Healthcare administrators play a critical role in preparing for and mitigating the impact of infectious disease outbreaks within the communities they serve. Managers and administrators are responsible for ensuring that established procedures and protocols are in place, regularly reviewed, and adhered to by all staff.
Since 2000, the world has faced several dangerous epidemics and pandemics, including SARS, H1N1, Ebola, and most recently the COVID-19 pandemic of 2020.
It is an iterative process, with each episode revealing response gaps. These gaps are opportunities to better prepare for the next infectious disease emergency.
Preparing for Infectious Disease Outbreaks
The recent COVID-19 outbreak demonstrates the complex nature of preparing for a coordinated response. Two overriding principles define that response: infection control and caring for infected patients.
In the article Healthcare Settings as Amplifiers of Infectious Disease, for example, the National Center for Biotechnology Information (NCBI) examines the SARS outbreak of 2003. The article notes how SARS “was spread globally by relatively few people and amplified by super-spreading events that occurred primarily in healthcare settings.”
The article identified several weaknesses that served as amplifying forces, including:
- Communication
- Coordination
- Early detection and control of emerging diseases
- Oversight of healthcare services
Examining each one, in turn, helps illuminate the role of healthcare administrators in preparing for and coping with infectious disease outbreaks.
Communication
Clearly defined lines of communication must be part of any healthcare facility’s infectious disease response plan.
Hospital Preparedness for Epidemics Guidelines published by the World Health Organization (WHO) outline these various chains of communication required for an effective response:
- Within and between the different departments of a hospital;
- Between hospital healthcare managers and staff;
- Between different hospitals, public health authorities, and other healthcare organizations;
- Between hospitals and the local health workforce;
- Between hospitals and the local community;
- Between hospitals, emergency services, local providers of water, power, waste management, transport and communication services, and medical supplies.
As the list describes, a reliable, tested, and transparent web of communication across sectors is essential preparation for responding to an infectious disease outbreak. Healthcare administrators throughout the community maintain this multidimensional communication network.
Response Coordination
The NCBI describes an epidemic response plan as “the process of anticipating, preventing, preparing for, detecting, responding, and controlling epidemics in order that the health and economic impacts are minimized”
The type and scope of a response plan will differ depending on the organization and will remain flexible enough to respond to conditions on the ground. In all cases, anticipating supply stress and system shocks is fundamental to any effective response plan.
The CDC offers guidelines for healthcare providers, including healthcare systems critical infrastructure planning.
An article in the Harvard Business Review emphasizes the importance of supply chain management during a health crisis. As the article points out, the COVID-19 pandemic highlights the enormous challenge of coordinating a response to a rapidly expanding pandemic while facing shortages of PPE and ventilators. Dealing with critical supply shortages during a crisis leads to an uneven, ad hoc response.
Monitoring and Early Detection
Infectious disease outbreaks may be unexpected when they happen, but they should never be a surprise. Epidemics have been with human societies throughout history. Ever since we made settlements, built cities, and explored new parts of the globe there have been episodes of rapidly spreading infectious disease.
In a mobile, globalized society, disease can spread around the world in a matter of weeks, even as it lay in wait for years. An article in Nautilus describes how the H1N1 flu epidemic of 2009 started with a pig slaughtered in 2004 at Hong Kong’s Sheung Shui Slaughterhouse. Frontline monitoring of disease vectors is the first defense against infectious disease outbreaks.
At the global level, front line monitoring of emerging risks provides an early warning to potential infectious disease outbreaks. An article published by the NCBI discusses “frontline field epidemiology training programs” as a key strategy for disease surveillance and response coordination.
The World Health Organization publishes its annual World At Risk report for global preparedness risk monitoring. The “situational awareness” healthcare administrators maintain of the global picture informs their preparation for a coming potential outbreak.
Facility Oversight
Infectious disease is always a primary concern within the healthcare sector, even when there is not a general outbreak.
The Field Epidemiology Manual issued by The Centers for Disease Control and Prevention (CDC) highlights this general threat, saying: “Healthcare-associated infections (HAIs) are one of the leading causes of unnecessary death and avoidable harm for patients receiving medical care.”
The CDC publishes guidelines, resources, and toolkits for reducing and preventing HAIs.
The Need for Well-Trained Healthcare Administrators
As with healthcare professionals of all types, there is a growing need for well-trained and experienced healthcare administrators. The online Master of Health Administration degree program at Boston College prepares motivated students to meet the demand.
A career in healthcare administration is challenging but rewarding, and a vital link in the health and well-being of the communities they serve.