Safety Culture Key to Ebola Fight in Healthcare

Nov. 22--It wasn't Emory University's special isolation unit that protected health care workers there as they treated the first Ebola patients transported from West Africa to the United States, an expert who trained them said Friday in Memphis.

Their success safely treating a doctor and nurse last February at the Atlanta hospital also had absolutely nothing to do with their personal protective equipment or their staff, Sean Kaufman told an audience at the University of Tennessee Health Science Center.

"It had to do with their culture," Kaufman said. "It was a nurse-driven, workforce-driven strategy all the way up."

With that culture, the nurses were able to resist recommendations by the Centers for Disease Control and Prevention and an infectious disease physician managing them that they wear protective gear that offered a lower level of protection.

Instead, the nurses insisted on wearing what Kaufman had recommended -- top-level protective gear available because a mock biocontainment lab he had led for training purposes at Emory was headed for the scrap heap after its federal grant funding ran out. The nurses' physician leadership listened and was flexible.

"That was the success story of Emory," Kaufman said. "It was a healthy safety culture."

With a background in behavioral psychology, Kaufman said his career has taken him from working with HIV/AIDS patients in San Diego to work at the CDC that included advising 9/11 first responders and postal workers threatened by anthrax about how to protect themselves.

His work at Emory and training workers on protecting themselves from infectious diseases at biocontainment labs and his own Georgia-based firm, Behavior-Based Improvement Solutions, have drawn Kaufman from Belgium to Liberia spreading the word about how health care workers can avoid contracting the potentially deadly disease.

In Memphis, Kaufman is providing training at UTHSC's regional biocontainment laboratory during a three-day stay, said Gerald Byrne, lab director.

Concern after the 9/11 terrorist attacks about infectious diseases that could be used as weapons led the National Institutes of Allergy and Infectious Diseases to provide nearly $18 million toward the cost of the $25 million lab. As a "biosafety level three" lab, it doesn't handle Ebola, but other pathogens including Francisella, Burkholderia and SARS, Byrne said.

Based on his experience, Kaufman said disorganized triage in handling potential Ebola patients when they arrive, an inability to properly take off protective gear and poor waste management are three main reasons health care workers have gotten sick.

"I'm coming into the clinical world, you be ready," he said.

Copyright 2014 - The Commercial Appeal, Memphis, Tenn.