Page 154 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan
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152 Chapter 7
of a Public Health Event of International Concern, and the coinciding increased media attention, led to an extended demand for intensified preparedness among curative partners involved in the chain of identification, transportation, isolation, diagnostics and medical care of possible EVD patients (Figure 1) (3). A patient with potential EVD would consult either a general practitioner (GP) or an emergency department of a hospital, or would be attended by an am- bulance (first responders). Upon suspicion of EVD, the first responder would notify the PHS and the patient would subsequently be isolated and referred to an academic hospital for clinical assessment. The CID is informed about all sus- pected patients, as part of the centralized case ascertainment and because of legal notification requirements by the PHS to the CID. Because of the demand for intensified preparedness among first responders, peripheral and academ- ic hospitals and public health specialists, the CID organized centralized expert meetings for coordination and consultation, and developed elaborated guide- lines for amongst others triage, diagnostic procedures, and waste management of possible and confirmed patients with EVD.
The need for a uniform and joint preparedness among partners in the pub- lic and curative health sectors, involving isolation, diagnostic and treatment protocols, was a unique situation in the Netherlands. In the aftermath of the Eb- ola outbreak, the CID evaluated experiences of the EVD preparedness process among the involved stakeholders. This is in concordance with the recently devel- oped WHO Joint External Evaluation Tool (JEE), which highlights rapid, effective response, requiring multisectoral, national and international coordination and communication (4). Experiences of EVD preparedness and response in hospitals outside the Ebola epidemic area have been described before (5-9); however the cooperation between the curative and public health sectors in a high-income country has not been addressed. This study investigates the process of prepar- edness for an introduction of EVD in the Netherlands in both sectors. Secondly, we aim to identify experienced obstacles and needs among involved parties. Lastly, we investigate timeliness of referral of patients to the hospital during the Ebola outbreak as indicator for preparedness of care. Results may be applicable to countries with comparable health systems and support the development of new standardized preparedness protocols overarching both the public health sector and the curative sector.
































































































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