Paris Regional Medical Center held two Ebola drills recently. One was planned; the other was not.
About 18 hours before a scheduled walk-through exercise of the hospital’s Ebola preparation on Friday, the plan was unexpectedly tested when a patient entered the PRMC emergency department Thursday afternoon claiming she had been exposed to Ebola and wasn’t feeling well.
“That turned out not to be the case,” said Stephen Grubb, the hospital’s CEO. “But the plan was in place and everyone responded like professionals. It was a great way to jump start today’s drill.”
According to Grubbs, a patient presented at the emergency room late Thursday afternoon, saying she had reason to believe she had been exposed to Ebola. She told the ER registry staff she had been in a Dallas hospital around the same time as Thomas Eric Duncan, the first patient diagnosed with Ebola in America.
The patient – who Grubbs could not identify due to patient privacy regulations — was immediately placed in isolation and examined by
“Upon further examination, it was determined she was not at risk,” said Grubbs. “The patient was not treated for Ebola and was discharged. It was a positive outcome.”
The exercise Friday morning had been scheduled for a number of days. The hospital has recently held a series of meetings and educational seminars on the subject of Ebola and has spent a considerable amount of time refining and refreshing its infection control protocols in case the need arises.
Friday’s drill began with a meeting of department heads in the hospital administration conference room before moving to the emergency department.
Diane Nation, a hospital employee, played the part of the patient. She entered the emergency room waiting area on foot, pretending to have a cough and told personnel at the sign-in desk she was ill and had only recently returned from a mission trip to West Africa. This automatically triggered the Ebola response plan.
As a number of selected observers — from key hospital department heads to a representative of the city’s emergency medical services — looked
on, emergency room personnel walked through the steps of the plan. The patient was provided with a face mask, questioned further, and immediately escorted out of the waiting room and into a nearby room designated for use as an isolation area.
Cheryl Perry, the hospital’s human resource director, answered questions from other patients in the waiting room, reassuring them what they were seeing was a drill. Corey Fagan, the emergency department director, took on the role of the triage nurse, donning personal protective equipment from head to toe before entering the room the supposed patient was in.
Throughout the process, observers took notes, while other employees, following their assigned part of the plan, began notifying key departments and other interested agencies the drill had begun.
“It’s a calling tree system,” explained Debra Taylor, PRMC’s chief nursing officer, of the notifications being made. As one department head was alerted, they in turn alerted others, until all personnel were apprised of the situation.
The exercise ended before the supposed patient was to be “admitted” to the hospital, but every department, from administration to housekeeping took part. A crew from janitorial services donned full protective gear before making their way to the emergency department to test their response time.
Fagan, who was in full PPE during his interview with the patient, took the opportunity to drill on the proper procedures for doffing and disposing of the protective gear. He was aided by Priscilla Neals, director of surgical services.
After the exercise, department heads reassembled in the administration offices for a debriefing. They discussed concerns and gave suggestions on ways to improve the already complex, but vital process.
Grubbs lead the discussion as Patty Monczewski, PRMC’s COO, compiled notes on a wall board.
Topics centered on communications and notifications; procedures; available equipment and equipment on order; and the training on that equipment.
There was discussion on ways to further ensure the level of containment of any possible high-risk patient and the safety of everyone in the hospital from staff to patients to visitors.
About 30 people took part in the exercise, and the departmental debriefs continued even after the larger group broke up. Grubbs thanked everyone for their efforts and announced another drill, continuing the treatment process, would be scheduled for next week sometime.
“We are determined to be ready,” said Grubbs.