Transcript ProvConnect Implementation

Region 9 Healthcare Coalition
Ebola Symposium
April 23rd, 2015
Navigating Readiness
• Went through countless drafts of
policies/procedures/competencies
• Utilized the Emory Policies extensively
• Had the opportunity to visit Emory in
February to hear first hand about their
experiences
2
Pre-Hospital Transport Plans
• All potential Ebola patients from other facilities will
be direct admit to the ICU.
• Patients arriving via EMS will be screened by the
ambulance service prior to arrival in accordance
with the Spokane County EMS and Trauma Care
Council’s Suspected Ebola Virus Disease EMS
protocol
3
Emergency Department
Preparedness
• All ED staff trained in PPE
• Triage staff asking the screening questions
and responding appropriately
• Rooms identified for isolating patients
4
Staffing of the Ebola Patient
Care Team
• After the Texas Health situation, there was
extreme concern from the ICU staff over safety.
Much discussion in report and during breaks
• Conversations around the ethics of refusing to
care for these patients
• A call went out for volunteers for the team
• 24 staff stepped up, most after word went out that
the management team of the unit were being
trained
5
Staffing of the Ebola Patient Care
Team
• On Call list initiated if patient with “some
risk” identified by the Health District to be in
the community
• Staff competencies developed for PPE,
patient care, lab procedures, Environmental
Services and Waste Management
• Critical Care Intensivists trained on PPE
and telehealth/e-stethoscopes
6
Telehealth Provided by PH&S
7
Patient Placement
• 2 South ICU was identified as the unit the
patients would be admitted to.
• 4 Negative air flow rooms, along with 2
anterooms.
• Rooms connected by a hopper room. 1
room for patient care, 1 room for waste and
doffing of PPE.
• Adding toilets to the rooms
8
Monitoring Healthcare Personnel
and Managing Exposures
9
Monitoring Healthcare Personnel
and Managing Exposures
• A nurse who is part of the assigned care team will
be stationed in the anteroom to monitor entry of
personnel into the room
• Names will be kept on a log and faxed to
Employee Health daily
• Employees to log into EHS Sharepoint website
and enter current body temperature and
responses to symptom questions
10
Monitoring Healthcare Personnel
and Managing Exposures
• This will be done the beginning with the first day
of contact with the patient, patient’s lab
specimens, or with the waste stream and will
continue twice daily through the end of the 21st
day from the last shift worked, including days
when not scheduled to work.
• EHS will provide an Ebola monitoring kit which
includes a thermometer, copy of the policy, phone
numbers and log in information
11
Laboratory Safety
• Separate lab area set up in the SHMC lab.
• Volunteers stepped up to man that lab
• iSTAT training for the ICU staff, procedure
written for transport of specimens.
• Lessons learned: false alarm case came
into the ED, blood tubed to Lab, YIKES!!
12
Management of Waste
• Mike Charles, Director of Environmental
Services, worked with Steri-Cycle for
agreement of transport of waste
• Procedure developed for waste disposal in
the toilets including rinsing with bleach
• Secure area built at street level for waste
storage
13
Lessons Learned from CDC visit
• Shrouds for PAPRs did not allow for
removal of CO2, RN would slowly pass out
and die, not what we wanted!!
14
• Carpeting at entrance of Emergency
Department should be removed and
replaced with non-porous floor covering
• Need for a specific area for EMS to doff
PPE and decontaminate the truck
• High praise for the incorporation of Ethics
into the plan, had not seen that before to
the extent addressed at PSHMC
15
We Are Ready, Willing and Able
• This was an amazing team effort
• From start in October to CDC visit in
December all responses to any requests
were “what do you need and when do you
need it?”
• All involved Department Managers fully
engaged and supportive of their staff
16
17