Am­bu­la­tory clin­ics pre­pare for Ebola pa­tients

Modern Healthcare - - NEWS - By Adam Ruben­fire

An Ebola scare at an ur­gent-care clinic in Texas and another at a doc­tor’s of­fice near Bos­ton have un­der­scored the need for am­bu­la­tory care providers to pre­pare for pa­tients who may present with Ebola-like symp­toms, ex­perts say.

Ebola was ruled out in both cases— one at a CareNow ur­gent-care clinic in Frisco, Texas, Oct. 8 and another at Har­vard Van­guard Med­i­cal As­so­ciates in Brain­tree, Mass., Oct. 12.

The Cen­ters for Dis­ease Con­trol and Preven­tion has posted doc­u­ments to help out­pa­tient providers, in­clud­ing a check­list to eval­u­ate pa­tients for Ebola and a preparedness check­list. If a pa­tient presents with symp­toms of Ebola—which can in­clude fever, headaches, weak­ness, vom­it­ing and di­ar­rhea—and has trav­eled to West Africa or had con­tact with an Ebola pa­tient in the past 21 days, providers should iso­late the pa­tient in a sin­gle room with a pri­vate bath­room and close the door.

If pa­tients present with symp­toms at the front desk, they should be placed in the near­est room pos­si­ble, said Julie Loomis, as­sis­tant vice pres­i­dent of risk man­age­ment at State Vol­un­teer Mu­tual In­surance Co.

Loomis said it is es­pe­cially im­por­tant that all med­i­cal of­fices pur­chase CDC-rec­om­mended per­sonal pro­tec­tion equip­ment for ev­ery staff mem­ber who could come into di­rect con­tact with pa­tients. Most non-emer­gency clin­ics cur­rently do not have per­sonal pro­tec­tion equip­ment, or not enough for ev­ery staff mem­ber, she said.

Dr. Ron Yee, chief med­i­cal of­fi­cer for the Na­tional As­so­ci­a­tion of Com­mu­nity Health Cen­ters, said most com­mu­nity health cen­ters have some per­sonal pro­tec­tion equip­ment but likely not enough for all staff. An ef­fort is un­der­way with the cen­ters’ state part­ners to en­sure they get ad­e­quate equip­ment.

Loomis said screen­ing pa­tients at the front door could cre­ate un­nec­es­sary panic. Other ex­perts say such a pro­ce­dure could vi­o­late providers’ le­gal and med­i­cal obli­ga­tions if they turn away a pa­tient with a se­ri­ous con­di­tion.

Ul­ti­mately, pa­tients should be told not to come to a doc­tor’s of­fice if they think they might have Ebola, Loomis said. She added that staff could screen pa­tients about their re­cent travel his­tory when they call to make an ap­point­ment.

Yee

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