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1. Introductions
2. Emerging Diseases
3. Bi-monthly Review
4. 2014 EOP Update
5. Upcoming Training and Exercises
6. Closing Comments
Agenda
Updates:
• Travel Screening in place• Travelers from impacted areas are identified• Communication local Health Departments• Monitoring occurs• Onset of Symptoms—result in a coordinated admission
• UVA and VCU as designated hospitals for Virginia• Hospitals will rule in or out Ebola• Confirmed cases will be sent to federal biosafety facilities• If no space, UVA and VCU will care for confirmed cases
• CDC site visit on November 18
UVA Health System Mission
• Ensure UVAHS staff are safe as they safely care for Person Under Investigation (PUI) for Ebola or other emerging infectious diseases following appropriate infection prevention procedures• Team member safety• Safety of other medical center staff• Safety of other patients and visitors• Safety of the community
• Ensure patients are provided exceptional care
Planning Timeline• May 2014: Emerging Infectious Diseases Committee Formed for MERS-CoV
• Multidisciplinary team includes Emergency Management, Infection Control and Prevention, Hospital Epidemiology, Emergency Department, Transfer Center, Bed Coordination Center, Patient Relations, MICU, EMS, Employee Health, Student Health, Environmental Services, Public Relations
• July 2014: MERS-CoV tabletop exercise• August 2014: Emerging Infectious Diseases Committee planning expanded
to incorporate Ebola• Developed screening tool• Preparedness planning
• September 2014: Ebola plan tested with “rule out” of patient with Ebola-like symptoms admitted to MICU
• Phases of the Ebola Emergency Response Plan:
• Situational Awareness
• Phase 1: ≤2 patients
• Phase 2: 3-4 patients
• Phase 3: 5-10 patients
• Phase 4: >10 patients
Tiered Response Plan
Situational
Awareness
Phase 1
Phase 2
Phase 3
Phase 4
Review of Plan
Educate• Identify and train staff involved in care of an Ebola patient (e.g. MD, LIP, RN,
RT, EVS)• Targeted areas will include ED, UVA Medical Transport, select MICU staff,
select PICU staff, select EVS, select RT, select consult services• Not all staff and faculty will need to be trained
• Checklists and observation of donning and doffing PPE is essential
Appreciate (Identify Potential Cases)• Uniform Travel Screening Tool is in place in ED, Transfer Center, and Bed
Center• Roll-out for use throughout the Health System is underway
Review of Plan
Isolate• Designated rooms in ED and MICU are identified
• Include anterooms and toilets• Plan is to minimize patient movement and contact• Transfer protocols from non-ED locations to the MICU are defined• Maintain entry/egress logs, monitor room traffic• Personal Protective Equipment (PPE) that will be in use:
• Impervious gown• Impervious shoe/leg covers• Double gloves • Fit tested N95 mask• Full face shield• Head cover
Review of Plan
Communicate• Emergency management system• Public health authority notification• Health System communications
Care• UVAHS lab testing (point of care, minimize central lab testing)• VDH/DCLS Ebola testing (same-day turnaround)• Anticipated medical needs for an Ebola patient (fluids and electrolytes)• Care plans for EMS, ED, MICU already defined• Environmental hygiene plans being tested• Waste management plan is solidified• Decedent affairs is involved
Active Preparations
1. Education began in September and will be continuous
2. Continue developing and refining operations and care plans as new information and protocols emerge
3. UVA Children’s Hospital Plan is being discussed and developed
4. Clarify plans of other regional hospital and care sites (urgent care centers)
5. EMS (and Medic 5) transfer protocols are being further defined
6. Education/coordination with UVAHS ambulatory practices underway
7. UVA (employee, student, etc.) returning traveler protocols in place
8. Phase 2-4 planning is next
Potential Scenarios
• Ebola Identified “in the field”• Emergency Department• Ambulatory Care• Transfer Request
Exercises • Great Shakeout
Training• UMA Clinic WPV Training• Ebola PPE Training • HAZMAT Decon Equipment Checks
Actual Events• None recorded
Bi-monthly Update
I Evacuation (11/14/2014)I Inclement Weather Webinars (11/24-29/14)I Active Shooter Drill (December…)
Upcoming Training and Exercises