LAUSR

Background Despite lessons learned following healthcare worker (HCW) acquisition of Ebola Virus Disease (EVD) during the 2014-2016 outbreak, a 2018 facility assessment revealed multiple gaps in preparedness. This project utilizes a multidisciplinary approach to prepare a frontline urban community hospital to screen, identify, and care for patients with suspected HCID (high-consequence infectious diseases) according to the “Identify, Isolate, Inform” model recommended by the Centers for Disease Control (CDC). Methods This project began with a 2018 assessment and gap analysis of existing HCID preparedness. A multidisciplinary team was created for action planning in each of the areas requiring intervention. A thorough review of existing practice guidelines was conducted. Subject matter experts from the regional biocontainment center team were engaged as reviewers to ensure hospital interventions were appropriate and offered constructive feedback where appropriate throughout the project. Interventions focused on: PPE and equipment procurement, staff training and competency, development of response algorithms for frontline clinical staff, development of standard operating procedures, and electronic medical record enhancements to facilitate standardized travel screening in all intake areas. Effectiveness of the preparedness interventions was assessed through a series of 15 minute internal drills, a state-wide no-notice exercise, and a dozen real-life persons under investigation (PUIs) for various HCIDs. Effectiveness of the education intervention was quantified using course evaluations. Results Exercises revealed improved travel screening, implementation of immediate infection control measures, staff activation of response protocol, resource availability, and comfort with PPE donning and doffing procedures. Post-education evaluations revealed 94% of respondents felt more prepared to conduct travel screening in triage, 95% felt more prepared to implement immediate infection control measures, and 100% reported feeling more comfortable with Special Pathogen PPE donning and doffing after training. Conclusions A multi-disciplinary approach to the gap analysis facilitated implementation of a high-consequence infectious disease preparedness program in an urban community frontline hospital.