All U.S. healthcare facilities need to be prepared for the rapid pace
and dynamic features of a SARS outbreak. All hospitals should be equipped
and ready to care for a limited number of SARS patients as part of routine
operations and also to care for a larger number of patients in the context
of escalating transmission. Plans should outline the administrative,
environmental, and communication measures and the individual work practices
required to detect the introduction of SARS-CoV, prevent its spread,
and manage the impact on the facility and the staff.
This document details planning issues that should be addressed in preparing
for potential SARS outbreaks. It will be important for planning committees
to consider the logistics of both basic and enhanced control measures.
Section IV: Recommended Preparedness and
Response Activities in Healthcare Facilities, below, details activities that should be discussed by a planning
committee. The response matrices in Appendix C1 provide specific recommendations
on implementing these measures.
Ideally, SARS planning will not occur in a vacuum but will build on
existing preparedness and response plans for bioterrorism or other infectious
disease emergencies and will be addressed by the same groups responsible
for developing those plans.
Objective
1: Develop a planning and decision-making
structure that ensures the capacity of the healthcare facility to detect
and respond effectively to SARS.
Activities
- Designate
an internal, multidisciplinary planning committee with responsibility
for SARS preparedness and response. Select persons with decision-making
authority and appropriate technical expertise, and include representatives
from all potentially affected groups. An existing preparedness team
with appropriate membership (e.g., bioterrorism response) could take
on this role.
- Identify
a local or state health department staff member who will serve as liaison
for SARS preparedness planning and response. If possible, include this
person on the planning committee.
- Identify
a SARS coordinator to direct planning and response efforts and serve
as the facility's point of contact for communication internally (i.e.,
in the facility and/or healthcare system) and externally (i.e., to
public health agencies, other healthcare facilities, law enforcement
agencies, media, and other partners).
- Consider
including representatives from the following groups on the planning
committee:
- Administration/senior management (including fiscal officer)
- Infection control/hospital epidemiology
- Hospital disaster/emergency coordinator
- Engineering/physical plant/industrial hygiene/institutional safety
- Nursing administration
- Medical staff (including outpatient areas)
- Intensive-care unit
- Emergency department
- Laboratory services
- Respiratory therapy
- Environmental services (housekeeping, laundry)
- Public relations
- Security
- Materials management
- Education/training/staff development
- Occupational health
- Diagnostic imaging
- Consider
including representatives from the following areas as adjunct members
to provide additional expertise and support:
- Infectious
diseases
- Mental health
- Risk management
- Labor and unions
- Human resources
- Pharmacy
- Emergency
medical technicians ("first responders")
- Social work
- Director of house staff/fellowship and other training programs
- Pulmonary medicine
- Pathology
- Local law enforcement
Objective 2: Develop a written SARS preparedness and response plan.
Activities
- Develop
a written plan that considers/accounts for each of the topics
addressed in the box below and in Section
IV: Components of Preparedness and Response in Healthcare Facilities.
- Ideally,
the logistics of both basic and enhanced measures should be
discussed in advance of a SARS outbreak.
- Formulate
written policies and work practices to ensure the prompt triage,
identification, and management of possible SARS patients while
minimizing the risk of transmission to other patients, personnel,
and visitors.
- Devise
a system for periodic review and updating of the plan as indicated.
Objective 3: Assess the capacity of the facility to
respond to SARS.
Activities
- Consider
using simulations ("table top" or
other exercises) to test the facility's response capacities.
- Identify
criteria and methods for measuring compliance with response measures
(e.g., infection control practices, case reporting, patient placement,
healthcare worker illness surveillance).
- Develop
strategies to quickly correct deficiencies.
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