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Answering the Tough Questions: Kentucky’s Region 7 HCC Ebola Response Exercise

Edgewood, KY

The 2014 Ebola virus outbreak in West Africa shocked the world. Questions and fears grew as the virus crossed international borders and health care workers fell ill. Health care organizations in the United States faced the real possibility of an Ebola patient arriving on their doorstep – were they ready?

medical personnel dressed in protective clothing.  

Two years after the Ebola virus outbreak first began, Kentucky’s Region 7 health care coalition (HCC) – a network of hospitals, emergency medical services, public health departments, and emergency management agencies – continues to train, exercise, and plan together for the possibility of a patient with a highly infectious disease presenting at a local health care facility. With funding from the Hospital Preparedness Program (HPP), Region 7 HCC members collaborate so that each member has the necessary medical equipment and supplies, real-time information, communication systems, and trained health care personnel to respond to emergencies like Ebola and save lives.

With HPP cooperative agreement funding, Region 7 HCC members conducted an Ebola response exercise in October 2016. The exercise scenario involved a very sick patient arriving at the Emergency Department at St. Elizabeth Hospital – Edgewood, a Region 7 HCC member and one of Kentucky’s Ebola assessment hospitals. In the exercise scenario, hospital staff suspected that the patient was infected with Ebola after conducting an intake interview. The hospital immediately implemented their Ebola Response Plan. However, before the patient could be transferred to an Ebola treatment center, the patient died.

Hospital staff, the Kentucky Department for Public Health (KDPH), members of Kentucky's Infectious Disease Fatality Management Team (IDFMT), and numerous observers and evaluators participated in the day-long exercise. In 2014, St. Elizabeth Hospital – Edgewood used both HPP and private funds to construct a replica of its intensive care unit for conducting realistic patient care trainings. HCC members exercised inside the replica unit, practicing complicated clinical techniques and procedures; rehearsing navigation around tight corners and in hallways while wearing bulky protective gear; and assessing existing plans and protocols. HCC members also practiced using HPP-funded specialized equipment to prepare the deceased patient’s body for transport and protect those involved with the decedent’s care. The exercise tested KDPH, IDFMT, and St. Elizabeth Hospital – Edgewood guidelines and procedures for clarity and utility, as well as strengthened relationships between HCC members.

The exercise brought to light the need for clearer instructions and more practice donning and doffing personal protective equipment to ensure practitioners’ safety during a real-world emergency. “We are updating our guidance and protocols to be as precise as possible,” commented Ms. Jasie Logsdon, a KDPH Healthcare Preparedness Coordinator. “We are capturing lessons-learned in an after action report to inform our future efforts. This exercise was critical in helping us identify gaps, and we would not have been able to conduct this exercise without HPP funding and guidance.”

Olsson learned from this exercise will be applied to improve incident command and standard operating guidance for future HCC exercises and joint responses across Kentucky. As noted by Ms. Jessica McElroy, the Region 7 HCC Coordinator, it is critical for the IDFMT to exercise with each of Kentucky’s six Ebola assessment hospitals in order to be familiar with each hospital’s staff, facilities, and procedures. “By continuing to plan, coordinate, and exercise together, we know we are prepared and able to work together to protect the citizens of Kentucky from highly infectious diseases,” reflected Mr. David Guethlein, the Disaster Chairman for St. Elizabeth's Hospital. “We are proud of what we have accomplished together in Region 7 with support from HPP – we know what we need to do to help keep Kentucky safe during the next major outbreak.”