CEOs will want to talk to their emergency management coordinators and infection preventionists about plans to handle a predicted spike in H1N1 swine flu and seasonal flu cases this fall.
Federal health officials recently held a conference call with hospital planners to discuss H1N1 response efforts.
Patient surges in ERs and ICUs are likely complications hospitals will need to handle, even if the H1N1 strain remain relatively mild, said Nicole Lurie, MD, assistant secretary for preparedness and response at the U.S. Department of Health and Human Services.
Lurie and others offered five tips for CEOs and hospitals to stay ahead of H1N1 and seasonal flu cases in the community:
1. Evaluate your sick leave policies.
Department managers and the human resources office should have mechanisms in place to track employee absenteeism rates daily should an H1N1 or seasonal flu outbreak occur, health officials said.
Hospitals also need to review their sick leave policies in light of the H1N1 pandemic, said Jeff Hageman, an epidemiologist with the Centers for Disease Control and Prevention (CDC). This is an important interim recommendation from the CDC that hasn't received as much attention as other recommendations.
Employees who contract the flu may either need to stay home to recover or not show up to work if they're fearful or have ill family members.
The CDC recommends that in communities with H1N1 outbreaks, healthcare workers who become ill with the flu remain away from work for seven days or until the symptoms have resolved, whichever is longer.
Traditionally, many healthcare workers will come into work with flu symptoms, so such behavior is a real threat this fall, said Tom Michaels, an infection preventionist at Health Partners Medical Group, a physician group with locations throughout northwest Indiana and southwest Michigan.
Don't forget to check in with your contractors to find out how their sick leave policies might affect the hospital's day-to-day operations and supply chains, Hageman said.
2. Pay attention to clinics and physician offices.
Expect the first signs of trouble with H1N1 to occur in these settings, and with that in mind educate employees there, Michaels said.
This spring's first H1N1 wave hit Health Partners Medical Group's clinics the hardest, not the group's affiliated hospitals, he said.
3. Determine proper access points into the building.
Talk to security directors about how to ensure access control into the hospital during an outbreak, which is another important concern that hasn't been in the spotlight, Hageman said.
The CDC recommends hospitals post signs at entry points instructing patients and visitors to notify staff members if they have flu symptoms. Limiting points of entry into the building is also suggested in communities where outbreaks are occurring.
4. Keep close ties with your vendors.
Given that supplies of N95 respirators and other personal protective equipment is finite, hospitals need to know what suppliers they deal with and how quickly those vendors can stock resources, including medical gas, health officials said.
The Joint Commission requires hospitals to keep a documented inventory of resources and assets on hand that could be used during an emergency response such as a pandemic.
5. Prepare to inoculate staff members.
At this point, we all know the various reasons the majority of healthcare workers do not obtain their annual flu shots.
Once the H1N1 vaccine becomes available, CEOs may need to push for greater employee vaccination rates. "Are you prepared now to vaccinate all of your frontline healthcare workers when the vaccine becomes available in your state?" Lurie asked.
The federal government will make the vaccine available to providers for free, and health officials have indicated the Medicare program will cover the administration fees associated with the vaccine, Lurie said.