BACKGROUND: In response to the 2014 West Africa Ebola epidemic, the Michigan Department of Health and Human Services (MDHHS) secured funds to support development of robust infection prevention and control programs via the Michigan Special Pathogen Response Network (SPRN). The goal of the SPRN is to strengthen Michigan’s emergency response to new or emerging public health threats. The SPRN includes MDHHS, Michigan hospitals, life support agencies, local health departments and the regional healthcare coalitions. Guided by a tool developed by the Centers for Disease Control and Prevention (CDC), the SPRN team offers on-site technical assistance (TA) visits to healthcare facilities to strengthen facility preparedness programs.
METHODS: An online fillable survey was sent to all hospitals in the state with a response time of one week. The hospitals were to report on their ability to implement guidance, screen/isolate patients, communication protocols, clinical care/support, personal protective equipment (PPE), laboratory testing/specimen transport, environment of care and medical waste management. The hospitals were asked to self-identify into 1 of 4 tiers based on their level of hospital infrastructure available to detect, isolate, and treat or safely transfer patients with known or suspected pathogens. Tier 1 and 2 facilities are treatment facilities; Tier 2 facilities only accept transfers from their usual referral patterns/network. Tier 3 facilities are assessment facilities which will identify, isolate, test and provide care until test results are available. Screening, or Tier 4, facilities should have the capacity to identify and isolate patients pending transfer for testing and necessary treatment elsewhere.
RESULTS: Ninety-five percent (161/169) of Michigan’s licensed hospitals responded to the survey. Statewide, seven hospitals self- identified as either Tier 1 or 2 facilities, and 40 as Tier 3. Thirty-two hospitals requested TA. To date, nine hospitals have received TA. Common strengths identified were strong infrastructure, staffing, and clinical management. Identified areas for opportunity were PPE and laboratory capabilities.
CONCLUSIONS: The SPRN will provide sustainable training and assistance to close gaps and strengthen infection control capacity at all facilities. Currently, planned activities to address gaps include: continued quarterly statewide hospital conference calls; quarterly exchange calls for Tier 1 and 2 facilities; a state-wide SPRN meeting and exercise in March 2016; and a proposed decedent handling workshop. In the long term, statewide healthcare infrastructure will be better positioned with response plans for the next emerging pathogen in coordination with the overall healthcare emergency preparedness program.