Preparations for the Safe Management of Severe Acute Respiratory Syndrome (SARS) Research Protocol Patients

ISSUE: The Warren G Magnuson Clinical Center (CC) strives to achieve a balance between its mission and worker and patient safety. PROJECT: As part of its mission as one of the government's primary research facilities, the CC must be able to address epidemiologically significant public health concerns as they arise. After its initial description in the fall of 2002, the global threat of SARS became readily apparent. To address its mission, investigators working at the CC designed two protocols to study this new disease. To protect our patients and our staff, we quickly developed infection control guidelines based on what was known about the epidemiology and pathogenesis of this new disease. RESULTS: We created a multidisciplinary team to identify risk points during the admission and treatment phases of these protocols. This group met once or twice weekly for 6 months. New policies and procedures were created which were patterned after the CDC guidelines but which met the unique needs of our existing infrastructure and patient populations. We created a new position (isolation monitor) to ensure compliance with infection control precautions. We also conducted a failure mode and effects analysis (FMEA) to identify additional areas of risk. Policies and procedures were reviewed by: 1) a multi-institute physician committee, 2) an external expert in hospital epidemiology, and 3) the CC Medical Executive Committee. Detailed practice sessions have been held to ensure compliance with these new and detailed precautions. LESSONS LEARNED: Readiness for complex infectious diseases is multifaceted and requires advance planning and detailed assessments. Preparing for SARS has placed our organization in a much better position to deal with emerging airborne infectious diseases.