Health care professionals learned valuable safety lessons from Ebola casesReprints
Hospital risk management and safety professionals say their health care systems have strengthened safety procedures and implemented specialized training in the wake of recent Ebola cases in the United States, in order to protect hospital workers who may need to treat other potentially deadly pathogens.
Strategies include working with dedicated teams of health care professionals to undergo training that would help reduce the chance of infection, and rigorous practice in donning and doffing personal protective equipment to ensure that such gear can be removed without spreading disease.
“I can't imagine an organization that didn't start drilling with their emergency management teams,” said Rebecca Havlisch, vice president of business health with Phoenix-based Banner Health System, which has more than 39,000 employees at 25 hospitals and other medical facilities in seven states.
Heightened safety procedures could be helpful in protecting health systems from costly workers compensation claims that could result if a health care worker contracted Ebola or other serious communicable illness in the future, experts say.
“I think we all need to realize that there's going to be some type of emerging infectious disease on the horizon,” said Lauri Laudano, network safety officer with Seton Healthcare Family in Austin, Texas. “It may not be Ebola, it might be something else ... and we just always need to stay prepared.”
Seton has nearly 13,000 employees at 11 hospitals and three health care clinics in Texas. The health care system began strategizing how to protect its patients and employees from Ebola, after two nurses at Texas Health Presbyterian Hospital in Dallas tested positive for the virus in October while treating an infected man who later died.
“That was a bit scary for us, since we really didn't know how the nurse was infected who was caring for that patient in Dallas,” Ms. Laudano said, regarding Texas Health Presbyterian which isn't a Seton-owned hospital. “So we were second guessing our (personal protective equipment) practices and whether we were really fully protected.”
The system sent email communications to all of its associates on safety procedures they should be aware of, and implemented computer-based training for select groups of hospital employees — such as those in the emergency room — who would be most likely to come in contact with a patient who might have Ebola, Ms. Laudano said.
A smaller set of emergency room staff and other medical workers attended hands-on training that included practice on how to safely put on and remove protective gear that included full face masks, she said.
Additionally, the system took precautions such as treating Ebola as an airborne pathogen — even though Seton medical experts know that the virus isn't transmitted via air — in order to add another layer of safety protocols that could protect patients and employees against any type of disease.
Ms. Havlisch of Banner Health said the hospital's facilities in the Phoenix area and northern Colorado also drilled employees on the proper way to don and doff protective gear. Banner Health recruited staff members across a number of disciplines — such as nursing, intensive care and infectious disease specialists — to participate in a SWAT team that would be highly trained in treating Ebola patients and could be mobilized to various Banner Health facilities.
Training a select group of medical workers allowed Banner Health to make sure the SWAT team had comprehensive training rather than providing more limited training to a wider group of employees, Ms. Havlisch said.
“We didn't think we could get the level of experience that we wanted ... by training thousands of nurses (compared with) training a couple hundred first responders and 50 or 60 (employees) on our SWAT team,” she said.
Banner Health's two-week SWAT team training was modified in the middle of the course to implement tightened protective gear guidelines that were introduced by the U.S. Centers for Disease Control and Prevention in the midst of the Ebola scare last year.
In an October statement, the CDC said medical facilities needed to ensure that all health care providers “practice numerous times to make sure they understand how to appropriately use” personal protective equipment. That led Banner Health team members to repeatedly practice using personal protection equipment.
“We know that the more you do something the better you get at it,” Ms. Havlisch said.
In addition to keeping health care workers safe, such protection can help employers avoid paying “significant” medical expenses associated with treating an employee for Ebola or another infectious serious illness under a workers comp claim, said Christopher Flatt, managing director and leader of Marsh L.L.C.'s Workers' Compensation Center of Excellence in New York.
“If something is contracted in the course and scope of employment and it's particular to their industry, it's likely that there would be workers comp coverage,” Mr. Flatt said.
Avoiding such risks can be especially important in the workers comp market, since some workers comp insurers are seeking ways to exclude Ebola-related claims in light of last fall's Ebola cases, said Mark Zwickel, executive vice president of Pacific operations for Lockton Cos. L.L.C. in Los Angeles.
“One of the carriers, as part of their underwriting criteria, asked a question in the form of a warranty that they would not treat anyone with Ebola,” Mr. Zwickel said.
Experts say safety precautions taken during last year's Ebola virus cases in the United States likely have prepared hospitals to better handle potential outbreaks that could come down the line.
“It raised our awareness,” Ms. Laudano said. “Hospitals can sometimes slip into complacency with training programs and preparedness programs when you're not actually responding to that kind of event. So I'd say it was a wake-up call that we needed to ensure our programs are sustainable, even if we don't see Ebola for 10 more years.”