Community preparedness for a bioterrorism attack or influenza outbreak has been the focus of much interest and effort in recent years.
Now, public health experts at NewYork-Presbyterian Hospital/Weill Cornell Medical Center have developed a strategy for how hospitals can most efficiently inoculate their own staff with minimal disruption to patient care.
The study by the Division of Outcomes and Effectiveness Research of the Department of Public Health at Weill Cornell Medical College is published in the May issue of the journal Infection Control and Hospital Epidemiology and reports the results of computer simulations comparing several inoculation strategies.
"During an infectious outbreak, it's vitally important that hospitals remain fully functioning. This study suggests that assigning each staff member a time for inoculation is the most effective method to ensure that our caregivers stay healthy and patients continue to receive optimal care," says Dr. Nathaniel Hupert, senior author of the study. He is assistant attending physician at NewYork-Presbyterian/Weill Cornell and assistant professor of public health and medicine at Weill Cornell Medical College.
Using discrete-event simulation -- a standard technique in operations research -- researchers compared two staff-management strategies with specific rules for dispensation and an unmanaged scenario in which staff would line-up for inoculation all at once or at the time of their choosing. In the scenarios, dispensing stations were located by existing hospital pharmacy outposts. Each station was run by three nurses and other support staff, administering medicine to 200 employees during an eight-hour shift, figuring an average dispensing time of five minutes each.
The method found to be the best, called the "ticket strategy" and inspired by the practice of customers taking numbers at a delicatessen, assigned staff members a specific time of day to receive prophylaxis based on a number such as the last digits of their identification badge. Assuming that 75 percent of staff followed the rules, the expected time in line would be only slightly more than two minutes. Waits were still much less than those of the unmanaged scenario, even if levels of compliance were as low as 25 percent