Healthy Choices

Two Sacramento health systems outline preparedness efforts after Ebola scare

Dr. Douglas Kirk, chief medical officer at UCD Medical Center, on Thursday explains the hospital’s preparedness for Ebola patients.
Dr. Douglas Kirk, chief medical officer at UCD Medical Center, on Thursday explains the hospital’s preparedness for Ebola patients. rbenton@sacbee.com

UC Davis Medical Center’s chief medical officer briefed the public on the hospital’s preparedness Thursday, after an Ebola scare earlier in the week tested the response of its emergency department workers and revealed some areas in need of improvement.

“This is a very fluid process,” Dr. J. Douglas Kirk said of the Sacramento hospital’s protocols for treating infectious diseases such as the notorious Ebola virus. “We’ve stepped up education and training for our staff and set new guidelines for front-line staff.”

It was a front-line staff member who identified a patient as a potential Ebola carrier in the emergency room “a couple of days ago,” Kirk said in an interview. In questioning the patient about recent travel history, the intake staff member determined the patient had been to West Africa, ground zero for the devastating Ebola outbreak that’s now spread to the U.S.

That determination set into motion steps that health care workers must take in order to handle an Ebola case safely. The patient was escorted to an isolation room, and a team of health care workers set out to don the protective gear meant to block their exposure to the deadly virus, which is transmitted through contact with bodily fluids.

In a memo to UC Davis Medical Center staff, obtained by The Sacramento Bee, Kirk wrote: “Because it was a potential case, a set of special protocols and procedures, which are based on guidance from the federal Centers for Disease Control and Prevention, were immediately initiated. Fortunately, it was a false alarm. But the event helped us recognize some of the protocols that worked well and some that need more refinement and practice.”

“Today’s event was a good learning experience,” the memo said, adding that there were “the lessons learned.”

Yet Kirk was forgiving in his tone to hospital staff. He wrote, “Keep in mind, every hospital in the nation is facing the same situation. We are all working hard to be fully prepared for a possible case.”

After identifying the potential Ebola patient, UC Davis health care workers suited up and entered the isolation room and continued questioning the patient, only to find out the front-line worker had misconstrued what the patient had said.

The UC Davis staff relied on guidelines that the CDC has now deemed to be too lax in instructing health care workers on the proper precautions in donning and taking off their protective gear. CDC Director Dr. Thomas Frieden recently released stricter guidelines.

Many infectious-disease experts say that U.S. hospitals have not properly trained their staffs to deal with Ebola patients because of the looser, earlier CDC recommendations. Some prefer a set of deliberate steps developed by Doctors Without Borders.

While undressing, Doctors Without Borders workers wash their hands with chlorine solution eight times. Most important, they disrobe only under the supervision of a colleague whose job is to prevent mistakes.

Kirk said the hospital will continue to keep abreast of changes and improvements to protocol for protecting health care workers from harm while treating infectious patients.

“As we receive additional information, we have evolved and ramped up the acuity of our preparedness plans,” he said.

Kirk said the medical center purchased 500 new kits of protective gear for the health care workers. During a press conference Thursday, he displayed contents of the kits – surgical gowns, booties, gloves, neckwear, face masks.

“Our top priority is to keep the health care workers safe and the patient safe,” he said.

No matter the outcome of the Ebola scare at UC Davis, Kirk indicated the episode was useful as a dry run.

Primarily, staff learned how tedious and time-consuming it may be to put on the protective gear and take it off properly. The exercise is done with a sort of buddy system, he said, with one or two colleagues observing and assisting the third, who’d be putting on the complex gear. Drills will help speed up and smooth out the cumbersome process, he said.

UC Davis Medical Center is prepared to treat as many stricken patients as is necessary, he said. But the Sacramento hospital likely will not be one of the University of California facilities chosen as a priority treatment hospital by the CDC, he said.

Regardless, when the UC Davis Medical Center issued a call for volunteers to be part of a special Ebola response team, more than twice the number of health care workers the hospital sought stepped up.

The medical center’s display of transparency came as several hospital systems in the region had yet to reach out to the communities they serve and ease the fears of an Ebola outbreak.

Later Thursday afternoon, the Sutter Health system released a statement listing the steps its hospitals are taking to address community concern. Like UC Davis, Sutter officials said they are following CDC guidelines as they get updated for “policies, procedures and action plans in place at hospitals, care centers and patient call centers throughout the Northern California network.”

Sutter has a range of strategies to tap in case of emergency, from an “Ebola Virus Disease Action Plan” to an “Ebola Virus Disease Screening Protocol” to “Ebola Virus Disease Response Training.”

The announcements came after U.S. Rep. Doris Matsui, D-Sacramento, expressed her concerns in letters to hospital executives that they were faltering in communicating plans to an increasingly nervous public.

Worries about the virus spreading followed news that two Dallas nurses had come down with Ebola. They are being treated in isolation units at high-level care units designated to take in patients with infectious diseases.

Call The Bee’s Cynthia H. Craft, (916) 321-1270.

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