BACKGROUND: In 2015, CDC funded state health departments to conduct Ebola Readiness Assessments (ERAs) of Ebola Assessment Hospitals (EAHs) and Ebola Treatment Centers (ETCs). The Maryland Department of Health & Mental Hygiene (DHMH) in collaboration with Maryland hospitals identified 5 EAHs and 2 ETC/EAHs. ERAs were conducted in all 7 hospitals. While individual facility assessment follow-up was conducted, concurrently a collaborative group of the 5 EAHs and DHMH was established to address gaps and perceived needs across facilities and share best practices.
METHODS: EAH Collaborative membership included representation from DHMH and the 5 EAHs comprising infection preventionists, hospital epidemiologists, emergency planners, unit managers, clinicians, and hospital administrators. Meetings were held via conference call, e-mail, and in-person.
RESULTS: Challenges included identifying meeting dates and a location that could accommodate decision-makers from hospitals located geographically across the state. At least one representative from each EAH participated in all meetings. Topics for EAH Collaborative discussion included a review of the initial EAH ERAs, ideal frequency for PPE training and drills (quarterly re-training of staff and yearly full-drills), PPE standardization (hospitals agreed that strict standardization was not feasible, but requested DHMH provide overall guidance), refinements to CDC guidance on the management of deceased patients, healthcare worker monitoring, and infection control topics beyond Ebola (MERS-CoV, avian influenza, infection control assessments). Suggested topics for future meetings include coordination of ambulance transport issues between facilities, disinfection of re-usable materials, exclusion criteria for healthcare workers on an Ebola unit, “crash-out” protocol standardization, laboratory issues, waste management protocol, case studies of previous Persons Under Consideration for Ebola, and pediatric patient considerations.
CONCLUSIONS: The EAH Collaborative is a useful platform for addressing infection control gaps and needs across EAHs, reducing resources required for individual follow-up, especially as lessons learned during ERAs were often applicable to all EAHs. The Collaborative allowed for open dialogue to discuss and make decisions with real-time input from hospitals. Additionally, the Collaborative provided hospitals from different systems with a means for sharing policies and resources, avoiding duplication of efforts at each hospital. The Collaborative shows promise for additional activities, including a meeting rotation allowing each hospital to demonstrate specifics of their units and receive direct on-site feedback from colleagues and subject matter experts. Furthermore, the Collaborative has established a framework for hospitals working across systems in collaboration with the health department to address issues of public health importance.