Home' The Source : First Quarter 2015 Contents to develop, while Ebola can take as long as three weeks.
So we allow a generous timeframe to o set errors or
Standardizing the intake questions ensures patients
will be screened and also enables HCA to mine the data
in a number of ways beyond just tracking a possible Ebola
case, explains Jason Hickok, assistant vice president of
Research and Academic A airs, Infection Prevention
and Lab at HCA, whose team developed and manages
"We collect the data in our data warehouse, and we
can analyze it in various ways. For example, we can see
where flu outbreaks are occurring and how severe they
are," Hickok says. "We've validated that our data mirrors
the CDC models, but ours is more current. The CDC data
has approximately a week-long lag; ours is 48 hours."
If a patient's travel history and symptoms indicate
a possible Ebola infection,
the emergency response team
dons protective gear and takes
The patient is isolated and
stabilized, and tested for the
Ebola virus. If the test is posi-
tive, the hospital will care for
the patient until he or she can
be transported to one of 49 (as of
Jan. 15, 2015) facilities the CDC
has designated as Ebola treat-
ment centers. This process can
take several days, during which time the local hospital
must care for the patient.
Proper use of personal protective equipment (PPE) is
vital to prevent infection, Moody says.
"One thing we learned right away was that many sta -
ers didn't know how to put on and remove the protective
equipment in a way that was 100 percent safe," Moody
says. "So we needed to train people how to do that so they
didn't inadvertently contaminate themselves or others.
"And we used it as a golden opportunity to re-educate
everyone in our hospitals, including support sta , on the
proper techniques for preventing infection from any kind
of disease, not just Ebola," Moody adds.
The kind of PPE worn by each member of the team
depends on how sick patients are and how much expo-
sure a caregiver has to patients and their bodily fluids.
"The more direct contact with the patient, the greater
the level of protection needed---and the greater the drain
on personnel, because the gear can be very fatiguing,"
The robing/disrobing process is very similar to that
used by surgical sta , so HCA tapped those resources to
assist with training to help the response team members
cope with the rigors of using PPE.
The PPE traps body heat and taxes caregivers' stamina
so that they can work for only a few hours. "It's like a
close-fitting cocoon," Moody says. "You get warm even
if you aren't doing any work. Once you start working, you
quickly get very warm---a challenge for sta who may be
in with a patient for several hours.
"You're totally covered, and that changes some basic
procedures," Moody adds. "For instance, if you have a
hood over your head, you can't use a stethoscope, so
you have to rely more on technology to evaluate the
Besides wearing PPE, the protocol for treating Ebola
calls for minimizing the amount of potentially contami-
nated material leaving the isolation unit. This means
doing as many tests as possible at the bedside. HCA hos-
pitals use a bedside lab testing technology device called
the iStat (HealthTrust Contract No. 500273) that per-
forms many of the most common tests without needing
to transport samples to a lab.
HCA hospitals also have the company's emergency
management program available. It is designed to support
its facilities through all hazards, whether hurricanes,
tornadoes, earthquakes or infectious disease outbreak,
When an emergency happens, the appropriate HCA
division o ce serves as an emergency operations center
providing support, guidance and resources to the a ected
facility so sta can focus on patient care. The corporate
emergency response team oversees and assists in any way
it can, such as expediting delivery of needed supplies.
In early 2015, Ebola was still a concern in parts of
West Africa, though it had retreated from most of the
region. It now appears to pose less of a threat outside
of those areas.
Public health and healthcare o cials are using
this respite to evaluate their response and fine-tune
protocols in anticipation of a future crisis.
But Ebola has a well-established pattern---vicious, un-
predictable outbreaks that slowly burn out followed by
a period of dormancy---so it's certain that it will appear
again sometime. HCA and HealthTrust stand ready to
respond should the need arise. S
"Working with HealthTrust, we were able to ensure that we
had the proper equipment and standardize it. HealthTrust's
purchasing power helped ensure that we could procure the
right equipment promptly. Going forward, we were also able
to make sure the equipment would be on hand or readily
available anywhere it was needed."
--- Scott Cormier, director, Emergency Preparedness & Management Clinical Services Group at HCA
Continued from page 26
First Quarter 2015 | The Source 29
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