HHS Conference Call Discusses Ebola-Related Issues in Ambulatory Care
November 19, 2014 | Strategic Insights for Health System
"The right place to evaluate patients for Ebola virus disease is not in the ambulatory care clinics," stressed Arjun Srinivasan, MD (CAPT, USPHS), associate director, healthcare-associated infection prevention programs, Centers for Disease Control and Prevention (CDC), during a November 10, 2014, conference call with other leaders from the U.S. Department of Health and Human Services (HHS). Instead, the focus is on "working to ensure that patients who might have Ebola . . . do not present unexpectedly to ambulatory clinics," he said. One component is active symptom monitoring of travelers from affected countries and those who have had contact with people with Ebola; thus, public health departments generally know which individuals are at risk and how to route them for care should symptoms arise. Ambulatory providers can also use "aggressive telephone triage" to ask patients about risk factors and symptoms when making or confirming appointments. They may also place notices on the door asking patients with risk factors and symptoms to tell staff immediately or to call a phone number before entering. Once a patient has arrived, the strategy is to "identify, isolate, and inform," as outlined in CDC's algorithm for ambulatory care. The provider should isolate the patient immediately (e.g., by putting him or her in a private room and closing the door). "Your next immediate step is to inform public health," said Srinivasan.