Infectious disease – coming to a hospital near you?

While the “ER” has been glamorized over the years by too many television dramas to count, the emergency room also is the front line of health care in both large cities and small towns. But a new plot twist has now arrived, in the form of lots of unwanted scrutiny for a Dallas-area hospital for its unasked-for role in the Ebola panic in the United States.

If we believe what’s on TV, maybe it’s not so hard to believe a patient who just arrived from West Africa with a fever and flu-like symptoms could actually be treated and released despite 24-hour media coverage of Ebola. Emergency rooms are chaotic and short-staffed, right? But now that a nurse who treated the now-deceased patient has tested positive for Ebola, what is clear is that some (and arguably many) hospital systems are not adequately prepared to handle patients with certain communicable diseases.

Of course, the finger pointing has begun. The director of the U.S. Centers for Disease Control and Prevention (CDC) blamed a “breach in protocol” at the hospital for the nurse’s exposure and subsequent infection. That charge that was quickly denounced by the National Nurses United union, which called it “a system failure” indicating a broader gap in training across hospitals nationwide. Whatever the gap, top health officials have some difficult decisions ahead about how to identify and handle cases of Ebola, and those decisions will determine a lot about the potential for the spread of this disease.

Seemingly, the risk potential for smaller city or rural hospitals is low. But then again, with international travel easier and more prevalent than ever before, who is to say someone carrying Ebola but having no outward symptoms couldn’t go undetected in screening upon arrival at Washington Dulles airport or New York JFK and then get in a car and drive just a few hours to Pittsburgh, where we could soon have a situation on our hands like the one in Dallas.

My guess is the CDC is painfully aware of that possibility and is mobilizing to get advanced infectious disease training in place for as many hospitals as it can while simultaneously trying to stop the entry of the disease in the first place as we’ve already seen at major international airports. However, the lesson from Dallas is a warning for every hospital nationwide, large or small: taking time to re-evaluate infectious disease containment and protection procedures among staff, contractors and vendors would be an excellent use of time right about now.

While the Dallas hospital is under continued scrutiny for its recording and containment practices, it’s also come under fire for the way in which it first reported the case and for its flawed communications with the patient’s family. This case serves as yet another example to hospital systems, and especially those serving large international populations, the importance of regularly reevaluating and updating crisis communications plans to address current issues.  When the national and international spotlights shine strongly on your organization, a well-thought-out communications plan could be the difference between mitigating a crisis and sparking additional controversy.  

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