With 40 swine flu cases in the U.S. already diagnosed, a number that promises to go much higher, an executive for one hospital system in San Diego County that treated some of the first cases has a few pointers for his peers.
"Stay informed," first and foremost, says Chris Van Gorder, CEO of Scripps Health. Keep in close contact with area public health agencies and the Centers for Disease Control and Prevention.
"We are keeping our leadership informed, especially our elected physician leaders, infectious disease experts, emergency departments, and clinics since they will see the patients first. And they are keeping us informed."
"Information, properly managed and communicated, will actually prevent rumors and panic," he says.
Patty Skoglund, Scripps' director of Disaster Preparedness, advises hospital officials to track the number of flu lab tests and not the number of patient visits, and track costs related to serologic testing of staff and inpatient costs with H1N1 diagnoses. They ultimately may be federally reimbursable, she says.
Van Gorder also advises hospitals to check supplies and order more. "Contact vendors to make sure they are prepared to increase supply delivery if necessary. Most hospitals use 'just-in-time' inventories now so they don't maintain excess stock." Having extra lab test kits and N95 masks are critical, he adds.
Think ahead with other community hospitals to maximize healthcare resources. Most of the time, county public health officials coordinate this activity, but if they can't or don't, hospitals will have to step in, he says. "Monitor patient capacity, isolation capacity, and equipment respiratory disease capacity," he says.
Also, he says, review plans for how to manage employees as well as their families. Providers may have family members who are ill at home and may have to stay at home to help them. "Pandemic plans must incorporate consideration of family members," he says.
The University of Pittsburgh Medical Center (UPMC) is among countless hospitals bracing for a local outbreak of swine flu cases. "We have spent most of our time concentrating on developing the proper communication for staff and physicians," says William Smith, senior director of emergency preparedness for UPMC. "This has been difficult as the CDC information keeps changing."
For example, initially the CDC recommended using airborne and contact precautions on swine flu patients, but on Monday the agency changed its position to droplet and contact precautions.
UPMC is also increasing laboratory capacity by adding a second shift and ensuring that testing materials and processes at all of the system’s sites are the same, which can be a difficult exercise, Smith said.
CDC acting Director Richard Besser, MD, says he recognizes "incredible work" being done by the medical provider and public health community in a difficult period of "uncertainty" and limited knowledge.
"These periods of uncertainty where we’re working with very limited knowledge and very limited information are very difficult and people are doing an outstanding job across the country trying to understand this," Besser says.
Though swine flu has been a hot topic in the news the past few days, the CDC said Monday that there has been only one hospitalization linked to swine flu out of the 40 cases in five states so far.
HHS has added information about swine flu on its Web site.