Page 159 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan

Ebola preparedness among the curative and the public health sector 157
pitals were selected for prolonged treatment of patients with confirmed EVD. However, this measure did not achieve the intended decreased burden for pre- paredness for the other academic hospitals.
Other needs from participants involved requests for criteria for institutio- nal preparedness and contingency plans, improved financial compensation for the preparedness investment, and more clearly defined regions for referral to academic hospitals to facilitate regional cooperation in preparedness.
Coordination by CID and cooperation with curative sector
The coordinating role of the CID was generally accepted and well appreciated especially regarding timeliness and clarity. According to the participants, the CID adequately followed up on developments regarding the ongoing EVD outbreak in West-Africa and the implications for the Netherlands; medical professionals were informed through an electronic mailing system (inf@ct) about guidelines that provided appropriate information and were easily accessible through the internet. For some stakeholders (eg, the ambulance sector), cooperation with the CID was new, but useful. Many stakeholders stated that more coordination at national level is needed, for instance, in clarifying the roles and responsibili- ties of organizations involved in Ebola preparedness and response, by arranging meetings for the exchange of information and best practices and by facilitating the development of curative guidelines.
Joint expert meetings with curative and public health stakeholders at natio- nal level were a new initiative by the CID and were considered valuable. Media coverage of the Ebola epidemic in West Africa and patients with confirmed EVD among healthcare workers in the US and Europe contributed to fear for exposu- re amongst Dutch healthcare workers. Therefore, more information and stan- dardization of personal protection measures (PPE) were requested, as diversity of PPE was reason for concern amongst health care workers: “The PPE caused frustration amongst caretakers, as several times the type of PPE changed to a more safe and protective one” (quote FGS ambulance).
Timeliness of referred patients
Between April 2014 and January 2016, the CID was consulted 96 times about potential EVD patients. Thirteen patients were considered suspected patients and were referred and admitted to an academic hospital. Of those patients, 12 were transported by ambulance following isolation procedures, and 1 presen- ted himself at the academic hospital. Delays from date of onset of illness until consultation of a physician varied between 0 and 10 days (median 1.5 days,
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