Which HCWs will be first to get vaccine?
Hospitals consider pandemic scenarios
The Dana-Farber Cancer Institute in Boston will not be on the front lines in an influenza pandemic. The surge of sick patients seeking an emergency room will not be showing up at Dana Farber's doorstep.
Nonetheless, a pandemic would cause disruption at the specialty hospital and put both patients and employees at risk. The hospital is drafting plans for symptom screening of patients, the use of limited antivirals and vaccine, and the inflow of oncology patients from acute-care hospitals.
A planning committee and subcommittees meet regularly to discuss such topics as prioritization of antiviral medications and vaccines.
"It will be a plan we would put into place for any kind of infectious agent, whether it be bioterrorism, the flu, or some other infectious agent," says Lisa Foster, MS, ANP, program manager of the hospital's occupational health services.
The annual flu response also provides a framework for pandemic response, Foster notes. A flu team meets each fall to identify vaccine supply issues and to design a vaccination strategy, determining who should receive the first doses.
"We would do the same thing in a pandemic situation, Foster says.
Vanderbilt University Medical Center in Nashville has conducted drills, imagining possible pandemic scenarios, and has made changes as a result. For example, though it still uses just-in-time ordering, the medical center increased its on-site stock of masks and respirators.
Yet hospitals can't do all the planning on their own. In some communities, a critical component is missing: coordination.
Hospital leaders need to meet to discuss how they would collaborate to cope with scarce resources or manage the flow of patients.
"It's very difficult for any single hospital to take that leadership role," says William Schaffner, MD, chair of the department of preventive medicine at Vanderbilt University. "That leadership falls on the local public health authorities."
Federal and state public health authorities also need to lower administrative burdens during a crisis, he says.
"In the throes of a pandemic, the systems that we have in place to care for patients and to do public health are going to be overwhelmed," he says. "The [federal authorities] need to be very restrained in asking for information.
"Reporting to the local and state health department exactly how many people have been admitted and discharged by age group is not going to be our highest priority," he says.
The Dana-Farber Cancer Institute in Boston will not be on the front lines in an influenza pandemic. The surge of sick patients seeking an emergency room will not be showing up at Dana Farber's doorstep.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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