Creating a comprehensive multi-tiered influenza management plan for a large healthcare system

ISSUE: Influenza infections affect 20% of the U.S. population, with an average of 110,000 hospitalizations and 36,000 deaths annually. The shortage of influenza vaccine for the 2004–2005 season brought with it the potential for an even higher rate of morbidity and mortality due to influenza. The Infection Control and Healthcare Epidemiology Consortium of a 12-hospital healthcare system located in St. Louis, Missouri, determined that a comprehensive multi-tiered influenza management plan was needed. PROJECT: A team of four infection control practitioners (ICPs) was established from three of the system's hospitals, including a large, metropolitan teaching hospital, a comprehensive pediatric hospital, and a small community hospital, along with three system-level consultants, under the advisement of their medical directors. The team developed a resource packet containing a comprehensive multi-tiered influenza management plan. The packet included a core policy, to be customized by each entity, a checklist of recommended materials to have on hand, and algorithms for influenza testing, patient placement, and healthcare worker immunization. The packet also included an admission screening tool, examples of local health department' line list reports, and educational posters to be used throughout the healthcare facilities to heighten influenza infection prevention awareness. Many of the tools have specific recommendations for different stages of the influenza season; for example, extensive use of rapid diagnostic tests is appropriate early on, but unnecessary during peak flu season when diagnosis can reliably be made based on symptoms. The packet was developed as a guide to assist ICPs in preparing for an influenza season. RESULTS: A resource packet with a comprehensive multi-tiered influenza management plan was developed for all of the system's hospitals. The packet contains information addressing the action to be taken prior to and at the early onset of the influenza season, when there is an increased level of influenza activity, and during a pandemic event. LESSONS LEARNED: Annual influenza outbreaks are a serious threat to U.S. patients. To reduce that threat, it is necessary to carefully plan and prepare for each influenza season. A resource packet with a comprehensive multi-tiered influenza management plan is a useful tool in making the necessary plans and preparations.