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CDC issues new checklist for pandemic planning
Occ health plays a major role in preparedness
A new checklist for pandemic influenza planning emphasizes the role of occupational health to manage absenteeism, symptom surveillance, and personnel needs.
The Centers for Disease Control and Prevention in Atlanta issued a revised checklist for hospital preparedness to provide more specific guidance, says Deborah Levy, PhD, MPH, CDC's senior adviser for health care preparedness and a captain in the U.S. Public Health Service.
The checklist provides a roadmap for hospitals as they struggle to prepare for a pandemic amid a multitude of day-to-day challenges, says Levy. "Most facilities can't do everything at once, but they should work through [the checklist] and try to address all the issues in there," she says. "It does represent what they should be doing to get prepared for a pandemic."
Occupational health professionals are listed among those who should be included as members of a pandemic planning committee. The checklist also calls for hospitals to conduct tabletop simulation exercises and full-scale drills, and to update the plan regularly. (For an excerpt of the checklist, see box below.)
Can you manage employee
This is an excerpt from the Hospital Pandemic Influenza Planning Checklist, prepared by the Centers for Disease Control and Prevention.
The facility's human resource and payment policies should be reviewed to identify and eliminate language that may encourage staff to work when ill or even when they are symptomatic with influenza-like illness and especially when they are within the period of communicability. An occupational health plan for addressing staff absences and other related occupational issues has been developed that includes the following:
A liberal/nonpunitive sick leave policy that addresses the needs of ill and symptomatic personnel and facility staffing needs during various levels of a pandemic health crisis considers the following:
The CDC is urging hospitals to coordinate their plans with public health, local emergency management agencies, and other health care facilities in the community. That coordination is one of the major gaps in pandemic planning, says Levy.
"For single events, shorter-term [emergencies], you can't survive doing [without joint planning]. You can't with a pandemic," she cautions.
In fact, hospitals may not be able to survive more than a week on their own during a pandemic, based on the results of a survey by Novation, a group purchasing organization based in Irving, TX. About half (54%) said they could last one to three days without "external resources," and another 25% said they could last up to seven days without "external resources," Novation reported. The results were based on responses from 68 hospitals.
"Our survey provides some real insight into the supply crisis hospitals would face during a global flu pandemic," Christine Miller, senior clinical manager at Novation, said in a statement.
Hospitals have made plans to obtain additional supplies, including respirators, in the event of a pandemic, the survey found. Two-thirds reported working collaboratively with other hospitals and distributors.
Ensuring adequate staffing and monitoring the health of employees will be a crucial component of pandemic response. The checklist encompasses a number of issues that would require employee health input or coordination, including:
Other staff needs: Hospitals should have a plan to assist and support employees "whose family and/or personal responsibilities or other barriers prevent them from coming to work." That includes child care, elder care, transportation, and other issues. The plan also raises the possibility of quarantine: "A contingency plan has been developed in the event of hospital quarantine in conjunction with local jurisdictions to ensure quarantine is enforced and necessary supplies, equipment, and basic necessities can be delivered and maintained."
(Editor's note: The Hospital Pandemic Influenza Planning Checklist is available at www.pandemicflu.gov/plan/healthcare/hospitalchecklist.html.)