Lessons from the Ebola Crisis
By Shannon Saksewski
Since early October 2014, the conversation about Ebola in the US has been focused on fear regarding the disease's spread. Despite the fact that there has been, to date, only one Ebola death and handful of confirmed cases in the US (CDC, 2014)—most of whom are healthcare providers—the US public has been barraged with media stories that do little to promote public health and more often result in spreading fear of the disease. The US is far from the epicenter of the West African Ebola epidemic, but there are lessons to be learned from the cases of this disease in the US.
The countries most impacted by Ebola are Liberia, Sierra Leone, and Guinea, all in West Africa. In those countries, more than 10,000 cases and nearly 5,000 deaths have been reported as of October 27, 2014. These numbers are certainly indicative of an epidemic. However, just as world-wide concern over the spread of the disease has begun to dominate public discourse, providers at West African hospitals are reporting that beds are becoming more readily available.
Health systems have been the subject of a great deal of scrutiny regarding Ebola preparedness, and many are revisiting their resources, training, and practices as a result. However, even if the public conversation slowly shifts away from fear toward something closer to indifference, health systems must continue to prepare and practice infectious disease protocols. Below is an overview of just a few of the measures administrators are taking to ensure that their health systems are ready to face Ebola, if necessary.
Protocol and Equipment
Two nurses at Texas Health Presbyterian Hospital in Dallas presented with confirmed cases of Ebola. Both treated Thomas Eric Duncan, the Liberian man who contracted the virus prior to traveling to the US to visit family. Despite the fact that these caretakers wore protective gear while treating Duncan, it has been reported that protocols for the use of personal protective equipment (PPE) were inadequate to prevent transmission of the Ebola virus disease (EVD) to the nurses.
On October 20, 2014, the CDC issued updated guidelines regarding the protective gear which should be used when caring for a patient with Ebola. For a visual demonstration of the differences in requirements, click here. Not only is the recommended gear different, but the procedures for its use are much more intensive and may require additional training—including routine practice—for all employees who may come into contact with an Ebola patient. For updated recommendations regarding Ebola protocol, equipment, and transmission, click here.
Dissemination of best practices, along with staff education and appropriate allocation and distribution of resources is essential to an effective response to Ebola. While efforts are most needed in West Africa, recent events reveal that US healthcare facilities should also be employing these principles to ensure for public health and safety.
Crisis Communications Planning
Crisis communications plans, like most forms of insurance, are resources which most individuals and organizations hope to never have to use. However, the consequences of a lack of preparedness can be dire, a concept that Texas Health Presbyterian Hospital in Dallas and its parent system, Texas Health Resources, is familiar with. The hospital's handling of communications regarding the treatment of the first Ebola patient diagnosed in the US can provide critical lessons for other health systems in similar situations.
Communicating in a crisis must be prepared for in advance. Crisis itself implies a lack of time for on-the-spot preparation, and this is why plans like calling trees, public relations personnel and pre-designated channels of communication between staff is essential. In these situations, human instincts sometimes sway toward hiding facts rather than communicating early, honestly, and often, which can make these situations worse.
The public is highly apt to identify gaps in logic and any other communication missteps during a crisis, which can further complicate a coordinated response. This reinforces the need to have the organization's leaders and communicators briefed regularly and frequently with up-to-the-minute details regarding the situation at hand. Those communicators, in turn, should brief the public at least daily when embroiled in a crisis situation.
Frequent, detailed, professional information-sharing that adheres to legal and ethical standards boosts the organization's image as honest and competent, and builds trust. The University of Nebraska Medical Center has demonstrated this well, holding press conferences and delegating leaders to speak with the media daily regarding the treatment of Ebola patients in their bio-containment unit. If your healthcare facility does not yet have a detailed crisis communication plan, now would be a great time to develop one.
Practice Drills are Important
Even the best-laid plans can go to pieces in a crisis situation if they are not practiced routinely. System-wide drills during non-crisis times are crucial for healthcare facilities, and we have all been through them in some way or another. Think about the fire drills you have probably experienced since childhood. Without practice, the hundreds or thousands of people who congregate in schools, hospitals, and other buildings may forget what to do in the case of a emergency, and be more likely to panic with no particular direction.
Drills provide an opportunity to spot problems with processes and equipment, which are essential in combatting EVD, or any other biohazard. Identification of problems in protocols or procedures during drills allows for the opportunity to correct issues before they become life threatening in real world situation. The training of personnel and the routine practice of executing a disaster preparedness plan can be a great way to prevent mishaps in a real crisis.
While the transmission of Ebola to healthcare workers across the globe is of utmost concern, there is still time and talent enough in the US healthcare system to remedy gaps in our preparedness for combatting Ebola. The lessons learned from the many organizations working at the frontlines in West Africa, as well as those learned from the medical professionals in the United States, can and should be used to create a planned response. As a healthcare administrator, you hold a direct role in absorbing the lessons learned, from both mistakes and successes, and applying them to the situation at hand.
As you continue to play your part as a leader in healthcare, take a moment to reflect upon the following questions and use your answers to move forward.
What important lessons have you, or has your health system, learned through crisis preparation? What's your most important emergency preparedness tip?
(Figures about EVD infection in the US are based on Centers for Disease Control information and are current as of October 27, 2014. For an update on Ebola cases in the US, click here.)
Shannon Saksewski has been practicing and studying health strategy in multiple contexts for more than five years. She earned a BA in psychology and studies in religion, a MSW focused on counseling practice, and a MBA focused on health strategy from the University of Michigan. Shannon can be reached via email (firstname.lastname@example.org), Twitter (@ssaksews), or LinkedIn.