emerging infectious disease 'go team' · history and evolution the ebola impact the road...
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EMERGING INFECTIOUS DISEASE "GO TEAM"
WI Health Emergency Preparedness
Conference January 10, 2019
Tracey Froiland, MSN, RN
Tracy L Miller, MSN, RN
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LEARNING OBJECTIVES
• Describe the importance of community resiliency surrounding
infectious disease
• Understand the concepts and operationalization of a
community Go Team
• Identify own community gaps and opportunities for an
infectious disease outbreak: past, present, and/or future
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FOX VALLEY HEALTHCARE EMERGENCY READINESS COALITION
• 8 Counties
• 15 Hospitals
• 9 Public Health Departments
• ~45 LTC
• 85 CMS Partners
• 112 EMS
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HISTORY AND EVOLUTION
The Ebola Impact
The Road to Zero: CDC’s Response to the West African Ebola
Epidemic, 2014–2015
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KEY FACTS
• Ebola virus disease (EVD), formerly known as Ebola hemorrhagic fever
• Often fatal in humans
• Average fatality rate 50%
• Transmission via animals, then human to human
• Community engagement key in controlling outbreaks
• Case management, infection prevention and control, surveillance and contact
tracing, community education
• Early supportive care, symptomatic treatment
• Commercially licensed vaccine?
World Health Organization, 2018
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THE BEGINNING
September 30, 2014
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Airport Screening
State DPH Local PH Cat 2
Notification
PUBLIC HEALTH ROLE
Ebola Screening/Notification Process
• Gave ability to prepare and plan
• Will the next emerging infectious disease follow this process?
If not, then what….
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HOSPITAL ROLE: SCREEN, IDENTIFY, ISOLATE
Cat 3
• Frontline hospitals
• Screen, identify, and isolate a high-risk patient
• Transfer to Cat 2 facility
Cat 2
• Assessment Hospitals
• Provide care for potential Ebola case up to 96 hours
• Initially: 20 in WI currently 2-4
Cat 1
• Treatment Hospitals
• Prepared to care for confirmed Ebola patient
• UW Madison/AFCH, MCOW Froedtert/CHOW
• University of Minnesota Medical Center (Minneapolis)
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ADDRESSING A SERVICE GAP
Cat 3
• Frontline hospitals
• Screen, identify, and isolate a high-risk patient
• Transfer
Cat 2 • Facilities able to provide care for potential Ebola case up to 96 hours
• 2-4 in WI
Cat 1
• Pre-identified facilities prepared to care for confirmed Ebola patient.
• UW Madison/ AFCH, Froedtert/CHOW
• University of Minnesota Medical Center (Minneapolis)
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REGIONAL INNOVATION
PROACTIVE VS REACTIVE
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INFECTIOUS GO TEAM FOUNDATION
• HERC directed initiative
• Organizational support
• Time, compensation, liability and
workers compensation coverage
• Identify staff for participation
• Training with local PPE experts 3-4
times/year
• SME for program management
Goal:
Mobile response of trained staff
responding into the community to
assess, diagnose, and facilitate
transfer of high risk ID patients.
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REGIONAL COLLABORATION
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TRAINING TOGETHER= A REGIONAL APPROACH
Dr Michael Clark, Medical
Director
Infection Preventionist
RN
ED Tech
Respiratory Therapist
Public Health
EMS
Support Staff
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PROGRAM DEVELOPMENT FROM A VISION TO REALITY
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CLASSROOM PROCESS DEVELOPMENT
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TECHNOLOGY
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TRAINING FACILITY
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TEAM DEPLOYMENT
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ACTIVATION
Public Health Identification
RMCC
Dispatch
RMCC Activates Team
Team Deployment
Community Monitoring
Available team members report
Information to patient
Gather information for team
Situation analysis
Alerts team
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DISPATCH & RMCC ACTIVATION
Public Health Identification
RMCC Dispatch
RMCC Activates Team
Team Deployment
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DEPLOYMENT PROCESS
Trained Observer
Advance Team
Treatment Caregiver
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ARRIVAL
Trained Observer
Advance Team
Treatment Caregiver
• Situational assessment
• Role assignments
• Don role specific PPE
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ADVANCE TEAM DEPLOYMENT
Trained Observer
Advance Team
Treatment Caregiver
• Review instructions with patient
• Establish zones
• Equipment, kits & set up
• Caregiver preparation
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PATIENT EVALUATION
• Mobile
evaluation
• Telemedicine
support
Treatment Caregiver
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FVHERC MOBILE TEAM AT WORK
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CHALLENGES AND OPPORTUNITIES
• Funding
• Equipment and resource management
•Maintaining team competency, growth planning
• Policy development and updates
•Addressing the “what if ’s”
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NEXT STEPS
• Stakeholder event 12/6/18
•Public unveiling, awareness, education
•Exercise with partners
•NETEC evaluation
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NOW WHAT?
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TODAY, RIGHT NOW….
•Awareness- is your facility really ready?
•Policies and procedures up to date?
•Equipment and supplies ready?
• Strict PPE education?
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C-SUITE ENGAGEMENT
September 4, 2015
Does Insurance Cover
Ebola Care? TIME 10/2014
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NOT IF…WHEN THEY SHOW UP WHAT NEXT?
• Do you know the readiness level of your facility?
• Is an exposure/travel screening questions asked?
• If so, do you have a follow through process to take the next steps?
• How does your facility keep up on emerging and current infectious
diseases?
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RESOURCES
• https://asprtracie.hhs.gov/
• Frontline Hospital Playbook: Special Pathogens
• Health Sector Resilience Checklist for High Consequence Infectious Diseases
• The World Health Organization: multi drug Ebola trial
• https://www.cdc.gov/vhf/ebola/hcp/ppe-training/index.html
• https://www.cdc.gov/vhf/ebola/healthcare-us/ppe/guidance.html
• 'Donning and Doffing' Ebola Protective Equipment PBS
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YOUR TURN…