Making Your Voice Heard
DeRisio pointed out that it’s relatively easy for an organization to provide education and information to medical staff, but deciding what exactly to do in an event and how to communicate that plan with other responders is difficult. “In our experience, for example, a major issue for us was how to communicate to the local community about the importance of providing an appropriate sample—what we would and would not accept—and timeliness of sample submission. There were too many messages coming from local, regional, and national sources that were confusing patients, physicians, and law enforcement. We decided that we wanted to speak with one voice.”

In order to provide a unified message about what to do in the case of a bioterrorism event, representatives from Alliance contacted the office of the Medical Director of the Cincinnati Department of Health as well as a recognized representative of local physicians and representatives from other hospitals served by Alliance. “What came out of this meeting was that all communications coming out of Alliance are reviewed and signed by the Medical Director and a physician representative so that there is some assurance that the information we present is the collective reasoning of a broad group of informed medical professionals. In addition, we let the community know that our policies were developed in concert with the guidelines set down by the CDC.”

Of course, it’s one thing to craft a response for a single facility or for the member facilities a health care organization, but it’s a much larger project to craft a regional response across an entire geographic region. For example, the greater Cincinnati metropolitan area includes parts of Ohio, Indiana, and Kentucky, and any comprehensive bioterror readiness plan would have to co-ordinate the activities of dozens of local hospitals and emergency responders from a half-dozen local municipalities, as well as address the concerns of public health labs and officials from the three states. Nevertheless, that’s exactly what the medical community in the Cincinnati area will attempt to do. DeRisio, Ansara, and other representatives from Alliance were planning to meet with representatives from a number of Cincinnati-area hospitals and physician organizations, along with the Cincinnati Department of Health, to map out a regional response to overt or suspected biological warfare.

“The decisions you make, the policies you set, and the communications you produce will have a far-reaching impact on the community,” said DeRisio. “If you recommend that people call 911, or the state police, or the FBI to handle a certain situation, you better be sure those agencies are ready to respond. So that’s what we did. It’s a good move on our part to talk to these folks and have an exchange of information.”

In Louisville, they have the “Adopt-a-Hospital” program, which includes a monthly meeting where representatives of all the hospitals in the area get together to plan local response. “It’s a good way to disseminate information and keep local authorities apprised of our collective resources and preparedness,” said Snyder. Meeting topics might include laboratory response, antibiotic distribution, communication with state and local health facilities, and even communications with state authorities in the event of a situation that necessitated a request for federal resources.

As important as external communications are, Snyder emphasized that a successful bioterror preparedness plan starts at the departmental level of each individual facility. “Here at the University of Louisville Hospital we have a medical task force consisting of key individuals representing the various departments and agencies within the hospital, including infection control, risk management, emergency medicine, the laboratory, engineering, security, and other hospital officials. This group is responsible for devising the institution-wide plan, with each sector also developing its own plan to reflect its activities. The key to success is co-operation. There is no turf when it comes to institutional planning; our motto is ‘Leave your ego at the door.’”