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saintleo university
Infectious Disease Outbreak at Saint Leo Hospital
Healthcare Management-Dr.Bal
Michelle Neeck
4/8/2015
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Disaster preparedness is something many patients and the general public do not think
about on a daily basis, but as a new member of the Saint Leo University Hospital disaster team
this is a constant worry as infections are common in hospitals and one of the number one
contenders for causing complications and possibly hospital wide outbreaks from different
infectious diseases such as staph and the even more deadly MRSA. Creating an effective and
well thought out disaster plan is essential for any hospital especially Saint Leo. One of the most
important factors to keep in mind how different aspects of the healthcare organization can play a
significant role in the development of any such disaster plan and these along with the medical
knowledge we know about various infectious diseases today. When discussing a disaster and
preparedness plan there are several different factors that almost all hospital plans and healthcare
organizations must take into consideration in regards to infections disease. The first of these is to
identify if the infectious is disease is caused naturally or is it a result of bioterrorism which is
defined as “A bioterrorism attack is the deliberate release of viruses, bacteria, or other germs
(agents) used to cause illness or death in people, animals, or plants. These agents are typically
found in nature, but it is possible that they could be changed to increase their ability to cause
disease, make them resistant to current medicines, or to increase their ability to be spread into the
environment.” (Emergency Preparedness and Response, 2015) The fear of bioterrorism is a very
real concern for many countries especially in the United States, the United Kingdom, and Spain
to name a few who have been the targets of terrorist attacks in the past and have taken great
precautions to prevent further attacks. Next after identifying that there is in fact an outbreak the
next step usually involves isolation and quarantine of all individuals in involved in which to
prevent the disease from spreading. These two methods are both associated as common practices
for both hospitals and other healthcare facilities. Keeping these practices in mind the foundation
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of creating a plan and applying modern healthcare organization techniques can help recognize,
contain, and prevent the spread of infectious diseases.
When creating a disaster preparedness plan it is important to keep in mind some of the
challenges to delivering healthcare both on a local and global scale. Focusing on the United
States it is important to take into consideration a systematic view of the healthcare system. There
are several reasons why. First, as the author suggests there are several factors that affect
healthcare such as infrastructure and nutrition, knowing these applying a basic framework can
help better identify what type of disaster plan will be right for a given community. Second,
navigating public policy can affect a disaster plan due to regulation of supplies, financing, and
who does and does not have access to healthcare. Thirdly, the systematic view and its important
with disaster planning also include what is called the value chain which examines the production
of goods of a company and the value associated with the products produced. In healthcare this
translates to the ability to offer state of the art healthcare products and services, being able to
deliver those services through knowledgeable staff, and the results include patient satisfaction
with the treatment they receive. This can have an impact on disaster planning as it is necessary to
apply this view of thinking because when it comes to preventing diseases by having the most up
to date care, delivering the care, and having patients feel secure with decisions of the hospital
and care received. Lastly, the ability to adapt to various changes is equally important as many of
the techniques for containing and responding to infections is constantly changing as our
knowledge of these diseases grows it is important for hospitals and preparedness plans to be
adaptable with the onslaught of new information. (Lawton Burns, 2012) Last year, the globe was
revised by the story of the growing number persons in Africa being infected with the Ebola
Virus. The Ebola Virus had remained quite dormant in the media spotlight for nearly 40 years,
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but news spread that more and more people were being infected with the virus and it spread to
several different countries in Africa some with major airports which fly passengers all over the
world. The threat of an epidemic was high and many held their breath waiting for news of the
next country to be included in this epidemic. The United States was eventually labeled with
persons being concretely diagnosed with the Ebola Virus. Several medical personnel would
eventually be included among those infected with the virus in the United States, but what was
more shocking from this development was the lack of preparedness by the hospital facilities in
disaster planning such as this. Many nurses and other medical professionals stated that they had
received very little training in this area and as a result there was an outcry in reinforcing and re-
teaching important safety policies. In the wake of Ebola being found in Dallas, Texas and a nurse
also being infected many of the nurses there became vocal about their lack of training stating
“There was no advanced preparedness on what to do with the patient. There was no protocol.
There was no system. The nurses were asked to call the infectious disease department” if they
had questions, but that department didn't have answers either, the statement said. So nurses were
essentially left to figure things out on their own as they dealt with “copious amounts” of highly
contagious bodily fluids from the dying Duncan.” (Mohan, 2014) This lack of cohesiveness
resulted in several medical professionals contracting Ebola and did not offer the public a sense
that hospitals had an effective response plan in place. This could have been prevented if the
hospitals had been following a systematic approach and following the regulations set in place by
the Center for Disease Control.
While systematic approach and delivery of healthcare is a very important aspect of
providing healthcare and development of a disaster plan, leadership can also play a leading role
when it comes to implementing a disaster plan into practice. Leadership can take many forms
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and it does not always have to come from the seemingly most important person, likewise
leadership can have an effect on any type of situation whether positive or negative. Leadership in
emergency type situations can as Demiroz describes “Leadership in managing disasters and
emergencies can minimize the damage inflicted by an event whilst lack of successful leadership
exacerbates the impact. Leaders should have certain skills and abilities in order to manage
catastrophes based on the environmental conditions, organizations they lead, scope of the
disaster.” (Fatiah Demiroz, 2012) Leadership as described can make or break disaster responses
and the level of perception of the emergency. One of the roles in leadership is to act as a strategic
problem solver and when developing a plan for a possible infectious disease outbreak in a
hospital such as Saint Leo Hospital. There are 8 steps to strategic planning which first begins
with defining the problem such as containing an infectious outbreak. Next is setting the overall
objective which would be to contain the outbreak. Step three is conducting a root cause analysis
to find out what is causing the outbreak such as improper wound cleaning. Following the
analysis is to generate alternatives such as more in depth wound cleaning or better wound care
materials. Step five is comparing these different alternatives which transitions into step six as
selecting best decision and why that are. Step seven is the development of the plan and
implementing it and lastly developing an evaluation plan and evaluating how well your decisions
played out. (Lawton Burns, 2012) Being able to use all 8 steps is one thing, but is entirely
different when the actual disaster is happening. There can be several issues that could arise not
allow the plan to work properly such as a lack of manpower, lack of resources, and confusion. To
help overcome these possible downfalls of the disaster plan it is necessary to identify the type of
leadership role needed in the given situation. Iasija suggests that there are five styles of
leadership approaches that can be used and they are listed as follows: tells, sells, consults, and
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joins. (Iasija, 2012) Telling gives orders to a team and waits for a result. This may not be the
most effective method in disaster planning but it could be used to help decrease confusion and
begin the containment process such as in an infectious disease outbreak. Next, selling is used to
convince the team by focusing on positive and negatives which may be good to help the team
identify what is working and not working during the crisis. Next is consulting, which as Iasija
says “Leader consults the team and allows them to participate in the decision making with the
view to making small adjustments but the main thrust of the decisions of the leader are more or
less final.” (Iasija, 2012) Lastly is joining which is the most influential of all the leadership styles
as the manager gets down in the trenches and “Discusses thoroughly the problem and the likely
course of action. Every member of the team is involved in the discussion and finally the
consensus decision prevails. This style consumes most time but later work is smooth.” (Iasija,
2012) These different styles can be used on their own and they can mix in different orders
depending on the process of the disaster plan which managers may find that some tactics are
more appropriate than others. This is important to keep in the mind as the concern regarding
outbreaks and the world being so interdependent one another that having a well devolved plan
and the leadership skills is necessary. In an article by Margaret Parker she explains “In a
contagious event, there may be a continuous stream of new patients requiring critical care
support, overwhelming our current intensive care unit capacity. Planning to develop processes
that will enable us to expand our intensive care unit capacity, and likely adapt our standard of
care Using the processes and resources we are currently using to improve patient safety can
provide a framework for developing the necessary processes.” (Parker, 2006) In a possible
outbreak in a hospital setting, as Parker describes there may be an onslaught of patients and the
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need to be able to control the amount of patients coming in and out and leadership is definitely
important.
Continuing on, the role of organizational structure can be the make or break in the proper
functioning of a hospital and the functionality of the disaster preparedness plan that will be set in
place to combat an infectious disease outbreak. Organizational structure is then defined as “The
typically hierarchical arrangement of lines of authority, communications, rights and duties of an
organization. Organizational structure determines how the roles, power and responsibilities are
assigned, controlled, and coordinated, and how information flows between the different levels of
management.” (Organizational Structure, 2015) The structure then can lend itself to completing
and assisting with the goals of the organization such as preparing the hospital for a possible
infectious disease outbreak. Some of the best information for creating the right organizational
structure can come from failures in the past such as Ebola outbreaks, pneumonia outbreaks, and
so on. Murat Balamir offers some suggestions on how to help prevent disasters from past
experiences by the following suggestions “(a) the use of information concerning formal planning
procedures; (b) pre- or post-disaster emphasis in preparations; (c) the political or technical basis
of decisions; (d) the extraordinary or routine nature of responses; (e) the general or specialized
nature of financial sources used; (f) and their compatibility with the order of priorities in risk
management An evaluation of the conventional policy in Turkey clarifies a position closer to the
`fatalist' model and indicates the lines of action for improvements.” (Balamir, 2002) When
designing and organizational structure and preventing infectious disease outbreaks using the
model as described by Balamir using technology such as programs designed to keep track of the
number of patients, current treatment regimes, and the patient’s status can help make outbreaks a
bit more manageable. Financial resources are also a cause for concern as if the budget is not big
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enough to compensate for the cost of drugs, and allowances for an increase in the volume of
patients. Adding to this is further evidence of the importance of organizational structure and
handling mass casualties or patients of infectious disease outbreaks. Surgeon Dr. Christopher
Born speaks on behalf of the surgical side of the hospital disaster response plan which can be
important especially for a threat of infectious disease outbreak which may require surgeons to go
in and help clean out some of the disease or infections that might spur from the disease. Dr. Born
states as his thoughts on disaster preparedness as follows “An effective response to disaster and
mass casualty events should focus on an “all hazards” approach, defined as the ability to adapt
and apply fundamental disaster management principles universally to any mass casualty incident,
whether caused by people or nature. Organizational tools such as the Incident Command System
and the Hospital Incident Command System help to affect a rapid and coordinated response to
specific situations.” (Born, 2007) The all hazards approach that Born refers to is similar to the
notion that part of organizational strategy and disaster preparedness is being prepared for every
situation and being able if no plan is in place the ability to adapt to whatever may come out of an
infectious disease outbreak whether it being more members of the hospital than predicated
becoming infected or running out of supplies sooner than expected is all a part of being able to
establish a strong organizational structure and disaster preparedness model. This idea can also be
found in Andrew Milton’s Cambridge journal article Prehospital and Disaster Preparedness
stating that “Hospitals continually have difficulties and failures in several major areas of
operation during a disaster. Common problem areas identified include communication and power
failures, water shortage and contamination, physical damage, hazardous material exposure,
unorganized evacuations, and resource allocation shortages.” (Milton, 2012)These are all
problems that the hospital has to conquer on a daily basis regardless if there is a disaster or not.
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Disaster Preparedness is an important function in being able to capitalize on these normal day to
day functions and being able to streamline all processes such as patient registration, diagnosing
patients, providing care, and making patients well if that is a possibility as it also important to be
understand that during a disaster such as an infectious disease outbreak that all patients will
survive. Implementing proper organizational structure is an essential part of hospital functioning
and keeping in mind the 8 steps to strategically solve problems such as what protocols are
needed to help in the disaster planning of an infectious disease outbreak in the Saint Leo
University Hospital.
Creating a sound organizational structure is an important step in being able to develop
and carry out disaster plans in the event of a crisis such an infectious disease outbreak. Despite
best efforts working in teams during times of high stress periods can create some sort of conflict.
Although conflict is often thought of with a negative connotation it can also have positive
qualities which can lend themselves to life altering decisions. Identifying and managing conflicts
are two very important abilities to master as the lead of the disaster planning team. Anderson
describes conflict in both local and national terms. The local level of conflict usually involves
“Conflict in the mind of one person and may spill over into the community. By focusing on that
person an aid worker may be able to defuse the conflict.” (Anderson, 2005) This idea of local
conflict can be applied to an infectious disease setting in a sense if infected patients are
quarantined and one of those individuals feels that the efforts made by the doctors and nurses are
hopeless, it may have an effect on all the patients in that particular wing. Conflict in an infectious
disease outbreak can cause many different issues, but there is one important negative impact that
is important for both physicians and other persons to be cognisant of and that is stress among
patients and their perceived ability to recover. If there is a visible or palpable amount of doubt in
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the air this could to physically poor outcomes. Gouin delves into the intricate relationship
between stress and recovery. Gouin studied wound healing and the amount of stress or duress a
patient was experiencing. Gouin found that patients who were experiencing apprehension prior
to surgery were found to consistently suffer from more complications in post-surgical care and
wound care than those who had a positive attitude towards the situation. This is evident in
Gouin’s observations as described “Among 309 consenting consecutive patients who underwent
an elective coronary artery bypass graft surgery, patients who were more optimistic were less
likely to be re-hospitalized than less optimistic individuals. Conversely, patients who
experienced more depressive symptoms were more likely to require hospitalization for infection-
related complications than individuals reporting less distress.” (Gouin, 2011) Stress can be a
common response to conflict especially in an instance of an infectious disease outbreak when the
future of the health of various individuals may be uncertain causing conflict between medical
staff and patients due to unknown outcomes. Keeping patients calm and the mode or moral
positive is essential in a disaster situation. Adding to the need to reduce conflict and stress by
keeping a positive attitude amongst patients and staff, it is also important to look to past failures
to also help reduce conflict. Looking at past failures does not have to be limited to infectious
disease, as a senior hospital executive it is important to draw knowledge from many different
sources to help provide the best care for patients. In 1972 a town called Wilkes-Barre suffered
from a natural disaster, tropical storm Agnes. There was no disaster planning established and as a
result many individuals were displaced and repairing the city was slow going and there arose
many conflicts between competing relief agencies and disgruntled citizens. Despite the obvious
differences between a natural disaster and an infectious disease outbreak, but the need to
establish a plan is clear in this event and any future events. (Heffron, 1977) One manner in which
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to learn from this experience and reduce conflict is through Pre-Disaster planning. Pre-Disaster
planning is an essential tool to help disperse responsibility and establish a chain of command and
create ties between other agencies during time of need; for instance, the Center for Disease
Control or the World Health Organization to help investigate infectious disease outbreaks.
(Heffron, 1977) Other possible conflicts that may arise during an outbreak can originate from
conflicts between the hospital and other agencies. Establishing open communication channels is
important as the free flow of information especially current research on various infectious
diseases is needed to help control and monitor any outbreaks or possibility of an outbreak. Using
other agencies can help the hospitals gain new techniques and insights as to how to control an
infectious disease outbreaks because the agency, CDC, has many world renowned experts
studying and experimenting with some of the world’s deadliest diseases and keeping in contact
with this agency could possibly help reduce the number of outbreaks and reduce recovery time
for patients and reduce stress and conserve materials for all the hospital personnel working to
treat the outbreak.
Reducing conflict and preventing an infectious disease outbreak can be easily prevented
or at least much more manageable if there is a strong sense of quality improvement present in the
hospital setting. Quality improvement as Burns defines is “Is an organized approach to planning
and implementing continuous improvement in performance. QI emphasizes continuous
examination and improvement of work process by teams of organizational members trained in
basic statistical techniques and problem solving tools, and empowered to make decisions based
on their analysis of the data.” (Lawton Burns, 2012) Using this definition that burns has provided
it is clear that quality improvement stats with engaging people within the organization. Some of
the ways in which engaging people might help aid in controlling an infectious disease outbreak is
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by using job enlargement of various personnel in the nursing staff to help act as a bridge between
the patients who are affected by the outbreak and the healthcare executives who are writing and
creating the disaster plans. (Phillips, 2015) Medical directors are beginning to realize the
importance of incorporating quality improvement methods not just in day to day activities, but
can be equally as effective in applying these techniques to disaster preparedness program such as
on focused on the possibility of an infectious disease outbreak. The necessity to review data is
becoming more common place and as such many executives feel that “The boards of directors of
such health systems are beginning to request methodologically rigorous research and
comparative preparedness data for benchmarking and quality improvement of emergency
management—the customary practice over the past decade for health care quality and, more
recently, patient safety.” (Phillips, 2015) Patient safety is considered a high priority for most
hospitals and because of this it is equally important to apply this priority to disaster preparedness
as well. The goal of quality improvement when it is associated with disaster preparedness is to
provide patients with the access to care that they need. The National Health Security Strategy of
the United States of America (NHSS) has developed several different strategies to help use the
idea of quality improvement to better patient access to care in times of disaster. NHSS has
identified several areas that need immediate attention in order to help fulfill the patient’s need to
access care during an infectious disease outbreak. Some of these areas in need of improvement
include “Develop and maintain the workforce needed for national health security. Ensure
situational awareness. Foster integrated, scalable health care delivery systems. Ensure timely and
effective communications. Promote an effective countermeasure enterprise.” (Preparedness,
2015) Providing quality improvement in healthcare elicits many other skills needed in order to
identify problem areas and provide solutions. For instance, the NHSS cited communication as
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the one major concern in which improvement was drastically needed and in order to use quality
improvement methods communication is an essential skill. Communication skills are needed in
the collection and interpretation of data and then conveying that data in meaningful message to a
board of executives or to the local community to explain how the hospital can improve their
delivery of healthcare to patients both for day to day care and in times of crisis such as an
infectious disease outbreak. Applying these skills and taking the lead from NHSS reviewing
some of their areas of needed focus can help healthcare executives understand more of their own
challenges within their hospital, but there is more to quality improvement than just focusing
inside the hospital to prevent an infectious disease outbreak. Looking beyond the hospital can
help solve and provide solutions to challenges within the hospital such as creating a disaster
preparedness plan for infectious disease outbreak. The CDC (Center for Disease Control) has
developed three different elements to help apply quality improvement methods to preventing an
infectious disease outbreak which is often looked over as part of the disaster preparedness plan.
The first element to be considered is “Strengthen public health fundamentals, including
infectious disease surveillance, laboratory detection, and epidemiologic investigation.”
(Friedman, 2011) The first element provides the foundation for identifying and controlling an
infectious disease outbreak and preventing the disease from reaching the public by giving the
public proper knowledge of diseases and best practices to carry out in order to prevent coming in
contact and spreading said infectious diseases. As a healthcare executive this is one of the most
important steps in creating a disaster plan is by having a very informed public before any threat
has been issued. The second element is classified as “Identify and implement high-impact public
health interventions to reduce infectious diseases.” (Friedman, 2011) High impact intervention
involves looking at risk populations and providing solutions to preventing an infectious disease
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outbreak by focusing on health disparities within a local area as well as using the latest
technology for disease prevention. Hospitals can use their support from stakeholders and various
other sources such as government funding to carry out philanthropic endeavors to help prevent or
reduce risk of infectious disease in their local communities which can help prevent a large scale
crisis. The last element is “Develop and advance policies to prevent, detect, and control
infectious diseases” (Friedman, 2011) Policy writing is a type of quality improvement that can
affect controlling an infectious disease outbreak and providing high quality improved healthcare
to patients. Policy writing extends beyond the hospital creating global ties by implementing the
best known science for solving infectious disease outbreaks and as such can partner very well
with techniques applied to local communities using these quality improvement methods to
contain, treat, and prevent infectious disease in a well thought out and expertly communicated
way.
While quality improvement can be an effective way in which to contain an infectious
diseases outbreak, but what can also help to create a proper procedure for a disaster preparedness
plan through forming alliances with different healthcare organizations. The United States
Department of Health and Human Services provide 10 objectives that should be considered when
creating alliances and how these alliances should help solve healthcare issues and as an executive
of a hospital this is an important venture to carry out. The first objective is to enhance the global
surveillance. Global surveillance is impotent from an alliance and infectious disease point of
view is to help identify, control, and prevent the spread of diseases which from a hospital stand is
crucial to be aware of any type of epidemics or pandemics that might infiltrate a hospital setting.
(Strategy Objectives, 2015) The second objective is the prevention of infectious disease. The
prevention of an infectious disease outbreak is easier said than done and working with
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organizations to help “Enhance healthcare security and prevent the introduction, transmission
and spread of infectious diseases and other health threats within and across borders.” (Strategy
Objectives, 2015) Alliances working together in order to prevent the transmission of infectious
will be far more successful at keeping infectious disease at bay and as such in order for a hospital
executive to write and carryout a successful disaster preparedness plan. A third objective is to
prepare for and respond to public health emergencies. The ability to mobilize and respond
quickly to public health emergencies is essential to providing high quality healthcare and being
able to tackle a health emergency such as an infectious disease outbreak quickly and effectively
could surely prevent the spread of the disease to other patients as it is more than likely that a
public health emergence will most certainly affect local hospitals. The fourth objective in
ensuring positive relations between various healthcare alliances is the increase in safety and
integrity of global manufacturing and global supply chains. While this object is not an obvious
as other objectives as means for preventing an infectious diseases outbreak the need for high
quality equipment is most important to aid in the treatment of patients and faulty equipment
could spell disaster in contain the infectious disease. The fifth objective is to strengthen
international standards through multilateral engagements and described as such as “Provide
leadership to establish, strengthen and implement science-based international health and safety
standards and support multilateral efforts to improve global health policies, programs, and
practice. (Strategy Objectives, 2015) The sixth objective is to catalyze on health research
globally. This alliance object can help to open doors to further research and new techniques in
order to treat infectious diseases can be obtained through alliances with researchers and
pharmaceutical companies such as Pfizer or AstraZeneca. The seventh objective entails
identifying and exchanging best practices ideas between say a hospital and another healthcare
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organization. Exchanging best practices such what type of scrubbing techniques are best to
prevent the spread of infection in surgical setting can help change how hospitals treat infectious
disease and how disaster plans are written. Objectives eight and nine focus on addressing global
changes in death and illness and focusing on the Global Health Initiative. These two objectives
can be seen working together to understand disease and disparity in healthcare. These objectives
can be used through alliance relationships to understand why some infectious disease cause more
harm than others, what type of treatment work best and why others seem to fail, and providing
equal healthcare treatment to all patients. The final objective is advance health diplomacy, this
objective can be defined as “Engage directly with diplomatic partners, and strengthen peer-to-
peer technical, public health, and scientific relationships. (Strategy Objectives, 2015) Fostering
relationships such as these can help further the knowledge and procedures of infectious disease
control and prevention. These objectives for creating worthwhile alliances by finding the right
partners either through mutual goals are for legal or ethical reasons. Alliances also work in a life
cycle format beginning with emergence and defining the alliance followed by the transition stage
such as hiring a coordinator to begin the establishment of the alliance. (Lawton Burns, 2012) The
final stages include maturity and critical cross roads. The maturity stage involves sustaining a
certain level of commitment towards alliance members and lastly critical cross roads involve
managing the decisions about future alliances either maintain or forming new alliances with
other healthcare organizations. (Lawton Burns, 2012) Alliances can prove to be advantageous
relationships in trying to combat infectious diseases and creating effective and useful disaster
preparedness plans.
Disaster preparedness plans are important delivering quality healthcare while preventing
various public health crises such as an infectious disease outbreak. In creating a disaster plan
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such as this it is important to pay close attention to health policy and regulations. One of the
most important regulations that must be considered is the Health Insurance Portability and
Accountability Act which has a great impact on health providers as HIPPA is a safeguard of a
patient’s privacy and security of protected health information. (Lawton Burns, 2012) Health
information includes anything that could identify a single patient such as medical records, billing
information and other personally identifiable information. Working as a hospital executive it is
important to ensure that all patient information is safeguarded and there is leaking of personal
information especially those that are infected with an infectious disease outbreak. Protecting
patient information is a regulation policy that must be carried out on a daily basis whereas the
Emergency Medical Treatment and Labor Act are applied on a more case by case basis.
EMTALA is defined as “Preventing institutions of denying care to anyone seeking emergency
medical treatment, regardless of citizenship, insurance status, or ability to pay. (Lawton Burns,
2012) There are two requirements that are included in health policy regulation. The first requires
that a hospital must perform an initial patient evaluation, which is translated to anyone who
comes to the hospital asking for treatment must receive an evaluation. In regards to an infectious
disease outbreak it is important that all patients who come to the hospital complaining of
symptoms similar to that of any possible infectious disease should be evaluated and determine if
a patient does indeed have an infectious disease or not. The second parameter that is a part of
EMTALA concerns that hospitals stabilize individuals that are deemed to be in the midst of an
emergency situation must be stabilized before being discharged or moved to another facility. In
this case a person who has been determined to have an infectious disease cannot therefore
discharged before treatment is complete of if they must be transferred to another the patient must
be stable to make the journey and must be held responsible until the transfer is complete.
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(Lawton Burns, 2012) The Center for Disease Control is one authority that is responsible for
using and implementing federal regulations in regards to healthcare and infectious disease
control. The CDC identifies two methods for hospitals and other agencies to adhere by as
“Isolation and quarantine help protect the public by preventing exposure to people who have or
may have a contagious disease as the following Isolation separates sick people with a contagious
disease from people who are not sick. Quarantine separates and restricts the movement of people
who were exposed to a contagious disease to see if they become sick.” (Legal Authorities for
Isolation and Quarantine, 2015) These two methods are useful in a hospital setting and should
considered in part of the disaster planning by containing the infectious disease to small area and
reduce the amount of potential exposure to other individuals and hopefully decrease the amount
of time it will take contain and eradicate the disease. Infectious disease policy includes reporting
of any possible outbreaks as such some of the following steps must be “Creating or enhancing
surveillance systems and case information collection tools to allow for simultaneous or
sequential reporting of time-sensitive health data coordinated among local, state, territorial,
tribal, and federal public health authorities. Appropriating federal funding to support the
technology and infrastructure needed to efficiently collect, analyze, and disseminate infectious
disease surveillance and reporting information and allow for transmission among the local, state,
territorial, and federal health authorities.” (Infectious Disease Policy Statement, 2015) As an
executive of a hospital it should be important to develop a plan in order to identify and notify an
infectious disease outbreak in order to receive help funding treatment options or acquiring new
scientific technology to treat an infectious disease outbreak. As well as notifying all important
governing bodies it is important to use healthcare polices to prevent infectious disease. In order
to help prevent the spread of infectious diseases it is important that following health policies
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such as the following are important for adhering to all legal and ethical issues “State and
territorial public health agencies collaborating with local health entities and the clinical sector to
promote basic principles of hygiene and infection control and prevent transmission of existing
and emerging infectious diseases.” (Infectious Disease Policy Statement, 2015) Collaborating
with other public or private entities is equally important to aiding in the maintenance adhering to
all health policies. All federal health regulations are in place to help to reduce risk and increase
patient safety through evidence based practices which are constantly evolving and hospitals are
required to keep up with ever changing practices and developing current disaster plans. (Lawton
Burns, 2012)
The globalization of healthcare has had a dramatic impact on healthcare around the world
and the provisions of such connectedness can be felt in the hospitals as well. Globalization is the
result of “Economic processes, technological developments, political influence, cultural and
value systems, and social and natural environmental factors. These varied forces, as part of the
processes of globalization, impact directly or indirectly on health at a number of different
levels.” (Saker, 2004) Globalization is the gradual openness of national borders to economic
influence, financial, human movement, information, goods and services. (Lawton Burns, 2012)
Overtime infectious disease has been one the main contributors to morbidity around the world
until non communicable disease began to overtake infectious disease on a global scale. In a
global sense infectious disease does not refer just to one disease, but a broad sense of conditions
and the importance of a given disease are also dependent upon the region in which healthcare
professionals find themselves. (Saker, 2004) In the United States there are some infectious
diseases in which hospitals like St. Leo need to extra mindful of such as the following four
infections “ A rise in HIV prevalence in gay men as there were 50,000 new cases in 2011 alone.
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The second disease that hospitals must consider seriously is hospital acquired infections about
one in 20 people who are hospitalized contract a hospital-acquired infection (HAI). Patients who
have invasive surgery, a catheter or receive a lengthy course of antibiotics are at greater risk for
HAIs. Roughly 99,000 people died from HAIs in 2002, the most recent year for which figures
are available, according to the report. Thirdly, Whooping Cough is now a growing threat as there
is a small movement to not vaccinate their children and therefore a rise in preventable diseases
will see an awakening of centuries old diseases. Lastly, keeping in mind new and old diseases
that can cause a public health crisis is equally important as globalization of healthcare.” (Firth,
2013) Globalization has posed as a challenge for healthcare professionals especially for
executives creating a new plan that must encompass many different varieties of infections of
disease that may come their way as a part of the growing movement of people from one country
to another. When creating a disaster plan, it is important to consider government involvement
especially concerning matters that could have a global effect from any disease that might present
itself in a hospital setting. The government can have beneficial effects on public health and
infectious disease control and as such it is described “The state constitutes the key actor in
infectious disease governance. Governance responses to globalization occur at national,
international, and global levels. National governance occurs when a state acts within its own
territory to respond to globalization. International governance involves states cooperating to
confront globalization challenges and often creates norms, rules, and institutions to facilitate
cooperation. Global governance involves not only states and international organizations but also
non state actors, such as multinational corporations and nongovernment organizations whose
participation becomes critical to the success of governance efforts. (Fidler, 2003) The
government can provide assistance to for issues of global matters as government programs such
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as state programs or the Center for Disease Control which can help control with infectious
disease such as providing up to date research for providing up to date care in the treatment and
management of infectious disease outbreaks. As such hospitals are in charge of providing care to
those who walk through the doors and are looking for care and therefore when treating patients
from visiting countries it is important to take into account regional diseases and the possibility of
spreading such diseases to other patients and hospital personnel such was the case with the Ebola
outbreak as hospital nurses where not fully educated on proper caring procedures for the patients
and therefore resulted in the spread of the disease to medical staff. However, the future of
healthcare is going to continue to be effected on a global scale. According to Morse on the
emergence of infectious of diseases “Specific factors precipitating disease emergence can be
identified in virtually all cases. These include ecological, environmental, or demographic factors
that place people at increased contact with a previously unfamiliar microbe. These factors are
increasing in prevalence; this increase, together with the ongoing evolution of viral and microbial
variants and selection for drug resistance, suggests that infections will continue to emerge and
probably increase and emphasizes the urgent need for effective surveillance and control.”
(Morse, 1995) Which all must be considered as a hospital executive in drafting a disaster plan for
an infectious disease outbreak in preventing an infectious disease outbreaks by taking into
consideration all health and risk factors on a global scale.
Disaster planning is an integral part of an executive’s responsibility to coordinate an
emergency responsiveness plan for containing an infectious disease plan in a hospital setting.
Delivering healthcare at a higher level can be quite challenging and applying effective leadership
skills to devise a plan to contain an infectious disease outbreak and prevent this disease from
spreading into the community. Preventing infectious requires a team effort and structural
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organization is a must for hospital executives to implement team cohesiveness and properly
informing all hospital personnel and other healthcare officials to perform tasks and contributing
ideas to reducing an infectious disease outbreak such as washing of the hands or appropriate use
of antibiotics. New plans such as the ones suggested can from effective communication skills on
behalf of the hospital executive to communicate effectively these ideas through either personal
reminders, seminars, and as well as evidence based research. Each of these methods can
contribute to the quality improvement of hospital quality care. Quality care improvement can be
obtained from implementing new methods of infectious disease control and using these methods
to treat patients. This information can be obtained through strategic alliances and the sharing of
information can contribute new information and new technology and as globalized healthcare is
an ever present threat to caring for patients. The risk of patients being exposed to diseases that
are not regional or are the result of poor public health initiatives that could all be changed with
an effective disaster plan. The proper disaster plan can help prevent the spread of infectious
diseases by evaluating all possibilities that lead and contribute to this pressing healthcare issue
and the ability of a healthcare executive to solve them.
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