Outbreak Response and Incident Management: SHEA Guidance and Resources for Healthcare Epidemiologists in United States Acute-Care Hospitals

Abstract

This expert guidance document was developed as a resource to provide healthcare epidemiologists working in acute-care hospitals with a high-level overview of incident management for infectious diseases outbreaks and to prepare them to work within an emergency response framework. It addresses how the epidemiologist's skills and expertise apply to scenarios that require enhanced preparedness and response efforts, eg, when pathogens associated with outbreaks are poorly characterized or when outbreaks require additional interventions including, but not limited to, healthcare personnel education, enhanced infection prevention and control measures, added staffing, supplies, and resources, adjustments to clinical and support activities, and external communications. Its recommendations are not pathogen-specific and are meant to apply to a range of potential infectious diseases outbreaks. To provide high-level guidance and context for incident management, the authors specify recommendations for the healthcare epidemiologist, as well as involvement and responsibilities of the facility and other healthcare personnel (HCP). 2017, vol. 38, no. 12 The SHEA/CDC ORTP Expert Guidance Writing Panel (ie, the authors) were selected based on additional expertise in guidance and guideline-writing, and are the primary authors of this document. Advisory Panel members, the overseeing body for the entire ORTP, contributed to this guidance by conducting a needs assessment to determine knowledge gaps and identify effective strategies for outbreak response and incident management, and by reviewing, analyzing, and summarizing resources identified by the CDC for the Expert Guidance Panel to consider for inclusion in the expert guidance document, and by reviewing and providing comments on drafts and the final version of the expert guidance document (see the Methods section).background

Controlling infectious disease outbreaks in low-income and middle-income countries

“…New comprehensive US guidelines for infectious outbreak control were published. Although low-income countries may not have the resources to follow such guidelines, the full content may help to address most issues on controlling outbreaks [32].…”

Involving antimicrobial stewardship programs in COVID-19 response efforts: All hands on deck

“…To the Editor-To our knowledge, no formal recommendations exist for the inclusion of antimicrobial stewardship programs (ASPs) in disaster planning or emergency response preparedness efforts. 1 A PubMed search utilizing the search terms "antimicrobial stewardship" AND "disaster planning" was performed on March 4, 2020, and yielded no results. ASPs are now ubiquitous.…”

Elements of an Effective Incident Command Center

“…The role of HICS in any rapidly evolving complex incident is to help manage the information, logistics, and operational needs in a systematic manner. 1 Requests to HICS and finished work from HICS should flow through the incident commander, and work done in HICS should flow within the HICS chain of command ( Figure 2) to ensure all work items are coordinated and accounted for. Although maintaining HICS activities requires immense personnel resources, HICS should be activated when the urgency, pace, or complexity of an incident overwhelms routine operations.…”

“…he Hospital/Health Care Incident Command System (HICS) provides the operational coordination needed for an institution to respond to disease outbreaks. 1 Although some institutions may have used HICS to prepare for the Ebola outbreak of 2014 or other highconsequence infectious diseases (HCIDs), the coronavirus disease 2019 (COVID-19) pandemic has presented different challenges related to patient surge and to implementing system-wide operational adaptations. 2,3 Herein, we describe some of the lessons learned through COVID-19 HICS activation at Mayo Clinic.…”