New Ebola protocols will cost hospitals more

Many are welcoming the Centers for Disease Control and Prevention's tighter safety guidelines for treating Ebola patients.

But meeting those standards may pose financial challenges for hospitals.

Last week, CDC Director Dr. Thomas Frieden detailed more stringent protocols for personal protective equipment, calling for gear that leaves no skin exposed. The CDC also advised hospitals to assign an observer who monitors clinicians and workers as they don and doff equipment, as well as a site manager to make sure all protocols are maintained.

The government beefed up its guidelines after the Ebola virus was transmitted to two nurses at Texas Health Presbyterian Hospital Dallas who treated the first U.S. Ebola patient, who later died. “This is the level of protection I and other colleagues in the field had been calling for even prior to the transmissions,” said Dr. Dan Hanfling, a contributing scholar at the Pittsburgh-based UPMC health system.

The agency previously advised healthcare workers to wear at least gloves, a fluid-resistant gown and eye protection.

Frieden said the infection of the two nurses showed the CDC's previous guidelines were insufficient. “The way care is given in this country is riskier than in Africa,” he said. “There's more hands-on nursing care, and there are more high-risk procedures.”

The new guidelines place greater emphasis on rigorously training staffers to safely put on and remove protective equipment. Hanfling said the procedure for taking off the protective equipment is the riskiest part and requires “very close attention to detail.”

The tougher standards, however, will increase the costs of preparing for Ebola patients. Facilities must invest more in protective equipment as well as in intensive training of employees designated to interact with Ebola patients.

Dr. Lee Norman, chief medical officer at the University of Kansas Hospital, said when his facility decided recently to go beyond the previous recommendations for protective equipment, it put in an order for $100,000 worth of jumpsuits, hoods and respiratory devices. “And that was just to get through what we thought would be two weeks with one patient,” he said.

His hospital also installed a new air system in the three rooms designated for Ebola patients. But Norman said the hospital probably couldn't treat more than one patient at a time given the space needs for equipment and medical waste.

On the other hand, Dr. Ashish Jha, a professor of international health at Harvard University, said, “It will be really, really expensive to be unprepared if an Ebola patient shows up.”

Follow Steven Ross Johnson on Twitter: @MHsjohnson