Highlights
- •The domestic Ebola response yielded valuable lessons for infectious disease events.
- •Lessons may improve health care system resilience to infectious disease events.
- •Important interview themes include health care facility and workforce issues.
- •Researchers developed a checklist to improve health care system resilience.
Background
The domestic response to the West Africa Ebola virus disease (EVD) epidemic from 2014-2016
provides a unique opportunity to distill lessons learned about health sector planning
and operations from those individuals directly involved. This research project aimed
to identify and integrate these lessons into an actionable checklist that can improve
health sector resilience to future high-consequence infectious disease (HCID) events.
Methods
Interviews (N = 73) were completed with individuals involved in the domestic EVD response
in 4 cities (Atlanta, Dallas, New York, and Omaha), and included individuals who worked
in academia, emergency management, government, health care, law, media, and public
health during the response. Interviews were transcribed and analyzed qualitatively.
Two focus groups were then conducted to expand on themes identified in the interviews.
Using these themes, an evidence-informed checklist was developed and vetted for completeness
and feasibility by an expert advisory group.
Results
Salient themes identified included health care facility issues—specifically identifying
assessment and treatment hospitals, isolation and treatment unit layout, waste management,
community relations, patient identification, patient isolation, limitations on treatment,
laboratories, and research considerations—and health care workforce issues—specifically
psychosocial impact, unit staffing, staff training, and proper personal protective
equipment.
Conclusions
The experiences of those involved in the domestic Ebola response provide critical
lessons that can help strengthen resilience of health care systems and improve future
responses to HCID events.
Key Words
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Article info
Publication history
Published online: December 15, 2017
Footnotes
Funding/support: Supported by the U.S. Centers for Disease Control and Prevention (contract no. 200-2015-M-87759).
Conflicts of interest: None to report.
Disclaimer: The conclusions and opinions expressed in this paper are those of the authors and do not necessarily represent the official position of the U.S. Centers for Disease Control and Prevention.
Identification
Copyright
© 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.