Bridging the gap between clinical and public health

Bridging the gap between clinical and public health

by Melanie Padgett Powers, writer

A public health team in Oregon used a federal preparedness grant to zero in on the individualized needs of hospitals across the state. In the APHL 2020 Virtual Conference session, “Bridging the Gap Between Clinical and Public Health,” attendees learned how hospitals and public health laboratories in Oregon developed important partnerships to prepare and react to emerging threats like Ebola, Zika, measles and COVID-19.

In 2015, Oregon received a federal Ebola Epidemiology and Laboratory Capacity (ELC) preparedness grant. One of the primary focuses of the grant was to conduct on-site readiness consultations at the designated Ebola assessment hospitals throughout the state.

The Oregon State Ebola Consultation Team included a physician infectious disease lead, plus an industrial hygienist, microbiologist, state public health physician and a nurse who was an infection preventionist.

The Oregon team visited each of the state’s Ebola assessment hospitals three times over the course of a year. First, they determined the readiness gaps for receiving an Ebola patient(s). The gaps were addressed in partnership with the hospital team through on-site consultation and training using resources from the US Centers for Disease Control and Prevention (CDC). Mitigation and implementation plans were developed, and the teams followed up several times over the next year to make sure the gaps were being addressed.

The plan was “very individualized, person-to-person, team-to-team work,” said Judith Guzman-Cottrill, DO, professor of pediatric infectious diseases at Oregon Health & Science University School of Medicine, who led the team.

Being able to visit the hospitals in-person helped build and solidify the partnerships, she said. “We made it very clear to them that this was not a regulatory visit. We were there to help them as preparedness partners. We were there as consultants, and we were there to create real relationships that were going to be long-lasting.”

As the partnership solidified, hospital personnel acknowledged to the consultation team that an Ebola case in Oregon did not seem likely. So the consultation team pivoted, asking each hospital team what areas they wanted to improve upon such as general laboratory technician biosafety training and planning for other emerging pathogens like Zika or measles.

The consultation team was able to continue to prepare the hospital team for Ebola cases and meet the grant requirements, while also individualizing the assessment and training to address the unique needs of each hospital, Guzman-Cottrill said.

“We still have those relationships that we created five years ago with Ebola that are now moving into COVID-19, where I’m getting emails and phone calls from the hospital team members that we met five years ago and they’re asking about COVID-19 testing now,” she said.

She stressed that clinical partners do not have to be only in laboratories. Potential partners could also include clinicians in the hospital’s infection control department and occupational health department, and physicians and nurses who have focused time to improve the electronic health record system as well. Other partners may be found on the Healthcare Acquired Infection Advisory Committee (HAIAC) at the state department of health.

To create strong partnerships, Guzman-Cottrill recommended maximizing federal preparedness grants by using some of the funding to invite clinical experts to participate. “Good public health strategies can become really great strategies when coordination occurs across the continuum of care,” she said.

Melanie Padgett Powers is a freelance writer and editor specializing in health care and public health.

APHL 2020 Virtual Conference is being held online September 22-October 15, 2020. View the final program and follow #APHL to join the conversation.

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