a few hours on dry surfaces 1. AEM 2008, 74(3), 555-563.
4 Timeline of the west African Ebola outbreak John Saeki/Adrian Leung (AFP)
Rapid Detection and Treatment 2 5 Screening travelers (airport) Enhanced entry screening Risk assessment Medical evaluation Monitoring by public health 21 days since departure Rapid identification of signs and symptoms Patient care by health care facilities Safe and rapid identification, isolation, evaluation, management, and transfer 2. CDC MMWR March 6, 2015 / 64(08);222-225
6 http://www.cdc.gov/vhf/ebola/healthcare-us/preparing/hospitals.html
CDC Strategy for Approach: 7 Frontline Healthcare Facility Quickly identify and isolate patients suspected to have EVD Inform local/state public health officials and facility infection control Prepare for patient transport, if high risk or lab confirmed EVD Maintain Ebola personal protective equipment (PPE) for at least 12 to 24 hours of patient care
CDC Strategy for Approach: 8 Ebola Assessment Hospital Receive and isolate suspected patient Initiate laboratory evaluation and coordinate EVD testing Provide patient care for up to 96 hours or until patient is discharged or transferred Prepare for patient transport to Ebola Treatment Center in coordination with public health officials Maintain PPE for up to 5 days of patient care
CDC Strategy for Approach: 9 Ebola Treatment Center Receive and isolate a lab confirmed case of Ebola Provide medical management for patients with Ebola for the duration of illness Prepare sustainable staffing plan to manage patient care for several weeks of care Maintain PPE for at least 7 days of care and prepared to restock if needed
Ebola Readiness Assessment () 10 To assess the hospital s ability to meet the minimum criteria to provide services as an Ebola Assessment Hospital Collaboration between hospitals and public health Site visits by public health ( Team) August 2015 to December 2016
Team Members 11 City of Houston Department of Health and Human Services Bureau of Epidemiology Bureau of Laboratory Services Public Health Preparedness Informatics Texas Department of State Health Services
Four Phases of 12 1. Self-assessment (self-paced online survey) Beginning August 2015 2. Initial onsite visit to hospital by Team Aim to complete first assessment in September 2015 Remaining hospitals will be completed one per consecutive month in 2015 3. Remediation Six months after initial onsite visit 4. Second onsite visit Within six months after remediation
1. Self-Assessment 13 a. Online survey emailed to self-identified hospitals, n=2 b. Hospitals have three weeks from time of receipt to complete the survey c. Complete at least two weeks prior to onsite visit
Example of Online Survey 14
2. Initial Onsite Visit 15 a. Aim for first hospital to be visited in August 2015 b. Team will complete one hospital per month c. Onsite visits are expected to be one or two days in duration i. One day visit require hospital staff to be available all day ii. Two day visit will be half day sessions; hospital staff expected to be available half day
Proposed Attendees 16 Infection control practitioners Risk management Environmental services C-suite (CEO, CNO, CMO, COO, etc.) Infectious diseases physicians ER management ICU management Laboratory management
Remediation and Re-visitation 17 3. Remediation of any identified gaps a. Occurs six months after onsite visit 4. Second onsite visit a. Occurs within six months after the remediation
Link to Survey From CSTE 18 http://www.cstesurvey.org/epiinfowebsurvey/home/ 247b0527-7dc3-4327-88c5-d0bd8fe6eb4f CSTE: Council of State and Territorial Epidemiologists
Saving the Web Survey 19 Save and stop survey at any time Pass code and link to survey will be provided via email Survey will open on last page saved
Contact for Questions 20 Requests to be added to list of hospitals Nancy Vuong, Pharm.D., MBIOT, BCPS Nancy.vuong@houstontx.gov Questions regarding web survey Kiley Allred Kiley.allred@houstontx.gov Phone number: 832-393-5080
Acknowledgements 21 APIC Houston chapter