Despite their best efforts, health care facilities may be affected occasionally by one or more challenging outbreaks. When outbreaks occur, local infection prevention and control (IPAC) teams can turn to Public Health Ontario (PHO) for support.
When a health care facility experiences challenges in controlling one or more outbreaks, it can request a visit from an Infection Control Resource Team (ICRT). The facility’s senior leadership team, the local public health unit or both together can request the visit, at firstname.lastname@example.org. PHO will review the request and gather preliminary information from the facility and/or public health unit. To determine the level of support required, PHO must have a telephone consultation with the individual requesting the ICRT visit (or a designate). If the need for a visit is determined to be urgent, the ICRT will mobilize quickly.
Once an ICRT visit is agreed upon, the ICRT lead will select team members. All members are chosen from PHO’s IPAC team and include one IPAC physician, one IPAC manager, one IPAC specialist and members of the local Regional Infection Control Network (RICN). There are expectations of both the ICRT and the requesting facility with every visit. The ICRT is expected to use best practices and evidence-based guidelines when providing outbreak assistance. The facility is expected to ensure that a member of the senior leadership team participates in the visit and takes responsibility for moving recommendations forward.
As soon as the team and visit date have been selected, the ICRT will review the information provided by the facility in preparation for the visit. The day of the visit will begin with an overview meeting, during which the ICRT will meet all personnel involved and provide information on the roll-out of the day; this is meant to be an informal meeting to confirm the information the ICRT has received and allow facility staff to ask questions.
After the overview meeting, the ICRT will conduct interviews with relevant individuals, including the senior leadership team and representatives from affected areas. The ICRT will also interview the local public health unit representative. A tour of the facility, including the affected area(s), is also an important component of the visit, allowing the team to gather additional information and help make specific recommendations to address the current outbreak. The day will end with a debrief meeting, where the ICRT will present its preliminary recommendations.
Within four weeks, a final report will be drafted, reviewed and approved at PHO and then forwarded to the facility/public health unit. PHO staff will be available to review the report and/or provide additional support. The local RICN will also be ready and willing to provide ongoing support. PHO will follow up in six months on the implementation status of recommendations and determine whether additional support is needed.
Facilities are strongly encouraged to be proactive and reach out to their local public health unit and RICN when they identify increasing numbers of cases; lack of change in case counts after newly implemented IPAC measures; or other concerns about a current and ongoing issue. Health care facilities are not alone: RICNs can provide support and assist in determining whether an ICRT visit is necessary. If a visit is required, it is conducted in a supportive manner; the ICRT focus is on identifying root causes and providing recommendations to assist in the overall management of an outbreak or IPAC issue.
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