Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Center for Health Security, Baltimore, MD.
Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Center for Health Security, Baltimore, MD.
Am J Infect Control. 2018 May;46(5):533-537. doi: 10.1016/j.ajic.2017.11.001. Epub 2017 Dec 15.
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.
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.
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.
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.
2014-2016 年西非埃博拉病毒病（EVD）疫情期间，中国国内的应对措施为我们提供了一个独特的机会，可以从直接参与应对工作的人员那里汲取有关卫生部门规划和运作的经验教训。本研究项目旨在确定并整合这些经验教训，纳入一个可付诸行动的清单，以提高卫生部门对未来高后果传染病（HCID）事件的应对能力。
对 4 个城市（亚特兰大、达拉斯、纽约和奥马哈）参与国内 EVD 应对工作的 73 人进行了访谈，这些受访者包括在应对疫情期间从事学术、应急管理、政府、医疗保健、法律、媒体和公共卫生工作的人员。对访谈进行了转录和定性分析。然后进行了两次焦点小组讨论，以扩展访谈中确定的主题。利用这些主题，通过专家咨询小组对基于证据的清单进行了完整性和可行性的审查。
确定了一些突出的主题，包括医疗设施问题，特别是确定评估和治疗医院、隔离和治疗单元布局、废物管理、社区关系、患者识别、患者隔离、治疗限制、实验室和研究考虑因素，以及医疗保健劳动力问题，包括心理社会影响、单位人员配置、员工培训和适当的个人防护设备。
参与国内 EVD 应对工作的人员的经验提供了关键的经验教训，可以帮助加强卫生系统的应对能力，并改善未来对 HCID 事件的应对。
