Fort Smith area health and government leaders meet on Ebola plan

Ebola has yet to arrive in Arkansas, but that is not stopping local healthcare providers and government from working together on preparedness and response should the deadly virus ever be diagnosed within Arkansas' borders.

A meeting held Wednesday (Oct. 22) at the Hennessy Center at Mercy Fort Smith was called by leaders of Mercy Fort Smith and Sparks Health System to get local first responders in sync regarding a response to a diagnosed case, according to Dr. Bryan Clardy of Fort Smith AHEC (Area Health Education Center) of the University of Arkansas for Medical Sciences (UAMS).

Jennifer Thomas, vice president of ancillary services at Mercy Fort Smith, said by joining representatives from EMTs to doctors to local governments for a meeting on the threat of Ebola and how to respond, the community was being better protected.

"While we have various hospital partners in our community, it's important for each hospital to understand what's going on at the beginning of dispatch," she said, referring to when emergency personnel or doctors may first become aware of a patient's potential to have the Ebola virus.

"So (with this meeting and training), we understand what's happening at dispatch with EMS as they're responding as partners and we understand each step of the process and have plans and process for an individual who may be exposed to anything," she said. "Either viral exposure or chemical exposure, with any emergency response it is key for all partners to understand the processes so in the hand off (of patients from one medical provider to the next) we know the next step and what to expect and the patient's care is streamlined for best outcomes so there won't be any delays."

Thomas said individuals in the community may not realize that when a patient has symptoms that could pose a public health risk, such as Ebola, the work is not just left to the individual hospital to respond.

"When we do this, it's not just one agency that is responsible, but it is a coordinated response," she said. "It needs to be timely so we are doing proper patient handoff from one agency to the next and timely notifying of proper government agencies for a timely response for that patient and for our community."

To streamline coordination should a case of Ebola be diagnosed in the Fort Smith area, Sebastian County Judge David Hudson said he is prepared to declare a disaster which will make resources available to aid in the response.

"If an incident of that nature occurred in our community, then we would respond in a similar manner to declaring a natural disaster. The county judge would be responsible to declare the disaster, activate the emergency center and work with the state department of emergency management and other state (officials)."

Hudson explained that by declaring a disaster and opening the Sebastian County Emergency Operations Center, the leadership of the community and state would be able to come together in a central location "so resources can be allocated."

"Decision making and allocation of recourses function in connection with state and federal resources as needed through the declaration of a disaster," he said. "So that's the role. It'd be just like if he we had a major natural event. … The leadership comes together to coordinate and allocate resources as to how the response is handled."

He said beyond the practical aspects of providing a centralized location for leadership in government and medicine to meet, plan and implement decisions in coordination, declaring a disaster serves a larger purpose.

"A real compelling reason to do this is not just for communication and coordination, but it releases resources. If declaring a disaster, then it opens up state and federal resources. There's a communication and coordination reason, but there's also a financial reason to handle this matter in this fashion."

Thomas, a doctor of nursing practice (DNP/RN), said the actions of local, state and the federal governments will be essential to getting more than just the financial resources to the community in its time of need.

"You're not just talking financial resources, but human resources and informational resources. As we continue to partner with state and local governments to free up those resources, that's where communication is key. We want to do that as quick as we can."

She said training sessions have continued with guidance from state and federal partners at all regional hospitals to prepare staff on how to successfully stabilize and treat patients without putting themselves or others at risk. She said that training would continue just as it has since the first reported cases of HIV in the 1980s and preparation for possible mass casualty events following the attacks of Sept. 11, 2001.

"Back when HIV first appeared or 9./11 happened, there were concerns. So as an organization, we try to stay on top of current situations to prepare our staff for any situation. … We try to stay proactive with what current issues might be out there," she said.

Donna Bragg with Sparks Health System said the hospital's nurses, physicians and other staff were part of the multi-agency and multi-hospital meeting and were taking identical steps to Mercy.

"We are following the detailed checklist for EVD preparedness provided by the Centers for Disease Control and Prevention and monitoring all updates to this guidance," she said. "We understand the concerns in this current environment and want to provide reassurance of our preparedness. Our dedicated physicians and nurses remain alert and ready to provide care for our community."

UAMS' Clardy said while all the preparedness on the ground is vital, plans are to not have patients with confirmed cases of Ebola within the state of Arkansas for very long before being transported to medical centers in Georgia and Nebraska that have successfully treated the virus.

"And to clarify the regional plan, should we have an actual confirmed Ebola patient, the plan is to stabilize and transfer to a higher level of care, i,e, Emory in Atlanta or possibly Parkland in Dallas," he wrote in an email. "We wanted to inform the community of what measures we have been taking in terms of training, equipping and planning in the extremely unlikely event of an Ebola case present in the region."