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事件指挥系统在医院生物防护单元中的应用。

Application of the Incident Command System to the Hospital Biocontainment Unit Setting.

机构信息

Lauren M. Sauer, MSc, is Director of Operations, Johns Hopkins Office of Critical Event Preparedness and Response, Department of Emergency Medicine, School of Medicine, Johns Hopkins University.

Ms. Sauer and Dr. Romig are co-first authors.

出版信息

Health Secur. 2019 Jan/Feb;17(1):27-34. doi: 10.1089/hs.2019.0006.

Abstract

High-consequence pathogens create a unique problem. To provide effective treatment for infected patients while providing safety for the community, a series of 10 high-level isolation units have been created across the country; they are known as Regional Ebola and Special Pathogen Treatment Centers (RESPTCs). The activation of a high-level isolation unit is a highly resource-intensive activity, with effects that ripple across the healthcare system. The incident command system (ICS), a standard tool for command, control, and coordination in domestic emergencies, is a command structure that may be useful in a biocontainment event. A version of this system, the hospital emergency incident command system, provides an adaptable all-hazards approach in healthcare delivery systems. Here we describe its utility in an operational response to safely care for a patient(s) infected with a high-consequence pathogen on a high-level isolation unit. The Johns Hopkins Hospital created a high-level isolation unit to manage the comprehensive and complex needs of patients with high-consequence infectious diseases, including Ebola virus disease. The unique challenges of and opportunities for providing care in this high-level isolation unit led the authors to modify the hospital incident command system model for use during activation. This system has been tested and refined during full-scale functional and tabletop exercises. Lessons learned from the after-action reviews of these exercises led to optimization of the structure and implementation of ICS on the biocontainment unit, including improved job action sheets, designation of physical location of roles, and communication approaches. Overall, the adaptation of ICS for use in the high-level isolation unit setting may be an effective approach to emergency management during an activation.

摘要

高后果病原体带来了一个独特的问题。为了在为社区提供安全保障的同时,为感染患者提供有效治疗,全国范围内已经创建了 10 个高级隔离单位;这些单位被称为区域埃博拉和特殊病原体治疗中心(RESPTCs)。高级隔离单位的激活是一项高度资源密集型的活动,其影响会波及整个医疗体系。事件指挥系统(ICS)是国内紧急情况指挥、控制和协调的标准工具,是一种在生物控制事件中可能有用的指挥结构。该系统的一个版本,即医院应急事件指挥系统,为医疗保健系统提供了一种适应性强的全灾害方法。在这里,我们描述了它在安全护理感染高后果病原体的患者(多个)的操作响应中的效用,这些患者在高级隔离单位中。约翰霍普金斯医院创建了一个高级隔离单位,以管理具有高后果传染病患者的全面和复杂需求,包括埃博拉病毒病。在这个高级隔离单位中提供护理的独特挑战和机遇促使作者对医院事件指挥系统模型进行了修改,以便在激活期间使用。该系统已经在全面功能和桌面演练中进行了测试和完善。这些演练的行动后审查的经验教训导致了生物控制单元中 ICS 的结构和实施的优化,包括改进的作业行动单、角色物理位置的指定以及沟通方法。总体而言,ICS 适应高级隔离单位环境的使用可能是激活期间应急管理的有效方法。

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