Ebola Virus Disease (EVD) preparation: Common sense planning

Most hospitals have an infection control committee, nurse and/or physician (epidemiologist) on staff who can serve as point person(s) for sorting through Centers for Disease Control information on health care worker EVD prevention strategies, state health department notifications and other pertinent resources for planning purposes (see links below). Utilize your experts and plan to meet regularly to review EVD specific management planning, policies and procedures. Link with expert epidemiologists (at CDC or other designated facilities) as needed to specifically address confidential patient/exposure matters of importance. Regularly update the hospital staff on EVD initiatives, and have a methodology in place for receipt of questions and concerns from staff. Every effort should be made to address fear of transmission, misinformation and disinformation. Retrain staff in isolation techniques, prevention of direct contact of body fluids and proper donning and doffing of personal protective equipment.

When working with a patient who is suspected or confirmed as having EVD, maintaining patient confidentiality is critical. Think of the same processes that are in place to protect patient confidentiality with other socially sensitive diagnoses (e.g., HIV+, hepatitis or sexually transmitted diseases) and put the same patient identity/confidentiality protections into place. Likewise, review and reiterate to all staff that absolute confidentiality is crucial for patient protection. Keep this point in mind when planning responses to media inquiries. The public’s "right to know” does not supersede the patient’s right to privacy. Counsel (with human resources expertise) may be valuable to assist with crafting the “correct tone” and importance of the message to staff, especially making all aware of inadvertent breaches, and warning of consequences for social media or other leaks of patient information.

Work with counsel prior to media coming to your doors for information on a suspected EVD patient or healthcare worker with potential EVD exposure. Media insistence should not force premature or ill-prepared statements. Determine what (if any) information will be provided, consider review of the use of protective personnel equipment with “no skin showing”, isolation room techniques that do not alienate the patient, etc. Plan to provide information you want the public to know that does not violate patient confidentiality.

The instantaneous nature of information (and disinformation) is a challenge to channel into a positive outlet for getting out your intended messages and information. Use avenues such as the media, social media and your website to get intended information out to the staff and the public. Consider creating website Q&As, providing coffee meetings with the public, making CEO webcasts, etc., to allow for flow of intended information out of your facility. Proactive information that is well thought out, planned and released when you are ready is always preferable over reactive responses.