EMERGING INFECTIOUS DISEASE "GO TEAM"

WI Health Emergency Preparedness

Conference January 10, 2019

Tracey Froiland, MSN, RN

Tracy L Miller, MSN, RN

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

FOX VALLEY HEALTHCARE EMERGENCY READINESS COALITION

• 8 Counties

• 15 Hospitals

• 9 Public Health Departments

• ~45 LTC

• 85 CMS Partners

• 112 EMS

HISTORY AND EVOLUTION

The Ebola Impact

The Road to Zero: CDC’s Response to the West African Ebola

Epidemic, 2014–2015

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

THE BEGINNING

September 30, 2014

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….

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)

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)

REGIONAL INNOVATION

PROACTIVE VS REACTIVE

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.

REGIONAL COLLABORATION

TRAINING TOGETHER= A REGIONAL APPROACH

Dr Michael Clark, Medical

Director

Infection Preventionist

RN

ED Tech

Respiratory Therapist

Public Health

EMS

Support Staff

PROGRAM DEVELOPMENT FROM A VISION TO REALITY

CLASSROOM PROCESS DEVELOPMENT

TECHNOLOGY

TRAINING FACILITY

TEAM DEPLOYMENT

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

DISPATCH & RMCC ACTIVATION

Public Health Identification

RMCC Dispatch

RMCC Activates Team

Team Deployment

DEPLOYMENT PROCESS

Trained Observer

Advance Team

Treatment Caregiver

ARRIVAL

Trained Observer

Advance Team

Treatment Caregiver

• Situational assessment

• Role assignments

• Don role specific PPE

ADVANCE TEAM DEPLOYMENT

Trained Observer

Advance Team

Treatment Caregiver

• Review instructions with patient

• Establish zones

• Equipment, kits & set up

• Caregiver preparation

PATIENT EVALUATION

• Mobile

evaluation

• Telemedicine

support

Treatment Caregiver

FVHERC MOBILE TEAM AT WORK

CHALLENGES AND OPPORTUNITIES

• Funding

• Equipment and resource management

•Maintaining team competency, growth planning

• Policy development and updates

•Addressing the “what if ’s”

NEXT STEPS

• Stakeholder event 12/6/18

•Public unveiling, awareness, education

•Exercise with partners

•NETEC evaluation

NOW WHAT?

TODAY, RIGHT NOW….

•Awareness- is your facility really ready?

•Policies and procedures up to date?

•Equipment and supplies ready?

• Strict PPE education?

C-SUITE ENGAGEMENT

September 4, 2015

Does Insurance Cover

Ebola Care? TIME 10/2014

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?

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

YOUR TURN…

THANK YOU! TRACEY.FROILAND@DHS.WISCONSIN.GOV

TRACY.MILLER5@AURORA.ORG