title: Preparing an Academic Medical Center to Manage Patients Infected With Ebola: Experiences of a University Hospital.
abstract: As Ebola has spread beyond West Africa, the challenges confronting health care systems with no experience in managing such patients are enormous. Not only is Ebola a significant threat to a population's health, it can infect the medical personnel trying to treat it. As such, it represents a major challenge to those in public health, emergency medical services (EMS), and acute care hospitals. Our academic medical center volunteered to become an Ebola Treatment Center as part of the US effort to manage the threat. We developed detailed policies and procedures for Ebola patient management at our university hospital. Both the EMS system and county public health made significant contributions during the development process. This article shares information about this process and the outcomes to inform other institutions facing similar challenges of preparing for an emerging threat with limited resources. The discussion includes information about management of (1) patients who arrive by ambulance with prior notification, (2) spontaneous walk-in patients, and (3) patients with confirmed Ebola who are interfacility transfers. Hospital management includes information about Ebola screening procedures, personal protective equipment selection and personnel training, erection of a tent outside the main facility, establishing an Ebola treatment unit inside the facility, and infectious waste and equipment management. Finally, several health policy considerations are presented.
authors.affiliation: Center for Disaster Medical Sciences,Department of Emergency Medicine,University of California Irvine School of Medicine,Irvine,California.
authors.forename: Carl H
authors.initials: CH
authors.lastname: Schultz
authors.affiliation: Center for Disaster Medical Sciences,Department of Emergency Medicine,University of California Irvine School of Medicine,Irvine,California.
authors.forename: Kristi L
authors.initials: KL
authors.lastname: Koenig
authors.affiliation: Center for Disaster Medical Sciences,Department of Emergency Medicine,University of California Irvine School of Medicine,Irvine,California.
authors.forename: Wajdan
authors.initials: W
authors.lastname: Alassaf
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D000354:Africa, Western; D003695:Delivery of Health Care / Q000379:methods; D004196:Disease Outbreaks / Q000517:prevention & control*; D029043:Ebolavirus; D006801:Humans; D017053:Infection Control / Q000379:methods*; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D010356:Patient Isolation / Q000379:methods; D011050:Policy Making; D011634:Public Health / Q000379:methods; D014187:Transportation of Patients / Q000379:methods
keywords: disease outbreaks; infectious disease medicine; occupational exposure; patient isolation; public health practice