With another domestic case of Ebola diagnosed, metro Detroit hospitals are evaluating their policies in case they have to treat, and help contain, Ebola. Here is what they're saying about their preparedness.
Detroit Medical Center
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Hospitals routinely care for patients with a variety of infectious diseases. While the likelihood of receiving a confirmed Ebola patient remains very low, our hospitals are increasing training and conducting drills related to the identification, isolation, testing and treatment of such a patient, and the appropriate use of personal protective equipment and other protocols to prevent transmission to a healthcare worker or anyone else. We are also closely following new information being released by the Centers for Disease Control and Prevention providing the latest guidance for hospitals on Ebola-related safety practices.
St. John Providence
St. John Providence Health System has begun emergency preparedness planning for the possibility of treating Ebola patients in our facilities. St. John Providence has formed a response team that is building on the protocols we already have in place for infectious disease to further ensure the detection of infected patients and protect healthcare workers and patients. The safety of our associates and patients is our first priority. The response team is a multidisciplinary group, consisting of infectious disease, intensive care, and emergency physicians, our laboratory experts, nursing leaders, infection control specialists, environmental services partners, and many others.
We are working closely with Ascension Health, and following the recommendations of the Centers for Disease Control and Prevention, and other federal, state and local partners to increase associates' understanding of Ebola and to prepare for any potential cases. We are using triage tools to screen our patients at care sites in the acute and ambulatory setting to help identify patients who may be at risk for Ebola, specifically those who have traveled to West Africa in the last 21 days.
Henry Ford Hospital
Here's what we've been doing since August:
• Issued guidelines and worked with its Emergency Departments and front-line staff for how to evaluate, identify and manage Ebola in the event a patient presents with symptoms.
• Created multiple educational resources for informing staff about Ebola, including a Web site for accessing the latest information.
• Training staff about the proper use and removal of Personal Protective Equipment, or PPE.
• Training staff about treatment of Ebola, and managing lab specimens.
• Working closely with the CDC and Michigan Department of Community Health.
Also, at Henry Ford Hospital, we are planning both a tabletop exercise and full-scale exercise in the coming weeks. The scope of the exercise is to test our preparedness, emergency operations coordination, surge of mock patients, command and control assets and safety of health care workers. This also will involve the evaluation, detection and managing of Ebola, and proper use and removal of Personal Protective Equipment. More than 300 health care workers will be involved.
Ebola and other infectious diseases has been on our radar for emergency preparedness for several years, and our planning for an Ebola-specific exercise began this summer. As part of our emergency preparedness, Henry Ford Hospital routinely conducts exercises every year. These have ranged from a flu pandemic and tornado to active shooter and dirty bomb detonation.
Beaumont Health System
Along with extensive preparations on many levels, Beaumont Health System is conducting drills and practicing the proper use of personal protection equipment. We are screening patients for their travel history and potential symptoms of Ebola Viral Disease. This screening is occurring in the Hospital Emergency Centers, onsite Medical Clinics and Family Birth Centers.
Warning signs for Ebola include:
i. Fever greater than 38.6 degrees Celsius or 101.5 degrees Fahrenheit AND additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained hemorrhage
AND
ii. History of travel to West Africa within the past 21 days BEFORE onset of symptoms, such as residence in – or travel to – an area where Ebola transmission is active (currently Liberia, Sierra Leone and Guinea; or contact with blood or other body fluids of a person KNOWN to have or suspected to have Ebola.)
For additional information about how Beaumont Health System is responding to concerns about Ebola, click here.
University of Michigan Health System
While the risk of Ebola to most people is quite low, emergency response plans are in place at the University of Michigan Health System to care for such patients while protecting our staff and other patients and visitors. University of Michigan Health System care teams and staff have conducted exercises, training and had consultations with state public health officials and the Centers for Disease Control. Our preparation includes training in the proper use of protective gear, reviews of internal processes, and training in safe care and treatment.
Mercy Memorial Hospital System
Mercy Memorial Hospital System has been closely watching the Ebola Virus Disease news unfold. Several weeks ago, a multidisciplinary team (nursing, infection prevention, medical affairs, administration, quality and housekeeping) began meeting and reviewing existing policies and procedures as well as becoming familiar with the Centers for Disease Control and Prevention's (CDC) guidelines regarding Ebola Virus Disease. These guidelines were immediately adopted by the Emergency Department as well as other outpatient points of entry.
Mercy Memorial's ultimate goal is to provide a safe environment for its patients, staff and physicians and to provide high quality care.
Mercy Memorial already practices STANDARD*, CONTACT and DROPLET* precautions as appropriate for the patient condition. Guidelines and assessment tools recommended by the CDC were also sent to all members of the Mercy Memorial medical staff for use in their offices. We are continuing to monitor the CDC for any ongoing updates.
Mercy Memorial maintains open communication lines with the Michigan Department of Community Health and the Monroe County Health Department as well as several federal, state and local professional medical organizations to keep current on the best practices surrounding the triaging and treatment, as well as monitoring, of potential and actual patients infected with this disease.
Ebola Virus Disease symptoms are:
• Fever greater than 100.4?F or 38.0?C
• Severe headache
• Muscle pain
• Vomiting
• Diarrhea
• Abdominal (stomach) pain
• Unexplained hemorrhage (bleeding or bruising)
Ebola is not spread through casual contact. It is spread by contact with blood and body fluids of persons, including items of those persons, exposed to the disease, particularly someone who is ill.
What should the community do if they suspect they have been exposed to Ebola?
• Wash your hands with soap and water frequently, using friction and running water for a minimum of 20 seconds.
• Call your personal physician, the emergency department and/or the Michigan Department of Community Health, if at all possible, prior to arrival to the health care facility with your concerns and for further instructions.
• Seek medical care if you develop a fever (greater than or equal to 100.4?F or 38.0?C) and any of the other symptoms listed above.
• Limit your contact with other people until and when you seek medical treatment. • DO NOT travel anywhere else besides to a healthcare facility.
*Standard Precautions – Use of hand hygiene and personal protective equipment while providing care to any patient.
*Contact and Droplet Precautions – Use of hand hygiene, gloves, gowns, masks and eye protection by staff to prevent the transmission of infection by droplets in the air originating from the patient. Patients also wear masks during transport throughout healthcare facility.
Saint Joseph Mercy Health System
Although no Ebola cases have been reported in Michigan and the risk of contracting Ebola is extremely low, Saint Joseph Mercy Health System has procedures in place based on Centers for Disease Control and Prevention (CDC) guidelines in the event of a case presenting in one of our six hospitals across southeast Michigan. Our Infection Prevention and Control teams are continuously engaged in emergency preparedness and, as with any infectious disease outbreak, we participate with the CDC, local and state public health departments on calls to monitor the current status and risk. We continue to make updates to our clinical protocols as more information comes in daily so that staff can quickly identify and respond in the event they are faced with a high-risk patient. In the event of that risk, Saint Joseph Mercy Health System hospitals would work with the state health department immediately and inform the public.
McLaren Macomb
While it may be unlikely that a patient with Ebola is treated at McLaren Macomb, the hospital is prepared at a very high level to protect all patients, employees and visitors.
McLaren Macomb has taken immediate steps to ensure our team is prepared in the event that a patient with Ebola arrives at our facility. These include:
• The development of an Ebola Preparedness Task Force comprised of team members from the hospital's executive team, clinical leadership, infectious disease, patient communication, plant operations and quality, as well as ambulance transportation. A core group of this team will be on-call 24/7 in the event that a patient arrives with Ebola symptoms.
• Patient screening procedures in the emergency department. The dedicated team in McLaren Macomb's emergency department has already begun screening patients in accordance with the Center for Disease Control and Prevention (CDC) guidelines. In the unlikely event a patient arrives with Ebola symptoms, a process has been identified to immediately quarantine that patient to ensure minimal exposure to patients, staff and visitors.
• An updated policy to specifically address all procedures related to protecting staff while screening and treating patients with Ebola. This policy will continually be reviewed to ensure it is aligned with any changes in CDC recommendations.
• Updated orders of personal protective equipment (PPE). McLaren Macomb's PPE plan is over and above the CDC required minimum. PPE will be consistent throughout McLaren Health Care to help ensure continuity in training and to provide a source of back-up PPE supplies if needed.
• McLaren Health Care Ebola preparedness coordination. McLaren Health Care has assembled a corporate-wide task force to help standardize processes and share information regarding Ebola.
Garden City Hospital
In regards to Ebola Training and Safeguards, Garden City Hospital is doing the following:
1. Educating front line staff for signs and symptoms of Ebola
2. Reviewing ED triage protocols
3. Adopted a screening tool for the ED triage for Ebola
4. Working with a group on implementing house wide education, screening and alertness of Ebola.
5. Working to designate areas of point of contact for screening
6. Working with local EMS crews to help identify patients for screening and having a communication to area hospitals alerting transfer of pt.
7. Attending webinars with the CDC/WHO regarding Ebola
8. Receiving daily updates from the Region 2 south emergency preparedness and the CDC.
9. Inventorying our present PPE supplies
10. Training personal on the proper doffing and donning of PPE. (taking on and taking off of PPE)(Personal Protection Equipment)
11. Keeping contacts open with the Region 2 South and HEMS for updates on Ebola.