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Frontline Hospital Planning Guide: Special Pathogens


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Frontline Hospital Planning Guide: Special Pathogens


With the increasing demand for preparedness for and responses to the world’s emerging public health threats, this planning guide breaks new ground and leads the way as a distinctive domestic resource for healthcare delivery systems to customize their plans specific to their unique clinical, operational, and financial needs. (2)




Purpose and Audience:
All hospitals must be prepared to identify and isolate a patient presenting with a suspected special pathogen infection (i.e., one that is particularly virulent and requires care processes and personal protective equipment beyond daily infection control practices) and inform internal and external stakeholders. This document provides high level planning guidance for a frontline hospital multidisciplinary team (e.g., emergency management, infection prevention and control, emergency department, inpatient care, safety, public relations, and infectious disease, depending on the resources and role of the facility in the community) to support planning and training for the provision of initial care to such patients while determining whether and when the patient will be transferred to another facility for further assessment and treatment. Though the target audience is frontline hospitals, other facilities may fnd information that is applicable to their planning. The information in this planning guide is neither presented as a complete and stand-alone resource for special pathogen management nor is it intended as a universal document for all staff within an entire hospital. It aims to serve as a high level “jumping-off point” to be supplemented by the most current pathogen-specific guidance and customized to meet facility needs.

This document is NOT intended for facilities managing patients confirmed to have a viral hemorrhagic fever or special respiratory pathogen. Rather, this planning guide is designed to assist frontline hospitals to develop systems and provide training to screen for special pathogen infectious diseases and effectively identify, isolate, and inform when a case is suspected, and safely manage patients until diagnosis, transfer, or release. In certain circumstances, patients may require further intervention or invasive procedures based on clinical status or may be at frontline hospitals longer than 24 hours. Hospitals should always consult with public health officials to ascertain risk and to obtain the most current information available including their state and local health departments, the Centers for Disease Control and Prevention (CDC), and other sources to assure their practices and knowledge are current.

The planning guide format provides an overview of the issues that should be addressed as well as planning considerations for specific topics, particularly when such information is not easily accessible from other sources. Much more detailed guidance on infection control for specific pathogens as well as personal protective equipment and other topics is available and is referenced and linked throughout the document for use in planning by those personnel who need more specific information. Frontline facilities are varied, from critical access hospitals to major metropolitan medical centers, and depending on the regional resources and systems the frontline facility may have to simply recognize a suspect case and transfer them, or provide patient care for days at a time awaiting confirmatory testing prior to patient movement. This planning guide attempts to provide high level resources for the full spectrum of care and must be tailored to the specifics of the facility.

Notes and Caveats:
This document was created by subject matter experts using official or best practice information taken from multiple organizations that was vetted and assembled by NYC Health + Hospitals. This document does not constitute official policies or viewpoints of any government agency, including NYC Health + Hospitals.

The information contained in this planning guide is intended as a planning resource and should be incorporated in plans and procedures developed by frontline hospitals.

The authors take no responsibility and bear no liability for any clinical care outcomes, provider injury/illness, or inaccuracies in or resulting from this document. All content was current at the time of publication and vetted to the best of our ability.

Inclusion of specific references and resources is offered as an acknowledgement of their contribution of material and to identify sources of additional information, but it does not constitute endorsement or vouch for the accuracy or applicability of the referenced documents.