title: Lessons learned from hospital Ebola preparation.
abstract: BACKGROUND
  Hospital Ebola preparation is underway in the United States and other countries; however, the best approach and resources involved are unknown.
  
  
  OBJECTIVE
  To examine costs and challenges associated with hospital Ebola preparation by means of a survey of Society for Healthcare Epidemiology of America (SHEA) members.
  
  
  METHODS
  Electronic survey of infection prevention experts.
  
  
  RESULTS
  A total of 257 members completed the survey (221 US, 36 international) representing institutions in 41 US states, the District of Columbia, and 18 countries. The 221 US respondents represented 158 (43.1%) of 367 major medical centers that have SHEA members and included 21 (60%) of 35 institutions recently defined by the US Centers for Disease Control and Prevention as Ebola virus disease treatment centers. From October 13 through October 19, 2014, Ebola consumed 80% of hospital epidemiology time and only 30% of routine infection prevention activities were completed. Routine care was delayed in 27% of hospitals evaluating patients for Ebola.
  
  
  CONCLUSIONS
  Convenience sample of SHEA members with a moderate response rate.
  
  
  CONCLUSIONS
  Hospital Ebola preparations required extraordinary resources, which were diverted from routine infection prevention activities. Patients being evaluated for Ebola faced delays and potential limitations in management of other diseases that are more common in travelers returning from West Africa.
authors.affiliation: 1Veterans Affairs Maryland Healthcare System,Baltimore,Maryland.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Morgan
authors.affiliation: 3The Joint Commission,Chicago,Illinois.
authors.forename: Barbara
authors.initials: B
authors.lastname: Braun
authors.affiliation: 4Johns Hopkins School of Medicine,Baltimore,Maryland.
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Milstone
authors.affiliation: 5Duke University,Durham,North Carolina.
authors.forename: Deverick
authors.initials: D
authors.lastname: Anderson
authors.affiliation: 6University of Pennsylvania,Philadelphia,Pennsylvania.
authors.forename: Ebbing
authors.initials: E
authors.lastname: Lautenbach
authors.affiliation: 7University of Wisconsin,Madison,Wisconsin.
authors.forename: Nasia
authors.initials: N
authors.lastname: Safdar
authors.affiliation: 8Christiana Hospital,Wilmington,Delaware.
authors.forename: Marci
authors.initials: M
authors.lastname: Drees
authors.affiliation: 9University of Michigan,Ann Arbor,Michigan.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Meddings
authors.affiliation: 6University of Pennsylvania,Philadelphia,Pennsylvania.
authors.forename: Darren R
authors.initials: DR
authors.lastname: Linkin
authors.affiliation: 2University of Maryland School of Medicine,Baltimore,Maryland.
authors.forename: Lindsay D
authors.initials: LD
authors.lastname: Croft
authors.affiliation: 2University of Maryland School of Medicine,Baltimore,Maryland.
authors.forename: Lisa
authors.initials: L
authors.lastname: Pineles
authors.affiliation: 10University of Iowa School of Medicine,Iowa City,Iowa.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Diekema
authors.affiliation: 2University of Maryland School of Medicine,Baltimore,Maryland.
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Harris
mesh_terms: D015276:Health Care Rationing; D019142:Hemorrhagic Fever, Ebola / Q000517:prevention & control / Q000523:psychology / Q000628:therapy; D006761:Hospitals / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D017053:Infection Control / Q000379:methods / Q000458:organization & administration; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control; D017751:Safety Management / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology