The Johns Hopkins Hospital Biocontainment Unit Brian T. Garibaldi, MD Associate Medical Director, JHHBCU Assistant Professor of Pulmonary and Critical Medicine Johns Hopkins University School of Medicine 4/26/2016 1
Financial Disclosures/ Unapproved Use We have no financial relationships with a commercial entity that are relevant to the content of this presentation. JHH has received funding from the Maryland Department of Health and Mental Hygiene (DHMH) and the Assistant Secretary for Preparedness and Response (ASPR)
Objectives By the conclusion of this talk, you will be able to: Describe the critical elements of a biocontainment unit Understand the design process of the JHH BCU Recognize the multidisciplinary nature of BCUs Describe the mission of the JHH BCU in the broader context of national and international preparedness
What is a Biocontainment Unit?
Key features of a BCU Secure entry and exit points Advanced air handling system Highly trained nurse and provider team including adult, pediatric and obstetrics Laboratory Critical Care Onsite imaging Waste Management Infrastructure
Johns Hopkins Ebola Preparedness Screening/Triage Education &Training Supplies Transportation Cleaning, Disinfection Waste Management Laboratory Workforce Ethics Communications Designated Units Biocontainment
Why is this relevant today? 4/26/2016 7
The BCU Vision The Johns Hopkins Hospital Baltimore, MD
The BCU Vision April 26, 2016 9
Key Collaborations Emory University University of Nebraska NIH CDC Colleagues across the world 4/26/2016 10
Tackling the fear of contagion John G. Bartlett Established the AIDS clinical service at JHH in 1983 B. Frank Polk Pioneering research and clinical care for patients with HIV
Timeline of the BCU 4/26/2016 12
BCU Floorplan 4/26/2016 15
BCU Floorplan 4/26/2016 16
Patient Room 1 4/26/2016 17
Patient Room 1
Onsite Laboratory 4/26/2016 19
Onsite Laboratory
Available Laboratory Tests Analyte/Panel Instrument Tube Type Comprehensive Metabolic Panel (CMP) Abaxis Piccolo Green Top Electrolytes (Na, K, Cl) Abaxis Piccolo Green Top Magnesium Abaxis Piccolo Green Top Phosphate Abaxis Piccolo Green Top Lactate Abaxis Piccolo Green Top Heme-8 (CBC w/differential) Sysmex poch-100i Lavender Top Arterial Blood Gas w/cooximetry Venous Blood Gas w/cooximetry Radiometer ABL90 Radiometer ABL90 Blood Gas Syringe Blood Gas Syringe Ionized Calcium Radiometer ABL90 Blood Gas Syringe Whole Blood INR Hemochron Signature Blue Top Plasma equivalent aptt Hemochron Signature Blue Top Urinalysis Manual Dipstick Urine Screw Cap ABO typing Glass Slide Test Lavender Top
Waste Management 4/26/2016 22
Autoclave Unit Side
Autoclaves Clean Side
Radiology Sonosite Xporte Digital Xray 4/26/2016 25
Digital Stethoscope Think Labs One 4/26/2016 26
Unique Features of the JHH BCU Unidirectional flow of staff Donning and doffing rooms for all patient care areas Dual Pass-through autoclaves Physical space for obstetrics procedures Physical space for sterile procedures, including limited surgery Main patient room with two ICU headwalls to provide care for family Advanced Telecommunications System
Telecommunications 4/26/2016 28
Providers 4/26/2016 29
The Making of the JHH BCU https://youtu.be/ovmcbtowyqc 4/26/2016 30
Tour of the BCU https://youtu.be/rzsck4lm1t8 4/26/2016 31
The JHH BCU Vision 4/26/2016 32
PATIENT CARE 4/26/2016 33
Region 3 Ebola and Other Special Pathogen Treatment Center 4/26/2016 34
HHS Regional Centers Massachusetts General Hospital in Boston, Massachusetts Bellevue Hospital Center in New York City Johns Hopkins Hospital in Baltimore, Maryland Emory University Hospital and Children s Healthcare of Atlanta/Egleston Children s Hospital in Atlanta, Georgia University of Minnesota Medical Center in Minneapolis, Minnesota University of Texas Medical Branch at Galveston in Galveston, Texas Nebraska Medical Center in Omaha, Nebraska Denver Health Medical Center in Denver, Colorado Providence Sacred Heart Medical Center and Children s Hospital in Spokane, Washington 4/26/2016 35
National Ebola Training and Education Center (NETEC) (ASPR), (CDC) Emory University, University of Nebraska Medical Center/Nebraska Medicine & New York Health and Hospitals Corporation, Bellevue Hospital April 26, 2016 36
Training and Education 4/26/2016 37
Highly Infectious Disease Training Quarterly activation drills Yearly no-notice drills Monthly staff meetings and activities 4/26/2016 38
Infection Control Training 500 EVS employees have trained on the unit Compliance scores have increased across the hospital 4/26/2016 39
Research 4/26/2016 40
Research and Innovation PPE design and testing CDC Epicenter Grant FULD Fellow Self-Selector Study Genomics and infection April 26, 2016 41
Questions? 4/26/2016 42